Farm Doctor: Signs and symptoms of cancer affecting women

Despite common perceptions that agriculture remains an industry predominantly populated by men, the latest government statistics show that women make up more than half of the farming workforce in England. 

With October being Breast Cancer Awareness Month, farmer’s daughter and qualified doctor Camilla Baker told Farmers Weekly about the signs and symptoms of the most common cancer affecting women. 

See also: Farm Doctor: How to protect yourself from farmer’s lung

Camilla Baker © Supplied by Camilla Baker

“In the UK, around one in seven women will develop breast cancer at some point in their lifetime, with about 56,000 new cases each year – though it is worth noting that it is a disease that also affects some 400 men each year too,” Camilla explains. 

“Breasts are made of different structures including ducts, lobules and breast tissue. And this particular cancer occurs when the cells in the ducts or lobules start to grow at a faster, abnormal rate.

“When the cancerous cells are still confined to the duct or lobule, this is called ‘carcinoma in situ’. However, when the cancerous cells begin to spread into the surrounding breast tissue, it is called invasive breast cancer.”

What are the sign and symptoms?

“Many women find their breasts change in shape and size throughout their cycle, and they may feel more tender and lumpy before their period. So, it is important for women to know their own breasts, and check them regularly,” says Camilla.

“The most common finding is a breast lump, which is typically firm, painless and immobile or ‘stuck down’.”

Thankfully, most lumps are not cancerous and may be a simple cyst or clumping of tissue.

However, she says that it is important that women seek medical advice as soon as they notice a new lump or anything abnormal, as early detection is always best.

Other signs may include the following: 

• Dimpling or thickening of the skin overlying a part of the breast
• Changes in the nipple including the nipple turning inwards
• Discharge from the nipple
• A rash around the nipple, similar to eczema. This may be a sign of a rare type of breast cancer – Paget’s disease of the breast.
• A swelling or lump in the armpit. This tends to be the first-place breast cancer spreads, so an important finding to get checked out by your doctor.

Causes

Breast cancer can develop for no apparent reason; however, there are risk factors that may increase a person’s chances of developing it.

“Some factors we can control, others we cannot,” says Camilla. “We can’t change our age, our family history or the age at which our periods started or stopped.

“Most cases of breast cancer are in women over the age of 50, and about 1 in 20 cases are caused by a faulty gene that can be inherited. The most common genes are BRCA1 and BRCA2.

“You are also at an increased risk of breast cancer if your periods started early (before the age of 12) or if you went through the menopause later (after 55).”

There are, however, lifestyle choices that will affect your risk of developing breast cancer. These include:

• Being overweight or obese
• Alcohol intake
• Being on the contraceptive pill or hormone replacement therapy (HRT). There is a small increased risk of breast cancer with these medications; however, the risk goes down over time after stopping the medication. Speak with your doctor if you have any concerns.

For men, while they have less breast tissue and a much lower exposure to oestrogen, as with women, a strong family history of breast cancer, or inheritance of common faulty genes (BRCA2) can mean a higher risk of developing breast cancer.

Investigations and diagnosis

“If you are worried about a lump in your breast or armpit, or if you have noticed a change in the skin over your breast, it is important to visit your doctor for a review,” Camilla advises.

“Your doctor will then examine your breasts and armpits and ask you questions about your medical and family history.

“Remember, you can always ask for a chaperone or friend/family member to be present when being examined.

“Your doctor will then refer you to a specialist for a review. This may include an ultrasound, a mammogram (a special X-ray) or an MRI scan.

“The X-ray may be a little uncomfortable, but the discomfort should only last a short time,” she says.

A diagnosis of breast cancer is made by taking a small biopsy of the lump and looking at the cells. It may be done by a needle, with the help of an ultrasound scan, or with a small operation.

Further investigations will help determine if the cancer has spread and what stage it might be at.  

Management

Treatment for breast cancer is tailored to each person and will depend on the type of cancer and whether is has spread.

Treatment options include surgery, chemotherapy, radiotherapy, and hormone treatment.

The doctor will discuss the best course of treatment for the patient, including the different potential side effects.

Screening

In the UK, there is a screening programme in place with the aim to detect cancer at an early stage. It is estimated that screening prevents about 1,300 deaths each year.

Women between the ages of 50 and 70 will be invited for a breast cancer screening test every three years.

But if you are known to have a higher risk of breast cancer – for example, if one of your immediate family members has had breast cancer – you may be called earlier. 

“It is important that women, and men, know what their breasts or pecs feel like and what is ‘normal’ for them.

“This way, when they spot a change, or notice a lump they can seek medical advice quickly,” says Camilla.

Pink Ladies Tractor Road Run

Pink Ladies Tractor Road Run 2023 © Jonathan Slack

This year, the “Pink Ladies” celebrated two enormous milestones; 20 years of the tractor procession in aid of Cancer Research UK’s breast cancer appeal, and exceeding their whopping £1m fundraising target.

During the summer, a convoy of nearly 200 pink-clad tractors travelled through south Norfolk and north Suffolk, raising £201,000 and taking the total funds raised to £1.1m.

One of the Pink Ladies, a mother of three and wife of an arable farmer (who wishes to remain anonymous), shared her experience of proudly overcoming breast cancer and taking part in the tractor run.

“I found a breast lump in the shower, and I was fast to get it checked out. I had a mammogram and biopsy, and was diagnosed with early stage breast cancer.

“I was told that I needed chemotherapy, and ended up having six rounds, followed by four or five weeks of radiotherapy.

“I have had check-ups ever since, and so far everything is fine. We caught it early.

“From a personal point of view, I had three young children, aged two and a half, five and seven. My family helped support me through it and were brilliant.”

Five years on and she was taking part in the Pink Ladies tractor run, driving a 1962 Massey Ferguson.

“It was a real milestone for me because I wanted to help raise awareness and also try and own what I went through.

“It was a cathartic experience. It was very empowering and emotional.”

“It is absolutely so important that every woman is aware that they should be checking themselves and asking for help if they are worried.”