Breast cancer

Overview

Breast cancer is the most common form of cancer among women in Western Europe. A number of different genetic and hormonal factors increase the risk of falling victim to this disease. Typical symptoms include lumps in the breast or armpit. There can also be changes to the skin, the shape of the breast or the appearance of the nipple. Monthly self-examination is very important for early detection of the disease.

Symptoms

The first signs often only appear when the cancer is already in an advanced stage; the ideal would be to identify and treat the cancer before the following symptoms appear:

• Lumps or hardening in the breast or armpit
  • Can’t be moved, no sharply demarcated borders
  • Usually painless and not sensitive to pressure, but can sometimes be painful
• Change in the shape of the breast
  • Breast grows larger or thicker on one side
  • The breast as a whole is higher
  • Localised bulge or indented skin in some areas
• Change in nipple appearance
  • Becomes sunken; irregular deformation
  • The affected breast is higher and asymmetrical to the healthy one
  • Milky, bloody or watery discharge
• Immovable or noticeably thickened skin with enlarged pores (“orange peel skin”)
• Breast inflammation (mastitis) unrelated to childbirth and breastfeeding
  • Red patches on the skin
  • Breast is swollen, overheated, hard, often painful

Local recurrence, but a new tumour can also grow in the other breast

Causes and treatment

Causes

• Generally speaking, any woman can develop breast cancer
• Risk factors increase the probability
• Although rare, men can also get it

Risk factors

• Family history and genetic factors (gene mutations)
• Hormonal factors
  • No or late pregnancy, no breastfeeding
  • Early onset of menstruation, late menopause (long hormonally active period)
  • Hormonal birth control (currently or during the last five years)
  • Hormone therapy (risk-benefits analysis is needed)
  • Overweight (fat cells produce oestrogen), in particular after menopause
• Other factors
  • Advancing age
  • High breast density
  • Smoking, drinking too much alcohol
  • High radiation exposure (x-ray, CT scan, etc.)

Further treatment by your doctor / in hospital

Possible tests

• Physical examination and inspection of the breast
• Physical examination of the lymph nodes
• Ultrasound
• Mammogram (breast x-ray)
• Confirmation of diagnosis: Removal of tissue samples (breast and lymph nodes)

Possible therapies

• Depends on the stage of the disease and the form of cancer
• Operation
  • Breast-conserving (whenever possible), followed by compulsory radiation therapy
  • Mastectomy (complete removal of breast)
  • Removal of lymph nodes
  • Plastic reconstruction of breast
• Radiation therapy
• Chemotherapy, hormone therapy
• Symptom relief

What can I do myself?

• Self-examination of breast
  • Recommended for all women, early detection is important
  • Once a month, not more (easier to detect changes)
  • Best time: first half of menstrual cycle, ideally 8 days after period (glandular tissue is softer)
  • Instructions for self-examination

Get a personal Preventive Care Recommendation now.

When to see a doctor?

• Positive for risk factors: regular preventive examinations
• Every lump, every knot or skin change to the breast
• Change in breast shape and nipple appearance
• Lumps in the armpit, above or below the clavicle

Early detection via mammogram

• Cantons BS, BE, FR, GE, GR, JU, NE, SG, TG, VD and VS: free of charge once every 2 years for women aged 50 and over as part of a screening programme
• Other cantons: not a mandatory benefit under compulsory health insurance, may be covered by supplementary insurance
• Ask the doctor whether a mammogram would be a good idea
• Radiation exposure: the danger of diagnosing breast cancer too late is greater than the damage caused by radiation

Further information

Krebsliga Schweiz (Swiss Cancer League)
www.krebsliga.ch (general)
Mammography screening

University Hospital of Basel
Instructions for self-examination

Selbsthilfe Schweiz (Self-Help Support Switzerland)
www.selbsthilfeschweiz.ch

Synonyms

breast cancer, breast carcinoma