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Breast cancer: self-exam must be made priority

Gordon Wishart, Professor of Cancer Surgery and Chief Medical Officer of Check4Cancer has called for self-examination to be a priority amongst women as part of the fight against breast cancer.

“Women themselves are the first line of defence when it comes to breast health,” he says, “not only by moderating lifestyle factors that affect their risk but because they are best placed to detect unusual changes in their own bodies. So often cancer makes us feel that we are not in control of our health, but self-checking gives some of that sense of control back. More importantly, it also saves lives: around 90% of breast lumps are found by women themselves.”

Like other types of cancer, the incidence of breast cancer is increasing, with around 53,000 new cases in the UK per annum. The mortality rate for breast cancer has actually been falling since the 1980s, however, with 2012 figures showing a fall of 45% for women aged 50-64 since 1989, the year after the breast screening programme began.

Prof Gordon WishartProf Wishart explains: “As with all forms of cancer, early detection is key to effective treatment – and high levels of awareness and a national screening programme have made a huge impact. In my opinion, much of the success in reducing mortality from breast cancer during the last 15-20 years can be linked to early detection, and that is due to the issue being tackled on a variety of fronts – encouraging all women to be breast-aware and to self-check as well as having regular screening.”

Recent figures suggest that women in the UK are becoming too relaxed about breast cancer risk, however, with the proportion of women attending breast screening having dipped in the last few years. “We need to get the message across that screening is still vitally important, and is saving lives every day,” says Prof Wishart. The NHS calculates that, overall, the national screening programme saves one life from breast cancer for every 200 women who are screened – about 1,300 lives each year in the UK.

A comparison of the statistics for breast cancer with those of lung cancer puts the significance of early detection very clearly in perspective. “Lung cancer is the second most common cancer in the UK after breast cancer, but has a much higher mortality. There is no screening programme for lung cancer, and 90% of cases come to light as a result of symptoms such as weight loss, or coughing up blood. By the time this happens, however, it is already too late for effective treatment.”

45.525 new cases of lung cancer were diagnosed in UK in 2013 – a slightly lower incidence than breast cancer – but by comparison the number of deaths is huge. There were 11,716 deaths from breast cancer in the UK in 2012, but 35,400 from lung cancer. “If lung cancer could be detected at an earlier stage like breast cancer is, we could expect to see the number of deaths reduced by as much as two thirds.”

One of the key advantages with breast cancer is that lumps can potentially be detected by women themselves – something that is simply not possible with lung cancer. “Not all breast lumps mean cancer, of course, but if women seek further advice as soon as any anomalies are found, I believe we can improve early detection and survival rates even further.”

A short video in which Prof. Wishart explains how to self-examine for breast lumps can be found here.