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19th July 2024
Breast Cancer: Expert Advice from Prof. Malcolm Kell
A breast cancer diagnosis can often be worrying so understanding what follows your diagnosis can help to quell any confusion or fear you may be feeling.
At Mater Private Network, treatment plans are discussed among our multidisciplinary team of experts in cancer treatment. Once the team agree on the optimal approach, your consultant will discuss this approach with you to ensure that you are comfortable with, and fully informed about, your treatment options.
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Signs of breast cancer
Before discussing treatment for breast cancer, it is helpful to understand the signs and symptoms to be aware of.
Common breast cancer symptoms include:
- A change in size, shape or swelling of the breast: one breast may become larger than the other.
- Changes in the nipple: in direction or shape, pulled in or flattened, or unusual discharge.
- Changes on or around the nipple: a rash, flaky or crusted skin.
- Changes in the skin: dimpling, puckering or redness.
- Swelling in your armpit or around the collarbone.
- A lump, any size, or thickening in your breast.
- Constant pain in one part of the breast or armpit.
Prof. Malcolm Kell, Consultant Breast Surgeon at Mater Private Network in Dublin, recently highlighted the importance of understanding these symptoms and being able to identify them on Basically…with Stefanie Preissner.
He said: ‘Self-examination for patients is a very important thing to do. You can check your breasts once per month or pick a day in your menstrual cycle. Do what is normal for you. Become familiar with the area around your breast, under your armpit, to the top of your arm.”
If you do find something that you believe to be unusual during a self-examination, be mindful that it may not be cancer. Prof. Kell explained: “If you are wondering whether you have a lump, I advise to leave it for six weeks and reexamine yourself. If it is persistent and abnormal for you, then have it examined by a medical professional. If you are concerned about waiting, it is important to understand that a month or six weeks is a very short period in the lifespan of any cancer. For most patients, if you wait six weeks and reexamine the area where you found the lump, it will not be there.
“If you are checking for lumps you should be aware that the breast is also normally lumpy or nodular. There is the surface of the breast, and you have a line of fat in front of that. If patients have lost weight, they can feel lumps, but they are likely not concerning lumps. They may be feeling parts of their breast that they may not have felt before because fatty tissue was masking it.
“Another thing to be aware of is that throughout your menstrual cycle, the effect of oestrogen increases fluid volume in the breast and tension in the breast tissue. This can cause some discomfort.”
If you experience any breast cancer symptoms that are persistent, you should seek medical attention. If after medical investigation you are diagnosed with breast cancer, your consultant and care team will discuss your treatment options with you.
Breast Reconstruction
Breast reconstruction is an option for women who require a mastectomy. For some women, it helps them to feel more like themselves again.
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Is surgery the first step in breast cancer treatment?
If you are diagnosed with breast cancer, it is likely that you will require a surgical procedure to remove cancerous breast tissue.
Prof. Kell said: “For most patients, surgery is the first option for treating breast cancer. Patients can also have chemotherapy or radiotherapy, depending on their specific case.
“With BreastCheck in Ireland, most breast cancer cases are diagnosed at an early stage. By doing a simple surgical procedure known as a lumpectomy, we remove less than 5% of a patient’s breast tissue. With this procedure, you do not lose much volume in your breast.
“During this routine surgery, we move some of a patient’s own breast tissue into the area where we removed the cancerous tissue. It is a very simple technique, which means patients do not require a more complex reconstruction. Most cases are like this.”
There are rarer cases in which you may require more complex surgeries. Among them are cases in which gene mutations are identified which suggest that you may have a higher likelihood of developing breast cancer. In these cases, you may opt to have surgery to remove one or both of your breasts to decrease the likelihood of developing cancer.
There have been high profile cases of this in recent years, as Prof. Kell explained: “Angelina Jolie is the most notable celebrity who had a BRCA mutation. The two most common types of this mutation are BRCA1 and BRCA2 and they indicate that a person may have a genetic predisposition to cancer. She probably had a lifetime of incidence of 80% of developing a breast cancer.”
If you require a more complex surgery, your consultant will discuss with you the specifics of the surgery you require to outline the aims and potential outcomes of the surgery in the context of your overall treatment plan.
