The Impact A Diagnosis Has On Your Self-Esteem

Going through a breast cancer diagnosis can have a devastating impact on your physical health and your mental health.

Your body can go through many changes during treatment which can be hard to adjust to.

This can include the impact of chemotherapy or other treatments, or adjusting to your body with a mastectomy, bilateral mastectomy, lumpectomy or a reconstruction.

So how kind were you to yourself during and after your treatment?

The current Chair of Breast Cancer Trials Consumer Advisory Panel Leslie Gilham and the former Chair Leonie Young, both experienced changes to their mental health and body image throughout their treatment.

Leonie Young said she had to adjust to the changes to her body after breast cancer surgery.

She said even those who have undergone a reconstruction are left with scaring.

“It’s one of the biggest issues that women have to face going through this sort of surgery.”

“So, then it raises a whole array issues around sexuality and partnerships and marriages can struggle at this time because people don’t feel like they’re good enough.”

Leslie Gilham said it can be hard to adjust to the permanent reminder of your disease.

“You might have had radiation therapy, but you’ll still have some sort of marking or you’ll have tattoos, to remind you of the radiation, even down to chemotherapy, hair loss and that sort of thing” she said.

Leslie said she felt very supported while undergoing treatment, thanks to her clinical trial team.

“I tended to have a whole group of people supporting me, not only my family and friends but also a whole team at the clinic.”

“I guess because I was on that trial, I had to attend the clinic more often, so I had that support around my well being, probably more than those people who weren’t on trials.”

“So, for me personally, I can say I had a lot of support for my mental health.”

Leonie said others receive less support.

“I’m a little different to Leslie because I wasn’t on a trial and I was diagnosed a long time ago and everything has certainly changed in that area and there’s a lot more support around these days.”

She said there is still gaps in the system, with some in regional areas missing out on support.

“For some women, depending on where they live, that support is not there and it’s really important for them to access it somehow.”

“I come from Brisbane and there’s a lot of good support around there but there’s some people who live in rural and regional areas who feel very isolated” she said.

“There are ways, thankfully with modern technology, that people can keep connected but that still keeps them isolated in some ways. So, there are still some people struggling in that area.”

Both women agreed that finding a group of people who have undergone a similar experience will help to support those undergoing treatment.

“If you’ve got a group of friends who all have got something similar going on, you don’t have to explain yourself around it. People get it. And you start to feel good about yourself after a while” said Leonie.

Leslie agreed.

“The more that you can surround yourself with people that have been through the same situation as yourself the better, because you don’t have to explain yourself, they get what you’re going through.”

“It’s actually interesting, you might raise something that is happening, or something that is concerning you and someone else will go ‘oh, that happened to me’.”

“So, it puts you at ease” she said.

“Because quite often you’ll find that if you speak to someone who hasn’t been through a diagnosis or someone who hasn’t got the medical background to deal with your concerns, then all you’re going to do is make those concerns worse because they’ll start to create the anxiety that you don’t necessarily need at that time.”

Practical Ways To Help Boost Self-Esteem

Leonie also suggested other practical ways to lift the self esteem of those undergoing treatment, such a breast forms and getting fitted for nice lingerie.

“Breast care nurses are really vital in steering people in the right direction to know where to go and where to find out some of those things.”

“A lot of people don’t know that those things are available for them and they struggle and feel they have to wear something that’s not very attractive at all. I guess it’s getting into the right information sources.”

Breast Cancer In Young Women

Being diagnosed with breast cancer as a young women comes with its own set of unique challenges.

The disease can have different characteristics in young women and have poorer survival outcomes when compared to older women.

Medical Oncologist and Chair of the Breast Cancer Trials Scientific Advisory Committee, Associate Professor Prue Francis said although it is more uncommon, breast cancer still occurs in younger women.

“About a quarter of women with breast cancer might be pre-menopausal or under the age of 50” she said.

“In breast cancer literature, very young women are often considered under the age of 35 and that’s less common.”

Around 800 young women will be diagnosed with breast cancer each year in Australia.

How Outcomes Can Differ In Young Women

Associate Professor Francis said although it is a smaller percentage, a diagnosis at a young age can have different implications than if you receive a diagnosis at a later stage in life.

