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Breast Cancer

By 08 August 2017
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Breast cancer most commonly starts in the cells that line the ducts of the breast. 9 out of 10 of these cancers have no special features when the cells are looked at under the microscope. They are called invasive breast cancer (No Special Type). Around 1 in 10 breast cancers (10%) are invasive lobular carcinoma. This means that the cancer started in the cells that line the lobules of the breast. It is one of the most common types of cancer in women. It occurs mainly in females more than in males. Breast cancer survival has however increased over the years. The cancer is more invasive in young women than the elderly.

Who is at risk of developing Breast Cancer

  • Advancing age - Like most cancers, the risk of breast cancer increases as you get older. Most women who get breast cancer have had their menopause. Around 2 out of every 10 women (20%) are under 50 years old.
  • Late menopause (after 55 years) - You have an increased risk of breast cancer if your periods started early (before the age of 12). If you have a late menopause (after the age of 55) this increases your breast cancer risk compared to women who have an earlier menopause.
  • A women who has a late first pregnancy (first delivery after the age of 30) - Women who have children have a slightly lower risk of breast cancer than women who don't have children. The risk reduces further the more children you have. Your age when you have your first child also has an effect. The younger you are when you have your first child, the lower your risk.
  • Family history - Some people have a higher risk of developing breast cancer than the general population because other members of their family have had particular cancers. This is called a family history of cancer. Having a mother, sister or daughter diagnosed with breast cancer approximately doubles the risk of breast cancer. This risk is higher when more close relatives have breast cancer, or if they are under 50. But more than 8 out of 10 women who have a close relative with breast cancer will never develop it.
  • Obesity/ Overweight - Women who are overweight after their menopause have a higher risk of breast cancer than women who are not overweight. Men also have an increased risk of breast cancer if they are overweight or obese.
  • Alcohol - Drinking alcohol increases your risk of breast cancer by a small amount. Your risk increases with every extra unit of alcohol you have per day. One unit is a half pint of beer, a small glass of wine, or a measure of spirits.
  • Hormonal levels - Levels of the female sex hormone, oestrogen, and the male hormone, testosterone, can affect the risk of breast cancer. Women have small amounts of the male hormone testosterone in their bodies. After the menopause, women with higher levels of oestrogen and testosterone in their blood have a higher risk of breast cancer compared to women with the lowest levels. Women with higher levels of testosterone in their blood before menopause have a higher risk of breast cancer.

Symptoms

  • Breast lump - A new lump or thickening in your breast or armpit could be a sign of cancer. Many women have breast lumps and 9 out of 10 (90%) of these are not cancer. They are called benign lumps. It’s important to get any breast lump checked out by your doctor.
  • Change in size, shape or feel of a breast - Your breast might look bigger or have a different shape than usual. It might feel different. Many healthy women find that their breasts feel lumpy and tender before their period. Get to know the size, shape and feel of your breasts.
  • Breast pain - Breast pain is very common and it’s not normally due to cancer. You might get pain in one or both breasts for a while, which goes after a time. There might be no obvious reason for this pain, even if you have a lot of tests.
  • Skin changes - Skin changes include puckering, dimpling, a rash, or redness of the skin. The skin on your breast might look like orange peel. Or the skin might feel a different texture than usual. This can be caused by other things than cancer but get anything that is not normal for you checked out by your doctor.
  • Change in the position of your nipple - One nipple might turn in or sink into the breast. It might look or feel different to usual.
  • Fluid leaking from your nipple - Fluid leaking from a nipple in a woman who isn't pregnant or breast feeding can be a sign of cancer. But it can also be caused by other medical conditions.
  • Inflammatory breast cancer symptoms - A rare type of breast cancer called inflammatory breast cancer can have different symptoms to other types. Your whole breast might look red and inflamed and feel sore. The breast might feel hard and the skin might look like orange peel.

In males, symptoms include,

  • Lump
  • Nipple discharge
  • Reddening
  • Inversion of the nipple
  • Skin dimpling

Diagnosis

It is a combination of physical examination of breasts and mammography to get a more accurate result. There is no question that increased use of screening mammography has led to breast cancer, being diagnosed and treated at earlier stages improves overall survival. Women should know breast self-examination techniques. Husbands should also be educated on this.

How can you minimize risk of getting breast cancer?

  • Living a healthy lifestyle with physical activity
  • Having early and repeated pregnancy
  • Breastfeeding properly

Being physically active - Physical activity can help to prevent breast cancer. Studies have found a protective effect of about 15 to 20% in women who take half an hour of exercise 5 times a week. So being active might lower your risk of breast cancer by about a fifth. The reduced risk might be because physical activity lowers oestrogen and testosterone levels.

Breastfeeding - If you breastfeed you are less at risk of developing breast cancer, particularly if you have your children when you are younger. The reduced risk might be because your ovaries don't produce eggs so often when you are breastfeeding. Or it may be because breastfeeding changes the cells in the breast. So the cells might be more resistant to the changes that lead to cancer.

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