October marks Breast Cancer Awareness Month.

BCAM is a time for prioritising self-checking, becoming aware of the symptoms of the disease, and listening to the stories of those who have battled it. However, despite the increased coverage that breast cancer awareness has been getting over the past 30 days, people still have a lot of queries about the incredibly common disease. To mark the end of this year's Breast Cancer Awareness Month, Bupa UK's oncology nurse Emma Norton gave Her the answers to the most Googled questions about breast cancer These included queries about the size of breast cancer lumps, the causes of breast cancer, and the symptoms of breast cancer. This most common 10 questions are as follows: 1. Where are breast cancer lumps usually found?  "Lumps would usually occur in either the breast or armpit, as these two areas are connected by the same length of breast tissue and muscle," says Norton. According to the NHS, 90 percent of breast cancer lumps turn out to be benign, however it is still important to get any lump checked out by a GP. 2. Can you die from breast cancer?  Yes, but survival rates have nearly doubled in the last four decades. In the UK, they have risen from 40 percent to 78 percent. The rate of survival is now up to 85 percent here in Ireland. 3. How big are breast cancer lumps?  "There is no average size of breast cancer lumps, nor is it useful or accurate to convey its severity from a measurement," says Norton. "Smaller lumps are generally thought to be safer than larger ones, but there are other factors to be taken into account such as the speed at which they grow – a smaller lump could be growing faster than a larger one, etc." Similarly, benign lumps may not require removal unless they are bigger than 4 cm at their widest point. 4. Are breast cancer lumps painful?  Some breast cancer lumps can lead to prolonged pain, which Norton says is an indicator that a patient should make an appointment with their GP. However, she says "there won’t always be pain or discomfort from breast cancer lumps (...) which is why it’s so important to regularly check your breasts in order to avoid going undiagnosed in the absence of other symptoms." 5. Can a blood test detect breast cancer?  Breast cancer can be diagnosed many ways, including the following methods:

• Mammograms
• Ultrasound scans
• FNA (fine-needle aspiration) biopsies (taking cell samples from under the skin)
• Core biopsies (taking larger cell samples)

6. How is breast cancer caused?  Norton says that while the cause of breast cancer is still unknown, there are various factors that can increase a person's risk of developing the disease. These can include genetics, environment, and old age. "Statistics show that 80 percent of women with cancer are over 50 – most men are over 60," she says. "Obesity, excessive alcohol consumption, the contraceptive pill and exposure to radiation are a few of the known risk factors for breast cancer." 7. Where does breast cancer spread to first? This varies depending on the type of breast cancer a person is diagnosed with. "Secondary breast cancer (when it spreads to other areas) is also known as metastatic breast cancer, metastases, advanced breast cancer, secondary tumours or stage four breast cancer," says Norton. "When it does spread, it would ordinarily do so via the lymphatic system or blood. Areas it would usually spread to are the bones, lungs, liver and brain; sometimes the skin or abdomen." 8. What does breast cancer look like? Breast cancer is most usually diagnosed when a person notices a lump in their breast, armpit, or collar bone, however pain or discomfort can also be an indicator or something more serious. A person should make an appointment with their GP if they notice any of the following changes in and around their breast:

• Inverted nipples
• Dimples, redness, or a rash around the breast
• Changed or uneven size or shape of the breast
• Discharge from the nipples (possibly containing blood)

9. Why is breast cancer so common?  Although the cause of breast cancer remains unknown, Norton says that some research has suggested that western lifestyles could be behind the rising numbers of people being diagnosed with the disease. "This is due to the link with obesity rates and alcohol consumption," she says. "Those who have a family history of breast or ovarian cancer will be more at risk. "Around 55,000 women and 350 men are diagnosed each year, and it has been stated in research from Breast Cancer Now that around 23 percent of cases of the disease could be prevented with lifestyle changes." 10. Can breast cancer cause back pain?  Norton says that back pain can often be a symptom of breast cancer when it has spread to the bone. "This can be due to increased pressure on the spine, sometimes when the cancer grows close to the spinal cord and compresses it," she says. "The pain can intensify when standing up, lying down or lifting heavy items. A vertebroplasty can help to relieve this with an injection of bone cement." You can find out more about breast cancer and how to check your breasts on Bupa UK's website here.