I’m a doctor who got breast cancer at 40. This is what I wish all women knew

Last week, the actor Lucy Davis, best known for her role as Dawn Tinsley in , revealed that she had metastatic breast cancer. She had found a tiny lump eighteen months ago, but the cancer had already spread to her bones by the time she was diagnosed. The 53-year-old shared on Instagram that it’s too late for chemotherapy and she’s going to make the most of the time she has left. Her news sent chills down my spine. In 2015, I was diagnosed with breast cancer, and I live in fear of that phone call telling me that it’s back and I can’t be cured.

I was a 40-year-old breast surgeon at the time. I had no risk factors for breast cancer and no family history. I’d just got into triathlons and I rarely drank alcohol. I also never checked my breasts because I thought it would never happen to me, and I was too young for screening. I’d spent a lot of time breaking bad news, but it’s completely different when you’re on the other side.

Within a couple of weeks, I was sitting in a chemo chair, watching the drugs drip into my veins. My life was put on hold for a year of treatment whilst I came to terms with infertility and an instant menopause. Two local recurrences cost me my career. I retired for ill health reasons when I was 43. The life I’d dreamed of having was over. This is the impact of getting breast cancer when you’re forty instead of seventy.

Young women’s cancers are picked up later, and seem to grow more quickly

I’m now 51, and it’s been three years since my last recurrence on my mastectomy scar. I know there’s a good chance that I will get metastatic disease in the future. My original cancer was 13cm in size and had spread to four of my lymph nodes. I now get monthly injections of a hormone-blocking treatment, but cancer is sneaky, and it can find ways to get around the drugs. Accepting that it might happen makes things easier for me to cope with. I eat well and exercise regularly to lower the odds, but I know ultimately it’s out of my control.

Sales of battery
electric vehicles hit a record high last year.

Starts at £22,995 for the smaller battery

Available with either a 40kWh battery or a larger 52kWh pack, that offers almost 255 miles, the latest, retro-inspired Renault 5 is both a joy to behold and a hoot to drive.

The interior has been lavished with a level of detail that’s typically reserved for more expensive cars. 

4 min read

A champion of EV efficiency

It offers a remarkable 491 mile range on a single charge from the 85kWh battery.

It is a technological masterclass inside with the ability to option screens that span the entire width of the dashboard, including an optional display for the front passenger.

Priced from £37,400

2 min read

It’s a lot of money to part with, but this is arguably all the car you will ever need.

The £89,000 Macan is a premium SUV that somehow manages to blend Porsche’s reputation for dynamics and sporty driving with everyday practicality.

The 95kWh batteries can go from 10 to 80 per cent in as little as 21 minutes from the fastest public charging outlets.


With the business class-style six seat configuration costing a staggering £76,995, it is by far the most expensive Kia ever made, but it backs up its financial demands with a suite of genuinely useful and impressive onboard technology.

It’s fast, goes a long way between stops and charges relatively quickly but the interior is bland, the onboard technology is infuriating and the experience is devoid of emotion. 

All of its gadgetry can’t disguise the fact that performance is weak, even for a typically zippy EV, the ride is fussy at slower speeds and it’s not in the least bit enjoyable to drive on a country road.

  • While good value (prices start at £17,935) for the 200-mile max range, there are more interesting options from Hyundai, Citroen and Renault for similar money.
  • It attempts to wow with tech, much of which hinders, rather than helps. 
  • There’s no tangible benefit over mounting your phone to the dash.
  • Simply an average driving experience, adequate range and slow charging speeds. 

2 min read

The kitchen gadgets under £25

best kitchen gadgets

Victorinox paring knife

It’s comfortable to hold, with a point sharp enough for scoring pastry.

ProCook cast iron pan

For unbeatable searing and heat-retention, cast iron is the top choice. 

Tesco chopping board

Priced at just £22, I’ve yet to find another board that matches it for sheer value and quality.

The kitchen gadgets under £25

Pyrex jug

It is the perfect vessel for blending smooth sauces, melting butter, or warming stock. It won’t stain like plastic and the red measurements never fade.

Salter scales

“I’ve had my slim little set of Salter Disc Scales for over a decade, and I’m delighted to see they are still made to exactly the same reliable design today.”

Microplane grater

It uses photo-etched stainless steel teeth that stay razor-sharp for a decade, something the lookalike copycats simply can’t match. 

Braun hand-held blender

It’s an essential for everything from making velvety soup to getting the lumps out of white sauce. 

