1 October 2025
October is breast cancer awareness month, designed to promote widespread education about one of the most common cancer diagnoses. In fact, it is the most common cancer in women, or people assigned female at birth, with around 56,000 cases diagnosed annually in the UK. Therefore, each year during October fundraising projects take place such as the ‘wear it pink’ campaign where people don pink clothing or a pink ribbon to symbolise solidarity with breast cancer patients and to raise money for cancer research.
Breast Cancer Symptoms and Tests
Breast cancer diagnoses are not just limited to women. In fact, there are around 390 men diagnosed with it in the UK each year. This can be a difficult diagnosis for men to deal with given its mainly female association, meaning they can be less likely to report symptoms or issues out of fear or shame. This, together with the tens of thousands of women diagnosed with breast cancer each year in the UK, highlights the need to raise awareness about symptoms and available tests to aid early detection, as anyone regardless of sex or identity can be susceptible to this type of cancer.
Breast cancer symptoms can include a lump or swelling in the breast that is new or abnormal, as well as skin changes such as a rash or redness, either around the breast tissue or nipple. Additionally, if you notice discharge from the nipple when you are not pregnant or breast feeding, including if there is blood then this could also be a sign. Any of these, coupled with constant breast pain, lack of energy or appetite and weight loss should be investigated by a doctor.
Breast tissue extends into the armpits, and so when checking for any of these symptoms, it is important to consider this area too. It is recommended that you check your breasts for lumps around once a month, using circular motions with your fingers with a mix of light and firm pressure, feeling from each breast, up to the collarbone and under the armpit. It is sometimes easier to feel changes in the shower, and so many find this is a good time to do so.
Once symptoms are reported to a doctor, the usual next steps are to be referred to a breast clinic, where a mammogram will be done. This is an x-ray of the breast tissue which can detect changes in breast tissue such as lumps or masses. If a mammogram identifies this is likely to be breast cancer, patients may be referred for blood tests, biopsies, CT scans, MRI scans and sometimes PET scans. These can help to show the extent of the cancer and if it has spread, to allow for the right course of treatment to be ascertained.
BRCA 1 and 2 Genes
Cancer diagnoses can be the result of a range of different causes. Some can be spontaneous, with no obvious reason, whilst others can be caused by external factors such as medications, smoking or bad lifestyle (e.g. poor diet and sun exposure). Lastly, cancer can also be genetic, which is especially relevant with certain breast cancer variants.
If you have close family members, such as parents or siblings, who have been given cancer diagnoses, this can increase your chances of developing cancer yourself during your lifetime. However, with breast cancer, there are two gene variants – BRACA 1 and BRACA 2 – which are inherited and can increase your likelihood of getting breast cancer up to a staggering 90 percent. This can be a dangerous prognosis for some, and as a result can have serious knock-on effects for fertility, family building and genetic health.
Around 5 percent of breast cancer diagnoses are due to these gene faults, with one of the most famous examples of the presence of the BRACA gene being Angelina Jolie. She was told that she had an 87 percent chance of a breast cancer diagnosis, and as a result underwent a double mastectomy to try to prevent it. This reduced her chances down to 5 percent, and following her surgery she became an advocate for spreading awareness about the impact of these genetic variants.
In addition to causing breast cancer, the BRACA genes can also cause ovarian cancer. Around 39-58 percent of people assigned female at birth who have the BRCA 1 gene will develop ovarian cancer, and 13-29 percent will do so with BRCA 2. Albeit these percentages are lower than those for breast cancer diagnoses, it is still a significantly high proportion.
As such, these gene variants can impact individual fertility, quality of life and choice when it comes to family building. Therefore, especially during breast cancer awareness month, it is important to raise awareness about these genetic aspects of cancer, and the wider impact of this.
Impact on Fertility
There are several ways that breast cancer diagnoses, and associated genetics such as the BRCA genes, can impact fertility. Typically, fertility is impaired or lost as an adverse effect of the treatment used to combat the cancer, rather than the cancer itself, but it can also arise from precautionary measures which are taken to prevent this type of cancer from arising.
