UK women of all ages are being urged throughout October to be more breast aware and make sure they regularly check themselves for signs of cancer.

With a study from a leading charity revealing only around 40 per cent of women examine their bodies frequently it is more important than ever to raise greater awareness of the issue. Furthermore, of those that do check themselves regularly, only 40% feel confident in what they’re doing when they’re examining their bodies. This lack of confidence could be fuelling anxiety about breast cancer which remains high amongst many women and is often out of proportion with the actual risk they face.

New research shows around eight out of ten women under 25 years of age over estimate their risk of getting breast cancer. Conversely a significant figure of older women (70%), whose chances of getting breast cancer is statistically greatest, have underestimated their own risk.

Ultimately, the key message to women of all ages across the UK is not to panic but to make sure they DO check their breasts for any abnormalities on a regular basis to reduce anxiety and instil more confidence in women. As such, new device Breastlight aims to reassure women during their touch, look and check breast awareness routines.

Log on to our live and interactive webTV show to hear from Dr Sarah Burnett, consultant radiologist at London’s King Edward VII Hospital, who’s survived 11 tumours after being diagnosed with breast cancer at the age of 43. She will be joined in the studio by Lieva Nation, Breastlight Nurse Advisor, who will answer your questions about breast cancer, including how to check your breasts properly, recognise the symptoms, common risk factors andhow to cope with a positive diagnosis. It is essential advice that no woman can afford to be without.

Dr Sarah Burnett, breast cancer survivor, and Lieva Nation, Breastlight Nurse Advisor, join us live online to discuss breast cancer.

For more information visit www.breastlight.com

H: Lis Speight, host
S: Dr Sarah Burnett, breast cancer survivor
L: Lieva Nation, Breastlight Nurse Advisor

H: Hello and welcome to the Healthcare Show, I’m Lis Speight. A recent study revealed that less than half of women frequently examine their breasts, and many women lack confidence in knowing what their looking for, which is no doubt fuelling anxieties about breast cancer. One in nine women is likely to be affected by the disease, but the key message is not to panic. Well joining me today to discuss this is Breast Cancer survivor and consultant radiologist Dr Sarah Burnett

S: Hello

H: Welcome along Sarah, really nice to see you today, and also Lieva Nation, who is Breastlight’s Nurse Advisor, welcome along, thanks for coming today. But let’s talk a little bit more about this research that’s been done – why are women so uncertain, so sort of lacking in confidence about examining their own breasts

L: Sorry

S: I was going to say I think there’s two things – about ten years ago us doctors used to go to everyone and we’d say this is the way that you examine your breasts, and you do it once in the month, you do it in the shower, you do it lying down, and we were giving quite clear instructions, but now, partly to take the emphasis away from just lumps, because that was what it was all about, the instructions that women are getting are perhaps a little bit more – vague, really for want of a better term, so I think people are very unsure now about how to go about examining their breasts, what they should be looking for, you know what’s the difference between touching, looking and checking – the TLC campaign that’s about, and also women are scared, and they’re scared of that moment when you put your hand on your breast and you think “Oh my God there’s a lump there that wasn’t there beforehand.”

H: So Lieva what should we be looking for?

L: Anything at all that’s different to what you’ve seen before. It’s knowing your own body. You’re the best person, you’re in charge of your body. Most women don’t go around examining other women’s breasts, so what’s normal? It’s what’s normal to you is the important thing. We see pictures in magazines of women, and they usually perfect bodies- what we interpret as perfect bodies, but we’re not all like that. You can put a chart up for people of 30, 40 different shapes and size of breast, and they’re all perfectly normal, so it’s knowing your own body –

H: And then you know if there’s a change –

L: If there’s anything at all that’s different to your –

H: Or if there’s something different. So you should start young –

L: Yes start – start, same as you do for most things, start 18, 19 just doing it on an irregular basis, just knowing your body as you grow obviously your body’s going to change. You’re not going to stay looking an 18 / 19 year old shape or size, but knowing your own body as it changes, month after month

H: Ok. But it’s not the 18 and 19 year olds that are necessarily at risk. Who is most at risk of breast cancer?

L: The biggest statistics are the over 50s, but the people that sort of have a big worry are the 35s – 50s. Once you get to 50 you go for regular mammograms and if you have them done regularly, hopefully everything is fine and it’s caught quickly. It’s the women between 35-50, they always hear about other people, a friend of a friend whose had a problem, and they’re the ones thinking what do I do? Where do I go? I’m not sure how I should examine myself

H: Sarah you’ve actually been through this haven’t you?