“That’s the time of life when they might be building their career, building their family, building relationships and to be affected by breast cancer at that time is clearly devastating and plus we know that’s a group in which the cure rate has not been as high as in older women with breast cancer.”

She said the biology of the tumour could be to blame for these poorer outcomes.

“So, younger women are known on average to have more aggressive tumors biologically. These can be, in some instances, fast growing.”

Being Breast Aware

Younger women are typically diagnosed with more aggressive breast cancers and are at a higher risk of the disease spreading to other parts of the body.

Therefore, being aware of the normal look and feel of your breasts is just as important for young women as it is for older women according to Associate Professor Francis.

“So, a women who’s in her early 20s might go to her GP with a breast lump and everybody might think ‘well she’s in her early 20s and she can’t have breast cancer’, and certainly that would be uncommon to have breast cancer at that age, but it can occur even in that age group” she said.

Treatments For Young Women

As younger women are often diagnosed with more aggressive breast cancers, the treatments can be more intense and aggressive. There are also a number of medical and pyscho-social challenges that some young women are faced with being diagnosed at an early stage of their life said Associate Professor Francis.

“Fertility is a big one because nowadays, particularly in western countries, as childbearing is often occurring later than it did in earlier decades. So, someone may be diagnosed with breast cancer in their thirties before they’ve commenced their child bearing. So, there’s all those issues about how to best protect their future fertility so that when the time is right, they can have the option for childbearing.”

She said surgery options also cause a lot of anxiety for young women.

“Sometimes when women are diagnosed with breast cancer at a young age, they’re so afraid of recurrence, that they feel like they just want to have all their breast tissue removed which is obviously a very big procedure for somebody at a young age.”

The cause of a young women’s breast cancer may also be investigated further.

“Genetic aspects come into it, because if somebody is diagnosed with breast cancer at a young age then it would be standard to consider whether there’s a genetic aspect” she said.

Research Into Treatments For Young Women With Breast Cancer

Breast Cancer Trials is committed to finding new and better treatments for young women with breast cancer.

Past Breast Cancer Trials clinical trials, the SOFT and TEXT clinical trials, helped to improve the treatment and survival for pre-menopausal women with oestrogen receptor positive or hormone receptor positive early breast cancer.

Previously, the hormone treatment given to these women post-surgery, and if required, after chemotherapy, was five years of tamoxifen.

Previous studies have shown that this treatment was not as effective for young women under 35, as compared to older pre-menopausal women.

“In trying to think about why that was we were thinking about oestrogen, which comes from the ovaries in pre-menopausal women” said Associate Professor Francis.

“When pre-menopausal, you have oestrogen produced from your ovaries every month and we noticed from previous trials when women were pre-menopausal and given adjuvant chemotherapy that the very young women were less likely to have their periods stop after they got chemotherapy compared to the older pre-menopausal women.”

“So, the closer you are to the natural age of menopause the more likely you are to go into menopause with chemotherapy, that might be temporary, or it might be permanent” she said.

“So if you’re 48, when you get chemotherapy your periods will probably stop, whereas if your 28 your periods are very unlikely to stop and so we wondered if the adverse outcomes in the younger women were the fact they were not getting this effect of their periods stopping and that their ovaries were continuing to produce oestrogen every month and perhaps that oestrogen could be effecting the growth of any remaining cancer cells.”

Associate Professor Francis said the most recent follow-up of the study has show there is an improvement in survival for women by suppressing the ovarian oestrogen for five years to tamoxifen.

“We feel that this treatment is going to be most beneficial in very young women or women with more high-risk features to their cancer. For example, several lymph nodes involved, more aggressive tumors.”

What Are The Symptoms Of Breast Cancer Besides A Lump?

The most well-known symptom associated with breast cancer is finding a lump in the breast area. However, there are a number of physical signs or symptoms that could potentially indicate breast cancer. It is therefore important to be aware of the regular shape and feel of your breasts throughout the month and be aware of how your menstrual cycle can affects this. Pregnancy, weight and age can also alter the shape, feel and size of your breasts.

If you find one of the following symptoms, it’s important not to panic. Nine out of ten breast changes aren’t due to cancer. However, you should consult your doctor if you find any changes in your breasts.

