Breast Cancer

Breast cancer occurs when your breast tissue cells rapidly divide and grow abnormally. As these cells multiply, they accumulate and form lumps known as tumours.

Breast cancer usually starts in cells in your milk ducts or in your glandular tissue that supplies them with milk called lobules. As cancer grows, the cells can spread to your lymph nodes or other parts of your body.

Your doctor will stage your cancer according to the size of your tumour and whether and how far it has spread to help decide what your treatments options are.

The exact cause of breast cancer development in some people is not fully understood. However, there are risk factors that are known to increase the likelihood of developing breast cancer. They include:

• women over 50 years of age who have been through the menopause
• family history of breast cancer or ovarian cancer in close relatives
• previous non-cancerous breast lump or breast cancer
• taking a contraceptive pill or hormone replacement therapy (HRT)
• being overweight or obese
• drinking alcohol

You should regularly check your breasts and become familiar with their shape and feel so that you can recognise if any changes take place.

The first breast symptoms women usually notice is a lump or an area of thickened tissue in their breast that was not there before. Most often breast lumps are not cancerous but you should always get them checked by your doctor.

Other common breast cancer symptoms to have checked by your doctor include a change in size and shape of one or both breasts, a fluid discharge from either of your nipples, a swelling or lump in either of your armpits, dimpling of your breast skin, or a rash on or around your nipple.

Many different types of breast cancer can develop and knowing your cancer type will help your doctor plan the right treatment for you.

Breast cancer is often divided into:

• Non-invasive breast cancer – an early form of breast cancer, which is localised to your breast. The cells in your breast ducts turn into cancer but cancer has not spread into the breast tissue surrounding the ducts. It rarely shows as a breast lump and is usually found during a mammogram. The most common form is ductal carcinoma in situ (DCIS) and if left untreated, DCIS may become invasive.
• Invasive ductal breast cancer (IDC) – the most common type of breast cancer. The cancer cells have spread outside the lining of the ducts into the surrounding breast tissue. 

Other, less common types of breast cancer include:

• Invasive lobular breast cancer also called invasive lobular carcinoma (ILC) – breast cancer that grows in the cells that line your glands that make milk when breastfeeding, called lobules, before spreading into the breast tissue.
• Inflammatory breast cancer (IBC) - aggressive and fast-growing breast cancer that grows along the lymph vessels in the skin of your breast.
• Triple-negative breast cancer (TNBC) - the three most common types of receptors known to fuel most breast cancer growth (oestrogen, progesterone, and HER-2) are not present in your cancer tumour.
• Paget's disease of the breast - a rare form of breast cancer in which cancer cells collect in or around the nipple.
• Male breast cancer - cancer develops in the male breast tissue behind the nipples.

Metastatic breast cancer is when your breast cancer spreads to other parts of your body including your lungs, liver, bones or brain, usually through your blood or your axillary lymph nodes. It is also classified as stage 4 breast cancer.

Breast cancer treatment depends on the type and stage of your cancer, your hormone sensitivity, your age, overall health, and individual preferences. Cancer detected at an early stage can be treated before it spreads to other parts of the body.

We will discuss with you the best treatment plan for your breast cancer. Your breast cancer treatment options include:

Breast surgery - breast cancer treatment usually starts with surgery. There are several breast cancer surgeries including:

• Lumpectomy – breast-conserving surgery that removes the breast cancer tumour and a small margin of surrounding healthy tissue.
• Mastectomy – the removal of your breast, either just your breast tissue or your breasts together with some of the lymph nodes in the armpit. You’ll be offered surgery to have breast reconstruction either at the same time or at a later date.
• Sentinel node biopsy – the removal of some of your lymph nodes to accurately diagnose if cancer has spread, as your sentinel nodes are the first place that breast cancer spreads to.
• Axillary node clearance - if your sentinel nodes contain cancer cells, your surgeon may recommend the removal of more lymph nodes.

Drug treatments - anti-cancer medicines including:

• chemotherapy – drugs that destroy your cancer cells.
• hormone therapy – drugs that block hormones treat breast cancers that are sensitive to hormones.
• targeted (biological) treatments - drugs which target specific tumours.

Radiotherapy - high-energy beams destroy any cancer cells that remain after surgery.