S: Yes absolutely

H: Tell us about your story. You were quite young really?

S: I was, I was quite young

H: You still are quite young

S: Thank you! I was 43

H: Right

S: But I was screened from an early age because my mother had breast cancer, and obviously as a radiologist it was very easy for me to go, and go to the girls in the mammography department – can you squeeze me in?

H: So in a way you were lucky

S: I was terribly lucky. I mean my mother felt so guilty that she’d sort of given me these bad genes, but if she hadn’t had the breast cancer, and she’s still – 25 years later absolutely fine – then I wouldn’t have known to be looking. And I actually had 11 tumours at the time of diagnosis

H: Oh goodness

S: And if I’d waited until any of those were actually big enough to feel, then I think my outcome would be very different from what it has been

H:So what was your treatment then, what did you have?

S: I had a mastectomy and immediate reconstruction. They took some of the lymph nodes out of the glands in my armpits so –

H: So it had already spread –

S: No it hadn’t, they take them out to check

H: Right, ok

S: And obviously that’s quite a key prognostic factor is whether the lymph nodes were involved, and how many of them are, but they, thankfully, were all clear and then about two weeks after the surgery I started chemotherapy which I had for 5 months

H: Oh goodness – was that hideous?

S: Wasn’t as hideous as I thought it was going to be. I thought being bald was going to be a nightmare, and it wasn’t, it just meant I had to wear a bit more make-up than I do now, and do really big earrings! And the worst thing was the tiredness

H: Right

S: I didn’t particularly feel sick or anything, and also contrary to popular belief you put on a huge amount of weight because you’re just not physically able to go and do things, and the anti-sickness drugs are so good now that you eat normally, but your metabolic rate is terribly low

H: Is different. So is it hereditary? We’ve had some questions on this actually

S: Yes

H: Charlotte sent one in, she said “my mum died of breast cancer, does this put me at greater risk of getting the disease?”

S: It very much depends on the age at which your mum had it

H: Right

S: So if your mum had breast cancer at any age you’ve got a marginally increased chance of getting breast cancer

H: Ok

S: But probably not significantly over that 1 in 9 chance that we all have anyway. If your mum had it at – around the time of her menopause, then your risk is increased again

H: Ok

S: And the worst case scenario is if your mum had it before her menopause, in which case you should really be screened, and you can be offered a mammogram from 10 years below the age at which your mum got it

H: Oh that’s interesting ok so there is help out there. Treatment is getting better

S: It’s sketchy. A lot of GPs still aren’t kind of focused on what the actual policies are but that’s certainly what breast cancer specialists would recommend

H: But early diagnosis is key, isn’t it Lieva?

L: Yes it’s finding it – the quicker you find it the quicker you can get cured, and it’s the people that – if you’re finding at the very beginning the chances are one in – I’ve forgotten my statistics now,

S: For an early cancer 90% of women will be cured, depending on the grade, how aggressive it is

H: Right

S: But if you catch it once it’s spread beyond the lymph nodes in the armpit, to the bones or the liver perhaps, then you’ve only got a 10% chance of being cured

H: Right. So try and get it as early as you can

S: Absolutely

H: That’s the key. Ok let’s move on to some more of your questions, we’ve had one in from Sarah Bertelotti, she said “what is the risk if you’re in your 40s? I don’t get a mammogram and have to admit I don’t regularly check at home?”

S: You have a 1 in 50 chance of getting cancer before the age of 50 and obviously the closer that you get to the age of 50 the higher that is. Now there’s been an increase of some 2000 cases of breast cancer a year over the last 2-3 years, so we used to say 44,000. It’s not gone up to 46,000 and I think anecdotally most of the 2-3000 is in that sort of pre-menopausal age group

H: Right

S: So it’s very, very important for women in their 40s to check

H: Ok. So we need to check our breasts. We all know we should do it. We do it now and then don’t we, a lot of us? Speaking for myself, but we still don’t really know what we’re looking for, because until you’ve had it, you don’t really know what it is. So Lieva what would your advice to women be?