Bodum cafetiere

As well as delivering great results, cafetieres are easy to clean and there’s no ongoing filter paper costs or pod recycling to deal with.

5 min read

The kitchen gadgets under £25

Oxo peeler

What truly sets it apart is the chunky, rubberised handle that absorbs pressure and stays completely non-slip, even if your hands are wet. It is inexpensive and incredibly durable.

Falcon pie dish

Made by fusing porcelain onto heavy-gauge steel for smooth durability, it is dishwasher, freezer, hob, air-fryer and oven-safe. 

The golden rules for a happy, secure relationship

Psychiatrist and neuroscientist Dr Amir Levine, author of bestselling book , explains why we behave the way we do in love.

Happy woman walking with male partner in vineyard during sunset. Elderly couple are touring in field against sky. They are enjoying during weekend.

Golden rules for happy relationships

Start with your own behaviours

The foundation of a secure, connected life is being what I call CARRP: that means being consistent, available, responsive, reliable and predictable. All of these qualities can be enacted in small gestures every day.

Side view of affectionate happy couple sitting in the cozy cafe. - stock photo
Happy young couple spending quality time together at home

Express your needs

People need consistency and connection to feel safe. This is not, ‘You hurt my feelings by never replying to me’, it’s more ‘this is the kind of contact that helps me feel secure’.

Golden rules for happy relationships

Unhappy married couple facing away from each other in a quiet home, concept of emotional distance, loneliness in relationship and family problems - stock photo

The appendix ‘inflammation’ rule

If a relationship repeatedly inflames your nervous system, you need to disengage and deprioritise it.

Lean on community

You don’t need hundreds of friends. You need people and places that regularly remind you that you belong. 

Happy couples talking while walking embraced during spring day in a meadow.
Candid shot happiness and togetherness Asian mother supporting daughter try to standing and walking first time and positive emotion - stock photo

Stop blaming childhood

Humans are much more complicated than: ‘this happened to you, therefore you are doomed to be anxious’.

Financial problems. Worried middle-aged woman holding utility bills, managing monthly household budget, sitting on bed feeling anxious. Cost of living concept

Reach for a
secure script

When something unsettles you in a relationship, your first reaction is not always the most accurate one. 

If you’re anxious, your brain may jump very quickly to: ‘this is the beginning of the end’. If you’re avoidant, your brain may say: ‘this person wants too much from me, I need to get away’. So one very practical thing you can always do is pause and ask: ‘What would a secure person do here?’

Loneliness elsewhere

When people talk about loneliness, they often assume it means you don’t have enough people in your life. But you can be surrounded by people and still feel lonely if those relationships leave you feeling excluded, ignored or disconnected.

Frustrated lonely shy guy sitting apart of others teenagers - stock photo

What to do

  • Build a community that works for your temperament and gives you regular, reliable moments of connection.
  • You can still be kind to people while not treating them as someone who belongs in your inner circle. 
  • Explain what you need. Sometimes people simply don’t realise how you are experiencing them.
  • Check in with people: does this person actually feel that I’m reliable? Do they experience me as predictable? That’s the only way that you can start to become more secure.

Do some foods leave
you feeling hungry rather than satiated? Experts say there are…

Foods that leave you hungrier

A bowl of cereal and glass of orange juice

More refined cereals are digested quickly, and fruit juice, whilst one of your five-a-day, contains less fibre than whole fruit. This might mean you find yourself hungry again within 1-2 hours of eating this breakfast.

Woman eating colored breakfast cereal in front of laptop, workplace breakfast, quick healthy breakfast in office in the morning.

Swap the orange juice for a whole orange, the cereal for oats and milk or serve it with Greek yoghurt or a boiled egg. This would increase the fibre and protein content; two nutrients strongly linked with fullness.

Foods that leave you hungrier

Gail's croissant Image taken from https://gails.com/collections/breakfast/products/croissant

These pastries are made primarily from refined flour and butter, and are relatively low in protein and fibre.

Toast and jam

Toasted bread and white background
FILE PHOTO: Pufferfish sushi line is seen on a display window at a market in Shimonoseki, Japan February 7, 2020. Picture taken on February 7, 2020. REUTERS/Sakura Murakami/File Photo

Shop-bought packs can contain a lot of white rice, which is digested quickly, and the protein content is often modest.

