HEALTH: 10 FACTS YOU SHOULD KNOW ABOUT BEATING BREAST CANCER ; Breast Cancer is Estimated to Affect One in Nine Women in Britain. Luckily, There Have Been Huge Developments in Treatments Available Heres a Look at What the Future Holds for the Fight Again

By Compiled by: Octavia Walker.

1What causes cancer Were slowly unravelling the causes of breast cancer. In September 2004, Breakthrough Breast Cancer launched a 50- year investigation which will cover 100,000 women to discover more about the disease by looking at factors such as lifestyle, diet, and environment. Spokesperson for Breakthrough Dr Sarah Rawlings expects results in the next few years. For now, not being overweight after the menopause and drinking less alcohol are good ways to reduce risk.

2New screenings Free NHS screenings are available for all women over 50 but the uptake is 20% below what it should be. It might be a combination of not realising its available, finding it difficult to get convenient appointments or being afraid of the results, says Rawlings. Breakthrough is also backing a campaign to make MRI screening available to women under 50 in high-risk groups. It uses magnetic waves, rather than using X-rays as mammography does making it easier to find tumours in this age groups typically denser breast tissue. We are pushing for women to be offered this if they are high risk.

3Get seen fast Referral times are being cut. Rawlings explains, At present, if a GP is concerned about a particular woman she can get an urgent referral and be seen in two weeks. Weve been campaigning to get all women seen by a specialist within two weeks. The government has now pledged that this will happen before the next Parliament ends.

4New treatments Risks and side effects of treatment are being reduced. Following diagnosis, doctors must check the underarm lymph nodes to find if the cancer has spread and determine which treatment is best. Until recently, this involved removing lots of nodes. But, says Rawlings, This can lead to complications like lymphedema, where women can lose some of the use of their arm. Less risky is a new technique, called sentinel node biopsy. This involves removing the node the cancer is most likely to spread to first, enabling doctors to see the progress of the disease. Breakthrough is also supporting research into targeted treatments that dont have the side effects of chemo and radiotherapy.

5Check yourself Self-examination is the best way to catch breast cancer early. 80% of breast cancer is found by women themselves, says Helen Brahmbhatt, specialist breast cancer nurse with Breast Cancer Care. Breakthrough has a new campaign this year TLC. It stands for Touch, Look and Check (see p32 for info). Examine your breasts for anything unusual, and check anything you find with your GP.

6Stopping the spread The drug Herceptin is big news at the moment. Already licensed for women with secondary breast cancer (breast cancer that has spread to other parts of the body), recent trials show it can help some women with primary breast cancer (breast cancer confined to the breast) who have high levels of a protein called HER2, made by 15-20% of cancers, which helps the cancer cells multiply. Herceptin attaches itself to the protein and blocks its action. Despite breast cancer sufferer Barbara Clarks recent successful battle to be prescribed Herceptin, theres quite a way to go before it is widely available.

7Preventing relapses The current gold standard for treating certain kinds of post-menopausal breast cancer is Tamoxifen, but many women suffer difficult side effects. Recent studies show a class of medicines called amortise inhibitors (Arimidex, Femara and Armomacin) are as effective in preventing the return of breast cancer and have fewer side effects. Brahmbhatt says these drugs are not yet widely available, but will be in time.

8Customised treatment Genetic profiling is set to revolutionise breast cancer treatment. A tumour sample is taken to work out how an individual will react to treatment, based on their genetic make-up. Women who are given the same treatment do not always react in the same way, says Brahmbhatt. Individualising treatment may yield better results. Its now being used in parts of Europe, so watch this space.

9Alternative therapy Complementary therapies like vitamins, supplements and psychological treatments can be very useful. They can reduce side effects, improve quality of life and make patients feel better about what they are going through, says Rawlings. But some can interfere with conventional treatment so its important to get the right advice. St Johns Wort has been shown to reduce the efficacy of some chemotherapy agents and other herbs may have dangerous side effects for individual patients. Check with your doctor before using alternative treatments. The Bristol Cancer Help Centre (0845 123 23 10 or bristolcancerhelp.org) can also help you decide.

10Reconstruction Some clinics now offer reconstructive surgery at the same time as a mastectomy, allowing women to get back to a normal life more quickly and, in theory, reducing trauma. However, Brahmbhatt urges caution. Some women need time to grieve the loss of a breast. This can mean extra pressure at a time when youre having to make a lot of important decisions.