Page information and credit to Breast Cancer Foundation NZ & Breast Screening Health New Zealand - Te Whatu Ora

OCTOBER - BREAST CANCER AWARENESS MONTH

“What is it about breasts? Every second person in the world has them. They are odd looking, they’re for milk and your mother has them…” - As many will recall this was from the 1999 movie Notting Hill.

Yes, they are odd looking, and everyone has them, but for women this is a bit different. They change over time and age and it’s crucial that women get to know their normal.

BIG OR SMALL, LET’S SAVE THEM ALL!

Breast cancer is when abnormal cells in the breast begin to grow and eventually form a growth (tumour) which can spread within and beyond the breast. Anyone can get breast cancer, but it is most common in women. Breast cancer can often be found early on a mammogram, which can save lives and improve treatment outcomes.

BREAST AWARENESS

If you have breasts, you need to know what is normal for you.

92% of breast cancers are survivable when found early. Knowing the normal look and feel of your breasts can help you spot a change quickly.

KNOW YOUR BREASTS

Regularly check your breasts to know what’s normal for you. if you spot a change, get it checked by a doctor!

It’s as easy as TLC: Touch, Look, Check

There’s no ‘right’ way to check your breasts. But it's important to know your normal and check regularly for any unusual changes.

Your breasts will change over the course of a month. Overtime you will learn what is normal for you when you touch and look regularly.

If you’ve found something that doesn’t seem normal, it’s important to chat with your doctor.

TOUCH

Touch is about using your hands to feel for changes that aren’t normal for you. This may be a lump, thickened area, or anything that feels totally different from any other area in your breasts.

Standing or sitting

You can touch your breasts in a number of positions, wherever or whenever it suits.

It may be easier to check your breasts while you’re in the shower or bath, as your hands are wet. This makes it easier to slide your hand over your breasts.

An easy way to check your breasts is to:

Raise one arm above your head.
With the flat of your fingers press into your breast, feeling for any changes, softly at first and then more firmly.
Check the entire breast area, from your collarbone to under your breast, and from the side of your breast up into your armpit. A good way to do this is to move your hands over your breasts, in an up and down or in a circular motion. This is an easy way to make sure you’ve checked the whole area.
Repeat on the other breast

Lying down

If you have larger breasts, it may be easier to check when you’re lying down so your breast tissue is flatter.

Place a folded towel underneath one shoulder and put your arm above your head.
Using your other hand, check all over your breast, including the nipple, up to the collarbone and under your arm. Swap the towel to your other shoulder and repeat on the other side.

look

This is a very important part of TLC, as some breast cancers are detected by visual changes to your breast or nipples. Be aware of any discharge coming from the nipple (without squeezing).

With your hands on your hips, look at your breasts in a mirror. Notice their shape, colour and size. Then raise your arms above your head to check underneath the breast.

Check out the video above for more information on how to self-check.

check

It can be scary to find a change that doesn’t feel or look normal, but it’s important to get any concerning signs checked out by your GP, even if you’ve had a mammogram recently.

Most breast changes aren’t caused by cancer but check with your doctor to be sure. If you’ve had a breast change checked out by your GP and they aren’t concerned but it continues to grow or change, it’s important to go back and have it checked again or seek a second opinion.

If you’re not sure about talking to your GP, tell someone you trust, like a girlfriend or your mum. They can support you to see your GP. BCFNZ also has nurses available, who can give you free advice. Get in touch at 0800 226 8773 or breastnurse@bcf.org.nz.

MAMMOGRAMS

Find out when you should start having mammograms and why, and whether you can get them for free.

A mammogram is a safe, low-dose x-ray of the breast that can pick up very small breast cancers, well before a lump can be felt.

Women have a 95% chance of surviving breast cancer five years or longer if the cancer is detected by a mammogram. Because the risk of breast cancer increases as you get older, BCFNZ recommends women consider having regular screening from age 40. From age 45, you can book your free mammogram with BreastScreen Aotearoa! Freephone 0800 270 200