Foods that leave you hungrier

Sarawak laksa is one of many varieties of this noodle soup (Photo: Tham Kee Chuan/Getty)

Vegetable soup

On its own, it is often very low in protein and calories, so hunger can return quickly.

Unless it’s loaded with veggies, it’s probably pretty low in fibre.

WASHINGTON, DC - AUGUST 12: Chocolate Milkshake Smoothies photographed for Food in Washington, DC on August 12, 2024 (Photo by Scott Suchman for The Washington Post via Getty Images; food styling by Lisa Cherkasky for The Washington Post via Getty Images)

Liquids are generally less filling as they require little chewing which may not trigger satiety signals.

Foods that leave you hungrier

London, convenience store, snacks and sweets. (Photo by: Jeffrey Greenberg/Education Images/Universal Images Group via Getty Images)

Snack bars

They are ideal for a quick pick-me-up, but if reducing hunger is what you’re after, it’d be better to swap it out.

Low-fat yoghurt

A full-fat plain Greek yoghurt with berries and seeds tends to be much more filling due to the protein, fat and fibre.

Which yoghurts are the best options? (Unsplash)
BANGKOK, THAILAND - OCTOBER 17: A "KT Herbalist", a Kratom cocktail made from Kratom, coffee and siamese herbs is seen at Teens of Thailand, a bar in Bangkok's Chinatown on October 17, 2021 in Bangkok, Thailand. In April 2021, the start of Thailand's third and most deadly wave of the COVID-19 pandemic, the Thai government banned the sale of alcohol in restaurants and bars, crippling the already suffering food and beverage industry. With a lack of government aid and support, some bars have shuttered their doors in hopes of reopening post-lockdown, while others shuttered their doors for good. But six months into Thailand's most recent lockdown, Niks Anuman-Rajadhon, owner of Teens of Thailand, a gin bar located in a renovated shophouse in Bangkok's Chinatown, decided that instead of waiting for the government to allow the sale of alcohol again, they would take advantage of Thailand's recent legalization of Kratom. Kratom is a locally grown herbal drug with mild opioid and stimulant effects and was reclassified from a type-5 narcotic to a legal-to-grow herb in August 2021. While Thailand prepares for a tentative reopening on November 1st, the alcohol ban and curfew are set to continue, leaving business owners questioning if the country can revive its suffering tourism industry. (Photo by Lauren DeCicca/Getty Images)

On an empty stomach, it can actually increase your appetite.

What to eat instead

Instead of thinking about avoiding foods, think about what you can add to them.

  • Add beans, lentils or shredded chicken to your vegetable soup and pasta.
  • Thicken your smoothies with Greek yoghurt, chia seeds and oats.
  • Apple slices with peanut butter, yogurt with berries and hummus with oat biscuits are better snack options than a pre-made snack bar.
  • Have alcohol alongside a balanced meal containing protein and fibre.

How to age well
without pain

Will Harlow, a physiotherapist
for the over-50s and author of Independence for Life, shares
the key signs you’re ageing
badly – and what to do about it.

How to know

Ageing well is maintaining the ability to do what you want you want for as long as you want without needing help. Everyone is talking about longevity but what’s the point in living longer if the last decade is painful and you’re [totally] reliant on people?”

The signs to look out for

Senior woman on sofa feeling and suffering from back pain. - stock photo
  • The most obvious early warning sign of bad ageing is pain says Harlow. 
  • Another is losing confidence in doing daily tasks, which can quickly lead to a lack of independence.
  • One call Harlow often receives is people calling after having a fall and struggling to get up.

4 min read

How to age without pain

Not just stopping

When people retire, they often put their feet up and stop. Your body really is use it or lose it.

Throughout our entire lives, Harlow says we need between seven and nine hours of sleep.

Tired mature woman taking a nap on the sofa in the living room
Maribel Ezcurra, 77, a retired milling machine mechanic, practices tai chi with fellow seniors in a park in the Playa neighborhood of Havana, Cuba, Wednesday, April 15, 2026. (AP Photo/Ramon Espinosa)

Social isolation

The lack of connection can increase the risk of premature death by
as much as 29 per cent.

Strength training

It really is the proxy for
overall independence.

The more muscle mass you have, the less chance of heart disease, diabetes, falls and even anxiety, depression and dementia. 

This is a photo of a senior man helping his wife lift weights. See PA Feature HEALTH Physio. WARNING: This picture must only be used to accompany PA feature HEALTH Physio. PA Photo.Picture credit should read: Alamy/PA. NOTE TO EDITORS: This picture must only be used to accompany PA Feature HEALTH Physio.

