Cancer of the breast is the commonest type of cancer in women. It makes up about 1 in every 3 cancers in women with about 32,000 people in England and Wales developing the condition each year.

Breast cancer is commoner in older women. Less than 5 out of every 100 women with cancer of the breast gets it before the age of 40 and only 2 out of every 100 are under 35 when the condition is first diagnosed.

The main symptom of breast cancer is a lump in the breast which is usually, but not always, painless. This is the way 90 out of every 100 breast cancers first appears. More unusual symptoms are bleeding or discharge from the nipple, or a change in the shape of the nipple or the breast. Although the great majority of breast cancers first appear as breast lumps there are other causes of lumps in the breast which are much more common than cancer. These include fibroadenomas, affecting women in their 20s and 30s and cysts, which are most common between 40 and 60. Breast pain, without any sign of a lump, is only very rarely due to cancer.

The Department of Health has given guidelines to family doctors (GPs) suggesting they should arrange an urgent appointment with a specialist in breast disease to check for anyone who comes with either of the following problems:

• a distinct lump in the breast and you are aged 30 or over
  
• other signs that may be linked to breast cancer including an ulcer (or sore) of the skin of the breast, a nodule in the skin of the breast, distortion of the skin of the breast, eczema ( a dry scaly rash) of the nipple or a change in the shape of the nipple that has developed over the previous few months.

The guidelines also suggest referral to a specialist if there are any of the following breast problems, but for these the appointment need not be an urgent one:

• a distinct lump in the breast but you are under the age of 30
  
• you have lumpiness which is not the same in both breasts and which is still present just after you have your period
  
• you have a breast abscess (a sore, infected area)
  
• you have a breast cyst that has come back after treatment
  
• you have pain the breast that is not helped by simple pain killers or wearing a well supporting bra
  
• you have a nipple discharge and are over the age of 50
  
• you have discharge from both nipples that stains clothes, or blood stained discharge from either nipple, and you are under 50.

All these symptoms can have other causes apart from cancer but the important thing is that if you develop any of these problems you should see your GP who can discuss them with you and, if they think it is necessary, arrange an appointment with a specialist to be on the safe side.