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Wednesday, September 23, 1998 Published at 17:48 GMT 18:48 UK

Health: Medical notes

Breast cancer factfile

Screening can detect the disease early on

Breast cancer is the most common cancer in women in westernised countries and accounts for 20% of all female cancers. It is estimated that one in 12 British women will develop breast cancer at some time in their life. A patient's chance of survival is high if the disease is diagnosed early on.

What is it?

Breast cancer is a malignant tumour that develops from cells in the breast. The disease occurs mostly in women, but can also occur in men.

The female breast consists of three main parts:

Lobules - the milk-producing glands

Ducts - the milk passages that connect the lobules and the nipple

Stroma - made up of the fatty tissue and ligaments surrounding the ducts and lobules, blood vessels and lymphatic vessels.

Lymphatic vessels transport lymph - a clear fluid that contains waste tissue and immune system material - around the body.

Cancerous cells can enter the lymphatic system and move around the body, infecting other organs.

Breast cancers appear as a lump on the breast, but there are many different types of breast lump.

Most are harmless, or benign, and are usually caused by damage to connective tissue, cysts or the build-up of scar tissue.

Benign lumps are abnormal, but not life-threatening.

Cancerous lumps can be either invasive, meaning the cancer has spread, or non-invasive, meaning it has not.

The major types are:

Adenocarcinoma - a general cancer which can form anywhere on the body

Ductal carcinoma in situ - the most common type of non-invasive breast cancer. Most women diagnosed at this stage can expect a full recovery.

Infiltrating (or invasive) ductal carcinoma - starts in a duct of the breast and breaks through to invade the fatty tissue. At this point, it has the potential to spread to other parts of the body through the lymphatic system and bloodstream. It accounts for about 80% of breast cancers.

Infiltrating lobular carcinoma - is similar to the above but starts in the milk-producing glands. It accounts for 10 to 15% of invasive breast cancers.

There are also many other rarer types of breast cancer.

Most of the breast cancers seen in women can occur in men.

What are the symptoms?

Doctors encourage women to check their breasts regularly for signs of the disease. Advice on self-examination can be obtained from GPs and cancer organisations.

The key signs to look out for are:

A lump

Lumpiness

Changes in the shape of the breast or dimpling of the skin

An area that feels different to the rest

Discharge from the nipple

Nipple inversion

Pain

Discharge from the nipple will sometimes contain blood and is more common in men with the disease.

A mammogram or ultrasound scan can detect the presence of cancerous growths.

Can I prevent the disease?

There are a number of risk factors, most of which cannot be changed.

Being a woman is the greatest risk factor - breast cancer affects 1,170 women per million of the population. In comparison, just seven men per million are affected.

The risk also increases with age and if family members have suffered breast cancer.

Women who start their periods before they are 12 or who go through menopause after they are 50 have a slightly higher risk of breast cancer.

Obesity is a significant risk factor, particularly for men.

The relationship between body fat and cancer is not fully understood, but the extent of the risk is thought to vary depending on when the weight was gained and what sort of fat is consumed.

Studies have exposed many other risk factors related to lifestyle, but it is not certain how important these are in determining susceptibility to the disease.

They include:

Use of the oral contraceptive pill

The age at which women have children

Use of hormone replace therapy

Smoking

Alcohol

Recent American trials suggest the drug Tamoxifen, which is successful in treating breast cancer, may also prevent it. But the trials have proved controversial, with European research showing no evidence to support their findings.

What is the outlook?

The earlier breast cancer is detected, the more chance there is of a full recovery.

Treatment options will include surgery to remove the lump. This may also include removal of the infected breast.

If the cancer has spread, then chemotherapy - powerful anti-cancer drugs - will be given.

Radiotherapy is also an option.

Is help available?

There are several cancer charities which provide help and support to sufferers.

These include: the Cancer Research Campaign which produces factsheets with detailed information for patients and their relatives.

The organisation can be contacted by post at Cancer Research Campaign, 10 Cambridge Terrace, London NW1 4JL or by phone on 0171-224 1333.

The Imperial Cancer Research Fund also offers advice and information. Write to Imperial Cancer Research Fund, PO Box 123, Lincoln's Inn Fields, London WC2 3PX or phone 0171-242 0200.