Raising awareness, saving lives. Breast cancer and women over 70

North Trent Cancer Network Joan Brown, cancer survivor Raising awareness, saving lives. Breast cancer and women over 70 Barnsley Bassetlaw North Derbyshire Doncaster Rotherham Sheffield a

Contents Introduction 2 Introduction 3 What we are aiming to do 4 How you can help 5 Facts and figures 6 Breast cancer and women over 70 7 The importance of breast cancer awareness 9 Why is being breast aware so important 9 Reducing the risk 10 Older women and breast checking 10 Breast screening 11 Signs and symptoms 12 What to look for 13 Further information 14 Local organisations 15 Key messages Detecting breast cancer early significantly improves the chances of successful treatment. Raising awareness saves lives. Whether you re a volunteer, a community worker or a healthcare professional this booklet is designed to help you pass on information about spotting and treating breast cancer to the women you meet every day. It features information on the signs and symptoms, the importance of screening programmes, and of seeking medical attention immediately if they notice changes in their breasts. Evidence shows that a quick chat can have a lasting effect on someone s awareness of breast cancer. And because you are in contact with older women on a regular basis, you are in an excellent position to have that five-minute conversation. This approach is much more effective than just relying on leaflets, and could mean that they: remember to check their breasts regularly; make an appointment for a breast screen; and see their doctor if they notice any changes in their breasts. 1 2

What are we aiming to do? Our ultimate aim is to raise awareness of breast cancer among women aged over 70, so that they are in a better position to get an early diagnosis, and so live a longer and healthier life. The key messages we want to pass on to older women are that: the likelihood of developing breast cancer increases with age; there are several symptoms they should regularly check for; they should not delay seeing their GP if they notice these symptoms (they will not be wasting their doctor s time); they are still entitled to make a breast screening appointment, even if they re over 73; and the earlier cancer is diagnosed, the better. Notes: How you can help When you spend time with women who are over 70, try to find an opportunity to talk to them about breast cancer awareness. For example, you could: hand out leaflets as a conversation starter, helping them understand what to check for and why; ask them when they last had a breast screen and give them the number to make an appointment screening appointment; encourage them to see their GP as soon as possible if they have noticed an unusual change in their breast so they can undergo tests (and reassure them that many breast symptoms are not cancerous); ask a younger person to pass information on to their mother or older relative; give a presentation or informal talk to a local community group or colleagues (a presentation is downloadable from North Trent Cancer Network see Resources on page 13); and put up posters or display leaflets where you work, in community venues or in public places. You don t need to be a breast cancer expert, but a little information will help you speak with confidence and clarity about the subject. 3 4

Facts and figures The risk of developing breast cancer increase with age. 80% (four out of five) of cases occur in women over 50. Breast cancer is the most common cancer in the UK for women and the number of cases has increased steadily to nearly 48,000 cases a year. Breast cancer accounts for one in three of all cancers in women in the UK. One in eight women will develop breast cancer in their lifetime. Survival rates are also improving, thanks to better awareness, better screening and better treatment. More than 80% (four out of five) of women will survive for at least five years after their diagnosis. In the North Trent area, all women aged between 47 and 73 are invited for breast screening every three years. Older women can still be screened but need to make their own appointment. Notes: Breast cancer and women over 70 In the UK, one in three of all breast cancer cases are diagnosed in women over 70. However, the same age group accounts for half the total number of deaths. One in five older women with breast cancer seek medical help for the first time when it is already an emergency. The five-year survival rate from breast cancer decreases with age: - 80% for women younger than 70-66% for women 70 79-47% for women 80 89 One in three women over 70 do not check their breasts regularly (monthly). Only one in three women over 70 would contact their doctor within a week of noticing a change. Breast symptoms in older women are more likely to be cancerous than those in younger women (one in three older women compared to one in 10 younger women). 5 6

The importance of breast cancer awareness Research shows that breast awareness among women over 70 is low compared to younger women. This means that older women risk being diagnosed at a later stage, which results in fewer treatment options and a greater risk that the cancer has spread to other organs in the body. These are some of the most common myths held by older women that we want to overcome through better breast awareness: Myth: Women from more affluent backgrounds are at lower risk due to their healthier lifestyles. Fact: The incidence of breast cancer is actually higher among more affluent women. This may be linked to women having children later in life, having fewer children, their higher uptake of screening and their alcohol intake. However, the chances of dying are higher among women from particular backgrounds: lower social economic groups, ethnic minority communities, women living in care homes, women with disabilities, older women and single women. Advice: All women regardless of background should be breast aware. Myth: Having a family history is the biggest risk for breast cancer. Women without a family history are at low risk. Fact: Most breast cancers do not run in families (only one or two in 20 cases have a strong genetic link). Advice: Women with a close relative (mother or sister) who had cancer when they were younger than 50 should speak to their GP about possible risks. Myth: Older women are at lower risk because they are not called for screening. Fact: Getting older is one of the main risk factors, and one in three of all breast cancer cases occur in women over 70. Advice: Women over the age of 73 are still entitled to breast screening and should continue to be screened. They need to make their own appointment directly with their nearest breast screening centre every three years. Myth: Women will be wasting their doctor s time if they notice a change in their breasts and make an appointment. Fact: It is the doctor s job to investigate symptoms and refer a patient to hospital if necessary. Advice: NHS advice will always be to see your GP immediately if you notice changes in your breasts. Detecting cancer early saves lives. 7 8