Breast cancer can impair fertility or render someone infertile through chemotherapy. This is a widespread medical option to kill cancerous cells and is used to manage a wide variety of cancers. As successful as it can be to help control cancer growth, it can affect a person’s fertility by also targeting egg and sperm cells. This can either reduce the number of gametes a person has, and so make conception more unlikely, or in some cases can make a person entirely infertile.
Additionally, radiotherapy can cause a similar effect, regardless of whether the person who is suffering from breast cancer is assigned male or female at birth. If the breast cancer is more advanced and has metastasised, radiotherapy (the use of radiation to kill the cancerous cells) would be applied to other areas of the body, which can potentially affect egg and sperm counts. As a result, conceiving naturally may no longer be an option.
In relation to the BRCA genes specifically, there are also further impacts on fertility when precautionary measure are taken. Patients who are informed that they carry these genes are given the option to have an elective double mastectomy, which Angeline Jolie chose to do, and in some cases also to have an oophorectomy, or possibly a radical hysterectomy. An oophorectomy would subsequently make a person infertile, and also enter sudden menopause if they have not already done so, meaning they would no longer produce eggs and fertility becomes a sacrifice for the chance of a healthy and long life. A hysterectomy would render them unable to carry a pregnancy.
Ways Forward
Even if fertility is sacrificed to allow for effective cancer treatment, or precautionary measures, this does not mean that a person loses all hope to build a family. In fact, there are many ways that family building can remain an option, including gamete freezing, IVF, donor conception, surrogacy, and in some cases after their death through posthumous conception by a partner, spouse or nominated individual. In doing so, it is advisable to obtain specialist legal advice to maximise individual fertility and protect the legal rights, storage and use of any frozen gametes and embryos for use in future family building during life or after death.
One option is to consider gamete freezing, where a person may undergo an egg collection, or provide a sperm sample. Prior to an egg collection, the patient will be given hormones to produce more follicles and to stimulate the ovaries to produce more eggs for harvesting. As a result some more advanced and aggressive cancer diagnoses may prevent egg collection and freezing as the hormone medications may otherwise exacerbate the cancer and delay urgent treatment interventions.
To find out more about fertility preservation law in the UK click here.
The use of IVF can also help cancer patients and survivors build a family using embryos comprising their own gametes created and stored prior to treatment or subsequently created with their frozen gametes. Whilst IVF does not guarantee a successful conception and live birth, it can help maximise the prospect of a biological child for those whose fertility has been lost through cancer or treatment. For those unable to carry a pregnancy following a cancer diagnosis (e.g. where medication regimes prevent this or following radical surgery), the use of IVF in conjunction with surrogacy can enable the conception and delivery of a much wanted child/ren.
To find out more about fertility treatment law in the UK click here.
To find out more about donor conception law in the UK click here.
To find out more about surrogacy law click here.
It is also important to consider what should happen to any stored gametes or embryos in the event of an untimely death following a cancer diagnosis. The legal requirements of posthumous conception are complex and strict legal criteria govern whether they can be used in posthumous fertility treatment and surrogacy by a partner, spouse, or nominated person.This makes it very important to obtain specialist legal advice and document a gamete provider’s informed, written and signed consent to the storage and use of their gametes after their death to ensure their family building wishes are respected and their genetic legacy is preserved.
To find out more about posthumous conception law in the UK click here.
If you, or a loved one, is at risk or is facing a breast cancer diagnosis, it is advisable to seek expert fertility and family building law advice. This can help proactively maximise and protect individual fertility during life or after death. It can also help put into place effective legal and practical strategies to navigate fertility treatment, pregnancy, birth, and family life. If you would like to discuss your situation, or if you require specialist fertility, surrogacy and/or family law advice and assistance, please contact Louisa Ghevaert by email at louisa@louisaghevaertassociates.co.uk or by telephone +44 (0)20 79658399.
Images: Louisa Ghevaert CEO & Founder Louisa Ghevaert Associates
To find out more about Louisa Ghevaert click here.
