health articles Breast Cancer
Breast cancer is the most common cancer affecting women in the United Kingdom, with over 60,000 women being diagnosed with the disease every year. It’s worrying if you notice a breast lump, but early diagnosis, prompt referral and effective treatment can improve the chance of a cure. The experienced doctors at Virtually Healthcare will provide expert assessment, sensitive support and speedy referral when necessary.
Breast cancer care at Virtually Healthcare
Virtually Healthcare is an innovative GP practice, providing expert care in the comfort, safety and privacy of your home. The Virtually Healthcare service is designed to fit with modern lives. Consultations are easy to access, discreet and convenient, with virtual appointments available seven days a week.
The highly-skilled team includes more than 40 clinicians, including 15 female GPs. They work together to investigate and treat disease and help you optimise your health and wellbeing. As well as experienced GPs, the team includes sexual health specialists, physiotherapists and practice nurses to offer a comprehensive primary care service.
During the pandemic, many patients are finding it more difficult to access healthcare, which is worrying if you are concerned about cancer. Virtually Healthcare provides rapid access video or telephone appointments; with consultations available the same day if you contact us before 3 pm. Our clinicians can provide professional assessment, arrange for an appointment to examine your breast, and arrange for an expedited specialist referral within two weeks if they are concerned about a potential cancer.
What is breast cancer?
Breast cancer is a disease in which cells in the breast tissue start to divide and grow in an abnormal and uncontrolled way. These cells can multiply to form tumours. There are many different types of breast cancer, which grow and spread at different rates and respond to different treatment regimes.
How to check for breast cancer
Instead of following a strict breast-examination routine, our clinicians now recommend that you know the look, shape and feel of your breasts throughout life. By being breast aware, you’re more likely to notice any changes and abnormalities. You should check for:
- The breasts looking newly asymmetric or wonky.
- A change in breast size.
- Skin changes such as developing dimpling, puckering or a pitted appearance like orange peel.
- Redness and inflammation in the breast and overlying skin.
- A lump within the breast.
- An area of thickening, lumpiness or an area in which the breast texture has changed.
- Changes to the nipple including blood-stained discharge, a newly inverted nipple or an eczema-like rash that doesn’t settle with treatment.
- A lump or swelling in the armpit.
Can I speak to a GP online about breast cancer?
Virtually Healthcare can help whether you are worried about a breast lump or distressed following a cancer diagnosis. The service is readily available remotely or in person, with all appointments free of charge on the NHS. You can speak to a GP on the phone or by video link to access the emotional support and medical care you need.
What causes breast cancer?
Several different factors cause breast cancer. Your risk of developing the disease is linked to your age, family history, the way you live your life, and your lifetime exposure to the hormone oestrogen.
- Sex: Although men can develop breast cancer, women are at a much greater risk. Fewer than 400 men are affected every year in the UK.
- Age: Your breast cancer risk increases as you get older. Eight in ten breast cancers in the UK are diagnosed in women over the age of 50.
- Family history: Breast cancer is a common condition, so people with the disease can often have other family members affected. However, around 1 in 20 women may have a faulty gene that increases their cancer risk.
- Lifestyle factors include smoking and alcohol
- Being overweight or obese
- Taking hormone replacement therapy or the oral contraceptive pill
- Having dense breast tissue
- Having early periods before the age of 12, late menopause, or no pregnancies. These all increase the amount of oestrogen exposure during your life which is associated with a higher breast cancer risk.
What should I do if I'm worried about breast cancer?
If you have found a lump or another breast abnormality, make an appointment with a Virtually Healthcare doctor. They will provide timely assessment, advice and tests.
Fortunately, many abnormalities and lumps aren’t caused by cancer, but the sooner you are checked, the better.
Diagnosis and Treatment How is breast cancer diagnosed?
Virtually Healthcare’s doctors can arrange investigation by ultrasound or mammogram or refer you to a specialist breast clinic for tests. Investigations include:
- Mammogram: Mammograms are types of specialist X-rays used for breast screening and the investigation of breast changes.
- Ultrasound: Ultrasound scanning can be used for younger women with denser breasts and look for changes in the armpit’s lymph nodes.
