What are the symptoms of breast cancer in women, what are the stages of the disease and what happens at a screening?

One in eight women across the nation develops the disease in their lifetime and experts advise that women should check their breasts each month for signs of cancer, starting in their 20s. But do you know what to look out for? Here's a guide…

What is breast cancer?

Breast cancer is the name given to any cancers that have first developed in the breast tissue – there are many different types.

Nearly 1,000 people die from breast cancer every month in the UK, with the disease killing around 11,500 women and 80 men each year.

However, thanks to advances in medical research and early prevention, more people are surviving breast cancer than ever before.

While it is more common in older women, it does affect the younger generation and men too – with around 20 per cent of cases occurring in females under 50 and 350 male cases diagnosed in the UK annually.

What are the breast cancer symptoms in women?

For most women, the first sign or symptom of breast cancer is a lump or area of thickened tissue in their breast.

While 90 per cent of such lumps are not cancerous, it is vital to get them checked by your GP at the earliest opportunity – detecting the disease early can mean treatment is more effective.

It is therefore vitally important to be "breast aware" – know what feels normal for you, and therefore what changes to look out for.

One in three women do not regularly check their breasts, and a fifth of these women say it is because they don't know how to do it.

October is Breast Cancer Awareness Month (BCAM) an annual, worldwide campaign.

There are events held across the UK and the world to "highlight the importance of breast awareness, education and research."

People also wear pink, and the hashtag #wearitpink is used throughout October, and people can also wear a ribbon in support.

You can find out more information and ways to get involved by visiting the Wear It Pink website.

However, while the majority of women know to feel for unusual lumps and bumps, there are also other, less understood signs and symptoms.

Mr Kislaya Thakur, an expert at BMI The Blackheath Hospital in South London, said: "The most common symptom of breast cancer is a lump usually found by patients themselves.

"However other symptoms can indicate breast cancer.

"These include blood stained nipple discharge, nipple inversion or flattening, dimpling or tethering – including an orange-peel appearance – of the skin over the breast, lumps in the armpit or neck, or any redness which may suggest inflammation or persistent pain."

Here are the seven signs and symptoms you might not realise mean you could have breast cancer:

1. Change in breast size or shape

Breasts come in all shapes and sizes – and can look and feel different throughout a woman's life.

Carolyn Rogers, senior clinical nurse specialist at Breast Cancer Care, told The Sun Online: "They may change at the time of your period, when going through pregnancy as your body ages.

"By checking your breasts regularly, you’ll get to know whether a change in size or shape is part of what’s normal for you, or if it’s something unusual that’s worth getting checked out by your doctor.”

2. Redness or a rash

It is important to look out for signs of reddening or a rash, on the skin and around the nipple.

A rash in this area could just be triggered by new washing powder, or a lacy bra irritating the skin.

"But, if it's an ongoing issue, it could be a sign of something more serious," Carolyn warned.

3. Nipple discharge

If liquid comes from the nipple without squeezing it, it is important to get it checked by a doctor.

"We know from speaking to people on the Breast Cancer Care helpline that this can be a confusing one," said Carolyn.

"But, if it's not normal for you, then mention it to your GP."

4. Swelling in the armpit or around the collarbone

Lumps are the most common sign of breast cancer, but they don't always appear in the breast.

"Breast tissue can be found under the armpits and up to the collarbone, so you may notice an unusual swelling in these areas," explained Carolyn.

As a result, when checking your boobs each month it is important to be thorough and check all around the breast and surrounding area.

5. Change in skin texture

From puckering to the slightest hint of a dimple – changes in the skin's appearance on your breasts can be a sign of cancer.

For example, if it looks and feels like the peel of an orange, go and check it out with your GP.

A recent survey by the charity found one in six women had no idea this could be a sign of the disease.

6. An inverted nipple

Some people naturally have inverted nipples, which is absolutely fine, but everyone's breasts are different.

"If your nipple suddenly starts to be pulled inwards, or changes its shape or position in any way, then it could be a warning sign," explained Carolyn.

7. Constant pain

A dull ache that won't go away in the breast or armpit, is a warning sign for breast cancer.

However, it can be difficult to identify.