It is also important to note that some breast cancers will not cause any symptoms at all. It is therefore important to get regular screening mammograms. BreastScreen Australia recommends women aged 50-74 without breast cancer symptoms should have a screening mammograms every two years. In New Zealand, women aged between 45 and 69 years are able to receive a free mammogram every two years.

Changes to Skin

Most changes to the skin of the breast are due to benign conditions, like allergies. However, changes in the look and feel of the skin of the breast, such as persistent skin redness, a rash, a scaly appearance, puckering, unusual redness or other colour changes, or dimpling (an ‘orange peel’ appearance) should be investigated further.

Changes to Breast Size and Shape

It’s quite common for your breasts to change due to hormone changes. Pregnancy can cause the breasts to increase by an average of two cup sizes, and your monthly period can also cause your breasts to change including feeling swollen, tender or lumpy before a period begins.

It’s important you are familiar with these changes. Most changes to the breast shape and size are not cancerous, however if you are concerned or have additional symptoms, speak with your doctor.

Changes to the Nipple

If there is a new change in the shape or look of your nipple, this could be a symptom of breast cancer.

A cancer may be present if there is nipple inversion – that is, the nipple is pulled in and cannot be pulled out to a normal shape, and rather than forming a slit shape the nipple is pulled in together, the nipple has any scaliness or crusting; an ulcer of sore; or unusual redness or a lump can be felt behind the nipple. However, nipple inversion may also occur naturally with increasing age.

Other physical signs or symptoms that could potentially indicate breast cancer can include pain in the armpit or breast, and nipple discharge. Find out more below.

Male Breast Cancer

For men, the most common symptom of breast cancer is a painless lump in the breast, often behind the nipple. The symptoms of male breast cancer closely resemble that of female breast cancer. If you notice a new change in your chest or nipples, talk to your doctor. If you are concerned about a change in your breasts, speak to your GP.

Breast Cancer Trials is a unique collaboration of researchers, trial participants and YOU, our valued supporters working together to save and improve the lives of every person affected by breast cancer. Help find the newest breakthrough in breast cancer research.

How to Reduce Your Breast Cancer Risk

Over the course of your lifetime there are a number of risk factors you may be exposed to. Some cannot be changed, such as being a woman or having a strong family history, however other factors can be changed through healthy lifestyle decisions and risk-reducing strategies.

By better understanding your personal risk of breast cancer and getting regular screening, you can help improve your chance of better outcomes. You can use the iPrevent online tool to help better understand your breast cancer risk.

Clinical Trials Focused on Breast Cancer Prevention

A prevention-based breast cancer clinical trial is a research study designed to evaluate strategies, interventions, or treatments aimed at reducing the risk of developing breast cancer, particularly in individuals identified as having an increased risk. Breast Cancer Trials has conducted many clinical trials in the prevention setting including the BRCA-P clinical trial and IBIS-II clinical trial. Learn more about our successful trials and research. Donate to life-saving breast cancer clinical trials research.

The Importance of Breast Cancer Screening

The earlier breast cancer is found, the better the chance of survival. Screening mammography can detect breast cancer at its earliest state, before it can be felt.

BreastScreen Australia recommends women aged 50-74 without breast cancer symptoms should have a screening mammograms every two years. This is the targeted age group as more than 75% of breast cancers occur in women aged over 50. Women aged 40-49 and 75 and over are eligible to receive free mammograms but do not receive an invitation to attend.

In New Zealand, women aged between 45 and 69 years are able to receive a free mammogram every two years.

Ways to Prevent Breast Cancer

Medical Interventions

There are several medical interventions available to help prevent breast cancer, particularly for individuals at higher risk due to genetic factors, family history, or other risk factors. These interventions include medications, surgeries, and other medical strategies based on an individual’s risk profile.

• Risk-reducing medications: Certain medications can help lower the risk of developing breast cancer, especially those that are hormone-receptor positive. These can include tamoxifen, anastrozole, and exemestane.

Surgical Options

For individuals with a very high risk (e.g., BRCA1/BRCA2 mutation carriers), surgery can dramatically reduce the risk of breast cancer.

• Prophylactic (Preventive) Mastectomy: Involves the surgical removal of one or both breasts before cancer develops. Reduces breast cancer risk by up to 95% in high-risk individuals.

