Your questions on breast care

17 October 2012

As one of our Specialist Nurse Advisors, Claire Davidson offers support and advice to our oncology members as a Dedicated Nurse, and worked as a breast care nurse within the NHS before joining our team. In our live chat, Claire was more than happy to address your queries on everything from checking for signs of breast cancer, to finding the right bra after a mastectomy...and everything in between, in a welcoming open discussion on breast care.

Here’s what Claire had to say:

Fiona asked:Hi Claire - what is the best way to check for signs of breast cancer, I recently saw a poster saying it wasn't just lumps and that there are 5 symptoms...but I'm unsure as to what

Claire Davidson:Hi Fiona, you would be looking for breast changes as well as breast lumps. Signs to look out for are discharge from the nipple, inverted nipples a change in shape of the areola and orange peel skin. Other signs can be itchy sore breasts and redness.

A Twitter follower asked:I want to know whether you get many cases of male breast cancer? If so, are the symptoms any different to female breast cancer.

Claire Davidson:Hi AXA PPP, As yet I have not had any men suffering with breast cancer there are currently around 370 men diagnosed each year in the UK. Many of the symptoms and treatment are very similar to the female symptoms.

If a gentleman has concerns he should check his chest in the same way a woman would checking for lumps, skin changes and discharge from the nipple.

AXAPPPhealthcare:Thank you Claire One of our members has recently had one of her regular breast scans. She wants to know how reliable these are? There have been stories about these scans sometimes not showing up a cancer but is this the case in your experience?

Claire Davidson:Hi AXA PPP, mammograms are usually very reliable at detecting cancer which is why they are offered as a screening scan. In my experience they are normally very successful at detecting cancer. However, if the lady is concerned that something has been missed an ultra sound can also be performed. As well as a FNA (fine needle aspiration) if there is a palpable lump.

Jen asked:Hi there - my friend has been told there may be a gene in her family that means she will have an 80% chance of getting cancer. She's only 23 and is reluctant to get tested, but says if she does have it she will want to have kids straight away so she can get a mastectomy/hysterectomy

Is this the case or does she have a few years before she needs to get this done?

Claire Davidson:Hi Jen, If your friend has been told she has a high chance of getting cancer she really should get tested. She should speak to her GP to get referred to a one stop breast clinic where they do genetic testing. She should get tested now

Your friend may not have the cancer gene but she should get tested if her mother and maternal Grandmother has a diagnosis of cancer.

Jen asked:Thanks - if she does have the gene will it be likely that she will develop cancer very young? Or does she have some time before she needs to get operations (mastectomy/hysterectomy) so she can start a family?

Claire Davidson:She would need to discuss the outcome with a specialist surgeon/oncologist. At the moment if it were discovered she were at a high risk of getting cancer surgery would be classed as preventative. So by doing this she would be greatly reducing her chances of developing cancer.

Jen:Thanks - I'll let her know and hopefully she will get tested

Claire Davidson:Jen, you are welcome your friend is very young and at present if it were discovered she did carry a high risk of cancer she should have time to start a family.

AXA PPP healthcare:Claire, what can someone expect when they have chemotherapy to treat breast cancer? I know it can vary from person to person, but for example, would you always lose your hair? Are you likely to feel nauseous?

Claire Davidson:Hi AXA PPP, Everyone is different and reacts different to treatment, the hair may thin instead of fall out there are cold caps that can help with hair loss. The patient would be given anti sickness drugs to combat sickness. Patients can also suffer with fatigue, mouth ulcers and pins and needles in the hands and feet.

AXA PPP healthcare:Thanks Claire:What exactly is a cold cap?

Claire Davidson:A cold cap that acts to cool the scalp and therefore restrict blood circulating in that area and reaching the follicles. The cap is put on fifteen minutes before chemotherapy to start restricting blood flow, and kept on during and up to 1-2 hours after your chemotherapy. This does mean that your time in the unit is longer.

Although this cap has been shown to reduce hair loss some patients can still lose their hair so it is not always successful. There are two widely available methods of scalp cooling. One method uses a hat known as a 'cold cap', which is filled with a gel that can be chilled. The hat must be fitted snugly around the head to work properly. The other method of scalp cooling uses a small refrigerated cooling system to pump a liquid coolant through a cap that is attached to a specially designed refrigerator

AXA PPP healthcare:Thank you Claire - we've just had a question about mastectomies. Is there anyone who can advise on the correct clothing to wear, to ensure you look as normal and confident as possible after a mastectomy?

Claire Davidson:When someone has had a mastectomy they will get a soft prosthesis and will be given advice on a good fitting bra. They will then be invited back by their breast care nurse to have a permanent bra prosthesis you can even get ones that you can wear to go swimming. The best place to get bras would be Marks and Spencer. They have a range specifically for women who have had mastectomies. When they have the bra prosthesis they can usually wear the same clothes they did before the surgery.

Linda asked:Yes I do. Claire I have a friend who has been diagnosed with breast cancer. I am finding it very difficult to talk to her about it. I don't want to avoid the subject but I don't know what to say. It is difficult when it is your friend. You try to be as normal as possible but things aren't normal are they? What should I do?

Claire Davidson:Hi Linda, my best advice would be to treat your friend the way you normally would. At the moment she has had to go through so much change so having her friend there the way she normally is will help more than you know.

Linda asked:I know you are right Claire and although it is difficult I will just have to try.

Claire Davidson:It will be difficult for you Linda you can let your friend know that you are there for her if and when she wants to talk about what she is going through. Keep up communications with her as you normally would. Continue to ask her out invite her round to your for dinner or offer to go over to her house.

Linda asked:One more thing Claire - will she loose her appetite when she starts her treatment. Is there anything that will help?

Claire Davidson:Hi Linda, she may feel nauseated which will decrease her appetite. Her Doctor will prescribe anti sickness medications to combat this. She should concentrate on eating food that she enjoys. Pineapple chunks will stimulate her taste buds as will other citrus fruits. She may also be given steroids to help boost her appetite.

A Twitter follower asked:What is the most common question you have been asked by people undergoing or due to undergo a mastectomy? What are their concerns?

Claire Davidson:Again everyone has different concerns. Some people are concerned about the size of the scar and how it will feel post op. The appearance seems to be a big concern for most of the patients I have nursed. Some women just want to look straight away where as other women want to wait and build up to looking in the mirror.