L: Best time to check your breasts is usually immediately after a period

H: Right

L: That way your mammary tissue has gone down. If you try and do it just before your period your breasts are enlarged, they’re more painful, it’s uncomfortable. Do it in the privacy of your own bedroom when you’re nice and relaxed. Ideally stand in front of the mirror and look at your breasts first of all. Just look, make sure that they look the same as they did last month, as I said earlier they’re not going to look the way they did 20 years ago, just that they are the same as they were the month before. Looking for any change whatsoever, skin texture, skin colouring, puckering of the breast, nipples suddenly inverting if they haven’t done before. It’s perfectly normal to have inverted nipples but if they change

H: Right

L: Or if you have a discharge from the nipple. Standing in front of the mirror, lift your arms above your head, make sure both breasts move up with you. You shouldn’t look like Pamela Anderson and be rigid in front of you, they should actually move up. You’re also looking at the breast tissue underneath as well as on the top

H: Right

L: After you’ve done that and you’ve checked that everything is moving perfectly normal, ideally lie down or stand, using this part of your hand, place it on your breast and just gradually bring it in as if you’re a spiral – so as if you’re going in towards the nipple, then move round as a spiral in towards the nipple, doing those two movements you’d have felt any lumps and bumps there that are different. You will feel lumps and bumps, but it’s getting to know where your lumps and bumps are

H: Right

L: And you’ll feel different textures, you’ll feel mammary tissue underneath. The area across here often feels as if you’ve got an elastic band that’s pulling quite tightly

H: Right

L: And as you put your fingers on it, it “dongs”

H: Right

L: You’ll feel that and you’ll feel – underneath here you’ll find some lumps and bumps from your mammary glands

H: Ok

L: But it’s anything at all that is different, always go and seek advice. Don’t leave it

H: And how big a lump are you looking for? Because unless you’ve found one you don’t really know what you’re looking for

L: Approximately two centimetres –

S: Yes it would be unusual for someone who wasn’t medically trained to be able to feel a mass of under 2cm. Doctors can feel them at around 1 ½ cm, in fact my largest tumour was 13mm and I couldn’t feel it, but the radiologist who did my ultrasound could feel it, but of course he could see where it was,

H: So that helps

S: So that does help

H: Yes. Talking about seeing lumps in your breasts, we can’t all pop along like you could at work to get your breasts looked at, but there is this new product which I think is incredibly exciting – tell us a little bit about it Lieva?

L: It’s Breastlight, this is the product – it’s designed to work in conjunction with being breast aware

H: Right

L: So you know your own body, so when you’re doing your examination to know the inside of your body as well as the outside. The principle behind it is it picks up the red light in it picks up heamaglobin. When you place it, you do it in a darkened situation

H: So you shine the light into the breast tissue?

L: You shine the light – you turn the lights off, you’re in the dark, you place – you switch it on and there’s 3 LED lights. They look perfectly normal here – as they come in contact with the skin it lights up, and it’s picking up the haemoglobin in your blood supply. So you place it under your breast, you’re looking under or you look down, and you’ll see – like the road map of your breast, some people have a lot of blood vessels, a lot of veins and it will show up quite clearly. Other people just have very think capillary action, so you see very little, but it’s designed to pick up anything that’s different to normal. Tumours are fed by an increased blood supply

H: Ok

L: It’s called angiogenesis, and a few cells will change, and these cells have to be fed, so the body will send an extra capillary action and it will show up, with Breastlight as a darkened area or as a shadow

H: Ok. Now it sounds incredible actually. We have some video to show you, just to give you an idea of what it is, because I was quite amazed when I saw this, so just take a look at this video

Video Footage

“It’s important to use Breastlight in a darkened room, so choose somewhere where you can turn out the light and make as dark as possible. When you turn your Breastlight on, the light will be at a low level, and only become bright when you press it against your skin. There are four different settings. Generally larger or denser breasts will require a brighter light. Try all the brightness settings until you find the right one for you. If the light is too low you may now be able to see the veins in your breasts. Too high and you won’t see the fine details.

H: So this is quite a bizarre product I think, but it is incredible that you can look inside your breasts, and you should be examining your breasts and using the light – is that how it works?

