• Hyde Palk Walk
• The number of women under 50 diagnosed with breast cancer each year in the UK has exceeded 10,000 for the first time
• A study suggests women with breast implants may be diagnosed at a later stage than women without

Hyde Palk Walk
The Hyde Park Walk is now only a month away (on 9^th June 2013) and we are getting excited! Hundreds of walkers and runners will be helping us to celebrate our 25^th Anniversary and to show support for women with breast cancer – we’d love you come along and join in as well. The walk is a beautiful 10k route through Hyde Park. To enter, all you need to do is fill out an entry form, which can be found on our website.

If you have any questions or need extra entry or sponsorship forms, please contact Holly on h.lovering@cancerkin.org.uk or call 0207 830 2323.

The number of women under 50 diagnosed with breast cancer each year in the UK has exceeded 10,000 for the first time
New statistics from Cancer Research UK has shown that 10,068 women under the age of 50 were diagnosed with breast cancer in the UK in 2010. This was the first time the figure had exceeded 10,000 and represents an 11 per cent increase since 1995, when the number of diagnosed in the same age group was 7,712.

This rise in younger patients developing breast cancer contributed to an overall increase in diagnosis rates among women of all ages.  The total number of women diagnosed each year is now approaching 50,000.

The reasons for the increasing rates of breast cancer in this group are not clear, but it’s thought that increasing alcohol intake and hormonal factors such as having fewer children, having them later in life and increased use of the contraceptive pill may be playing a role.

However, the statistics also show that fewer women under 50 than ever before are dying from the disease. In the early 1990s, the mortality rate from breast cancer in women under the age of 50 was nine per 100,000 women in the UK. By late 2000, this had fallen to 5 in every 100,000. More than eight in 10 women diagnosed with breast cancer before the age of 50 now survive their disease for at least five years. This is thought to be due to better treatment.

Sara Hiom, Cancer Research UK’s director of health information, said: “Breast cancer is more common in older women but these figures show that younger women are also at risk of developing the disease. Women of all ages who notice anything different about their breasts, including changes in size, shape or feel, a lump or thickening, nipple discharge or rash, dimpling, puckering or redness of the skin, should see their GP straight away, even if they have attended breast cancer screening. It’s more likely not to be cancer but if it is, detecting it early gives the best chance of successful treatment.

“The number of cases in women under 50 diagnosed with breast cancer is increasing slowly, but thanks to research, awareness and improved care more women than ever before are surviving the disease”.

Tara Beaumont, Clinical Nurse Specialist at Breast Cancer Care said: “The increasing incidence of breast cancer in women under 50 reflects the growing incidence overall.

“Though it is not fully understood why the rates of breast cancer in this age group are rising, it is extremely encouraging to see a continuation of the downward trend in breast cancer mortality.”

For more information, please see Cancer Research UK, the Telegraph and Breast Cancer Care.

Study suggests women with breast implants may be diagnosed at a later stage than women without
A study which suggested that women with cosmetic breast implants who develop breast cancer may have a greater chance of dying from the disease was widely reported last week. As the NHS response shows, it is important to stress that the research the media has reported does not suggest that breast implants cause breast cancer.

The research, published in British Medical Review, focused instead on whether breast implants cause a delay in diagnosis in women who have breast cancer, which may increase their risk of dying from the disease. To test this, the researchers analysed the results of a number of small studies, which considered whether having cosmetic breast implants was associated with a delay in diagnosis.

They found that women with implants had a 26 per cent increased risk of being diagnosed at a later stage of breast cancer than women without. When they considered another five studies that dealt with outcomes, they found that women with implants had a 38 per cent higher risk of death from breast cancer than those without.

They suggest these results may be due to the implant material obscuring breast tissue examined by mammography. Even though there are screening techniques to compensate, both silicone and saline-filled implants create radio-opaque shadows, which mean some of the breast tissue is not visible on the film. This could mean breast cancers are detected later, which often leads to worse outcomes.

