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Sandra Melville, BSc, MRPharmS, is clinical pharmacist
at Lorn & Islands District General Hospital, Oban, Argyll,
and Lucy Heycock, MSc (cancer nursing), is a Macmillan nurse specialist
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Anatomical Travelogue / Science Photo Library
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SUMMARY
Breast cancer affects almost 42,000 people in the UK each year and there
are 12,700 deaths from the disease annually — it is the most common
cause of death in women between the ages of 35 and 55 years.
One in nine
women in the UK will develop breast cancer and although the incidence
is increasing, recent advances in prevention and screening together
with new treatments have resulted in improved survival rates.
Breast
cancer
also occurs in men, accounting for 1 per cent of cases in the UK.
However,
this series only applies to breast cancer in women.
Pharmacists, particularly in the community, are ideally placed not
only to give lifestyle advice about risk reduction, but also to
act as a valuable
resource for patients experiencing side effects during treatment. Full article PDF 80K
Risk factors for developing breast cancer
Age Incidence increases from one in 900 in those
under 30 years old to one in 10 in those over 85 years.
Oestrogen therapy Oral contraceptives slightly increase the
risk of breast cancer. Hormone replacement therapy increases the
risk of
breast cancer and decreases sensitivity of mammography.
Obesity Women who are obese, particularly post
menopause, are at increased risk. Adipose tissue is the main body
source of oestrogen
after menopause.
Menstrual and pregnancy history Early menarche, late menopause,
fewer pregnancies and shorter duration of breastfeeding are all
associated with increased risk.
Race Variations are seen with age and race. In women under 40
years old, Caucasian women are more likely than black or Asian women
to
develop breast cancer, while in women over 40 years black women
are at increased risk compared with Caucasian or Asian women. Asian
women
of all ages are at a decreased risk.
Family history A small proportion of breast cancers have a strong
genetic link. Carrying the BRCA1 or BRCA2 gene mutation leads to
a 50–80 per cent chance of developing breast cancer.
Height at age 14 Women who were taller than 165cm at the age of
14 years are at increased risk and those under 150cm at the age
of 14 years are at decreased risk. (Women in between these heights
are
at average risk.)
Birth weight Women who weighed over 4.43kg at birth are at increased
risk and those weighing less than 3.18kg are at decreased risk.
Socio-economic status There is a positive correlation between
risk and socio-economic status — those of higher status are
at greater risk.
Geographical location Women in urban areas are at higher risk
than those in rural areas. |
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The
Pharmaceutical Journal