Breast and General Surgeon.....
Cancer and Screening
Though breast cancer is the commonest
cancer in the UK, affecting over 45,000 women in 2005, the good
news is that over the past 20 years there has been a dramatic improvement
in survival from breast cancer with more women being successfully
treated than ever before. This is due to a combination of earlier
diagnosis from screening, increasing specialisation and improvement
in the different modalities of treatment including surgery, radiotherapy,
chemotherapy and hormone treatment.
The most common symptom is the presence
of a painless hard lump. Many cancers are diagnosed in asymptomatic
women at routine breast screening. Other suspicious symptoms include
a unilateral, bloody or blood-stained nipple discharge, recent nipple
retraction, rash or deformity and any unusual deformity of the breast.
Pain is not usually a symptom of early breast cancer. It is important
therefore that women are aware of how their breasts look and feel
at different times and therefore recognise any irregular changes.
The NHS provides free breast screening
with mammograms every three years for all women in the UK aged 50
and over. Women aged between 50 and 70 are routinely invited though
this is to be extended to between 47 and 73. It is a rolling programme
but most women should receive their first invitation before their
53rd birthday (or 50th with the new extended programme). Breast
screening saves lives and women are encouraged to avail themselves
of the service.
Lifestyle measures like avoiding
obesity, reducing alcohol intake and taking regular exercises reduce
the risk of developing breast cancer.
Ductal Carcinoma in Situ (DCIS)
is a pre-cancerous condition in which the cells within the milk
ducts have altered but without the ability to spread outside the
duct like a true cancer. If untreated however most would develop
into an invasive cancer. Most cases are diagnosed in asymptomatic
women from a mammogram often as specks of calcium known as microcalcification
though not all microcalification is due to DCIS. DCIS can also present
as a bloody or blood-stained nipple discharge, a lump or as an usual
nipple rash known as Paget’s disease.
is confirmed by biopsy. Treatment depends on the extent of the condition
and may be by wide local excision followed by radiotherapy or mastectomy
with or without immediate reconstruction.
© 2008 Kent Breast Surgeon.