However, as the researchers themselves point out, the results of this analysis should be viewed with caution as the review had several limitations. First, only a few studies were available.  Another concern is that the quality of some of the evidence was impaired by poor study methodology. For example, the section on outcomes was based on only five studies. Of these, three did not adjust their results for the woman’s age at diagnosis and all five remained unadjusted for the women’s BMI – both  important potential confounding factor that means the results should viewed cautiously.

As Dr Caitlin Palframan, of Breakthrough Breast Cancer, said: “Although it shows reduced breast cancer survival rates among women who had breast implants at the time of diagnosis, the findings are not conclusive and more research is definitely needed before we can fully understand the effect of breast implants on survival.

“We know there is some concern about whether breast implants make breast cancer more difficult to detect by mammogram, which could delay diagnosis, so we encourage women attending mammograms to inform their screening service that they have breast implants to ensure that all breast tissue is completely examined.

“Early detection offers the best chance of successful treatment, so we urge every woman with or without implants to be breast aware by regularly checking their breasts for any changes.”

Julia Frater, senior cancer information nurse at Cancer Research UK, also commented on the need for further research, saying: “This research suggests that breast implants may make cancer harder to detect, leading to later diagnosis. But it needs confirming in larger studies.”

For more information, please see the Guardian or the NHS website.

• Patient Support Group
• Research has found that women with breast cancer in poorer areas are less likely to be diagnosed quickly
• Further research has indicated that drugs, including tamoxifen, could be used to prevent breast cancer developing in average and high-risk women

Patient Support Group
This week we welcomed Yvette Cowles to our Patient Support Group. A belly dancer and comedienne who has been diagnosed with breast cancer three times, Yvette has written her own one-woman show, which offers a fresh perspective on breast cancer, body image, belly dancing and sisterhood through a blend of dance, drama and clowning (and a lot of sequins!). The show will be touring across the country, including two performances at the Rosemary Branch, Islington, for which Yvette will kindly be donating a percentage of the profits to Cancerkin.

As well as giving us a small indication of what we can expect from the show, Yvette also gave the class a taste of belly dancing. She had brought a collection of hip scarves with her and all the women that attended were given the opportunity to dress up and have a go. Everyone joined in and it was so lovely to see the room was full of women shimmying, jangling and laughing together. Feedback was incredibly positive, with comments including “it was relaxing, got me motivated!” and a very vocal call for belly dancing classes at Cancerkin!

Photos of the session will be put up very soon on our website and facebook page, so keep an eye out for them!

Research has found that women with breast cancer from poorer homes areas are less likely to be diagnosed quickly than more affluent women
Researchers from the University of Leicester have found that poorer women with breast cancer are less likely to be diagnosed quickly than women from affluent homes.

The study looked at nearly 21,000 women diagnosed with breast cancer and found that fewer women in the more affluent groups were diagnosed in the later stages, across all ages. As early diagnosis greatly increases the likelihood of surviving the disease, they estimated that 454 deaths could have been postponed beyond five years by eliminating differences in the stage at which breast cancers were diagnosed.

The researchers suggested that one reason for the different survival rates might be that women from deprived backgrounds delay reporting symptoms to their doctors. This may reflect differences in awareness, but could also be due to psychological barriers, such as fear of wasting doctors’ time and fear of dying, or impressions of cancer incurability.

Jayant Vaidya, reader in surgery at UCL and a consultant surgeon who specialises in the diagnosis and treatment of diseases of the breast, said: “If all women were diagnosed earlier, it would also mean they would need less-aggressive treatment, with fewer side effects. We know that radiotherapy, for example, can adversely affect the heart, an effect that is particularly important when cancers are diagnosed early.

“I don’t believe access to the treatment is different between classes in the UK, but it may be a combination of factors. The less deprived are generally more health-conscious – eg take more exercise, eat sensibly, and have a more disciplined lifestyle – and this could affect the outcome from cancer.”