A screening mammogram is an x-ray of the breasts and is used to detect breast cancer before it shows any signs or symptoms. Early detection can reduce the chance of dying from breast cancer by approximately one third, as small, early cancers are easier to treat. Screen-detected cancers are also more likely to be treated without having to completely remove the breast.
Jackie Clarke, a wonderful BCF ambassadors, let the public tag along to her mammogram for the TV show Kiwi Living. Check it out here.
Book your mammogram with BreastScreen Aotearoa! Freephone 0800 270 200
You can have a free mammogram every two years if you’re an eligible woman aged 45 to 69 years, although the Government has announced they intend to progressively increase the age for free breast screening to 74. (The Government has committed to "progressively increasing" the upper limit to 74 and you can enroll when this age extension comes into effect.)
When you arrive at the clinic or mobile unit:
- give the receptionist your name and details
- read and sign a form to agree to have the mammogram.
When your name is called, you will be shown to a private area to undress and given a cape or gown to put on.
You will meet the person doing your mammogram (the medical imaging technologist — MIT). Let them know if you have breast implants, are on hormone replacement therapy or have a heart device such as a pacemaker.
Your mammogram will take around 20 minutes. The MIT will try to make you feel as comfortable as possible. If your last mammogram was painful or you have any questions or concerns, let them know.
- To get the best picture the MIT will need to flatten your breasts. Some people find it uncomfortable, but if it hurts, let them know straight away.
- They will ask you to stand close to the machine and hold very still for about a minute while they take the pictures.
- Normally they will take 2 pictures of each breast. But if you have large breasts they may need to take more.
- Your MIT will quickly check the quality of the pictures, then let you know your mammogram is finished.
Sometimes you will be asked to have another mammogram because the first one was not clear enough. This is just a technical check, not because an abnormality has been found.
Your results will be sent to you within 3 weeks.
The results will also be sent to your healthcare provider unless you ask them not to. Sending your results to your healthcare provider helps them stay up to date with your health.
If you have not heard from us
If you have not heard from us after 3 weeks, call the BreastScreen Aotearoa team, freephone 0800 270 200
If anything out of the ordinary shows up on your mammogram, they will ask you to come back for an assessment. This is when a radiologist (a doctor who specialises in reading mammograms) takes a closer look at what was found.
The assessment may include:
- having another mammogram
- an ultrasound scan of the area of interest
- a physical examination by a doctor
- a needle biopsy (taking a sample of tissue from your breast and sending it to the laboratory to be examined under a microscope).
Surgical biopsy
You may need a surgical biopsy. This biopsy is done under a general anaesthetic. If you need a surgical biopsy, they will make another appointment for you.
You should plan to be at your assessment all day. We know it can be an anxious time for you. You may want to bring a support person or whānau member to the appointment with you.
Your support person may need to stay in the waiting room during some of the tests, but they are welcome to take part in any of the discussions with you on the day.
they will let you know when to expect your results. If you have had a biopsy, they will make an appointment for you to see a specialist to talk about the results.
If your assessment shows you have breast cancer, we will help you choose a specialist who will provide advice and treatment.

BOOK NOW

RISK FACTORS

Some people have a higher risk of breast cancer than others. Know your risk and what you need to do.

1 in 9 women will develop breast cancer at some time in their life.

This is a lifetime risk, which means that for every nine women who live to be 85, one will have developed breast cancer at some time in her life. Your risk for breast cancer is influenced by many factors including gender, lifestyle and genetics.

Read more about what you can do, and discussions you might want to have with your GP.

Learn more HERE

LOOK AFTER YOUR BREAST AT ANY AGE

- Breast cancer is extremely rare in adolescent and teenage girls, but you might be worried about some of the changes going on in your breasts. In your early teenage years, you shouldn’t worry too much about your breasts; however, there are some things you can do to reduce your risk over your lifetime.
  - Maintain a healthy body weight. It’s important to develop good patterns of healthy eating early in your life. Avoid junk foods and eat plenty of fresh fruits and vegetables.
  - Regular exercise also reduces your risk. It’s important to continue to exercise regularly throughout your life.
  - Avoid alcohol and smoking as both of these contribute to cancer risk.
Breast cancer in your twenties and thirties is uncommon, it’s important to be aware of any changes in your breasts, and if they persist, have them checked by your doctor. A mammogram is not recommended as a regular screening tool for women under 40 (unless you know of an inherited risk).
- Be breast aware - know how your breasts normally look and feel, and regularly check for any unusual changes.
- Understand your family history of breast cancer. Talk with your family members on both sides of your family.
- Reduce your lifetime risk of breast cancer by adopting healthy lifestyle choices while you are still young.
Your risk of breast cancer begins to increase in your 40s. It’s time to consider screening mammograms. Breast cancers also tend to grow faster in younger women, so it’s important to be aware of any new breast changes.
- Consider starting mammograms at 40. You’re not eligible for free mammograms until age 45, so you’d need to pay for them yourself at a private radiology clinic.
- Enrol for your free 2-yearly mammograms with BreastScreen Aotearoa from age 45 and alternate these with private mammograms.
- Understand your family history of breast cancer. Talk with your family members on both sides of your family.
- Be breast aware - even if you’re having regular mammograms, it’s still very important to check your breasts regularly.
Most breast cancers occur in women over 50 years of age. It’s important you keep up to date with regular mammograms after turning 50.
- Keep up to date with your free 2-yearly screening mammograms with BreastScreen Aotearoa.
- Be breast aware - even if you’re having regular mammograms, it’s still very important to check your breasts regularly.
- Adopt healthy lifestyle habits to help reduce your risk of breast cancer.
Be aware you are still at risk of getting breast cancer. In fact, your breast cancer risk is higher at 70 than it is at 50.
- Continue with your regular screening mammograms. Currently, mammograms in this age group are not publicly funded, so if you want to continue having mammograms into your 70s you will have to pay for them yourself. (The Government has committed to "progressively increasing" the upper limit to 74 and you can enrol when this age extension comes into effect).
  Even if you’re still having regular mammograms, it’s important to check your breasts regularly for any unusual changes.

