What Older Women Need to Know About Breast Cancer

Dame Maggie Smith was diagnosed with breast cancer at age 73 and Blanche D’Alpuget, wife of former Prime Minister Bob Hawke, at age 76. Older women may assume they are ‘past’ breast cancer because they are no longer invited for breast screening - but breast cancer is still the most common cancer in older women, with the average age of diagnosis being 62.

Disturbingly, there has been a 37% drop in new breast cancer cases during Covid-19, with many women too scared to go to the doctors even when they have symptoms. Delayed presentations mean more advanced disease, which is more difficult to treat and has poorer survival.

Central Coast Breast Surgeon Dr Mary Ling offers Seniors Digest readers the latest on what older women need to know about breast cancer and how to do a 3-point breast check.

1. A LUMP IS NOT THE ONLY SIGN

1 in 6 women with breast cancer present with symptoms other than a lump. Older women are less aware of the non-lump warning signs of breast cancer, which can lead to delay in seeking help. Non-lump signs include spontaneous nipple discharge, a ‘sunken’ nipple and dimpling or ‘orange-peel’ appearance of breast skin. It is never too late to become ‘breast aware’, so take a moment to know how your breasts normally look and feel during everyday moments.

2. SCREENING AFTER 75? YOUR CHOICE

There is no hard-and-fast rule for breast screening after the age of 75. Women in good health may wish to continue with biennial screening mammograms or be monitored through clinical or self-breast examinations. Whereas, women with serious health issues may decide screening is not a priority, as it may pick up cancers that might never cause symptoms. Discuss with your doctor about a personalised screening plan based on your current health.

3. WATCH THE MENOPAUSE WEIGHT GAIN

Obesity is an established risk factor for postmenopausal breast cancer. Research shows a 39% increase in the risk of hormone receptor-positive breast cancer in obese compared with normal weight women. Why? Postmenopausal women derive active oestrogen from fat tissue, with obese women having higher levels of oestrogen. However, it is not all bad news, as a modest 5% weight loss can significantly reduce the risk of breast cancer.

How do I perform a breast self-exam?

There is no right or wrong way to perform a breast self-exam. It is more important that you check your breasts regularly so that you can notice changes from the normal look and feel of your breasts.

Mirror Check

Inspect your breasts with arms by your side, behind your head and then hands on hips. At each step, look for any dimpling of the skin or pulling in of the nipple, as well as any changes in shape, size or colour of your breast (including your nipple).

Lying Down Check

Lying on your back helps flatten your breast tissue, making it easier to examine. Use the pads of your three middle fingers moving around the entire breast in a circular pattern. Cover the entire breast area from your breastbone to your armpit and from the bottom of your breast to your collarbone. Feel for any lumps or thickened areas.

Shower Check

Use the same technique for Lying Down Check.