Our Guide to Breast Cancer: Breast Cancer Awareness Month

1 in 8 women will be diagnosed with breast cancer in their lives. This is a frightening statistic and really puts things into perspective especially when I think about the number of women in my family, my group of childhood friends, and the group of girlfriends I enjoy a night out with.

October is breast cancer awareness month. This is a worldwide campaign which takes places in October every year. It is all about highlighting the importance of breast awareness, education and research. If you didn’t know how to check your breasts for breast cancer then ladies now is the time to educate yourself!

Firstly, look at your breasts and feel each breast and armpit up to your collar bone. You could choose to do this in the shower or bath or in front of a mirror. If you choose to do this in front of a mirror then check with your arms by your side and also with your arms raised.

Secondly, be familiar with the signs and symptoms you should look out for. Cancer research UK is an extremely helpful website, which highlights the signs and symptoms you should be aware of.

The signs and symptoms of breast cancer include the following:

  • A change in the look or feel of your breast, for example, puckering of the skin (imagine sewing a needle through material and then pulling the needle so the material gathers)
  • A change in the size or shape of your breast
  • A new lump or bumpy area in one breast or armpit which is different from the other side
  • Bleeding from the nipple
  • Nipple discharge which is not milky
  • A change in the position of nipple, for example your nipple being pulled in
  • A rash around your nipple
  • A moist, red area on your nipple that doesn’t heal easily
  • Any new discomfort or pain in one breast

Fortunately, breast changes can happen for many reasons and most of time it is not serious and not cancer. However, if the changes in your breast are new and not normal for you then always see your GP as soon as possible. This way you can at least rule out breast cancer.

Where cancer is detected then the appropriate treatment should be planned as quickly as possible. If it is found early, then treatment is more successful and there is a good chance of recovery.

In many cases women find their breast cancer treatment is quick and effective, and thankfully due to advances in science and improved awareness, the survival rate for breast cancer is high. Since the NHS introduced the breast cancer screening programme, the chances of early survival has vastly increased.

Types of Breast Cancer

There are several types of breast cancer:

  • Non-invasive breast cancer (also known as carcinoma as situ)

This is cancer which is located in the breast ducts which has not developed into the outside of the breast. Ductal carcinoma in situ is the most common type of non-invasive cancer.

  • Invasive ductal breast cancer

This cancer develops in the cells that line the breast ducts and can spread outside the breast but that does not mean it has spread. This is the most common form of breast cancer.

  • Invasive lobular breast cancer

This cancer develops in the lobes of the breast. This type can sometimes be difficult to diagnose on a mammogram because of the way in which it grows, and some women will require an MRI scan.

Your doctor will test the cancer cells to decide which treatments are best for you. They will look at whether the cells have receptors (proteins) for hormones like oestrogen or a protein called HER2.

  • Other types of breast cancer

There are also other types of breast cancer which are less common. These include:

  • Inflammatory breast cancer – this is when cancer cells grow along and block lymph vessels (tiny vessels) in the skin of the breast. In these cases the breast can become inflamed and swollen.
  • Paget’s disease of the breast- symptoms include a red rash which looks similar to eczema on the skin of the nipple.

Stages of Breast Cancer

Breast cancer is diagnosed in stages, from stage 1 to stage 4, with stage 4 being the most advanced.

Staging of cancer refers to the different staging systems which doctors follow for breast cancer to determine how big the cancer is and whether it has spread.

Grading of cancer means how abnormal the cancer cells look under a microscope.

Doctors will use the stage and the grade of a cancer to help them decide which treatment you need.

The most common staging system used in the UK is the TNM system.

TNM Stages of Breast Cancer

T              –              explains the size of the tumour

N             –              explains whether there are any cancer cells in the lymph nodes

M            –              explains whether the cancer has spread to another part of the body

Tumour (T)

T1           –              means the tumour is 2 cm or less

T2           –              means the tumour is more than 2 cm but no more than 5 cm

T3           –              means the tumour is bigger than 5cm across

T4           –              means the tumour has spread into the skin and/or the chest wall

 Node (N)

N1          –               means cancer cells have spread into the lymph nodes in the armpit but are

separate from surrounding tissues

 N2          –               means cancer cells have spread into the lymph nodes in the armpit but are

attached to each out and to surrounding tissues

 N3          –               means there are cancer cells in the lymph nodes either below the collarbone,

above it,or in the armpit and behind the breastbone

  Metastasis (M)

 M0         –              means there is no sign that the cancer has spread to a different part of the body

M1         –              means the cancer has spread to another part of the body

 

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Breast Cancer Guidelines

In the UK we have a Breast Screening Programme which is a fantastic tool. All women between the age of 50 and 70 are invited for screening every three years. You should be registered with a GP to be invited.

As part of this screening you will have two x-rays taken of each breast. The x ray is called a mammogram. You should then receive the results within two weeks.

There are many patients who will discover abnormalities in their breast and will visit their GP outside of this screening programme for advice.

If cancer is suspected your GP should follow referral guidelines set by the National Institute for Clinical Excellence (NICE). Sadly this does not always happen.

Once referred to hospital you have a Triple Test, which involves:

  1. A history is taken from you of your symptoms and a physical examination performed
  2. A mammogram and/or ultrasound is performed
  3. A fine needle aspiration can also be required

Treatment

The treatment given for breast cancer depends on the type and stage of breast cancer. The main treatment are:

  • Surgery- this might be a lumpectomy or a mastectomy
  • Chemotherapy
  • Radiotherapy
  • Hormonal therapy
  • Targeted cancer drugs

It might be that you have a combination of these treatment depending on your situation.

In the majority of cases GPs and nurses will act in accordance with breast cancer guidelines and will act and refer promptly. Whilst they do their very best for patients, there are times when GPs do not act quickly enough. These delays can lead to symptoms worsening and the cancer spreading.

There may also be failings in the care provided by hospitals. For example, a radiologist may have failed to spot cancer on a mammogram following a referral or during a routine breast cancer screening. This could have a serious effect on the patient’s health.

Support

As a solicitor I have investigated medical negligence for several breast cancer cases and continue to do so today. Whilst the care received by the majority of patients is appropriate I have witnessed those cases where the care has been unacceptable. The patient has not received treatment they should have received and as a result their cancer has spread.

I am an advocate for ensuring these types of patients get the answers they deserve from their doctor and get the legal support they need. Compensation is intended to put victims of medical negligence in the position they would have been had the mistake not been made. At Cleary & Co Solicitors we fight to obtain compensation for those who have suffered. We find this goes some way to help them move forward with their lives having suffered such a terrible disease, and we also fight to get answers from their doctors. We want to know why mistakes were made and what measures have been put in place to prevent them happening again.

We also put clients in touch with practical support services to help them cope physically and emotionally. There are also charitable organisations such as Breast Cancer Care who provide breast cancer patients with information and support.

If you have been diagnosed with breast cancer and have concerns about your treatment, and would like some advice, get in touch with Cleary & Co Solicitors on 0808 196 1684 or email info@clearyandcosolicitors.com

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