The brain can be linked to muscle mass too, Harlow says. It’s not just about being able to lift things. It gives you more energy, better sleep and you’ll look and feel better.

How to age without pain

Daily habits

Do short bursts of exercise, between 30 and 60 seconds, in otherwise dead time during the day.

Elderly woman exercising in a public park
A mature man rouses in the early morning light, stretching as he wakes.

Stretch in bed

Take joints through a full range of motion for five minutes to loosen it before getting up.

Don’t crash diet

A woman adds up food calorie counts in her kitchen

How to age without pain

Protein shake and chocolate protein powder in a scoop, Sports nutrition.

Harlow advises 1.6 grams per kilogram of body weight to stop muscle loss alongside resistance training.

Don’t wait

Harlow finds that many patients put off making a change to their lifestyle until their lives are consumed by pain. 

Menstrual pain, woman with stomachache suffering from pms at home, endometriosis, cystitis and other diseases of the urinary system - stock photo
Close-up view of female jogger tying laces of her sport shoes before running exercise routine. Motivation, healthy lifestyle and fitness concept.

For most people, it’s about reducing the number of times per week you’re exercising, not reducing intensity. 

The three ageing tests to do

  • Lie completely flat on the floor and get back up to a standing position using any technique. This should take less than 10 seconds.

  • See how many times you can sit on the chair and stand back up again in 30 seconds. Men should be aiming for more than 14 times and women 12. 

  • The single-leg stand, which involves standing on one leg and balancing for 10 seconds. Everyone should be able to do that and for those under 65, Harlow asks them to do it with their eyes closed.

Despite the job market hiring fewer entry-level roles, employers are still looking for grads…

But you should be prepared to keep an open mind.

We’ve compiled the sectors hiring graduate roles, what degree is required, and what they pay.

Young adults in graduation gowns joyfully tossing caps into the sky, celebrating achievement and new beginnings against a clear backdrop

The degrees to choose for a career

Hiring in the UK could
finally be on the up

47%

of employers offered entry-level
positions from July.

That is up nearly 15 per cent from the same period last year.

700,000

But graduate unemployment rose to six per cent in 2025 and 700,000 jobless graduates were claiming benefits.

Finance and insurance

  • Around 42 per cent of UK finance and insurance employers say they will be open to graduate roles this summer.
  • Business loan company Portman Finance Group has taken on 50 graduates over the past four years.
A lot of thought needs to be put into transferring a DB pension to a DC pot

Portman graduates start on £36,000 for the two-year programme and the education you need to apply is a minimum “ABB” of A-levels, and a 2:1 or above university degree. But not in a specific subject.

Mature businesswoman wearing casual, commuting to work in the city of Vienna. Female commuter leaving the subway train while commuting to work

Trade and logistics

What makes it particularly rewarding is that there’s always something to learn.

Nearly half (47 per cent) of trade and logistics companies will be giving graduates a go this year.

Salaries start at £30,000 with an uncapped bonus, rising to £50,000 plus a company car as a senior account partner.

Technology and IT

More than half (52 per cent) of UK tech and IT firms are actively looking for graduates. 

Successful entry-level candidates can earn a basic salary of up to £35,000, with the opportunity to triple that within their first three years of working.

Young business woman searching for job online. Woman writing resume on laptop.

4 min read

Public sector, health
and social services 

46 per cent of public sector, health and social services organisations are also ready to take graduates, according to a survey by Manpower. 

A policeman walking away from an elderly person's home. - stock photo
  • For example, Police Now runs a graduate programme into policing. They recruit graduates from any degree field, as long as they achieve a 2:2 or above. Starting salaries range from £31,164 to £42,210 depending on location and rising each year.

Can we treat guests without blowing our budget?

According to Waitrose, a dinner party revival is underway led by younger people trying to reduce the cost of getting together.

Always have bread

People will feast on the
bread, and then need less fish/steak/expensive whatever. All small plates restaurants know this: this is why the first thing on the menu is always artisan bread and butter.

