Breast

Symptoms to look for Symptoms to feel for How to be Breast aware Breast awareness 5 point code What is Cobalt doing to help Women detect Breast Cancer early? Factsheet Information Risk Factors How is Breast Cancer diagnosed? Picture of normal Breast and Breast Cancers Sentinel Node Biopsy How is Cobalt continuing to support our local Breast Services? Digital Breast Screening Mobile MR Imaging of the Breast Cobalt Breast Clinic

 

Symptoms to look for

Puckering or dimpling	Bleeding or discharge from the nipple
Change in the size, shape of either breast	Rashes on or around the nipple
Changes in the position of the nipple

Symptoms to feel for

Any lump or thickening in the breast or armpit	Swelling in upper arms
Enlarged glands in the armpit	Changes in sensation, pain or discomfort that is persistent

How to be breast aware?

Get to know how your breasts look and feel at different times of the month.

Look at your breasts for changes listed above- looking is as important as feeling your breasts.

Checking your breasts should be a natural part of being aware of your whole body and not a routine you perform once a month. By checking randomly you will soon get to know how your breasts feel during normal monthly hormonal changes.  Some women have lumpier breasts around the time of a period.  If the lumpiness comes and goes with your menstrual cycle, it is nothing to worry about.

Feel all parts of the breast gently but firmly, not squeezing or prodding.

Feel behind the nipple and then up into the armpit, paying particular attention to the upper outer quarter of the breast.

You are looking for a change, something new that was not there the last time you checked.

If you detect a change go and get it checked by your GP. You are not making a fuss and your GP will not feel you are wasting his/her time they know that early detection is vital. Most breast changes are not cancerous but simple cysts or benign lumps.  The only way to be certain is to see your doctor promptly.  The UK has amongst the highest mortality rate for breast cancer in the world which may be partly due to women delaying reporting changes to their GP. Breast cancer can be successfully treated when detected early.

There is a five point code to help us become Breast Aware

1. Know whats normal for you
2. Look at and feel your Breast
3. Know what changes to look and feel for
4. Report any changes without delay

5. Attend Breast Screening from the age of 50

 

What is Cobalt doing to help women detect breast cancer early?

The cancer prevention team hold free workshops and talks in workplaces and social clubs to help women become breast aware and recognise what changes to look and feel for - most breast changes are found by women themselves or their partners.

Factsheet and leaflet information

Look through the leaflets and factsheet - they can help you to become breast aware, know what breast changes need to be reported to your doctor and encourage you to go for breast screening when you are invited.  When breast cancer is found early there is an excellent chance the treatment will be successful.

Breast cancer factsheet  -  click here

Why be breast aware - what you need to know click here

NHS Breast Screening Programme click here

 

Risk Factors

• Being over 40 (biggest risk factor is increased age)
• Having a cancer in the other breast
• Family history of the disease (mother, sister, grandmother, aunt who has had breast cancer particularly if they were younger than 50)
• Starting periods early
• Stopping periods late
• Not having children or delaying them until your thirties or fortie
• Taking HRT
• Becoming overweight after the menopause

• Drinking alcohol - limit the amount of alcohol to no more than 1 unit per day

How is Breast Cancer Diagnosed?

Mammogram

Ultrasound Scan

Biopsy or Aspiration

 

Picture of normal Breast and Breast Cancers

To view different breast images place mouse cursor over the headings on the left of image.

 

Sentinel Node Biopsy

Sentinel node biopsy is a technique which can be used in some patients undergoing surgery for breast cancer. Lymph nodes located in the axilla (armpit) on the side of a breast cancer are one of the first places that cancer may spread to. The "sentinel" node is the first in a chain of lymph nodes that drains the breast. A sentinel lymph node biopsy involves the removal of one to three lymph nodes, for assessment by a pathologist. If these sentinel nodes do not contain cancer cells, it may be possible to avoid more extensive surgery.

The sentinel node can be identified using blue dye or a small dose of a low-level radioactive tracer which can be looked for in the nodes. Research has shown that it is best to use both techniques together. Both the blue dye and the radioactive tracer solution, which contains less radiation than a standard x-ray and emits gamma rays, are injected around the nipple area before the operation.

Once the tracer and dye have reached the nodes, the surgeon scans over the axilla to locate the sentinel nodes with an electric, hand-held gamma ray counter (called a Geiger counter). Once the sentinel node is located by measuring where the radioactivity is the strongest, the surgeon can, through a small incision, look for nodes containing blue dye and remove them for a pathologist to examine and analyse under a microscope.

Several clinical trials have shown that in most cases, if the sentinel node does not contain cancer cells, then the cancer has not spread past the breast. Surgery removing lymph nodes in the axilla may then not be necessary. This can prevent some of the complications of more extensive surgery such as lymphoedema (swelling), cellulites (infection), altered sensation and restricted movement in the arm.

The ultimate goal of sentinel node biopsy is to remove as few lymph nodes as possible in patients with breast cancer suitable for this procedure in order to reduce the complications than can occur when lymph nodes in the axilla are removed.

Consultant Radiologist Professor Iain Lyburn

How is Cobalt continuing to support local Breast Services?

Digital breast screening mobile unit

State-of-the-art mobile equipment costing £325,000 to aid the diagnosis of breast cancer has been donated to the Gloucestershire Hospitals NHS Foundation Trust by Cobalt thanks to local people and their continued support. The Unit has a newly developed digital imaging system giving instant superb quality pictures which will help speed up the service and cut waiting times, it will be used both by the County's NHS Screening and Symptomatic Services.

 

MR Imaging of the breast

MR Imaging used a powerful magnetic field, radio frequency, pulses and a computer to produce detailed internal pictures of the body.  MR imaging does not use ionizing radiation (as used in x-rays)  MR imaging cannot be performed on people with pacemakers and some other ferrous metallic implants.

Usually MR imaging of the breast is not a replacement for mammography or ultrasound imaging but rather a supplemental tool for detecting and staging breast cancer and other breast abnormatlities.

MR imaging of the breast is performed to:

• assess multiple tumour locations, especially prior to breast conservation surgery
• identify early breast cancer not detected through other means, especially in women with dense breast tissue and those at high risk from the disease, including those with a significant family history
• assess the effect of chemotherapy
• determine the integrity of breast implants

 

Thirlestaine Breast Centre - Cobalt House - The clinic is a joint venture between Cobalt and the Gloucestershire Hospitals NHS Foundations Trust.

It aims to be a centre of excellence for breast screening, diagnosis and care of breast cancer patients - bringing these services together under one roof. Treatment for breast cancer has seen great improvements in recent years, with more patients living longer. Much of this success is due to earlier diagnosis and improved screening.