L: That’s correct yes, they work together. It doesn’t replace mammograms, going to see your doctor. If you’ve got any worries whatsoever you still go and see somebody, but what it does, it just increases your breast awareness. It also helps you know the outside and the inside of your body

H: Ok. And tell us a little bit about how it works then, because there’s various buttons and what have you on there – just talk us through the product

L: It’s a rechargeable product, you just unplug there, switch it in, and just like your mobile phone, difference being the charge will last actually for months and months

H: Ok. So it lasts for ever really

L: It really does, yes. You press it on, and on the display is shows you how many days since you last used it. We all tend to think oh I examined myself last month, I was fine, you look down and it actually might say 62 days and you think whoops, perhaps I ought to examine myself tonight

H: Yes. So once a month would be ideal

L: Ideally yes. This just tells you how fully charged the battery is, and this is an intensity light,

H: Ok

L: It works with this one here. Depending on the density of your breasts, you might need more or less light. You press it and – until I’ve got it in contact with the skin you won’t see any difference. Let’s put it on the lowest setting first of all so you can see it go up.

H: Wow so that’s going right through –

L: That’s four different –

H: So if you have large breasts it will still work then?

L: Oh yes it works on all sized breasts – large, small, no problem

H: And so what are you actually looking for that might be unusual?

L: Any darkened areas, shadowing, spotting that you haven’t seen before. It’s being used to using it. If you use it on a regular basis, the first time somebody uses it they usually think “I don’t really want to do this, what am I doing – oh wow is that really what I look like inside?” And they might spend 10, 15 minutes actually examining themselves thoroughly. Subsequent times it only takes 2-3 minutes to do

H: Yes

L: But it’s any form of change

H: Yes

L: And the idea behind it is it’s picking up the angiogenesis, it’s picking up these darkened areas. If you’re somebody that suffers from cysts on the breasts, if they’re ordinary cysts they’re just fluid-filled, there’s no extra blood supply so the light would shine through

H: Oh that’s good

L: And if you have fatty deposits or you have fibrous tissue, there’s no extra blood supply so the light will still shine through. So it’s picking up anything that’s different

H: I suppose the worry is that we’re all going to get one of these and then suddenly the GPs are going to be flooded with people worrying about their breasts –

L: In actual fact the opposite has happened. We’ve done a lot of market research, we did a big survey last year of 1500 women and we had them in groups of 20, asking them to have a Breastlight between the 20, using it for several days and filling in all the forms, and out of the – sort of 1500 we got 1200 replies, and out of that 1200 only 14 women felt they had to go and see somebody

H: Oh ok

L: And out of that 14 only one actually had to have surgery

H: Yes that’s amazing

S: And there is – there are certain women who will go and see their GP every month anyway

H: Well yes

S: They examine themselves and they think oh gosh I’m not sure if that’s the same as last month, so I think that if anything that may reassure that particular

H: So it’s not

S: Group of women

H: So it’s not fuelling hysteria then –

L: It is actually the opposite

H: Yes

L: And then you’ll get a lot of women that will examine themselves, like Sarah was saying, every few days, an d they’re almost making themselves sore thinking there must be something in there. Then you get the opposite extreme, those that will only examine themselves about once every month, sorry once every year. And what Breastlight – we found in all the surveys is it actually brings the two levels in together

H: Right

L: And people are now sort of saying they’ve now got the confidence now if I do it every month, I won’t find anything horrendous

H: So it’s sort of a healthy interest really

L: It is. It’s also giving women confidence that if they do find something, they will go and see their doctor and actually go in there saying I’m used to examining myself, I want to go and see somebody. It’s giving them a little bit more empowerment

H: Ok. That’s interesting stuff. Move on to some more of your questions now, had one in from Rosie Barker, she says “I have very large breasts, 38G and find it difficult to self-examine. Would I be able to use Breastlight?”

L: Yes perfectly. We’ve used it on all shapes from an A cup right the way through to double whatever. The old adage of if – show us your tits, you know you’ve got the lady with the long thing – that you can pick up somebody’s breasts – the difference is if you’ve got large breasts it might be helpful to actually have somebody to help you

H: Right

L: Use your partner. It can be quite fun

H: Ok. Quite fun, it’s not a toy to use in the bedroom! Right we’ve had a question from D. Baker, she says “I’m 30 weeks pregnant can I use this Breastlight device? Is it harmful?”