Nick Ormiston-Smith, statistics manager at Cancer Research UK, said: “This research provides further evidence that deprivation affects a woman’s chance of surviving breast cancer. More needs to be done to tackle this inequality to ensure everyone has the same chance of surviving breast cancer, no matter where in the country they live.

“Diagnosing and treating the disease earlier is key to improving a woman’s chance of surviving, and we must ensure this is a reality for all”.

For more information, please see the Independent website.

Cancerkin believes that everyone should be aware of the signs and symptoms of breast cancer and comfortable about discussing any concerns with their GP. So we organise free breast awareness talks across East London. If you know of a community group or organisation that you feel would benefit from this, please contact Anisah on 020 7830 2310 or email her on eastldn@cancerkin.org.uk.

Further research has indicated that drugs, including tamoxifen, could be used to prevent breast cancer developing in women with a high risk of developing the disease
A study published in the Lancet has shown that tamoxifen and three similar drugs used for osteoporosis can significantly reduce the incidence of breast cancer in women at risk from the disease.

Researchers considered medical records for 83,000 women taking the pills, monitoring the effect of taking the drugs for five years and then for a further five years after the treatment was stopped. Known as selective oestrogen receptor modulators, these drugs work by interfering with the action of proteins known as oestrogen receptors, and, in doing so, prevent oestrogen from encouraging cells to divide. They are currently used to treat some cases of breast cancer, but are not available to women who have not yet been diagnosed because of concerns about treating patients unnecessarily.

This study found that during five years of treatment, the incidence of breast cancer among women using the drugs was 42 per cent lower than in a similarly high-risk group who were not treated. Women in the treated group were also 25 per cent less likely to develop breast cancer in the five years after they stopped taking the pills.

Lead researcher Professor Jack Cuzick, of Queen Mary, University of London, said: “These are very encouraging results and pave the way for more widespread use of these drugs in high-risk women in a manner similar to the way statins and blood pressure-lowering drugs are used to reduce the risk of heart disease and stroke.”

The study also showed that all four drugs significantly increased the risk of blood clots, and Tamoxifen was also associated with an increase in the rate of womb cancers.

As we reported in January, the National Institute for Health and Clinical Excellence (Nice), which examines the cost-effectiveness of new treatments, provisionally recommended that tamoxifen should be given to women at high risk of breast cancer. Nice is due to issue its final guidance later this year.

Hazel Nunn, head of health information at Cancer Research UK, said: “These results provide some of the clearest evidence to date of the ability of these drugs to prevent breast cancer. The study also offers clarity on the frequency of side-effects that can be expected from these drugs. Breast cancer is the most common cancer in the UK, and research like this has the potential to reduce the number of women diagnosed with the disease in future.”

Dr Caitlin Palframan, from Breakthrough Breast Cancer, said: “Draft guidelines from Nice recently took the historic step of recommending drug treatment to reduce the risk of breast cancer in women with a significant family history of the disease. Importantly, this may provide women with an alternative to risk-reducing surgery and we’re pleased to see that the findings of this study further support this recommendation.”

Nice’s final guidelines are expected to be announced in June.

For more information, please see Cancer Research UK, the Telegraph or the Guardian.

Holly Lovering                                                                                                                         2^nd May 2013

• Patient Support Groups
• East London Awareness Events
• Research has shown that women would rather go for screening than risk missing a cancer that could be treated, despite the risk of overdiagnosis

Patient Support Groups
The next Patient Support Group will take place at the Cancerkin Centre on Tuesday 30^th April, from 11am to 1pm. We will be joined by Yvette Cowles – comedienne, belly dancer and breast cancer patient. Yvette previously gave an inspirational talk (and belly dancing lesson!) to the Young Women’s Support Group and we are delighted that all our women will now have the opportunity to hear her story (and maybe join together in a little laughing and dancing!).

