Cancer specialist's advice on what to look out for

As part of the Public Health Agency's campaign to raise awareness of the signs and symptoms of breast cancer, breast cancer surgeon Robert Kennedy tells women what to look out for

While breast cancer usually presents as a new lump, this is not the only symptom
Robert Kennedy

THE risk of developing breast cancer in Northern Ireland is increasing – it is the commonest form of cancer affecting women, with 1,294 cases diagnosed in 2013. Like the majority of cancers, it becomes more common as people get older, but can occur at any age.

The good news is that very often it can be successfully treated. Early detection remains the most important factor. However, avoiding weight gain, reducing alcohol consumption and minimising use of the contraceptive pill can also slightly reduce the risk of developing breast cancer.

As most people are aware, breast cancer usually presents as a new lump, or mass, in the breast. However, a lump is not the only symptom. Occasionally dimpling or distortion of the skin can be a sign of an underlying problem.

Discharge from the nipple is usually a symptom of benign change. However, discharge which is blood-stained or clear in colour may be associated with cancer or perhaps pre-cancerous change in the milk ducts behind the nipple. An inverted nipple can also be due to the same benign changes in the milk ducts that can cause a discharge but equally may be a sign of a cancer behind the nipple.

If you notice any new changes in your breast then you should contact your GP without delay. If your GP is concerned about the symptoms and signs they see, then they will refer you to your local breast clinic.

There, you will first be seen by a clinician who will ask some questions about the symptoms you have been experiencing, and you will then be examined. If investigations are required then usually a mammogram or ultrasound scan will be performed first. If anything abnormal is found, biopsies will be performed where cells are removed in order to diagnose the cause of the symptoms.

Similarly when a woman is recalled for an abnormality after she attends for screening, mammograms or scans may be performed and a biopsy may also be required. Usually the results will be available that day or within a few days; fortunately only about one in 20 patients who attend the breast clinic will turn out to have a breast cancer.

Surgery is usually the first treatment for a patient diagnosed with a breast cancer. Increasingly, however, chemotherapy is offered as the first treatment for some. At least two thirds of patients will not require a mastectomy; sometimes a partial mastectomy will be sufficient. At each stage of the process all cases are discussed by the entire team of specialists at the hospital at a multidisciplinary team meeting.

The chance of a successful outcome from the treatment of breast cancer is highest when it is caught early. That is why it is essential to know what to look out for, and to check yourself regularly. If you find something which doesn’t seem right, speak to your GP urgently. Don’t be embarrassed and don’t delay – if it is cancer, the earlier it is caught, the better.

:: Robert Kennedy MD FRCS is consultant surgeon and lead clinician for breast services at the Ulster Hospital. To find out more about breast cancer, and other types of cancer, visit the Public Health Agency’s Be Cancer Aware website


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