Why is being breast aware so important? Older women and breast checking Most cases of breast cancer are found by women noticing unusual changes in their bodies, taking the initiative and making an appointment to see their doctor. The earlier breast cancer is found, the better the chance of beating it, which is why regular checks are so important. Being breast aware simply means knowing what your breasts look and feel like normally, and getting them checked out by your doctor if you notice any unusual changes. Lumps are a well-known symptom but there are other important signs to look out for too (see page 12). Reducing the risk It s very difficult to define exactly what causes breast cancer. However, statistics show that older women are at a higher risk and there is evidence that some genes contribute to the disease. Nonetheless, four out of every ten cancers are preventable, and women can reduce their risk by leading a healthy lifestyle. This could mean: drinking less alcohol maintaining a healthy weight staying physically active Walking to the shops, climbing a staircase or doing some gardening are all physical activities. Further information is available online (see Resources on page 13). Only one in three older women regularly check their breasts, and the main reason they don t is that they forget. Finding ways to help them remember is crucial. Everyone checks their breasts in a different way, but it s good to encourage women to check their bodies when they are relaxed maybe after a bath or shower and ideally in front of a mirror. You could recommend Breakthrough Breast Cancer s TLC approach: Touch do you feel anything different? Look can you see any changes in shape, size or texture? Check anything unusual with your doctor. Breast Screening Women are invited for a mammogram (breast x-ray) every three years from the age of 47 to 73. You have to be registered with a GP to be sent an appointment. Women over 73 will not be sent an invitation but can request an appointment every 3 years as they are still at risk. Mammograms can pick up breast changes even before symptoms appear. Breast cancer can also develop between mammograms so women should still check their breasts regularly and report any changes to their doctor. 9 10

Signs and symptoms There s no right or wrong way to check your breasts. Just try to get used to looking at and feeling your breasts regularly. You can do this in the bath or shower, when you use body lotion, or when you get dressed. 06 What changes should I look and feel Your breasts, yourfor? health: a quick guide to being breast aware 07 You decide what is comfortable and best for you. What to look for Remember to guide check all of your breast, your 06 05 What changes should Your breasts, your health: a quick toparts being breast aware I look and feel Your breasts, yourfor? health: a quick guide to being breast aware 07 armpits and up to your collarbone. Your breasts, your health: a quick guide to being breast aware 06 05 What changes should Your I look breasts, and feel yourfor? health: a quick guide to being breast aware 07 What changes should I look feel for? Whatand changes should I look and feel Everyone s breasts look for? and feel different. Areas to check Most women know that a lump could be a sign of breast cancer. But there are other signs that many women are not aware of. They include: a thickening in the breast or armpit; For many women it s normal to have lumpy breasts and/or tenderness pain around Everyone s breasts look andorfeel different. their period. It s also have one For many women it scommon normal totohave lumpy breast larger than the other, or breasts that changes in the skin, ie puckering, redness, dimpling or hardening; breasts and/or tenderness or pain around are different shapes. their period. It s also common to have one change in the size or shape of a breast; breast larger than the other, or breasts that When checkingshapes. your breasts, try to be aware of any are different Areas to check changes in the size, shape or position of the nipple; pain in the breast or armpit; and any other change that is unusual. changes that are different for you. The next pages show theseyour could be. try to be aware of any Visit www.breastcancercare.org.uk When what checking breasts, changes that are different for you. The next pages show what these could be. Sometimes, there are no obvious signs and symptoms, and only breast screening can detect changes in the cells. BCC152_YBYH quick Guide 2011.indd 4 Notes: Redness or a rash on the skin and/or around the nipple Redness or look a rash (which may on the skin and/or like eczema) around the nipple Redness or a rash (which may look on the skin and/or like eczema) A swelling in your armpit or around the nipple around your collarbone (which may look like eczema) A change in size or shape A swelling in your armpit or around your collarbone A swelling in your armpit or around your collarbone Redness or a rash on thein your A swelling skin and/or around the armpit or nipple around your (which may look likecollarbone eczema) A lump or thickening that feels different A lump from theorrest of thickening that the breast tissue feels different from the rest of the breast tissue If your nipple becomes inverted Constant pain (pulled in) or in your breast If your nipple changes its or your armpit becomesorinverted position shape Constant pain (pulled in) or If your nipple in your breast changes its becomes inverted or your armpit position or shape our Helpline Constant pain Call (pulled in) or on 0808 800 6000 Visit www.breastcancercare.org.uk in your breast changes its or your armpit position or shape A change in size or shape 11 A change in skin texture such as Discharge (liquid) puckering or from one or both of dimpling A change(like in skin your nipples texture peel) such as orange A change in skin texture (liquid) puckering Discharge (liquid) from one or Discharge or such as puckering dimpling both of (like your nipples change in skin from or one or both of A dimpling texture such as your nipples (like orange peel) orange peel) Discharge (liquid) puckering or from one or both of dimpling (like your nipples orange peel) 01/09/2011 15:24 A change in size or shape A lump or thickening that If your nipple becomes Constant pain your800 breast Call our Helpline on in 0808 6000 Call our Helpline on 0808 800 6000 Visit www.breastcancercare.org.uk feels different from the rest of inverted (pulled in) or changes or your armpit the breast tissue its position or shape BCC152_YBYH quick Guide 2011.indd 7 12 Call our Helpline on 0808 800 6000 www.breastcancercare.org.uk Call our Helpline on 0808 800 6000quick Visit BCC152_YBYH Guide 2011.indd 6 01/09/2011 15:24 01/09

