Cancer of the breast is the most common malignancy and the leading cause of cancer-related death in women. In Malta, over 300 women are diagnosed with breast cancer every year.

Risk factors for breast cancer include a previous history of breast cancer, a family history of breast cancer in a first-degree relative (parents, siblings, children), never having borne a child or first child after the age of 30, not having breast-fed, early menarche and late menopause, continuous hormone replacement therapy, radiation to the chest, tobacco smoking, being overweight and high alcohol intake.

While breast augmentation is not generally associated with an increased risk, the implant may make detection of cancer more difficult.

Men are also at risk. There is one male breast cancer for every 100 female breast cancers.  While breast cancer is easier to find in males due to the smaller breast size, lack of awareness may postpone seeking medical attention.

For this reason, together with the fact that the tumours are less contained and do not have to travel far to infiltrate skin, nipple or muscle tissue, male breast cancers tend to be more advanced.

All women are at risk of breast cancer and simply being a woman and getting older are the two most common risk factors

Over the past 20 years, mortality from breast cancer in Malta has shown a steady decline and survival from this disease has registered marked improvement, despite the fact that the number of new cases per year continues to increase. A local study compared the records of patients operated for breast cancer in the year 2000 and 2010 and showed that breast cancer is being diagnosed at an earlier stage.

All women are at risk of breast cancer and simply being a woman and getting older are the two most common risk factors. Early diagnosis through breast awareness and regular screening mammography and prompt treatment offers better outcomes and the greatest chance of long-term survival.

There five simple steps to be breast aware:

• Know what is normal for yourbreasts.

• Know what to look and feel for.

Look and feel for:

• A lump or thickening in or near the breast or in the underarm area;

• A change in the size or shape of the breast;

• Dimpling or puckering in the skin of the breast;

• A nipple turned inward into the breast;

• Discharge (fluid) from the nipple, especially if it’s bloody;

• Scaly, red or swollen skin on the breast or nipple;

• The skin may have pitting so that it looks like an orange.

• Report any changes to the doctor immediately.

• Make healthy choices to help reduce the risk of breast cancer.

• Breast mammography screening is a very effective way of detecting cancer in its early stages.

• Contact your family doctor for further advice on how to reduce your risk for breast cancer.

Dr Attard is a specialist trainee in public health medicine at the Health Promotion and Disease Prevention Directorate.