If you or someone you know has been diagnosed with breast cancer, the Irish Cancer society can provide the information you need, whether you're making a decision about treatment, looking for support or need to understand the basics.
Breast Cancer is now the second most common cancer in Ireland. It affects over 2,000 women in Ireland every year. Breast cancer is rare in women under the age of 30 and occurs more often in women over the age of 50. Men also develop breast cancer but this is very rare with about 16 men developing breast cancer each year in Ireland.
Types of Breast Cancer
Invasive ductal breast cancer
This is the most common type of breast cancer (also known as infiltrating or infiltrating ductal carcinoma). It starts developing in the milk ducts of your breast, but breaks out of the duct tubes, and invades, or infiltrates the surrounding tissue of the breast. Over time, invasive ductal carcinoma can spread to the lymph nodes and possibly to other areas of the body. Invasive ductal carcinoma accounts for about 8 out of 10 of all invasive breast cancers. Although this can affect women at any age, it is more common as women grow older.
DCIS
DCIS is an early form of breast cancer. You may hear it described as a pre-cancerous, intraductal or non-invasive cancer, which means the cancer cells are inside the milk ducts or ‘in situ’ and have not developed the ability to spread either within or outside the breast.
Invasive lobular breast cancer
Invasive lobular breast cancer starts in cells that make up the lobules at the end of the ducts. Breast tissue is made up of ducts and lobules where milk is made, stored and carried through to the nipple during breastfeeding. Invasive lobular breast cancer is uncommon, and affects about 10-15% of all women with breast cancer. It can occur at any age, but more commonly affects women in the 45-55 year age group. Men can also get invasive lobular breast cancer but this is very rare. It is generally no more serious than other types of breast cancer. However, it is sometimes found in both breasts at the same time and there is also a slightly greater risk of it occurring in the opposite breast at a later date.
Inflammatory breast cancer
Inflammatory breast cancer is so called because the overlying skin of the breast has a reddened appearance – similar to that seen with some infections of the breast. In patients with inflammatory breast cancer, the reddened appearance is caused by breast cancer cells blocking tiny channels in the breast tissue called lymph channels. The lymph channels are part of the lymphatic system involved in the body’s defence against infections. Inflammatory breast cancer is a rare type of breast cancer, accounting for only 1-2% of all breast cancers.
Paget's disease of the breast
Paget's disease of the breast is an uncommon form of breast cancer. This type of breast cancer starts in the breast ducts and spreads to the skin of the nipple and the areola the dark circle around the nipple. It occurs in around 1% of all women with breast cancer. Men can also get Paget´ disease but this is very rare.
Male breast cancer
Breast cancer in men is uncommon, with approximately 16 men diagnosed each year.
Hereditary breast cancer
Hereditary breast cancer occurs when a faulty gene is passed on from either parent. This greatly increases the likelihood that cancer will develop but people can carry such genes and not develop breast cancer.
Breast cancer screening
Breast screening involves a mammogram x-ray of the breasts, which can detect early signs of cancer before it can be seen or felt. Screening has been proven to reduce the number of deaths from breast cancer, as the disease is very treatable if detected early. BreastCheck, the National Breast Screening Programme, offers free mammograms to women aged 50-64. The programme invites eligible women, on an area by area basis, for free screening every two years. You can register for BreastCheck by calling freephone 1800 45 45 55.
What to do if you find something
If you do notice any change in your breasts, see your GP as soon as possible. Remember that most breast changes are not cancer and are harmless. When your GP examines your breasts s/he may be able to reassure you that there is nothing to worry about. If the change could be connected with your hormones, your GP may ask you to come back at a different stage in your menstrual cycle. Alternatively, you may be sent to a breast clinic for a more detailed examination. Don’t worry that you may be making an unnecessary fuss and remember that nine out of ten breast lumps are harmless.
Questions to Ask your Doctor
If your GP refers you for investigation or tests, ask
- Why are you referring me for investigation?
- Can I be referred to a specialist breast clinic?
- How quickly will I be seen?
- Is my referral urgent or non-urgent?
- Which tests will I need (ultrasound, mammogram, biopsy) and why? Ask about Triple Assessment.
If your GP does not refer you for tests, ask:
- Can you explain why you’ve decided not to refer me to a breast specialist?
- How can you be sure I don’t have breast cancer?
Diagnosis questions
If you are diagnosed with breast cancer, ask your specialist doctor or breast care nurse:
- What is the type and extent of the breast cancer?
- What’s my prognosis?
- What are my treatment options and how soon can they start?
- Should I continue taking HRT or the Pill?
- Are there any changes I should make to make to my lifestyle (diet, exercise, smoking)?
- Will I be able to carry on working?
- Are my female relatives at a higher than average breast cancer risk?
- Can I have tests to find out if the cancer has spread to other parts of my body?
- Are there any clinical trials that I might be able to participate in?
- What services does this hospital provide to help me through this?
- Who can I telephone later if I’m worried about diagnosis and treatment?
The aim of the treatment is to stop any spread of the cancer and, if possible to remove all cancer from the body. In deciding on the most suitable treatment, your Doctor will consider the size of the tumour, the type of breast cancer and whether the tumour had spread to the lymph nodes or other parts of the body. The lymph nodes in the armpit are of particular importance. Finding out if the cancer has gone to the lymph nodes is important in planning adjuvant (additional) treatment such as hormone therapy or chemotherapy.
In specialist breast units, plans and recommendations about treatment are discussed by your specialists at a team meeting. These include:
- the surgeon (surgical oncologist)
- medical oncologist – doctor who prescribes anti-cancer drug therapy
- radiation oncologist – doctor who prescribes radiotherapy
- radiologist – doctor who reads x-rays
- pathologist – doctor who looks at the cells in the lab to diagnose cancer
- breast care nurses
Surgery, radiotherapy, hormone therapy and chemotherapy may be used alone on in combination to treat breast cancer. Surgery and radio therapy are referred to as local treatments because they treat only the area where the cancer has occurred.
Chemotherapy and hormone therapy are called systemic treatments because they treat the whole body.
Your doctor will plan your treatment by taking into consideration a number of factors, including your age, whether or not you have had the menopause, your general health, the type and size of the tumour and whether it has spread beyond the breast. You may find that other women at the hospital are having different treatments to you. Remember every patients treatment is planned on an individual basis.
Ref: www.cancer.ie