Breast cancer is the commonest cancer affecting women. Survival rates are improving - through earlier detection and better treatment - but lag behind other European countries, and vary within Britain, partly due to treatment differences. Studies show that surviving breast cancer depends heavily on fast detection, reliable diagnosis and treatment by specialist teams.
Checking for breast cancer
Monthly checks are recommended by experts. Warning signs include any unusual change, such as a lump in the breast or armpit, swelling, persistent pain, differences in skin texture, size or shape in either breast, and changes in the nipples. Nine out of 10 lumps are not cancerous but seeing your GP quickly is vital - one third of women wait three months, according to the Imperial Cancer Research Fund.
Diagnosis
If the GP suspects a problem, you should be referred for tests quickly - within two weeks if urgent, the government stipulates. The gold standard test, recommended by national guidelines, is the triple assessment, involving a physical examination, mammography (x-ray) and fine needle aspiration. This usually detects more than 95% of cancers. Ideally it should be done within one day. If positive, further tests may be needed.
Treatment
Treatment by specialist teams, which should be the norm in most parts of the country, significantly improves survival. The team should include a surgeon, who specialises in breast cancer, specialist nurses and other health professionals. Together they should treat at least 100 new cancer patients each year.
A large study in Scotland found women treated by specialist surgeons had a 16% better chance of survival than those treated by general surgeons. Removing all detectable cancer is the first step. Studies show a partial mastectomy can be as successful as a full mastectomy in appropriate patients, so long as radiotherapy follows.
Radiotherapy reduces the risk of cancer returning by 24%, studies show. It is essential any affected lymph nodes are also removed. The second step is treating any undetected cancer. Almost all women, should be given chemotherapy and/or hormone therapy (like tamoxifen) after surgery. Both significantly reduce recurrence of cancer and improve survival.
• More information: Breast Cancer Care helpline: 0808 800 6000. Cancer Research Campaign: 0800 226 237.
• What works? is based on reviews of the most up-to-date and reliable evidence available. It is written in collaboration with the NHS Centre for Reviews and Dissemination at York university (01904 433 634) and verified by experts.
