Being diagnosed with breast cancer is a sad reality for many thousands of Australians every year. While we can reduce some of the risk factors for breast cancer, most risks can’t be avoided. Rather, the early detection of breast cancer can offer the best outcome.
Breast Cancer Statistics in Australia
According to Cancer Australia, It’s estimated that 20,030 new cases of breast cancer will be diagnosed in 2021. Of those, 19,866 will be females and 164 males. Breast cancer will account for an estimated 13% of all new cancer diagnoses this year. It was the second most commonly diagnosed cancer in Australia in 2017 but this year it’s expected to be the most common amongst adults and females.
An estimated 3,138 people (3,102 females and 36 males) will lose their life to breast cancer in 2021. Breast cancer will be responsible for around 6% of all cancer deaths in 2021.
Improved Survival Rates
Cancer Australia also states that the chance of surviving for at least five years after being diagnosed with breast cancer is 92% (2013-2017). Breast cancer survival rates have experienced positive improvements. Between 1988-1992 and 2013-2017 the five year relative survival for breast cancer has improved from 76% to 92%. Improvements in treatment and early detection are the main drivers for increased survival rates.
Risk Factors for Breast Cancer
Even though most women have some risk factors for breast cancer, the majority won’t develop breast cancer. However, having multiple risks should make a person more vigilant about self breast examinations and screenings to ensure any breast cancer is detected early.
Age - Most diagnoses for breast cancer are after the age of 50.
Genetics - Inheriting the BRCA1 and BRCA2 gene places a woman at greater risk of developing breast and ovarian cancer.
Family History - Having a mother, sister, daughter or multiple members on either side of the family diagnosed with breast or ovarian cancer places a woman at greater risk.
Dense Breast Tissue - Having more connective tissue than fatty tissue makes breast cancer more likely as well as more difficult to see tumors on mammograms.
Radiation Therapy - Having radiation therapy to the chest or breasts before the age of 30 increases the risk of breast cancer later in life.
Menstruating Longer - Women who began their period before the age of 12 and began menopause after the age of 55 are at higher risk of breast cancer.
Obesity - People who are overweight or obese later in life have an increased risk of breast cancer than those within the normal weight range for their height.
Hormones - Taking hormone replacement therapy (HRT) for more than five years during menopause increases the cancer risk.
Pregnancy - Not having a full-term pregnancy or not breastfeeding can increase the risk of breast cancer later in life.
Alcohol - Drinking more than the recommended intake of alcohol can also increase the risk of developing breast cancer.
Night Shift - Lastly, working night shifts can cause hormone changes that heighten a person’s risk of breast cancer.
The Importance of Early Detection
The five year survival rates after being diagnosed depend greatly on the stage of the cancer at the time of diagnosis. The cancer stage refers to the extent or spread of cancer. Stages are between I and IV with IV being the greatest spread. The stage at diagnosis and treatment outcomes are important determinants of cancer survival.
All types of cancer have a better chance of surviving longer than five years after diagnosis at the early stage but some more so than others. In the case of breast cancer, 100% of patients diagnosed with early stage 1 cancer live for more than five years but the survival rate drops to 32% for those diagnosed with late stage IV cancer.
In 2011, more than four out of every five breast cancers were diagnosed at either stage I or II.
For many people, breast cancer can’t be prevented but early detection can improve their outcome. By detecting breast cancer early it is more likely that the patient has:
Methods of Early Detection of Breast Cancer
There are three main ways of detecting breast cancer in its early stages - mammograms, self-examination and clinical examination.
Mammograms
Women aged 50-74 are recommended to attend the BreastScreen Australia program for two-yearly mammogram screenings. For women and men of all ages who have an increased risk of developing breast cancer, it’s recommended that they speak to their GP about an individualised surveillance program or starting mammograms at an earlier age.
Clinical Examination
A clinical examination requires an annual physical examination by a medical or allied health professional of a woman’s or males breasts who has no symptoms of breast cancer.
Self Examination
It’s recommended that women and men of all ages are aware of how their breasts look and feel so that they recognise any new or unusual changes. A monthly breast self-exam helps with being breast aware and noticing any differences.
How to Conduct a Self Breast Examination
There are five steps to follow to complete a self breast examination:
Step 1: Look at your breasts in the mirror with your shoulders straight and your arms by your side.
Check to see if your breasts are their:
Usual size, shape, and color
Evenly shaped without visible distortion or swelling
If you notice any of the following as changes, make an appointment to see your GP.
Dimpling, puckering, or bulging of the skin
A nipple that has changed position or an inverted nipple (pushed inward not out)
Redness, soreness, rash, or swelling
Step 2: Raise your arms and look for the same changes as you did in step 1.
Step 3: Still standing in front of the mirror, look for any signs of fluid (watery, milky, yellow fluid or blood) coming out of either nipple.
Step 4: Lie down and use your right hand to feel your left breast and then your left hand to feel your right breast. Use a firm, smooth touch with your fingers, keeping them flat and together, making small circular motions to cover the entire breast from top to bottom and side to side. Move all the way from your collarbone to the top of your abdomen, and across from your armpit to your cleavage.
To be sure that you cover the whole breast, follow a pattern. Start at the nipple, move in larger and larger circles until you reach the outer edge of the breast or move up and down vertically in rows. It’s important to feel all the tissue from the front to the back of your breasts. You will need a light pressure to feel the skin and tissue just beneath, medium pressure to feel the tissue in the middle of your breasts and a firm pressure for the deep tissue in the back right down to the ribcage.
Step 5: Feel your breasts while standing. Many find it’s easier to feel their breasts when their skin is wet, so they like to do this step in the shower. Cover your entire breast area using the same hand movements described in step 4.
What to Do if You Notice a Change in Your Breast
If you notice something is different with your breasts during a self examination, you should make a prompt appointment to see your doctor, but don’t panic.
Most breast lumps are benign (not cancerous). These lumps usually have smooth edges and can be moved slightly when you push against them. These lumps can be caused by changes in breast tissue, hormone levels, an infection, or injury.
At the appointment with the doctor, you may be asked questions about your health history. The doctor will perform a breast exam to feel for lumps or other changes in the breast tissue and under your arms.
If there’s fluid leaking from one of the nipples, the doctor may collect a sample to check for abnormal cells in the fluid. The doctor may request a blood test to check your hormone levels.
They might also do a mammogram or ultrasound to see if a lump is solid or filled with fluid. A biopsy is another option that your doctor may order. A tiny sample of the lump is removed with a small cut or needle to send to a lab for analysis.
While there are no sure ways of preventing breast cancer, detecting any cancer early gives you the best outcome. Monthly breast self-exams are one of the best ways of observing changes in the breast to allow for further investigation.