Breast cancer awareness: from signs and symptoms to reducing risk

Written by: Miss Christina Choy
Published:
Edited by: Alex Furber

Breast cancer is a cancer of the breast tissue which will affect around 1 in 8 women (and a small number of men) at some point in their lifetime*. October is breast cancer awareness month and pink ribbons will be on display across the globe and Miss Christina Choy, a leading London-based breast surgeon, offers her expertise on the disease. Here she discusses the signs and symptoms of breast cancer, as well as treatments, diagnosis, risk factors and more…

 

Breast cancer symptoms

 

One of the primary signs of breast cancer is the presence of a lump in either breast or a thickening of an area of breast tissue. It is worth noting that the vast majority of breast lumps are not cancerous, but should be checked by a doctor. Other breast cancer symptoms may also be present and changes to the breasts can indicate the presence of the breast cancer. A change in skin texture (such as dimpling) or size or shape of the breast may occur. In addition, changes to the nipple may occur, such as a sunken nipple, or a rash appearing on or around it. A swelling around the collarbone or the armpit could also be indicative of breast cancer, as can a discharge from the nipple, sometimes containing blood. 
 

Breast cancer diagnosis

 

Breast cancer screening is usually done by a mammogram or an ultrasound. A mammogram involves taking an x-ray, or multiple x-rays, of the breast to detect abnormalities. An ultrasound uses high-frequency sound waves through the tissue to create an image of the breast and can indicate the presence of a tumour. One or both can be used depending on circumstances.

If the result of screening is inconclusive, the patient may be sent for a biopsy to diagnose breast cancer. This involves taking a sample of the suspicious area for analysis in a lab and is the only way a diagnosis of breast cancer can be made. It is worth noting that even the majority of cases that get sent for a biopsy prove not be breast cancer.
 

Breast cancer treatment                
                                                                                             

There are a number of different factors that influence the way breast cancer is treated and managed. The age and general health of the patient is taken into account, as are myriad other factors including the stage and type of cancer, where in the breast the cancer is and whether or not the cancer has spread. Ideally, a patient should be treated by a multidisciplinary team (MDT) consisting of a range of specialists. In most cases surgery is the first port of call, followed by chemotherapy, radiotherapy or possibly by hormone or biological treatments.

Depending on the individual or the extent of progression of the disease, the extent of the surgery can vary. A mastectomy involves the removal of one or both of the breasts. In some cases it may only be necessary, or the patient may choose, to have a lumpectomy. In such cases only part of the breast tissue is removed.

On the whole, breast cancer survival rates extremely good for cases that are caught early on.
 

Breast cancer risk factors and prevention

 

Maintaining a healthy weight and a healthy diet, and cutting down on alcohol and saturated fats all seem to reduce the risk of breast cancer. Certain factors are however beyond the control of the individual; age is a determining factor and the risk increases as a person gets older. Genetics also play an important role in determining risk and indeed those with a family history of the disease may be at an increased risk. Genetic tests can be done to establish those who are at a particularly high risk of contracting the disease. In some cases, a person may opt to have a preventative (or prophylactic) mastectomy before contracting breast cancer. Medications are also available that are designed to prevent the disease, although they often have side effects. 
 

Tips to reduce the risk of breast cancer

 

A few simple changes to your diet and lifestyle may reduce your risk of breast cancer and promote general health and well-being. Try the following tips;

General advice

 

  • Limit alcohol consumption to a maximum of one glass of wine per day
  • Optimise body weight and undertake regular exercise (20 minutes daily)
  • Minimise the intake of red meat, processed meat, animal fat, sugar and sweets
  • Expose your skin to natural sunshine for 20 minutes daily
  • Increase the intake of olive oil, garlic, onions, leafy vegetable and fruits especially cherries, berries and pomegranate

Supplements

 

  • Vitamin D3 (1,000 IU daily or 10,000 IU once weekly)
  • Omega 3 (1-2 grams daily)

Specific Nutrients 

 

  • Flaxseed
  • Polyphenols (green tea and fruits)
  • Genistein (soybean in moderation)
  • Curcumin (turmeric)
  • Resveratrol (red grapes, raspberries and blueberries)
  • Sulforaphane, Indole3 carbinol and thiocyanate (cruciferous vegetables such as cabbage, sprouts, broccoli, kale and cauliflower) 
  • Lactobacillus (Low fat natural yoghurt)
  • Caffeinated coffee

Suggestion: why not try blending drink of fresh orange juice, Kale, blueberries & raspberries?

 *Source: Cancer Research UK

 

By Miss Christina Choy
Surgery

Miss Christina Choy is an experienced oncoplastic breast surgeon based in London, with a specialist expertise in one stop rapid assessment for various breast symptoms and lumps, family history risk assessment and genetic testing, breast screening and counselling, state of the arts management for both benign breast disease and breast cancer. She works at HCA hospitals in London with a group of dedicated multidisciplinary team members to provide holistic personal care with updated and cutting-edge management approaches for breast management. She is a trustee for Breast Cancer Hope Charity which promotes breast cancer research for improvement of breast cancer awareness and disease treatment.

Miss Christina Choy qualified from the Medical School of the University of Sydney in 1986 and undertook her postgraduate training in surgery and has worked in various major centres in Australia, Hong Kong and the UK, including The Royal Marsden Hospital and St Bartholomew’s Hospital. She worked as consultant breast surgeon in the NHS previously and was Lead for the Breast Service at the Homerton University Hospital. She has worked in the private sector since 2003. From January 2017 she has worked exclusively for HCA private hospitals including the London Breast Institute at the Princess Grace Hospital, the Harley Street Clinic, the Portland Hospital for women and the new HCA specialist unit at the Chiswick Outpatient and Diagnostic Centre.

Miss Choy is actively involved in research and has worked in conjunction with the pathology department at St Bartholomew's Hospital on a study of the gene arrays and demographic data of young women, particularly Afro-Caribbean women and other ethnic groups, presenting with breast cancer. Other projects that she is involved in include research into barriers to women accessing early diagnosis and treatment for breast cancer in various ethnic groups (in conjunction with King's College Hospital, recently presented in Parliament for Black Afro-Caribbean and Ethnic Minority Group, BAEM), the development of a 23 hours model for early discharge after breast cancer surgery and an audit to determine if sentinel node of highest isotope count can be the predictor of nodal status in breast cancer.

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