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What Is Breast Cancer? Symptoms, Early Detection and Treatment
Contents
- What Is Breast Cancer?
- What Are the Symptoms?
- Why Is Early Detection Important?
- Breast Cancer Screening
- Risk Factors
- Can Breast Cancer Occur at a Young Age?
- How Is Breast Cancer Diagnosed?
- How Is Breast Cancer Treated?
- Does Breast Cancer Always Require Mastectomy?
- What Happens if a Breast Lump Is Benign?
- Psychological Support
- Frequently Asked Questions
What Is Breast Cancer?
Breast cancer develops when abnormal cells in the breast grow uncontrollably and form malignant tumours.
Breast cancers most commonly begin in the milk ducts or milk-producing lobules. Early disease may remain within the breast, while invasive disease can spread into surrounding tissue, lymph nodes or distant organs.
Breast cancer is the most commonly diagnosed cancer among women worldwide. It can also occur in men, although this is much less common.
What Are the Symptoms of Breast Cancer?
Early breast cancer may cause no symptoms. This is why age- and risk-appropriate screening is important.
Possible signs include:
- A new lump or thickened area in the breast or underarm
- A new change in breast size or shape
- Dimpling, puckering or pitting of the breast skin
- A new change in nipple shape or nipple inversion
- Spontaneous or bloody nipple discharge
- Scaling or persistent changes around the nipple or areola
- Unexplained redness or swelling of the breast
Why Is Early Detection Important?
Detecting breast cancer while it is smaller and before it has spread can increase treatment options and reduce the risk of death from the disease.
Early detection includes awareness of breast changes and appropriate screening with mammography before symptoms develop.
Knowing what is normal for your breasts can help you recognise changes, but breast self-awareness does not replace mammographic screening.
Breast Cancer Screening
Screening recommendations vary by country and individual risk.
For people at average risk, mammography is the primary breast cancer screening test. Some international guidelines recommend biennial mammography from age 40 through age 74.
People at increased hereditary or clinical risk may require an individualised screening programme. Breast MRI can be used in addition to mammography in selected high-risk patients.
What Are the Risk Factors?
- Female sex
- Increasing age
- Family history of breast or ovarian cancer
- Certain inherited gene variants such as BRCA1, BRCA2 and PALB2
- Previous high-dose radiation exposure to the chest at a young age
- Obesity, particularly after menopause
- Alcohol use
- Certain reproductive and hormonal factors
- Some forms of postmenopausal hormone therapy
Many people diagnosed with breast cancer do not have a known family history or another obvious risk factor.
Can Breast Cancer Occur at a Young Age?
Yes. Breast cancer can occur at younger ages, although incidence generally increases with age.
It is therefore inaccurate to describe breast cancer as occurring mainly within one narrow age range.
When breast cancer occurs at a young age, assessment of hereditary risk and family history may be particularly important.
How Is Breast Cancer Diagnosed?
Evaluation may include clinical breast examination, mammography, breast ultrasound and, in selected cases, breast MRI.
If imaging reveals a suspicious lesion, a tissue sample is obtained.
A definitive diagnosis of breast cancer is established by pathological examination of a biopsy sample.
When cancer is confirmed, tests for biomarkers such as estrogen receptor, progesterone receptor and HER2 help guide treatment.
How Is Breast Cancer Treated?
Breast cancer is not a single disease, and treatment is individualised according to stage, tumour biology, lymph-node involvement, general health and patient characteristics.
Treatment may include:
- Surgery
- Radiation therapy
- Chemotherapy
- Endocrine therapy
- HER2-directed and other targeted therapies
- Immunotherapy for appropriate subtypes
Systemic treatment may be given before surgery as neoadjuvant therapy or after surgery as adjuvant therapy.
Does Breast Cancer Always Require Mastectomy?
No. A breast cancer diagnosis does not automatically mean that the entire breast must be removed.
Breast-conserving surgery can be an appropriate option for many patients. It removes the tumour together with a margin of surrounding tissue while preserving most of the breast.
Breast-conserving surgery is usually followed by radiation therapy. In appropriately selected patients, breast-conserving surgery plus radiation provides outcomes comparable with mastectomy in terms of breast cancer mortality.
Mastectomy may be recommended when the tumour is large relative to breast size, cancer is present in multiple areas, clear surgical margins cannot be achieved, radiation cannot be given or certain high-risk genetic conditions are present.
What Happens if a Breast Lump Is Benign?
Benign breast disease does not normally require removal of the entire breast.
Depending on the diagnosis, management may involve observation, imaging follow-up or limited surgery.
The important point is to establish reliably whether a new breast lump is benign or malignant.
Is Psychological Support Important During Breast Cancer Treatment?
A breast cancer diagnosis can affect emotional well-being, body image and quality of life.
Psychological or psycho-oncology support may be appropriate from the time of diagnosis and throughout treatment, depending on the patient's individual needs.
Breast Cancer Treatment Is Individualised
Early diagnosis, tumour biology and multidisciplinary assessment are important parts of selecting the appropriate treatment.
Frequently Asked Questions
References
- Academic Hospital. Breast Cancer and Treatment
- World Health Organization. Breast Cancer
- National Cancer Institute. Signs and Symptoms of Breast Cancer
- National Cancer Institute. Treatment for Breast Cancer
- National Cancer Institute. Lumpectomy vs. Mastectomy
