Breast Cancer And Oestrogen

Overview

Breast cancer and oestrogen are closely linked for many people. Oestrogen is a natural hormone that helps regulate the female reproductive system. In some people, oestrogen can make breast cancer cells grow. This is sometimes called oestrogen-receptor-positive breast cancer. Treatment often focuses on stopping oestrogen from reaching cancer cells or lowering the amount of oestrogen in the body.

Yes. Breast cancer is the most common cancer in the UK, and around 7 in 10 cases are oestrogen-receptor positive.

It mainly affects women and anyone registered female at birth, and risk increases with age. Men and people assigned male at birth can also develop breast cancer, though it is much less common. It can occur in younger people too, but it is rare under 40.

Symptoms

Common symptoms

• A new or unusual breast lump
• Change in the size, shape or feel of the breast
• Blood-stained or other unusual nipple discharge
• Skin changes such as dimpling, puckering, reddening or a rash
• Nipple changes – for example, a nipple turned inward
• Persistent breast pain that does not go away

Symptoms in children

• Breast lumps in children are very rare and usually harmless, but any unusual breast change in a child should be checked by a GP.

Symptoms in older adults

• The same symptoms apply in older adults. Age-related changes like drooping or shrinking of breast tissue are normal, but please see a GP if you notice something new, like a lump, skin change or discharge.

Causes

Main causes

• Breast cancer begins when cells in the breast multiply out of control. In oestrogen-receptor-positive breast cancer, oestrogen attaches to receptor proteins on the cancer cells and tells them to grow and divide. Other gene changes and damage to DNA inside breast cells also play a part.

Risk factors

• Age – risk increases as you get older
• Having had breast cancer in one breast
• A close family history of breast or ovarian cancer, especially at a young age
• Inherited changes in genes such as BRCA1 and BRCA2
• Starting your periods early or going through the menopause late
• Using some hormone replacement therapy (HRT) for a long time
• Being overweight after the menopause
• Drinking alcohol regularly

When to see a doctor

See a doctor urgently if:

• If you notice a new breast lump or any unusual breast change, make an urgent GP appointment
• If you have a lump that feels hard or fixed, rather than smooth and movable
• If you have a breast change that is getting worse, please do not wait

Book a routine appointment if:

• Persistent breast pain with no lump
• Nipple discharge without a lump
• Worries about your family history risk – you can discuss with your GP

Diagnosis

A GP will ask about your symptoms and examine both breasts and the underarm area. You may be referred to a breast clinic for imaging and, if needed, a biopsy.

Tests that may be done

• Mammogram (X-ray of the breast)
• Ultrasound scan
• Core biopsy (a small sample of tissue taken with a needle) or fine-needle aspiration
• Clinical breast examination by a specialist
• Hormone receptor testing on the biopsy sample to check for oestrogen receptors

What to expect at your appointment

At the breast clinic, you will usually meet a specialist team. You may need more than one test on the same day. Results may take a few days or up to two weeks. It is normal to feel anxious while waiting – your team should explain what is happening and support you.

Treatment

Treatment depends on the type and stage of the cancer and whether it has oestrogen receptors. Common approaches include surgery, radiotherapy, chemotherapy and targeted treatments. For oestrogen-receptor-positive cancer, hormone treatment is often a key part.

Self-care at home

• Ask your care team about support for side effects like fatigue, nausea or pain
• Talk to a specialist cancer nurse if you are unsure about a symptom
• Keep a list of your medications and questions for each appointment

Medical treatments

Medical treatment for oestrogen-driven breast cancer may include surgery, radiation therapy, chemotherapy, and hormone therapies that lower oestrogen levels or block oestrogen from helping cancer cells grow. There are also targeted therapies that focus on specific proteins on cancer cells. Your oncology team will tailor a plan to your situation.

When is surgery considered?

Surgery is often used to remove the tumour (lumpectomy) or the whole breast (mastectomy). Some people also undergo surgery to remove lymph nodes from the armpit to check for spread. Operations vary depending on the size and location of the cancer.

Living with this condition

Some days you may feel tired or low. Give yourself rest, and avoid comparing your recovery to others. Keep attending follow-ups and contact your care team for any new symptoms.

Lifestyle tips

• Take part in gentle activity like walking or yoga when you feel able
• Try to limit alcohol and avoid smoking to support your overall health
• Seek support from friends, family, or a support group – you don't have to manage alone

Diet and exercise

Aim for a balanced diet with plenty of vegetables, fruit, whole grains and protein foods. Eating well and staying active can help you regain strength, manage weight, and feel more in control during and after treatment.

Mental health and emotional wellbeing

A breast cancer diagnosis can trigger strong emotions such as anxiety, sadness, anger or fear. You may also worry about body image, relationships, or the future. Ask your GP if you need extra help such as counselling. If you are in crisis, reach out to a mental health crisis service in your local area.

Prevention

You cannot always prevent breast cancer, but some general health measures may lower your risk. These include keeping a healthy weight, limiting alcohol, and staying physically active. Being breast-aware also helps you find changes early – not to prevent the cancer, but to catch it at an earlier stage.

Vaccines

There is currently no vaccine to prevent breast cancer.

Screening programmes

Regular breast screening (mammograms) is offered to eligible people by the national screening programme. Screening can detect cancer before symptoms start. Ask your GP about your local screening programme.

Complications

If left untreated

• The cancer may grow locally and affect the breast skin or chest wall
• It may spread to lymph nodes, bones, liver, lungs or brain, making treatment more difficult
• Advanced cancer can cause pain, fatigue, weight loss or severe complications

Long-term outlook

The outlook for breast cancer has improved greatly. Many people with early-stage oestrogen-receptor-positive breast cancer are treated successfully and stay well for many years. Even if cancer has spread, modern treatments can control it for long periods. Your care team will work with you to give you the best possible outcome.

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