Removing Ovaries to Prevent Breast Cancer

A Prophylactic Oophorectomy is the removal of the ovaries and fallopian tubes to lower estrogen levels, reducing the risk of both breast and ovarian cancers. This is often recommended for women with genetic mutations like BRCA1/2, especially after childbearing.

Benefits of Oopherectomy:

• Reduced Cancer Risk: For premenopausal women, oophorectomy lowers estrogen levels, reducing the risk of hormone-receptor-positive breast cancer by up to 50%. In relation to ovarian cancer, reduces the risk by up to 95% in high-risk individuals (e.g., BRCA mutation carriers).
• Improved Survival: Studies suggest that prophylactic oophorectomy can significantly increase life expectancy for women with genetic predispositions to breast or ovarian cancer.
• Simplicity of Proceedure: An oopherectomy is a relatively straightforward surgical procedure, often performed laparoscopically (minimally invasive), with a shorter recovery time than more extensive surgeries.
  
• Eliminated Future Ovarian Issues: Prevents benign (non-cancerous) ovarian conditions, such as ovarian cysts or endometriosis, which can require further treatment.

Risk Associated with Oopherectomy:

• Surgical Risks: This can include typical risks of surgery such as bleeding, infection, and adverse reactions to anesthesia. Rare complications associated with surgical proceedures can include damage to nearby organs like the bladder or intestines.
• Premature Menopause: Unfortinately for premenopausal women, oophorectomy causes immediate menopause. Symptoms include hot flashes, night sweats, vaginal dryness, mood swings, and sleep disturbances. This may increase the risk of osteoporosis, heart disease, and cognitive decline due to the loss of estrogen.
• Impact on Fertility: Permanently ends the ability to conceive naturally, which can be a significant consideration for younger women.
  
• Potential Psychological Impacts: Loss of fertility and the sudden onset of menopause can lead to feelings of grief, anxiety, or depression. Some women may experience a reduced sense of femininity or sexual confidence.
  
• Residual Cancer Risk: Oophorectomy does not eliminate all cancer risk. There’s still a slight chance of developing primary peritoneal cancer (a rare cancer that arises in the lining of the abdomen, which shares origins with ovarian tissue).

Removing Breast Tissue to Prevent Breast Cancer

A prophylactic mastectomy is the surgical removal of one or both breasts in individuals who do not have breast cancer but are at high risk of developing it. This preventive procedure is intended to significantly reduce the risk of breast cancer, especially in those with genetic predispositions or other high-risk factors.

This procedure is typically recommended for individuals at high risk of breast cancer, including:

Genetic Risk:

• BRCA1/BRCA2 Mutations: Women with these mutations have up to a 72% lifetime risk of breast cancer.
• Other gene mutations like PALB2, TP53, and CHEK2.

Strong Family History:

• Multiple close relatives (e.g., mother, sister, or daughter) diagnosed with breast or ovarian cancer, especially at a young age.

Personal Medical History:

• Previous cancer in one breast (may opt for removal of the other breast to prevent future cancer).
• History of atypical hyperplasia or lobular carcinoma in situ (LCIS), which are precancerous conditions.

Dense Breast Tissue:

• Dense tissue can make cancer harder to detect with imaging and may slightly increase cancer risk.

The decision to undergo a prophylactic mastectomy is highly personal and depends on:

• Your genetic risk profile.
• Family and personal medical history.
• Emotional readiness for the physical and psychological impact.
• Long-term lifestyle and health goals.

Consult with a genetic counselor, oncologist, and plastic surgeon to fully understand the risks, benefits, and alternatives before making a decision. Other options, such as enhanced screening or chemoprevention, may also be worth exploring for risk management.

FAQs

Does Breastfeeding Prevent Breast Cancer?

Breastfeeding has been shown to lower the risk of breast cancer, particularly for hormone-receptor-positive types. The protective effect occurs for several reasons. First, breastfeeding lowers estrogen levels in the body during lactation. Since some types of breast cancer are fueled by estrogen, this reduced exposure to the hormone can help decrease the risk.

Additionally, breastfeeding causes the body to shed breast tissue, potentially removing cells with DNA damage that could otherwise develop into cancer. Breastfeeding also delays the return of menstruation, which reduces lifetime exposure to estrogen and progesterone, further lowering cancer risk. Moreover, the act of breastfeeding induces changes in breast cells that may make them more resistant to cancerous transformations.

