Understanding Breast Cancer
- Longtime advice giver Deidre Sanders, 77, was diagnosed with breast cancer after an achey feeling led her to a potentially life-saving mammogram.
- Breast cancer is a common cancer that has been the subject of much research, so there are many treatment options out there. Mammograms, a standard screening procedure for breast cancer, and self breast exams can save lives.
- Signs and symptoms of breast cancer can include a breast lump or thickening that feels different from the surrounding tissue; a change in the size, shape or appearance of a breast; changes to the skin over the breast such as dimpling; developing a newly inverted nipple; peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin; and redness or pitting of the skin over your breast like the skin of an orange.
- Risk factors for breast cancer include: being a woman, age, family history, having had a prior biopsy on an abnormal area, radiation exposure, lifetime estrogen exposure, not having a child before age 30 or never having children, obesity, drinking alcohol and lack of exercise.
Sanders was the beloved “agony aunt” (a British term for a female advice columnist) behind the long-running column “Dear Deidre” in The Sun newspaper before retiring at the end of 2020. She’s still one of the voices behind the similar phone-in section of the British daytime TV program This Morning. But instead of enjoying her semi-retirement, the popular advice-giver has been dealing with breast cancer.Read More
She also took the time to remind her fans exactly what led to the mammogram that discovered her cancer.
“I was just achy. I’m really glad I was actually, because that made me check,” she said. “I phoned my GP, they were very efficient, they saw me that day, and checked me over. They said there may be something there.”
Deidre Sanders’ Breast Cancer Diagnosis
In another article for The Sun published at the end of September, Sanders gave more details about her diagnosis. When she had failed to receive an invitation for a mammogram when she turned 70, she figured there wasn’t much of a point to getting one when The National Health Service in England, where she lives, fixed their mistake a couple years later.
“My little cancer story starts with me feeling achy back in the summer,” she wrote in the article. “I tend to have tense shoulders but I realized the ache seemed to be spreading into my right breast.
“I must have let at least a month pass while I wondered, ‘Is it anything to worry about? Is it just muscular? I am 77, after all, is it just the aches and pains of getting older?’”
When she finally called and talked to an advanced nurse practitioner, Sanders was told to come in that same day.
“She saw me in person that afternoon, thought she could feel a difference in the right breast and put me on the NHS [The National Health Service] two-week cancer pathway (the referral process where anyone suspected of having cancer is seen within two weeks for a hospital diagnosis),” she wrote. “I was booked in just ten days later when they put on an extra clinic the Saturday before we went away.”
Upon completing her mammogram and ultrasound scan, she was booked for a biopsy. That’s when doctor’s discovered her cells were malignant and she had breast cancer. For treatment, she has surgery to remove the carcinoma on Saturday.
“I was telling the This Morning team before last week’s problem phone-in that I have a teeny, tiny carcinoma, a cluster of malignant cells in a duct in my right breast,” she wrote. “This is labelled high-grade, which means it is the sort that would grow and spread aggressively — had it not been discovered so early.”
Sanders is grateful her cancer was spotted when it was, but she’s still kicking herself for not getting the recommended screening done when she turned 70.
“I happen to be among a cohort of several thousand women who, by error, did not get invited for a mammogram when they turned 70,” she explained. “We were offered it a couple of years later, but by then I reckoned I must be too old to need it any more as the NHS stops inviting you for a screening after that age. Hah!”
Learning about Breast Cancer
Breast cancer is a common cancer that has been the subject of much research. Many women develop this disease every year, but men can develop this cancer too – though it is more rare, in part, due to the simple fact that they have less breast tissue.
There are many treatment options for people with this disease, but treatment depends greatly on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors. These receptors – the estrogen receptor, the progesterone receptor and the HER2 receptor – can help identify the unique features of the cancer and help personalize treatment.
“These receptors, I like to imagine them like little hands on the outside of the cell, they can grab hold of what we call ligands, and these ligands are essentially the hormones that may be circulating in the bloodstream that can then be pulled into this cancer cell and used as a fertilizer, as growth support for the cells,” Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, previously told SurvivorNet.
One example of a type of ligand that can stimulate a cancer cell is the hormone estrogen, hence why an estrogen receptor positive breast cancer will grow when stimulated by estrogen. For these cases, your doctor may offer treatment that specifically targets the estrogen receptor. But for HER2 positive breast cancers, therapies that uniquely target the HER2 receptor may be the most beneficial.
Symptoms of Breast Cancer
Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms. It’s also important to be on top of self breast exams.
Signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue
- Change in the size, shape or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast, like the skin of an orange
It’s important to keep an eye out for these symptoms while remembering that having one or many of them does not necessarily mean you have breast cancer. Regardless, you should always speak with a doctor promptly if anything ever feels off or you’re experiencing one or more of the signs listed above. You never know when speaking up about your health can lead to a very important diagnosis.
Understanding Your Risk
The risk of developing breast cancer varies greatly from person to person, so it’s important to discuss your specific risk level with your doctor. That being said, there are some important risk factors to keep in mind.
In a previous interview with SurvivorNet, Dr. Comen laid out several risk factors for breast cancer including:
- Being a woman: Women are at a higher risk for breast cancer, though men can get the disease too.
- Age: “Breast cancer becomes increasingly more common as women age,” Dr. Comen said.
- Family history: “Some people think that breast cancer is only inherited through genes on the mom’s side,’ Dr. Comen said. “But it can also be related to genetic mutations that could be found on the father’s side.”
- Having had a prior biopsy on an abnormal area: “There are different markers, that if a woman has had a biopsy, it’s important that she talk to her doctor about whether those markers are lending themselves to an increased risk of breast cancer,” Dr. Comen said. If you’ve had a biopsy that indicated atypical hyperplasia, for example, you are at an increased risk of breast cancer. Atypical hyperplasia isn’t cancer, but it is a precancerous condition that describes an accumulation of abnormal cells in the milk ducts and lobules of the breast.
- Radiation exposure: Cancer survivors who’ve had radiation to their chest are at an increased risk of breast cancer.
- Lifetime estrogen exposure: “About 2/3 of breast cancer are driven by the hormone estrogen,” Dr. Comen said. “So, that means if a woman has had her period at an early age and started to go through puberty at an early age, at seven, eight, nine, and potentially a later age of menopause, means that her lifetime of having had menstrual periods and being exposed to higher levels of estrogen is higher, and therefore her risk of breast cancer is slightly higher.”
- Not having a child before age 30 or never having children
- Drinking alcohol
- Lack of exercise: “While there’s more research to be done in this area, it looks like if a woman is not exercising, she may also increase her risk for breast cancer,” Dr. Comen said.