• Symptoms to look for
• Symptoms to feel for
• Risk factors
• How is breast cancer diagnosed
• Factsheet information

• What is the Cobalt Appeal Fund doing?
  • Breast awareness 5 point code
  • Breast awareness clinics
  • Sentinel node biopsy research

• Puckering or dimpling
• Change in the size of either breast
• Changes in the position of the nipple

• Bleeding or discharging from the nipple
• Rashes on or around nipple

• Any lump or thickening in the breast or armpit
• Enlarged glands in the armpit

• Swelling in upper arms
• Changes in sensation, pain or discomfort that is persistent

• Being over 40 (biggest risk factor is increased age)
• Having a cancer in the other breast
• Family history of the disease (mother, sister, grandmother, aunt who has had breast cancer particularly if they were younger than 50)
• Starting periods early
• Stopping periods late
• Not having children or delaying them until your thirties or forties
• Taking HRT
• Excessive alcohol intake (not more than 2 units per day are the recommended guidelines for women)

• Mammogram

• Ultrasound scan

• Biopsy or aspiration

Get to know how your breasts look and feel at different times of the month. Ensure you have time and will not be disturbed before you start – strip to the waist and in a good light look at your breasts in a large mirror whilst having your arms by your side and then raising them above your head. Turn and look at every angle. Bend at the waist and check for changes

To feel your breasts use the flat of your fingers (feel gently and firmly do not prod or poke) and circle the breast feeling behind the nipple, cover the whole breast - do not forget the area extending into the armpit.

1. Know what’s normal for you
2. Look at and feel your breasts
3. Know what changes to look and feel for
4. Report any changes without delay
5. Attend breast screening from the age of 50

Complete breast

Cutaway of breast

Cancer Examples

Ductal carcinoma
(non-invasive / early breast cancer)

Close up of Ductal carcinoma
(non-invasive / early breast cancer)

Invasive carcinoma

We run breast awareness clinics which are aimed at women 25 and over. A female doctor will explain which lumps and bumps are normal (this can be very reassuring) and how you can become breast aware. With practice you will then be able to detect changes early. Remember 9 out of every 10 changes are not cancer so don’t panic but get it checked out.

Book your free 15 minute appointment at the clinic by ringing 01242 535900

Look at the diary to see when we are having talks and workshops on breast cancer - make sure you book a place for yourself and why not encourage a friend to come along and join you.

Sentinel Node Biopsy - A New Advanced Procedure in Breast Cancer

Sentinel node biopsy is a new technique which can be used in some patients undergoing surgery for breast cancer. Lymph nodes located in the axilla (armpit) on the side of a breast cancer are one of the first places that cancer may spread to. The “sentinel” node is the first in a chain of lymph nodes that drains the breast. A sentinel lymph node biopsy involves the removal of one to three lymph nodes, for assessment by a pathologist. If these sentinel nodes do not contain cancer cells, it may be possible to avoid more extensive surgery.

The sentinel node can be identified using blue dye or a small dose of a low-level radioactive tracer which can be looked for in the nodes. Research has shown that it is best to use both techniques together. Both the blue dye and the radioactive tracer solution, which contains less radiation than a standard x-ray and emits gamma rays, are injected around the nipple area before the operation.

Once the tracer and dye have reached the nodes, the surgeon scans over the axilla to locate the sentinel nodes with an electric, hand-held gamma ray counter (called a Geiger counter). Once the sentinel node is located by measuring where the radioactivity is the strongest, the surgeon can, through a small incision, look for nodes containing blue dye and remove them for a pathologist to examine and analyse under a microscope.

Several clinical trials have shown that in most cases, if the sentinel node does not contain cancer cells, then the cancer has not spread past the breast. Surgery removing lymph nodes in the axilla may then not be necessary. This can prevent some of the complications of more extensive surgery such as lymphoedema (swelling), cellulites (infection), altered sensation and restricted movement in the arm.

Sentinel node biopsy is a new technique. The ultimate goal is to remove as few lymph nodes as possible in patients with breast cancer suitable for this procedure in order to reduce the complications than can occur when lymph nodes in the axilla are removed.

Dr Iain Lyburn
10th April 2005