Are you worried about breast cancer?

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1 Are you worried about breast cancer? This information is from the leaflet, Are you worried about breast cancer? which you may find helpful if you are worried about breast cancer running in your family. We can send you a copy free see page 8. We also have leaflets available if you are worried about cancer generally, bowel, ovarian or prostate cancer. Contents Cancer risk How does my family history affect my breast cancer risk? Other risk factors Reducing your risk Be body aware Regular checks and screening for breast cancer If you are still worried Cancer risk About 1 in 8 women in the UK develop breast cancer. We don t know the cause of most breast cancers, but we do know that some things, called risk factors, can increase your chances of developing cancer. Some risk factors are very likely to cause cancer, whereas others will only slightly increase your likelihood of getting it. Having a particular risk factor for cancer, or being exposed to one, doesn t mean that you will definitely get cancer just as not having it doesn t mean that you won t. Macmillan and Cancerbackup have merged. Together we provide free, high quality information for all. Questions about cancer? Ask Macmillan Page 1 of 8

2 Smoking is a good example of this. If you smoke, it isn t certain that you ll get lung cancer just as if you don t smoke, it s not certain that you won t. But smoking will greatly increase your risk of getting lung cancer. About 9 out of 10 people who develop lung cancer are smokers. Cancer is very common, and nearly 1 in 3 of us will develop it at some time during our lives. This means that most of us have relatives who have had cancer. Surveys have shown that many people think a history of cancer in their family greatly increases their risk of developing it. People often worry that an increased risk of cancer can be inherited or passed on from one generation to another. In fact, fewer than 1 in 10 cases (5 10%) are associated with a family history of cancer. How does my family history affect my breast cancer risk? Genes carry the biological information we inherit from our parents. They affect the way our bodies grow, work and look. Changes (mutations) in certain genes can increase the risk of breast cancer in family members who inherit the genetic change. However, only a small number of breast cancers (5 10%) are thought to be due to an inherited altered gene (genetic mutation) running in the family. Changes in two genes called BRCA1 and BRCA2 are know to increase the risk of breast and ovarian cancer. Rarely, one of these genetic changes runs in a family, and members of the family who inherit the mutated gene have an increased risk of these cancers. If you only have one middle-aged or elderly relative who has developed breast cancer, or if there is just one case of breast cancer on each side of your family, this may not significantly increase your risk. A genetic mutation that could increase your risk of breast cancer is only likely to be present in your family if you have: One close relative who developed breast cancer under the age of 40. Your close relatives are your mother, sisters or daughters. They are sometimes called your first degree relatives. Page 2 of 8 Questions about cancer? Ask Macmillan

3 Two close relatives on the same side of your family (your mother s side or your father s side) who developed breast cancer under the age of 60. Three close relatives on the same side of your family who developed breast cancer at any age. Breast and ovarian cancer on the same side of the family, a male relative with breast cancer or a close relative with cancer in both breasts. If any of these apply to you and you re worried about your risk of developing breast cancer, you may want to talk to your GP. BRCA gene changes may be more common in certain populations. If you have relatives with breast or ovarian cancer, and have Jewish ancestry or come from another ethnic background (Icelandic, Dutch or Norwegian) where BRCA gene changes are more common, you may want to discuss your risk with your GP. If they think you may have an increased risk of developing breast cancer because of your family history, they will refer you to a genetic counsellor, family cancer clinic or a cancer specialist. Women who are likely to have an increased risk of developing breast cancer because of their family history may be offered additional breast screening. This may involve yearly mammograms (breast x-rays) from the age of 40 and sometimes MRI scans from an earlier age. All women aged 50 and over are automatically invited to join the NHS Breast Screening Programme, and offered a mammogram every three years until they are 70. We have an online tool you can use to assess your risk of developing breast or ovarian cancer. OPERA (Online Personal Education and Risk Assessment) is an interactive program that will offer you personalised information and support about your inherited cancer risk. Visit macmillan.org.uk/opera for more details. Questions about cancer? Ask Macmillan Page 3 of 8

4 Other risk factors Risk factors other than family history can play a more important role in the development of breast cancer. Age Breast cancer mainly affects older women. In the UK, more than half of breast cancers occur in women over 65. Women under 50 are at a far lower risk of getting breast cancer than older women, and the risk is even lower for women under 40. Hormonal risk factors Your exposure to the hormones oestrogen and progesterone can affect your breast cancer risk. This means you may be at an increased risk of developing breast cancer if you: started your periods at an early age (under 12) and have a late menopause (after the age of 50) don t have children or have children after the age of 30 don t breast-feed, or breast-feed for less than 12 months in total. Other breast conditions Non-cancerous breast conditions are common and most don t affect your risk of breast cancer. But, a few can increase your risk. They include: ductal carcinoma in situ (DCIS) abnormal cells in the ducts of the breast lobular carcinoma in situ (LCIS) abnormal cells in the lobules of the breast atypical ductal hyperplasia slightly abnormal cells in the ducts in a small area of the breast These conditions may be discovered during tests to investigate a breast lump or during routine breast screening. If you have a breast condition that may increase your risk, your doctor can tell you if you need treatment or more frequent breast screening. Page 4 of 8 Questions about cancer? Ask Macmillan