The protective effect of breastfeeding increases with the duration of breastfeeding. Research suggests that breastfeeding for at least 12 months (across all children) may reduce breast cancer risk by 4–5% per year of breastfeeding. The longer the duration, the greater the benefit. Exclusive breastfeeding, where no formula feeding is involved, seems to enhance this protective effect even further.

Does Breast Massage Prevent Cancer?

Breast massage does not prevent breast cancer. While some people believe that regular breast massage can help with early detection by making it easier to feel lumps or changes in the breast tissue, there is no scientific evidence to support the idea that breast massage itself can prevent the development of cancer.

Breast cancer is a complex disease influenced by factors such as genetics, hormones, age, and lifestyle choices. While maintaining regular self-exams is an important part of breast health, it is the early detection of changes—such as lumps, thickening, or skin changes—that matters most for finding cancer at an early stage. However, breast massage is not a substitute for regular screenings, such as mammograms or clinical breast exams, which are proven to be more effective in detecting breast cancer.

Do Breast Implants Prevent Breast Cancer?

Breast implants do not prevent breast cancer. In fact, they do not offer any protective benefits against the development of breast cancer. While breast implants may change the appearance of the breasts, they do not affect the underlying risk factors associated with breast cancer, such as genetics, age, or lifestyle.

However, it is important to note that breast implants can make it more challenging to detect breast cancer through routine screening methods like mammograms. The implants can obscure breast tissue, potentially hiding tumors or making it more difficult for radiologists to interpret results accurately. Special imaging techniques, such as additional views during mammography or breast MRI, are sometimes used to help get clearer images for women with implants.

While breast implants themselves do not prevent cancer, they are not directly linked to an increased risk of breast cancer either. There are, however, certain rare conditions associated with breast implants, such as anaplastic large cell lymphoma (ALCL), a type of cancer that can develop in the tissue surrounding the implant. This is not the same as breast cancer but is an important consideration for women with implants.

Does Breast Reduction Prevent Breast Cancer?

Breast reduction surgery does not prevent breast cancer, but it may reduce some of the risks associated with the disease. The procedure involves the removal of excess breast tissue to reduce breast size and alleviate discomfort, particularly for women with very large breasts. While this can improve physical and emotional well-being, it does not eliminate the risk factors for breast cancer, such as genetics, age, or lifestyle.

One indirect benefit of breast reduction is that it can make it easier for individuals to perform regular self-breast exams and undergo screenings like mammograms. With smaller breasts, there may be less tissue to examine, which could lead to a more accurate detection of any potential changes or lumps. However, breast reduction does not remove all of the breast tissue, so regular screenings and exams are still necessary.

There is also some evidence that breast reduction might slightly lower the risk of developing breast cancer by removing some of the breast tissue that could potentially develop into cancer. However, this effect is minimal, and breast cancer prevention still largely depends on factors like genetics, lifestyle choices, and routine screening practices.

How You Can Help

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What Are Dense Breasts & How Do I Know If I Have Them?

Do you know if your breasts are dense?

Dense breasts are more common in young woman and women with dense breasts can be five times more likely to develop breast cancer.

However, it is not something that is commonly discussed between doctor and patient.

Rik Thompson is the Associate Director and a Professor of Breast Cancer Research at the Institute of Health and Biomedical Innovation and School of Biomedical Science at Queensland’s University of Technology. He is also a Breast Cancer Trials Board Member.

A research focus for Professor Thompson is mammographic density or dense breasts.

What Is Mammographic Density?

“Mammographic density is the whiteness on your mammogram” said Professor Thompson.

“Without having a cancer in it, the normal breast mammogram can either be quite dark or will have different amounts of whiteness in it and it’s the whiteness which is the mammographic density.”

Professor Thompson said its not possible to know if you have dense breasts by feel or touch alone.

Research Into Mammographic Density (Dense Breasts)

Research into mammographic density is incredibly important as your risk of breast cancer is higher if you have dense breasts, but researchers are not yet sure why.

“It’s linked with oestrogen action which is known to be a promoter for breast cancer” said Professor Thompson.