ELLA RISBRIDGER, AUTHOR OF THE KITCHEN BOOK – GOOD FOOD FOR EVERY DAY
Female Hands cutting bread. - stock photo

Use vegetables as centrepieces

Variety Fresh of organic fruits and vegetables and healthy vegan meal ingredients in reusable eco cotton bags on beige background . Zero waste shopping concept. Healthy food, clean eating, eco friendly, no plastic. Flat lay, top view - stock photo
Beautiful woman unpacks a full fabric bag with fruits and vegetables on the kitchen. - stock photo


Add pantry items

Graham’s recipes include a braised cabbage with a preserved lemon sauce, a roast cauliflower with saffron, and harrisa roast carrots with mango labneh.

How to host on a budget

Table top view of Indian food.

Improve the everyday

Guests will always appreciate a stellar interpretation of the ordinary. Think lasagna or curry.

Cooking dinner for your guests is spoiling them – you’re being generous with your time, your effort, and your home. So don’t feel the need to go overboard elsewhere.

A group of friends is toasting together during a dinner party. They are smiling, celebrating together.
Man serving friends salad at backyard dinner party - stock photo

Ask for help

Ask friends to bring a contribution, be it a nibble or a pudding.

Big platter energy

[Presentation] can be the key to elevating something . Spaghetti and tomato sauce suddenly looks like a feast when tumbled on a lovely big plate, dressed with olive oil and parmesan and placed in the middle of the table.

Food writer and editor Eleanor Steafel 

How to host on a budget

Taco party

Have one expensive filling, like shredded chicken, and two cheaper options, like refried beans, says Ella Risbridger.

Traditional ice cream parlours are still going strong (Shutterstock)
Tacos are a popular dish throughout the country (Photo: Daniela White Images/Getty)

Shop-bought ice cream is so easily zhuzhed up with the help of handy toppings, says Eleanor Steafel.

Lynsey Crombie @lynsey_queenofclean, home expert and TV presenter

Low-effort tricks for
a cleaner house

While many Britons feel inspired to tackle their homes during summer, the warmer months can also make cleaning harder.

But Lynsey Crombie, known as the Queen of Clean, says the hotter months can increase mould, musty smells and sweaty clothes. 

Here, she shares the tips and practical
hacks she lives by.


A study of 1,000 UK residents by Domestic & General revealed that almost one in 10 Brits have never cleaned their washing machine, yet it could be grubbier than the toilet seat.

Overhead view of young Asian woman loading the washing machine with laundry - stock photo
Woman loading washing machine in the kitchen - stock photo

Crombie says after 30 washes, use 500 grams of soda crystals on the hottest wash to clean out the drum. If there’s sludge, run a quick rinse cycle with some white vinegar.

Always make sure to leave the door and drawer ajar for 10 minutes to dry out too and avoid stale smells.

Household ingredients to use

Ensure clean drinking water at home with kitchen filtration. Cropped woman hands filling glass with tap water

White vinegar

This is Crombie’s go to. It can descale the kettle and taps and deodorise places in her home.

Table salt

For tough stains like red wine, rub salt into the stain, leave overnight and wash as normal.

Unrecognizable female friends celebrate and drink red sparkling wine
Fresh lemons and sugar cubes on marble counter top

For stubborn water marks, use half a lemon and bicarbonate of soda and leave on for 30 minutes before rinsing.

Detail of a man cleaning a wooden kitchen floor with a mop and bucket, taken on March 3, 2018. (Photo by Olly Curtis/T3 Magazine/Future via Getty Images)

Cold water is better

You’re damaging [wooden] floor [with hot water], making it expand, stretch
and cause gaps…

During hot days, Crombie says to avoid cleaning with hot water altogether to avoid adding humidity to the home.

“Cold water is much better, and if you’re using the right floor cleaning product, it’s still going to be clean,” she says.

Hacks for a cleaner home

Three is the magic number

Wash your towels after two to three uses and make sure they dry properly in-between.

Orange microfiber towel hanging on a rack in a bathroom
TOTO Neorest WX TOTO toilets www.gb.toto.com Image supplied by Julienne Webster

Focus on hotspots

Clean the “high traffic” areas, like the toilets, kitchen worktops and the hallway daily.

Open the windows

To keep a home fresh open the windows for 15 minutes each day – even in colder months.

An African American stand near the bedroom windows, closing the blinds, while wearing casual clothing.

Weekly habits

Do it more frequently, to cut down how long it takes

Lazy boyfriend hanging in phone while his girlfriend cleaning his dishes after dinner in kitchen. Inequality of men's and women's rights. Family arguement

One task Crombie does weekly is her fridge. This includes a 10-minute wipe-down, focusing on the salad and vegetable tray. “If you save that job up and do it every other month, it’s going to be a very big chore.”