5 Dense breast tissue If your breasts have more glandular and connective tissue and less fatty tissue, this will make your breasts appear denser on breast x-rays (mammograms). Dense breast tissue increases your risk of developing breast cancer. Radiation Women who have had radiotherapy to their chest at a young age (under 35), for cancers such as Hodgkin lymphoma, may be at an increased risk of breast cancer may and be offered more frequent breast screening. Body weight Being overweight, particularly after the menopause, increases the risk of breast cancer. This may be because it alters the levels of hormones in the body. Lack of exercise Evidence suggests that regular physical activity reduces your risk of breast cancer. Alcohol Drinking alcohol increases your risk of developing breast cancer. The increase in risk is small for women who drink within the recommended guidelines, but it increases steadily the more alcohol you drink. The European Code Against Cancer recommends that women should drink no more than one unit of alcohol a day to reduce their risk of developing cancer. A unit is half a pint of ordinary strength beer, lager or cider, one small glass (125ml) of wine or a single measure (25ml) of spirits. Questions about cancer? Ask Macmillan Page 5 of 8

6 Reducing your risk Some cancer risk factors, such as age and family history, are beyond your control. But, there are some risk factors you can control, known as lifestyle risk factors. About 1 in 4 cancers diagnosed in the UK (25%) could be avoided if people made changes to their lifestyles. Here are some things you may want to consider: Keep physically active You don t need to go to the gym regular walking, cycling or swimming can be enough. Maintain a healthy weight Eating a balanced diet, which contains plenty of fibre, fruit and vegetables, and is low in red meat, fat and salt, can help. Your GP can give you more advice. Give up smoking Help is available if you want to give up smoking. Ask your GP for advice, or call the NHS smoking helpline: England Mon Fri, 9am 8pm; Weekends, 11am 5pm Scotland Daily, 9am 9pm Northern Ireland Mon Fri, 12pm 10pm Wales Mon Thurs, 8.30am 5pm; Fri, 8.30am 4.30pm The website smokefree.nhs.uk also has useful information. Limit your alcohol intake Drinking more than the recommended amount of alcohol increases your cancer risk. Page 6 of 8 Questions about cancer? Ask Macmillan

7 Making these changes doesn t mean that you definitely won t get breast cancer but they make it less likely and will improve your health generally. Be body aware This means knowing what is normal for you and what is a serious change. When it is found early, breast cancer can often be treated successfully. You should see your GP if you have: lumps or bumpy areas in your breast a change to the outline or shape of your breasts unusual nipple discharge that is not milky unusual discomfort or pain in one breast (many women say that their breasts are more tender or a bit lumpy just before their period). In most cases, changes to your breasts don t mean that you have cancer, but it is worth seeing your doctor. You are not wasting your doctor s time if you have discovered a change in your breasts. Regular checks and screening for breast cancer Breast screening can help detect breast cancer early, when it s easier to treat. Women over 50 are invited to join the national screening programme and have a mammogram (breast x-ray) every three years until they are 70. Women aged 70 and over can continue to have regular mammograms by contacting their GP, who will arrange an appointment at a breast screening clinic. Planned expansion of the breast screening programme means that, by 2012, all women aged will be called for regular breast screening. Questions about cancer? Ask Macmillan Page 7 of 8

8 If you are still worried A common reaction to serious illness in the family, or to bereavement, is to feel more vulnerable to the same disease. If you can t stop worrying, you may find it helpful to see a counsellor. You can ask your GP, or call our cancer support specialists on for details of a local counselling service. The mental health charity MIND has published a leaflet called How to Stop Worrying. Go to mind.org.uk or call for a copy. OPERA (Online Personal Education and Risk Assessment) can offer you personalised information and support about your inherited breast and ovarian cancer risk, at opera.macmillan.org.uk More information and support If you have any questions about cancer, ask Macmillan. If you need support, ask Macmillan. Or if you just want someone to talk to, ask Macmillan. Our cancer support specialists are here for everyone living with cancer, whatever you need. Call free on , Monday Friday, 9am 8pm We make every effort to ensure that the information we provide is accurate but it should not be relied upon to reflect the current state of medical research, which is constantly changing. If you are concerned about your health, you should consult your doctor. Macmillan cannot accept liability for any loss or damage resulting from any inaccuracy in this information or third party information such as information on websites to which we link. Macmillan Cancer Support Registered charity in England and Wales (261017), Scotland (SC039907) and the Isle of Man (604). Registered office 89 Albert Embankment, London, SE1 7UQ REVISED IN APRIL 2011 Page 8 of 8 Questions about cancer? Ask Macmillan