Further information Local organisations This guide should give you all the information you need to confidently talk about breast cancer awareness to women over 70. Spreading the message The most effective way to spread the word about breast cancer awareness is face to face. A five-minute chat can have a lasting effect on someone. Try talking to friends and family first, and then people you work with. We re trying to reach women over 70 so always encourage the people you talk with to tell their relatives, neighbours and friends too. Resources North Trent Cancer Network (www.northtrentcancernetwork.nhs.uk/) has more resources to help you spread the breast cancer awareness message, including leaflets and downloadable presentations these include PowerPoint slides and a ready-made talk that can be used for small informal groups. There is more detailed information online. The two main breast cancer charities are: Breast Cancer Care: www.breastcancercare.org.uk Breakthrough Breast Cancer: www.breakthrough.org.uk NHS Choices: www.nhs.uk NHS Direct: www.nhsdirect.nhs.uk/ Doncaster and Bassetlaw Macmillan Cancer Information Support Tel: 01777 863282 St John s Information and Support Centre Weston Road Balby Doncaster DN4 8JS Tel: 01302 796853 Doncaster & Bassetlaw Breast Screening Unit Cameo Centre, Chequer Road Clinic Chequer Road Doncaster DN1 2AD Tel: 01302 320112 Sheffield Weston Park Cancer Information and Support Centre 23 Northumberland Road Sheffield S10 2TX Tel: 01142 265391 Email: info@cancersupport centre.co.uk Sheffield Breast Screening Centre Floor C, Out-Patients Hallamshire Hospital Glossop Road Sheffield S10 2TX Tel: 01142 711922 Rotherham Macmillan Cancer Information & Support Centre Earl of Scarborough Suite Level C, Rotherham Foundation Trust Hospital Moorgate Road Rotherham S60 2UD Tel: 01709 427659 Rotherham Breast Screening Centre Level C, Rotherham Foundation Trust Hospital Moorgate Road Rotherham S60 2UD Tel: 01709 304807 Barnsley Healthwise Cancer Mobile Information Unit (based at Barnsley District General Hospital) Tel: 01226 433979 Email: Bdgh-tr.healthwise@nhs.net Barnsley Breast Screening Unit Barnsley Hospital NHS Foundation Trust Gawber Road Barnsley South Yorkshire S75 2PS Tel: 01226 432100 Chesterfield (N. Derbyshire) Breast Screening Service Breast Screening Unit Chesterfield Royal Hospital NHS Foundation Trust Calow Chesterfield S44 5BL Tel: 01246 513056 Chesterfield Cancer Drop-In Centre 3rd Floor, Dents Chambers New Square Chesterfield Tel: 01246 555514 13 14

Key messages Everyone can play a part in raising breast cancer awareness. Pass this information on today and help save lives. 1 in 3 women diagnosed with breast cancer are aged over 70 The risk of breast cancer increases with age 1 in 5 older women with breast cancer present as an emergency (that is; the cancer is already developed) Women over 70 can still request breast screening even if they are not routinely invited. Unclear on anything? Visit northtrentcancernetwork.nhs.uk/ 15 Crown copyright Department of Health 2011