4 min read

Hacks for a cleaner home

An employee of the French pan maker Cristel, wipes a frying pan at the Cristel factory, on May 23, 2024, in Fesches-le-Chatel, eastern France. At Fesches-le-Chatel, in the Doubs region of France, the Cristel factory is on a roll: France's number-one manufacturer of stainless steel kitchen equipment has seen "demand explode" since the National Assembly passed a law restricting the use of PFAS in April. (Photo by SEBASTIEN BOZON / AFP) (Photo by SEBASTIEN BOZON/AFP via Getty Images)

Stainless steel

Crombie’s hack is one product: Barkeeper’s Friend in powder form.

The expensive products

“If you spend more money, you get the floral scents. The difference is scent, not performance.”

Deep cleaning glass door handles for Covid-19 disease prevention. alcohol,disinfectant spray on Wipes of Banister in home for safety,infection of Covid-19 virus,contamination, germs - stock photo
Cleaning day at home - stock photo

Ignore online advice

The biggest issue she sees is product overuse. “You don’t need half a bottle of washing up liquid to clean a surface.”

Crombie’s essentials

Four products can do do a full clean of the house.

  • Antibacterial washing-up liquid: “It can clean almost anything, and any brand works.”
  • : It’s pet-friendly, eco-friendly and “ticks all the boxes.”
  • Cif cream cleaner: “It’s an old school product. It’s so good.”
  • White vinegar: ““It’s great for washing sportswear, gym kits and is a great stain remover.”

Young women with cancer aren’t treated any differently from our mums and grannies. But young women are more likely to have chemotherapy, because our risk of recurrence is higher. That’s partly because our cancers aren’t picked up through mammogram screening – it’s only when we notice a change that we get checked out. This means that our cancers are often larger when they’re found. And breast cancers in young women can behave differently. While most breast cancers take ten years to grow into a lump you can feel, in young women they can grow and spread more quickly, which is another reason why so many of us have chemo.

I spent months beating myself up. If only I’d checked my breasts regularly, I might have avoided chemotherapy. Even though I knew most breast cancers are due to bad luck, I worried that all the alcohol I drank at medical school, coupled with a bad diet as a junior doctor, were partly to blame.

Back then, breast cancer in young women was fairly uncommon, but the numbers are steadily growing in women in their twenties, thirties and forties. Diagnoses among these women have risen by 40 per cent in the last twenty years.

If you spend any time on social media after a cancer diagnosis, you see breast cancer everywhere. Young women are sharing their stories. It can feel like you’ll be next, but the numbers are still small. In your 30s, your risk rises from one in 4,000 women to one in 3,000 women. However, if you’re the one who’s got cancer, it’s a huge deal.

File photo dated 06/12/08 of The Office actress Lucy Davis has said she was diagnosed with "incurable stage four breast cancer. In a post shared on Tuesday she said was diagnosed a year and a half ago and the cancer has "metastasised" to her bones including her spine, right hip and ribs, and it is "too late" for chemotherapy. Issue date: Tuesday August 11, 2026. PA Photo. Photo credit should read: Ian West/PA Wire

Most breast cancers are diagnosed in women in their 60s. The two biggest risk factors are being a woman (simply because you have more breast tissue) and getting older. Like most cancers, the longer you live, the more likely your cells are to make mistakes, develop mutations and become cancerous.

The risk of getting breast cancer is actually highest in your 70s, 80s and 90s. That’s why we screen women with mammograms from age 50 to 70 to pick up breast cancer at an early stage.

Fewer women are dying of breast cancer. In the 1990s, one in seven women died. Today, thanks to enormous advances in screening, awareness and treatment, it’s one in twenty.

Why breast cancer is going up in the under 50s

However, the small but unexplained rise in breast cancer in young women is causing concern among experts. It’s also worrying that the number of women like Lucy Davis, who are diagnosed with incurable cancer from the start, is also rising. Data collected by the US National Cancer Institute reported an increase of 1.2 per cent each year, but for the under-40s, it’s going up by 3 per cent each year.

So what is causing the rise in cases? The internet is full of people telling you they know why. They are blaming everything from microplastics to Covid vaccines to endocrine-disrupting chemicals called parabens in your cosmetics and toiletries. And while they can make a very good case using studies done on cells in a lab with massive doses of these products, there is no proof that they cause breast cancer in humans.

