Regular breast checks are something many women think about doing but tend to put off. Epworth medical oncologist Dr Ross Jennens urges all Australian women to have regular breast screens once they turn 40.
A mammogram can help find tumours that are too small to feel.
"I have recently seen three women in their 40s who have breast cancer, so don’t wait until you are 50 to start checking," Ross says.
"However, with survival rates of 85–90 per cent ten years after treatment, the outlook is pretty good for most women who have had breast cancer,’ he says. ‘However early detection is the key to good outcomes."
Patients who show any sign of unusual breast lumps are referred immediately for a biopsy, which involves extracting some of the cells from the lump for testing. Should the biopsy show cancerous cells, surgery will be required. This will involve either a lumpectomy (removal of the lump), or mastectomy (removal of all of the breast tissue). Lymph glands under the armpit are also often removed.
At Epworth, each patient has a multidisciplinary team including the surgeon, a medical oncologist, radiation oncologist and a breast care nurse working together to ensure the best treatment and care path.
The treatment regimen following surgery may include anti-hormone therapy, chemotherapy and radiotherapy. Some women may only require one or two of these therapies, whereas others may be recommended to have all three.
Chemotherapy is the first cab off the rank, usually involving three to six months of treatment. Depending on the features of the cancer, this might be once a week or up to once every three weeks. Chemotherapy often causes hair loss, however Epworth has recently purchased scalp cooling machines for patients to use, which minimise hair loss during treatment.
Following on from that, radiotherapy is often used, which involves three to six weeks of treatment, each weekday over that period.
Most women then go onto anti-hormone therapy, which involves taking a daily tablet for five to ten years.
Ross says that the most important follow up after breast cancer treatment is annual mammogram, breast ultrasound or sometimes MRI of the breasts following treatment. Routine blood tests or body scans are generally not recommended unless there is a specific symptom of concern.
So what causes breast cancer and is there any way to minimise the risk of getting it? Ross says some of the factors which can increase the risk for breast cancer include alcohol consumption, long term use of the contraceptive pill, late menopause, and early start of menstruation (traditionally under 14 years old but now more likely to be younger).
There are also two genes, known as BRCA1 and BRCA2 genes, which are passed on through families. Women who have other family members with breast cancer can screen for these genes.
"However, in the vast majority of cases, breast cancer is simply caused by bad luck. Mistakes in cells happen all the time, which the body pick up and corrects most of the time. Unfortunately sometimes it misses them, and cancer can be a result," he says.
"So talk to your GP about a how to check your breasts, and go to regular screening once you are 40 as early intervention is the key to a better outcome."
Epworth Freemasons runs a breast clinic with screening and on site mammography services. A doctor referral is not needed.