"Having pain in the breast area is really common," said Carolyn.

"It could be caused by a number of things, for example changing hormone levels before your period or even a badly fitting bra."

But, if the pain doesn't disappear after a reasonable amount of time, it is worth telling your doctor, she said.

For more information visit Breast Cancer Care.

What happens at an NHS screening for breast cancer?

Around 2million women are screened for breast cancer each year.

When you attend, you will have an X-ray (mammogram) at a clinic or mobile breast screening unit.

This is carried out by a health practitioner called a mammographer and appointments take less than half an hour.

Women undress to their waist and place their breast on the machine, a plate is then lowered to gently flatten it for the X-ray.

The NHS Breast Screening Programme is currently for women aged between 50 and 70, and involves screening every three years.

In some parts of England, this has been opened to women aged 47 to 73 years old as part of a trial.

Health Secretary Jeremy Hunt claimed 450,000 women aged 68 to 71 weren't invited for their last mammogram, between 2009 and the start of 2018, and hundreds may have died as a result.

What are the stages for breast cancer?

There are four stages for breast cancer, with one being the earliest and four meaning it has spread to other parts of the body.

Here are the different stages, as shared by Cancer Research UK.

Stage one

There are two parts to stage one:

  • 1A – This means the tumour is 2cm or less and hasn't spread outside the breast
  • 1B – Small areas of breast cancer cells are found in the lymph nodes close to the breast. There is also no tumour in the breast or the tumour is 2cm or less.

Stage two

There are two parts to stage two, and this stage means the cancer is in the breast or nearby lymph nodes:

  • 2A – There is no tumour or a tumour 2 centimetres (cm) or smaller in the breast and cancer cells are found in 1 to 3 lymph nodes in the armpit or in the lymph nodes near the breastbone. It can also mean the tumour is larger than 2cm but not larger than 5cm and there is no cancer in the lymph nodes.
  • 2B – The tumour is larger than 2cm but not larger than 5cm and there are small areas of cancer cells in the lymph nodes. Or it can mean the tumour is larger than 2cm but not larger than 5cm and the cancer has spread to 1 to 3 lymph nodes in the armpit or to the lymph nodes near the breastbone or the tumour is larger than 5cm and hasn't spread to the lymph nodes.

Stage three

There are three parts to stage three, and this stage means the cancer is in the breast or nearby lymph nodes:

  • 3A – There is no tumour  or the tumour may be any size and cancer is found in 4 to 9 lymph glands under the arm or in the lymph glands near the breastbone. Or the tumour is larger than 5cm and small clusters of breast cancer cells are in the lymph nodes. It could also mean the tumour is more than 5cm and has spread into up to 3 lymph nodes in the armpit or to the lymph nodes near the breastbone.
  • 3B – The tumour has spread to the skin of the breast or the chest wall. The cancer may have spread to up to 9 lymph nodes in the armpit or to the lymph nodes near the breastbone.
  • 3C – There are 10 or more lymph nodes in the armpit, lymph nodes above or below the collarbone or lymph nodes in the armpit and near the breastbone.

Stage four

This means the cancer has spread to other parts of the body such as the bones, lungs, liver or brain.

What celebrities have had breast cancer?

Celebrities who have battled with breast cancer include Julia Louis-Dreyfus, Anastacia, Sheryl Crow, Kylie Minogue, Olivia Newton John and Cynthia Nixon.

Michelle Heaton had a double mastectomy due to having the BRCA2 gene – meaning she had an increased risk of getting certain types of cancer.

Brave Linda Nolan revealed in March 2017 that she had secondary breast cancer which is terminal.

Her diagnosis came after she fell over and a routine scan revealed an unexpected cyst on her hip.

How is breast cancer treated?

There are a range of treatments for breast cancer, with the type or combination used depending on how the cancer was diagnosed and the stage it has reached.

Once cancer has been diagnosed, you should be assigned a multidisciplinary team who will discuss the most suitable course of treatment.

As well as the stage and grade of the disease, doctors will take into consideration the patient's general health and whether they have experienced the menopause.

The key treatments are:

  • surgery
  • radiotherapy
  • chemotherapy
  • hormone therapy
  • biological therapy (targeted therapy)

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