Can I speak to a GP online about breast cancer?

The short answer is: “Yes please!” If you find any new lumps or changes to old lumps in the breast, we ALWAYS want to hear about it, even if you think it’s unlikely to be anything worrying. Neither us nor your NHS GP will EVER feel like you are wasting anyone’s time by booking an appointment about this. If the lump is tender and comes on before your period, it’s okay to wait to see if it goes when your period ends. Otherwise, get in touch.

If you’d like a longer answer, then please read on!

What is it?

There are lots of different causes of breast lumps that have nothing to do with cancer. The delightfully named but completely benign ‘breast mouse’ (fibroadenoma) for example: named this way (presumably the rodent comparison was made by an unenlightened soul years ago) due to the lump’s tendency to move away when one tries to place a finger on it. Or a blocked milk duct in a nursing mother. Or some hard, rocky-feeling ‘fat necrosis’, often left behind after a bruise settles. Or a plain old simple cyst. Or even normal glandular breast tissue.

The trick here (in case you missed it in my opening paragraph) is WHENEVER there is a new lump, GET IT CHECKED. There’s a good chance it may be one of the things listed above, but please don’t assume it is until you at least speak to a doctor, either online with us (https://checkuphealth.co.uk/) or at your doctor’s surgery. Especially if it persists past your period if you have periods, or more than 2 weeks if you don’t.

How to check?

Generally it’s best to check yourself just once a month. More often than this and it can be hard to notice changes. Less often and things may go missed for longer.

Ideally, first have a look in the mirror for any skin (dimpling, changes in texture) or nipple changes (pointing in where it used to point out, persistent nipple eczema, discharge).

Then have a feel of your breast eg with soapy hands in the shower. Use the flat of a few fingers together (picture HRH’s royal wave), rather than just fingertips. Some people prefer dividing the breast up into quarters and tackling a quarter at a time. However it feels most comfortable, have a gentle but firm prod round the whole breast. Make sure to cover the area under the nipple and all the way up the side of the chest to your underarm – yes, you have hidden breast tissue all the way up here (aka ‘the tail of Spence’ – named after the Dr James Spence who somewhat disappointingly did not have a tail himself, but was instead a Scottish surgeon in the 1800s).

Dr Sarah Jarvis MBE has done a great video for patient.info going through the self examination. Watch it here: https://youtu.be/vhuW8V84p4c

What are the causes?

While it’s harder to pin down the exact cause of any case of cancer than it is to pin the tail on a moving donkey after being spun in a high-speed tea cup ride, blindfolded in the dark on a boat in a storm… we do know that the following can affect one’s risk of breast cancer:

• Family history and in particular, certain genes (eg ‘BRCA1’ and ‘BRCA2’)
• Smoking
• Age
• Age at starting periods, being pregnant, menopause
• (Not) breastfeeding
• Being overweight
• Certain hormone treatments

For more details on these risks and others, check out https://www.breastcancer.org/risk

Diagnosis

A doctor can tell a lot just by the story of your symptoms and also through an examination. Sometimes though further tests are needed, such as:

• An Ultrasound Scan: Probe + jelly = grainy black and white images that can actually show quite a lot. Same sort of process as pregnancy scans.
• A Mammogram: Same type of machine as used for screening but more x-ray pictures taken of the area of concern.
• A Biopsy: Where tissue is removed from the area of concern/lump and examined under the microscope for a detailed assessment

Breastcancer.org has some fantastic resources that go through different possible tests and diagnoses in a lot more detail. Check them out if you’re interested here: https://www.breastcancer.org/symptoms/testing/types and here: https://www.breastcancer.org/symptoms/types

Treatment

Of course this depends very much on what exactly is found, how far (if at all) it has spread, what the aims of the treatment are, and the health of the individual. There are a lot of treatment options these days such as hormone therapy, chemotherapy, immunotherapy, and there may even be a combination of treatments suggested eg surgery plus radiotherapy.

Check out patient.info’s page for more details here:
https://patient.info/cancer/breast-cancer-leaflet#nav-6

The good news is that the outlook even for someone diagnosed with breast cancer is getting better and better with new types of treatment available. However, it’s still best when things are picked up earlier. So please do attend your NHS screening, and if you do notice anything new or strange, whether it’s a lump or a change to the skin or nipple area, pick up the phone and get in touch (via the app of course, we wouldn’t expect you to have to actually ring us unless you want to!).

Download the CheckUp Health app now and book a video or audio call with a private GP, daytime or evening, 7 days/week.