Another date for your diary is Tuesday 25^th June – the date of June’s Patient Support Group – where our guest speaker will be Dr Anmol Malhotra, Lead Imaging Consultant at the Royal Free Hospital. Dr Malhotra will be discussing current and future developments in breast imaging. Please note that the session will start at 2.00pm and finish at 4.00pm (rather than the usual 11.00am – 1.00pm).

If you would like to book your place at either of these groups, or just want more information, please contact Reema on 020 7830 2323 or email r.ved@cancerkin.org.uk.

East London Awareness Events
Anisah and her Awareness Ambassadors, Marisa and Afaf, have been very busy in East London this week, giving awareness talks at both the Wally Foster Community Centre in Hackney and the Lincoln and Brudette Centre in Tower Hamlets.

At the Wally Foster Community Centre, the team spoke to their Forever Young Over 50s Group. 14 women came to hear the breast awareness message and were very animated and engaged in the discussion. Tea, biscuits and a chance for a more relaxed question session followed the talk.

The talk at the Lincoln and Brudette Centre was more informal. Anisah set up a breast awareness stall at the centre’s Parent’s Forum toddler group, and everyone was able to stop by and find out more information as their children played. 12 young women attended and all were very interested in the information, and keen to learn the signs and symptoms of breast cancer.

We would like to thank Angie Melaniphy and Tarra Canum at the Wally Foster Community Centre and the Lincoln and Brudette Centre respectively, for inviting us and being such excellent hosts. If you know of a community group that would welcome a talk, or if you just want more information, please contact Anisah on 020 7830 2310 or email eastldn@cancerkin.org.uk.

Research has shown that women would rather go for screening than risk missing a cancer that could be treated, despite the risk of overdiagnosis
Following on from the Independent Breast Screening Review (which we reported on in November 2012), Cancer Research UK funded a study to look at the attitudes of British women towards overdiagnosis in breast screening. The research suggested that although women are surprised to learn that breast screening can lead to overdiagnosis, they would still rather go for screening than take the risk of missing a cancer that could be treated.

The study, published in BMJ Open, carried out focus groups with 40 women to explore their existing knowledge and experience of overdiagnosis. All the women were in the mammography screening age range (aged between 50 and 71) and none had a personal history of cancer or worked in occupations related to cancer or cancer screening. The study included women who had already attended screening and others who had not.

All the participants were given information on breast screening and overdiagnosis – the possibility that a proportion of slower-growing cancers detected through screening might never cause a problem in a woman’s lifetime – before being invited to discuss this information.

The researchers found that although women were initially “surprised and shocked” to discover that breast screening could result in cancers being found that might not ever have needed treatment, the majority of participants remained positive towards breast screening, noting that they preferred the risk of over-treatment and side-effects to under-treatment.

The study also found that many women had difficulty in understanding the concept of overdiagnosis, believing it was mainly an issue for treatment decisions rather than one which would affect their decision about whether or not to go for screening.

Dr Jo Waller, study author, said: “Our research is the first of its kind to look at the attitudes of British women towards overdiagnosis in breast screening.

“We found a widespread lack of awareness of overdiagnosis and a strong view that the information was important, although it rarely changed women’s beliefs about the value of screening or their decisions about attending in the future.

“Our study also highlighted the difficulty of communicating risk information about cancer screening. Population-level data and statistical modelling are difficult even for medical experts to understand, and more so for individuals to use to weigh up the personal pros and cons of screening.”

Dr Hannah Bridges, from Breakthrough Breast Cancer, said: “Breakthrough believes women should have the full picture on breast screening to help them confidently make a decision about whether to attend, so it’s encouraging to see this study add support to this approach.

“In the future we hope to see better tests to reduce unnecessary treatment, and our researchers are working to develop ways to predict which breast cancers won’t grow and cause problems. But in the meantime, we know that screening saves lives, and evidence shows that, overall, the potential benefits of routine breast screening outweigh the risks.”

For more information, please see the Cancer Research UK and Breakthrough Breast Cancer.

Holly Lovering                                                                                                    25^th April 2013