- MRI scanning
- Breast lump biopsy: If the investigations show an abnormality, the surgeon will take a biopsy. They will usually perform the procedure under local anaesthetic, sometimes using ultrasound to precisely target the area. The tissue samples are sent for analysis.
- Breast cancer typing: Molecular tests analyse genes within the tumour. The results can help with treatment planning, especially for predicting which post-surgical treatments are likely to be effective.
Surgery
You will usually have surgery to remove the cancer as the first line of treatment. You may also need further treatments to reduce the chance of the tumour recurring or spreading. The type of surgery will depend on the cancer.
Lumpectomy
Lumpectomy is surgery to remove the lump and some surrounding tissue while conserving the rest of the breast. The surgeon may also remove some of the lymph nodes in the armpit to check for cancer cells. This is called a sentinel lymph node biopsy.
Mastectomy
Mastectomy is surgery to remove the breast. The surgeon may just remove the breast tissue or extend the procedure to remove the armpit’s lymph nodes, where breast cancer can spread. In a radical mastectomy, the surgeon also removes the muscles under the breast. Your surgeon should discuss the best options for you.
Targeted therapy
Another type of receptor, Her2, is found in high numbers in 20% of breast cancers. It can drive the cancer cell to grow and spread. These receptors can be blocked by a drug called Herceptin.
What is the treatment for breast cancer?
Your hospital team will plan and co-ordinate your breast cancer treatment. However, the doctors, practice nurses and physiotherapists at Virtually Healthcare will be there to support you throughout your cancer journey.
The treatment for your breast cancer will depend on the type of cancer, the size of the tumour, the cancer position, and the stage of the disease.
Chemotherapy
Your oncology team may prescribe a combination of chemotherapy by mouth or intravenous injection. These powerful drugs can destroy any remaining cancer cells and prevent them from proliferating and spreading.
Radiotherapy
Radiotherapy is a type of targeted X-ray treatment. High energy radiation is precisely directed at the chest, killing cancer cells left behind following surgery.
Hormone therapy
Breast cancer cells frequently have receptors for the hormones oestrogen and progesterone. Your natural female hormones may bind to the receptors and drive cancer cell growth. Oestrogen blockers such as the drug Tamoxifen can block the hormone and reduce the risk of the cancer returning.
Hot topics in breast cancer care - One of Virtually Healthcare's GPs, with a particular interest in women’s health, reports on the questions and concerns that they are currently seeing in their consultations so that you can learn more about breast cancer and cancer risk. Cancer investigation and treatment during the pandemic
Too many patients have been worried about bothering doctors or afraid to access healthcare service during the pandemic.
There have been delays to many hospital treatments due to COVID-19, but we want to emphasise that the health professionals at Virtually Healthcare are ready to support you with all your healthcare needs.
We have designed a service that is quick, efficient and available in the comfort and safety of your own home. If you need a face to face appointment, we will ensure that we follow all COVID safety guidelines. Urgent cancer investigations and treatments are still an absolute priority during the pandemic, so if you are concerned about symptoms, make an appointment today.
Genes and breast cancer risk
About 1 in 20 women may have a faulty gene that significantly increases their risk of developing breast cancer. The genes BRCA1 and BRCA2 can be passed down through families. However, not everyone with a close relative with breast cancer will have the gene.
Not everyone with a faulty or mutated BRCA1 or BRCA2 gene will have a family history of cancer. However, a pattern of cancer makes it more likely. Macmillan gives these examples:
- A first-degree relative (parent, sibling or child) developed breast cancer at a young age before 40.
- Several family members have had breast or ovarian cancer.
- A male relative developed breast cancer.
- A relative had cancer in both breasts.
- You have a history of cancer in your family, and you are from an Eastern European or Ashkenazi Jewish background. Some types of BRCA mutations are more common in these ethnic groups.
- If you are worried about a history of cancer in your family, make an appointment with a doctor at Virtually Healthcare. They will be able to either provide reassurance or refer you for genetic counselling.
Types of consultations we offer
We offer written, telephone and video consultations with a range of male and female clinicians from GPs, nurse practitioners, and primary care specialists such as physiotherapy.
Telephone
Video
Written