Scientists have proven that three things are driving some of the increase in cases, and the first is obesity. For years, I was taught that being overweight when you were premenopausal slightly lowered your risk, while obesity after menopause increased it. But recent evidence has flipped this on its head. Obesity is now a risk factor for breast cancer in young women, particularly for triple-negative disease, which is harder to treat. Excess body fat can cause chronic inflammation which can trigger mutations in healthy cells. It will be interesting to see what the impact of GLP-1 drugs like Ozempic will be in ten years.

It’s not just our body weight, but what we eat as well. Ultra-processed foods (UPFs) hit the headlines in 2023 when The Lancet published a paper stating that people who eat large quantities of UPFs are 10 per cent more likely to get cancer. That sounds terrifying, but it doesn’t mean you have a 1 in 10 chance of getting breast cancer if you eat a takeaway at the weekend.

If a woman lives until she’s 80, her lifetime all-cancer risk is about 40 per cent. A 10 per cent increase takes that to 44 per cent. That’s an extra four women getting cancer over 60 years. And the cancer risk was only seen with animal-based UPFs, not bread, cereals or dairy produce. Eating UPFs won’t automatically give you cancer, but if you eat a lot of them, you’re more likely to gain weight, and obesity will then increase your cancer risk.

Alcohol is another cause, and as a group 1 carcinogen, it increases your risk of seven cancers, including breast. One unit a day increases your risk of breast cancer by seven to ten per cent. If you are in your 40s, this means an extra 15 cancers for every 10,000 women. It’s only a small rise, but over the years it all adds up. The more you drink, the greater the increase in your risk. There is no safe amount.

The third factor relates to female hormones and reproduction. Oestrogen is an important hormone in the human body, and it helps your breasts develop at puberty and during pregnancy. All healthy cells have receptors, like a lock, and oestrogen is the key. But some breast cancers have a huge number of receptors, and oestrogen stimulates the cells to grow.

We know from observational studies that women who’ve had a longer exposure to oestrogen are slightly more likely to get breast cancer. For example, you get your first period at ten instead of fifteen (and puberty is starting younger in girls), or you have a late menopause. These are out of your control.

Having several children and breastfeeding them decreases your risk. And if everyone delayed having children until their late thirties instead of their twenties, we would see an extra 40 to 50 cases per 100,000 women a year. But this increase is small and should not be a reason to make decisions about when to start a family. It is not my fault that I got breast cancer because I was 40 and childless. Please don’t blame yourself if you’re in the same boat.

What every woman can do to lower her risk

These three factors aren’t the only reason for the rise in breast cancer in young women. Slim young mums who don’t drink get breast cancer too. And while scientists are looking at our environment and the microbiome, we still don’t have all the answers. The Sarah Harding Legacy Fund is behind the BCAN-RAY trial trying to identify young women who have a higher risk of breast cancer, but it will take time to get results. So what can we do in the meantime?

Lowering the age of screening sounds like a good idea, but it’s not that simple. Mammograms work by picking up tiny areas of cancer before they form a lump. These spots look white. Just like breast tissue.

When you go through menopause, your breast tissue starts to turn to fat, which looks black, so small cancers are easier to see. Mammograms aren’t as accurate in young women. And the pick-up rate of cancers will be a lot smaller which makes it hard to justify the expense. And when only 50-60 per cent of women in their fifties are going for their screening mammogram, there is no guarantee that young women would turn up.

The answer is three-fold. There are tools being developed to identify which women have a higher risk. One, called Boadicea, developed at Cambridge University and funded by Cancer Research UK, is doing just that. Family history only accounts for 5-10 per cent of all cancers, meaning 95 per cent of high-risk young women are being missed. Boadicea also takes into account your lifestyle, reproductive and genetic factors to give a more accurate picture. If we can identify these women before they get cancer, we can discuss treatments like Tamoxifen that can reduce their risk. We also need to remind young women that being overweight, drinking alcohol and not exercising regularly will increase their risk.

And finally, we need to encourage everyone to check their breasts every month. It was too late for Lucy, but imagine how bad things could have been if she hadn’t had that tiny spot checked out. No adult is too young to get breast cancer. And finding it early could save your life.

Dr Liz O’Riordan is a breast surgeon and author of books including The Complete Guide To Breast Cancer. Follow her @DrLizORiordan

Original source I’m a doctor who got breast cancer at 40. This is what I wish all women knew

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