S: It’s not going to be harmful because basically it’s just a bright light

H: Right

S: What I would say, I think the changes in the breast at that sort of stage of pregnancy are quite marked anyway

H: Yes

S: I don’t know what our experience is with –

L: Well we recommend that – as you say there’s no harm whatsoever in using it, because it’s just LED light, but to say once you get 2-3 months pregnant, stop using Breastlight and don’t use it until after you’ve finished lactating. So if you’re breastfeeding for 6 months / a year, don’t use Breastlight, it’s a lot harder to see through. But the light itself will not do any harm

H: Right ok, so it’s not harmful but when you’re pregnant your breasts – they do funny things –

S: They change on a daily basis

H: Yes they do, they do and it’s –

S: And you can get little bleeds and things when you’ve got a bit of mastitis or whatever and then that might be alarming when it’s not necessary

H: Ok well just leave it until you’ve had the baby –

S: Still do your routine

H: Yes, yes

S: Examination though

H: Yes it’s always useful to know what your breasts are doing isn’t it, but maybe not with a Breastlight. Ok another question in from Heidi Snape, she says “my aunt has recently been diagnosed with breast cancer, so I’m really worried about my chance, and my cousin’s chance of getting the disease. Can we share the Breastlight between us?”

S: Well if I can just say something about her risk. Her cousin’s – well it depends on the age of her aunt, again, so if she’s around her period – her menopause or before it then her cousins’ are at quite significantly increased risk. She will be at a marginally increased risk if it’s not her own mother or sister, so it’s really – first order relatives

H: Right

S: So it’s mums and sisters that are the risk, unless you’ve got a whole family where everybody tends to get breast cancer

H: Yes, yes

S: And then clearly the whole family is a traditional risk. But I’ll hand over to Lieva for the question about the –

H: Yes so sharing it? Is that ok?

L: Absolutely perfect. We have this a lot from women. Groups of friends together, mothers, daughters – absolutely no harm. Within the Breastlight there is no area there that can have contamination, all you do is wipe it down with a wet wipe in between time and pass it on. Obviously the date stamp on it at the bottom, that’s null and void if you’re using it with other people

H: Yes ok

L: But other than that it’s a good idea.

H: It might be worth investing with your sister, as long as they live close. As long as they don’t live in New Zealand, it’s a bright light but not quite that bright! So you’ve got the gel there as well, so you have to use the gel –

L: Yes – this is the Breastlight pack that comes along, and within there you have an instruction leaflet, you also have a DVD. It’s a very good DVD explains fully all the footage that you saw earlier on is on there, also has a helpline, we have a nurse on-call from 9 o’clock through to 11 o’clock 7 days a week, because obviously Breastlight is used in the evening mainly

H: Yes

L: Most people haven’t got a darkened room they can use it in

H: No

L: And there’s nothing worse than if you think you’ve seen something, to think oh my God there’s no one I can talk to, our nurse from the company is on duty all that time and she’ll answer any questions. If there’s anything she can’t answer she’ll refer you to somebody and reassure you. Can I just point out that if you do see something it doesn’t necessarily mean it’s something horrendous

H: In fact it probably means it isn’t

L: It probably means it isn’t. It can be bruising, particularly women with young children, are notorious, you pick up your toddler and they kick you in the boob

H: Bash you in the boob, yes

L: And of course because there’s so much fatty tissue in the breast, it doesn’t always show on the surface, so you might have a bruise inside. Or you might have a blood-filled cyst which again will show up. So it’s any area of bleeding will show up, so it just means go and have it checked out. But within the pack you have a gel, just a small tube, but as you can imagine if you’re doing this in a darkened room, you’ve got your Breastlight, you’ve got your mirror, you’ve put your gel on your fingers and you want to turn your light off –

H: And then the phone goes!

L: That’s right. So it’s a bit messy. So we thought right from there what we’ve done we’ve now actually brought it out as a roll-on

H: Oh that’s useful

L: So it’s lovely and easy, nice and clean, wipe it round yourself – you can use it with or without gel. One of my colleagues when she demonstrates always uses gel. When I do it I actually prefer to not use gel, so it’s a preference, that’s all

H: Ok lovely. Well we’re out of time actually so Sarah and Lieva thanks very much for coming in and talking us through this, and I hope you stay well

S: Thank you

H: You’re looking very fit and well today. And do examine your breasts at home, but if you do find something then it probably is nothing, the vast majority of lumps are just cysts and what have you, but if you do find a lump go along to your doctor just to put your mind at rest. If you want any more information you can go to the website which is www.breastlight.com. Well thanks very much for watching and we’ll see you next time on the Healthcare Show. Bye bye

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