Introduction to Breast Cancer
Breast cancer is a disease characterised by the uncontrolled growth of abnormal cells within the breast tissue, which can form a tumour and potentially spread (metastasise) to other parts of the body if left untreated.
Breast cancer most commonly starts in the cells lining the milk ducts but can also arise from the milk-producing lobules. While it mostly affects women, men can also develop breast cancer.
Common symptoms of breast cancer include a lump in the breast or underarm area, changes the appearance, shape or size of the breast, pain or discomfort, and change in the position of or discharge from the nipple.
Risk factors include lifestyle factors, extended exposure to oestrogen, previous breast biopsies or benign breast diseases, inherited genetic mutations and a family history of breast or ovarian cancer.
Diagnosis may involve pre-symptomatic screening via mammograms, ultrasound or MRI, physical examination in a clinic, genetic testing and biopsy of any abnormalities.
Treatment options include surgery, chemotherapy, radiation, hormone therapy, immunotherapy and targeted therapies. Early detection, through regular self-examination and screening, can improve outcomes.
General Symptoms
Symptoms of breast cancer can vary widely, and some individuals may not show any symptoms. It is important for people to regularly check their breasts and speak to their healthcare provider if they notice any changes. Common symptoms include:
Lump/swelling: A new lump, thickening or swelling in the breast, chest or armpit.
Breast changes: Changes to the feel, size and shape of the breast as well as changes to the appearance of the skin, such as, dimpling (sometimes having an orange peel appearance), puckering, redness or a rash, which may be flaky.
Nipple discharge: Leakage of fluid from the nipple, excluding breast milk in women who are pregnant or breast-feeding. The fluid may contain blood.
Nipple changes: Flattening, changes in position or turning-in of the nipple.
Pain: Unexplained, persistent pain in the nipple, breast or armpit.
Diagnosis
Breast cancer diagnosis usually starts when or a patient talks to their healthcare provider after noticing a change in their breast or when routine screening, e.g., a mammogram, detects an abnormality. Common tests include:
Breast examination:
A healthcare provider checks manually for lumps or tissue changes.
Imaging Tests:
Mammogram: An X-ray of the breast that can show tumours too small to be felt.
Ultrasound: A radiation-free, non-invasive scan using high-frequency sound waves bounce back off structures within the breast tissue. The sound waves do not affect or damage the tissue.
MRI (Magnetic Resonance Imaging): MRI uses magnetic fields to provide detailed images of breast tissue.
Biopsy:
A small tissue sample is taken from the suspicious area of the breast and the cells examined to determine whether cancerous cells are present.
Additional Information Resources
Cancer Research UK: About Breast Cancer: https://www.cancerresearchuk.org/about-cancer/breast-cancer/about
NIH: National Cancer Institute: Information for patients: https://www.cancer.gov/types/breast/patient/breast-treatment-pdq
Komen.org: Breast cancer Self Awareness: https://www.komen.org/wp-content/uploads/Breast-Self-Awareness-Messages-card.pdf
Komen.org: Educational materials: https://www.komen.org/support-resources/tools/komen-education-materials/
Cleveland Clinic: https://my.clevelandclinic.org/health/diseases/3986-breast-cancer
CDC: Breast Cancer Risk Factors: https://www.cdc.gov/breast-cancer/risk-factors/index.html
StatPearls: In depth educational resource: https://www.ncbi.nlm.nih.gov/books/NBK482286/