Breast Cancer (Hansard, 20 October 2003)

§ Miss Melanie Johnson

It is not clear exactly what causes breast cancer, but it is thought that there are many risk factors, some already well established and some still being investigated. The main risk factors are being female and increasing age. The majority of other risk factors are linked to lifestyle. Key prevention measures include improving dietary intake, including increasing fruit and vegetable consumption, increasing physical activity and staying at a healthy weight.

About five per cent. of all breast cancer cases (fewer than 2,000 per year) may be caused by breast cancer genes. The National Institute for Clinical Excellence is developing a clinical guideline on the classification and care of women at risk of familial breast cancer in primary, secondary care and tertiary care. The guideline is expected to be published in February 2004.

The Government's White Paper, "Our Inheritance, Our Future—Realising the Potential of Genetics in the NHS", was published in June 2003. The Department has collaborated with Macmillan Cancer Relief to develop a model approach to genetic cancer services for people at risk of, or concerned about, familial cancer. The model is patient-centred, describing a continuum of advice and 454W care involving primary care, local cancer services and specialised genetic and cancer services. A tendering exercise has begun to pilot all or certain aspects of the model. It is envisaged that there will be six evaluated pilot sites in England to inform the future development of cancer genetic services, as envisaged in the National Health Service Cancer Plan. Bids for pilot project funding must be submitted by 31 October 2003.

Women should be breast aware at all times. The Government promote the overriding importance of teaching women to be breast aware, knowing that 90 per cent. of breast cancers will be found by women themselves. The breast awareness five point code is as follows:

know what is normal for you;
look and feel;
know what changes to look for;
report any changes without delay; and
attend for breast screening if aged 50 or over.

The Department, together with Cancer Research UK, produces a leaflet entitled "Be Breast Aware". The leaflet is widely available from general practitioner's surgeries and breast screening units. 1.5 million copies were printed in 2002–03.

Officials from the Department have had discussions with the Department for Environment, Food and Rural Affairs regarding possible links between environmental chemicals, in particular, organochlorine pesticides, and breast cancer.

In 1999, the independent Committee on Carcinogenicity of Chemicals in Food Consumer Products and the Environment (COC) considered this issue and concluded that lindane and other organochlorine pesticides were not a significant risk factor in breast cancer. The remit of the COC is to advise Government Departments on all aspects of the carcinogenicity of chemicals. The COC is currently reviewing new data on this issue.

The COC has also considered the possible association between alcoholic beverages and breast cancer. A statement was issued in 1995, indicating that there was not enough evidence to conclude that the ingestion of alcoholic beverages was a cause of breast cancer. The COC is reviewing new data on this issue with a view to updating its statement next year.

There have been allegations of an association between environmental radiation and breast cancer and these are being considered by the independent Committee on Medical Aspects of Radiation in the Environment. The remit of this Committee is to advise Government Departments on the health effects of environmental exposure to radiation.