BREAST CANCER

If you’ve been diagnosed with breast cancer you’re bound to have questions.

Outlined is the essential information, from diagnosis all the way through to treatment, to help you understand what you’re going through.

BREAST FACTS

Breast cancer occurs when abnormal breast cells grow in an uncontrolled way, usually forming a tumour.

Breast cancer is most likely to occur in women over the age of 50, but young women and men can get it too. It's most treatable when it’s found early, so it's important that you know what to look out for.

What is breast cancer?

Breast cancer is the result of abnormal gene “mistakes” or mutations, which are usually acquired over time as we age. These mutated cells grow and multiply in an uncontrolled way. Read more HERE

Breast cancer in NZ

Breast cancer is the most common cancer for Kiwi women and the third most common cancer overall. We cover some fast facts, age risks and diagnosis rates. Read HERE.

Breast anatomy and development

To understand breast cancer, it’s important to know what makes up healthy breasts, and how they develop. Read more HERE

Men get breast cancer too

For the most part, your treatment will be the same as it is for women with breast cancer. Find out what to expect through diagnosis, treatment, and life afterwards. Find out more HERE

TYPES OF BREAST CANCER

Everyone’s breast cancer is different.

Your treatment pathway and prognosis will be influenced by many factors, from the cancer’s size and spread to your own age and sex.

What type of breast cancer do you have?

DCIS and LCIS
This type is sometimes called pre-invasive or Stage 0 cancer. Find out what this means for you.
Invasive breast cancer
Learn about your kind of invasive breast cancer, and what this means for your treatment.
Receptor status
The results of these tests will indicate whether certain treatments, particularly hormone therapy and targeted treatments, might be appropriate for you based on the receptor status of your breast cancer. You will receive your receptor status information in your pathology report.
Breast cancer in young women
If you’re a young woman recently diagnosed with breast cancer, you’re not alone. Learn more HERE

TEST & DIAGNOSIS

If you've been recalled after a mammogram, you'll need to go through a few more tests.

This will involve a clinical breast examination and an ultrasound or extra mammogram views to clarify the nature of something which was seen on your screening mammogram. A biopsy may be necessary to diagnose an unusual change or lesion in your breast.

It's important to know most women recalled for assessment don't have breast cancer.

Although most breast changes are a result of benign (non-cancerous) breast conditions, a proper assessment is essential for an accurate diagnosis.

You will be referred to a breast specialist for a clinical examination of both breasts, further imaging as appropriate and if necessary, a biopsy which removes cells or a small amount of tissue for diagnosis. This is known as the Triple Test.

The Triple Test

The most reliable way to diagnose breast cancer is through a 'triple test'. Learn more about this process and what to expect. LEARN MORE

Understanding your pathology report (FULL REPORT HERE)

After your tumour is removed during surgery, it’s sent to a pathology laboratory for analysis. The pathologist will compile a report of the findings and your breast specialist will discuss the results with you. Learn more about what information your pathology report will contain. LEARN MORE

Breast cancer stage & grade

Every breast cancer diagnosis is given a stage and a grade. These, along with the type of cancer, help to determine what treatment is best. LEARN MORE

Gene expression profiling

Pathologists use tests to determine the size, stage, grade, lymph node involvement, and receptor status of a tumour. LEARN MORE

TREATMENT OPTIONS

After you've been diagnosed, your specialist team will meet to review your pathology results and plan a course of treatment.

This is known as a multidisciplinary team meeting (MDT) and is attended by the clinicians involved in your diagnosis and treatment. This would normally include your surgeon, a radiologist who views and reports on the imaging, a pathologist who reports the findings from the surgical specimen, a medical oncologist who assesses the need for chemotherapy and/or hormone therapy and a radiation oncologist who advises whether radiation therapy is necessary. Breast care nurses and radiographers will also usually attend these meetings.

Your specialist will discuss the recommendations with you afterwards and then you can decide on the option that you feel most comfortable with.

Treatment for breast cancer can be given both locally (surgery and radiation therapy) and systemically (chemotherapy, targeted therapy, hormone therapy).

Each treatment plan is individualised, as no two cases of breast cancer are exactly the same. It is important to understand why a particular treatment plan has been recommended for you and what the expected outcomes and possible side effects are. Many people find that it helps to take a friend or family member to appointments to help remember what is discussed, and to take notes.

Cancer treatments can be complex so don't be afraid to ask for clearer explanations. Remember that no treatment is undertaken without your consent.

Follow the link below to learn more about the types of treatments options available and questions to ask.

Learn more