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BREAST CANCER
Breast Cancer, growth of malignant cells
affecting, initially, the breast.
As with other forms of cancer, it begins when
the DNA in cells is altered, resulting in
abnormal, uncontrolled cell growth. The cells
continue to proliferate until they form a tumour.
Breast cancer spreads when cells escape from the
tumour and travel via the blood or lymphatic
system to other parts and organs, such as the
spine or lung, where they begin to multiply,
forming other tumours, in the process known as
metastasis.
SYMPTOMS
Breast cancer symptoms include an unusual lump,
or change in the size or shape of the breast;
puckering or dimpling of the skin of the breast;
drawing back of the nipple; swelling of the
upper arm, or in the armpit, or just above the
breast; or pain or discomfort (although pain is
only rarely a symptom of breast cancer). Only 1
in 40 women who reports any of these symptoms to
a doctor is found to have cancer.
EARLY DETECTION
Early detection is all-important. Research
in Britain and Sweden has shown that small
breast cancers—those less than 15 mm (y in) in
diameter—are less likely to have spread and are
less aggressive. In 1994-1995, the National
Breast Screening Programme identified 6,500
cancers, and 2,660 were smaller than 15 mm.
Nearly 20 per cent of the cancers found had not
become invasive, that is, they had not spread
beyond the breast ducts. In the United Kingdom
all women between 50 and 65 are invited to have
a mammogram (breast X-ray) every three years
through the National Breast Screening Programme;
women over 65 are entitled to be screened on
request. The programme aims to cut breast cancer
deaths by 25 per cent in the screened population
and it has a 77 per cent take-up rate.
Women are advised to practise self-examination
between screenings or if they are under 50.
Self-examination involves a monthly check for
unusual lumps or other breast changes, such as
nipple discharge or bleeding. At present,
however, there is no clear evidence of the
effectiveness of breast self-examination in
reducing deaths from breast cancer.
Nevertheless, the majority of breast cancers are
found by the women themselves rather than
through mammography screening. Many doctors
believe that women should be made aware of
breast cancer symptoms and encouraged to examine
their breasts, or at least be aware of how they
usually feel, so that any changes can be
reported to their family doctor quickly.
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