⏱ 2 Min Read
Contraception, family history and pain: common breast cancer questions answered
Words
Dr Liz O'Riordan interviewed by Eleni Stefanou
Updated on
13 Aug 2024
About the expert
Dr Liz O'Riordan is a former breast cancer surgeon who was forced to retire after her own breast cancer diagnosis. She has a doctorate in the molecular biology of cancer and is the author of The Complete Guide to Breast Cancer, published by Penguin Books.
Does contraception cause breast cancer?
We know that if you are on the pill or hormonal contraception for more than 5-10 years, it does increase your risk of breast cancer, but the risk is negligible; it’s two in a 1,000 instead of one in a 1,000. It’s a tiny increase but the press sells it as it doubles your risk. Whereas if you use the pill, and also exercise and eat healthy, that lowers your risk by 30%.
Unless your doctor has told you not to use the pill for medical reasons, there is no reason to stop using it. Even if you have inherited the BRCA gene (which increases your chance of breast cancer by 60-80%), I would much rather you use contraception and avoid an unwanted pregnancy, which can have far more dramatic health impacts.
Are painful breasts a sign of cancer?
The number of women with pain as the only symptom who end up with breast cancer is one in a 1,000. If your pain is in both breasts, it's almost certainly hormonal. This can happen in your teenage years when your breasts are developing and in your 30s and 40s as you get closer to perimenopause.
If you have persistent pain in one breast for more than 2-3 weeks, get it checked to be on the safe side. You will almost certainly be told it's fine, but it stops you worrying.
Bra-fit trouble
Often your bra won’t fit you properly because you haven’t taken new measurements over the years. I thought I was a 34A when I was 30B and suddenly my bra was really uncomfortable.
If you feel pain around the edge of your breast, near your armpit or where the underwire sits, that's muscular pain and it’s almost certainly because your bra doesn't fit properly.
What if my granny had breast cancer?
About 10% of all breast cancers are inherited, which means a mutation in the DNA has been passed down to you from your mum or your dad. Those are genes like the BRCA. Women with this mutation will be advised to have regular screenings from a young age or have their breasts removed.
Assessing your genetic risk
If only one relative in your family has had breast cancer, your risk is slightly higher than someone without a family history, but only if they are a first-degree relative (so your mother or your sister). Additionally, they must have been diagnosed before the age of 40 to place you in the moderate-risk category. So if your granny had breast cancer at 70, you don't need to worry.
If there are two or more people in your family with close ties to you like your mum, sister or auntie, and they were in their 40s or 50s when they got breast cancer, ask your GP to refer you to your local breast cancer family history service. They will assess your family history and may send you to a geneticist to work out whether your risk of getting breast cancer is moderate or high. Based on their findings, they may recommend mammograms starting at an early age.
If you do have a strong family history, it's even more important to check your breasts and take lifestyle measures to reduce your risk.
Do I need to worry if I’m in my 20s or 30s?
If you’re in your 20s and find a lump, it's probably a fibroadenoma, a harmless growth which doesn’t increase your risk of cancer. We call them breast mice because they can move around.
When you’re in your 30s and 40s, your hormones start to change. This can lead to cysts in your breasts, which feel like firm lumps. These are more common in women in their 40s.
Lumps in people over the age of 50 or 60 are probably going to be breast cancer until proven otherwise. So the younger you are, the less likely a lump is going to be breast cancer.
Younger women can get breast cancer, but we don't offer mammograms to pick it up, so it’s really important that you check your breasts every month.
I found a lump. What should I do?
If you notice anything that feels or looks abnormal, make a note in your diary and leave it for 1-2 weeks. Lumps can come and go with your period. Check the other breast as well. If it feels the same, it’s more likely to be lumpy breast tissue.
If the lump, dent or dimple is still there after two weeks, I want you to get hold of your GP. If there isn’t an appointment for a while, tell them you think you have breast cancer. Someone will screen your request and get back to you so you don't sit at home worrying and imagining the worst. Your GP will send you to a breast clinic, where they will examine and scan you.
Breast Cancer Now has helpful information on what to do if you find a lump.
Pro tip
If you menstruate, perform your self check mid-cycle - that's when your breasts are less lumpy and much easier to feel.
1. Monitor the signs
If you notice anything different or unusual about the way your breasts look or feel, monitor these signs and book a GP appointment if they persist for more than 2-3 weeks.
2. Know your risk
If two or more of your close relatives have had breast cancer before their 60s ask your GP to refer you to your local breast cancer family history service so they can assess your risk level.
3. Be chill about the pill
An unwanted pregnancy carries far greater health risks than taking contraception, while adopting lifestyle changes can cut your breast cancer risk by 30%.
4. Pain isn't typically concerning
If your breasts feel sore, it’s unlikely to be breast cancer. Make sure your bra size is correct and if the pain persists, book a GP appointment to be on the safe side.