“It’s got some genetic links. So, some of the genes which are linked to mammographic density are the same as those that have an effect on breast cancer predisposition and risk, but a lot of them are not.”

“We’re trying to find out at a molecular level why are the cells in those dense regions, or in denser breasts, are more likely to end up becoming a breast cancer.”

How Common Are Dense Breasts?

Around 45% of women have dense breasts according to Professor Thompson. However, as Australia does not have a notification process surrounding mammographic density, many woman are unaware of it.

“It’s something that’s being hotly debated and investigated and considered in Australia.”

“There’s quite a number of approaches and workshops and special initiatives to try and understand how best to deal with this information, how to accommodate it, how to afford it, how to pass it on in a meaningful way.”

What Do I Do If I Have Dense Breasts?

If women are concerned about mammographic density, they could take a look at their mammogram and discuss mammographic density with their GP said Professor Thompson.

“I think most women could look at the literature and look at the websites around mammographic density and have a look at their mammogram and they could get a pretty good picture as to whether they’re dense or not.”

“It’s certainly something that I think increasingly women could discuss with their GP.”

If you are aware of your mammographic density, Professor Thompson stresses that you should still get regular screening.

“I think the most important thing even if mammograms don’t work as well in dense breasts because it can mask it, mammography is still the best way to find breast cancers, even in the densest scenario.”

“Women shouldn’t ever think ‘I won’t get a mammogram anymore, it doesn’t help me, my breasts are too dense’. You can still find breast cancers and it’s very clear from all the professional groups that it’s paramount.”

He also said that having dense breasts is no cause for alarm.

“Mammographic Density is only one of a number of risk factors for breast cancer.”

“You could have the densest breasts in the world but if you had no other risk factors, you’re probably still fine.”

“So, you’ve got to look at your family history, you’ve got to look at your age, your BMI, and all of those factors that are well established and so, it’s really a composite assessment of risk that probably should be what’s used to think about what to do next.”

If you would like to learn more about mammographic density, you can visit www.informd.org.au

Why Are Breast Cancer Statistics & Survival Rates Important?

Collating breast cancer statistics is important in order to track how many people are being diagnosed with and surviving breast cancer each year. These statistics allows us to track how improved treatments and screening techniques have contributed to better survival rates.

It is also important to record how different factors can vary these statistics. For example: types of cancer, stage of cancer, age and gender.

This information allows doctors to better inform their patients of their individualised survival chances, which can also help to inform treatments.

New Cases of Breast Cancer

In 2019, the Australian Institute of Health and Welfare predicts 19,371 women and 164 men in Australia will receive a breast cancer diagnosis. In New Zealand, approximately 3,500 people will be diagnosed with breast cancer. It is the most commonly diagnosed cancer for Australian and New Zealand women.

The number of people diagnosed with breast cancer has steadily increased over time, however survival rates have improved. In the past 20 years, the five-year relative survival rate for early stage breast cancer has increased from 73% to 91% in Australia. In New Zealand, the chance of surviving five years is 88%. The chance of surviving at least ten years in Australia is 83%, while in New Zealand it is 80-95%, if detected early via a mammogram.

Survival Statistics By Stage of Diagnosis

The relative five-year survival rate for a female diagnosed with breast cancer in its earliest stage or stage one is effectively 100%, according to 2011 data from the Australian Institute of Health and Welfare. When females are diagnosed with metastatic breast cancer (advanced or stage four), the 5-year survival rate is reduced to 32%1. This highlights the important of detecting cancer at an earlier stage to improve survival chances.

On average, breast cancer in females is diagnosed at stage one or two. The higher proportion of cases diagnosed as stage one and two for breast cancer may be partly attributable to the national breast cancer screening program.

Breast Cancer Mortality Rates

In 2019, the Australian Institute of Health and Welfare estimates 3,090 people will die from breast cancer. It is the 4th leading cause of death from cancer in Australia. The risk of dying from breast cancer before age 75 is 1 in 78 for women, and 1 in 7,922 in males. The risk of dying from breast cancer before age 85 is 1 in 43 for women and 1 in 3,455 for males.

In New Zealand, approximately 630 people will die from breast cancer this year. About 70% of women who are diagnosed with breast cancer and about 80% of women who die from it are 50 years or older.