Breast cancer

Whether you’ve just been diagnosed, or your friend or loved one has received a diagnosis, going through breast cancer can be a worrying, overwhelming time, with a lot of information to process. We’re here to help break down important information about breast cancer and provide the important information you need to understand your diagnosis, including where to access support for yourself or your loved ones.

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Types of breast cancer

Breast cancer can be invasive (meaning the cancer has spread from the breast ducts or lobules into surrounding breast tissue) or non-invasive, but most of the time breast cancers are found when they are invasive. Invasive breast cancer can be categorised as either early, locally advanced or advanced (metastatic).

The main types of invasive breast cancer are:

  • Invasive ductal carcinoma (IDC) accounts for about 80% of breast cancers, and begins in the milk ducts
  • Invasive lobular carcinoma (ILC) makes up about 10% of breast cancers and begins in the lobules.

The main types of non-invasive breast cancers are:

  • Ductal carcinoma in situ (DCIS) is abnormal cells found in the ducts of the breast.
  • Lobular cancer in situ (LCIS) is abnormal cells found in the lobules of the breast and is not technically cancer but does increase the risk of breast cancer. This being said, most women with LCIS won’t go on to develop breast cancer.

Risk Factors

There are a number of lifestyle, medical and genetic factors that can increase your risk of breast cancer, but it’s important to remember even if you have more than one risk factor, it does not mean you will go on to develop the disease.

Risk factors for developing breast cancer can include:

  • Age – most breast cancers are diagnosed in women over 40, with the average age being 62.
  • Breast density – if you’ve had a mammogram that showed dense breast tissue, you may be at increased risk of breast cancer.
  • Weight – being overweight or gaining weight after menopause can increase your risk.
  • Lifestyle – risky alcohol consumption, not getting enough physical activity, and smoking tobacco can increase your risk
  • Alcohol – drinking daily increases your risk of breast cancer.
  • Exposure to female hormones (natural and administered) including taking the contraceptive pill for an extended time increases your risk, though only slightly, long term use of menopause hormone therapy (MHT) that contains both oestrogen and progesterone, or you or your mother taking diethylstilboestrol (DES) during pregnancy.
  • Reproductive history – starting your period before the age of 12, having your first baby after the age of 30, going through menopause after the age of 55, not giving birth and not having breastfed can all increase your risk of breast cancer.
  • Family history – having a close family member, for example a mother or sister, who had breast cancer or a certain kind of ovarian cancer (particularly if they were diagnosed at a young age) can increase your risk, as can having a previous diagnosis of LCIS or DCIS, a condition called atypical ductal hyperplasia or a condition called proliferative disease without atypia. For men, family history of breast cancer in first-degree relatives (male or female) who have had BRCA2 breast cancer; or several relatives who have had colon, prostate or ovarian cancer
  • Klinefelter Syndrome – in men, a rare genetic condition called Klinefelter Syndrome where they inherit three sex chromosomes (XXY) instead of two (XY) can increase the risk of breast cancer.

Symptoms

Sometimes, the first sign of breast cancer is when it is found on a routine mammogram, which is a breast cancer screening tool that uses a low-dose x-ray of the breast. There mightn’t have been any symptoms beforehand.

If you do notice symptoms, these might include:

  • Changes in either the shape or size of your breast or nipple, or a nipple that becomes inverted when it wasn’t beforehand
  • Skin changes like dimpling, a rash, scaly appearance or redness
  • Oozing, crusting, ulcers, sores or unusual discharge
  • A lump, hardening or lumpiness in the breast
  • Swelling or pain in the armpit
  • Breast pain or discomfort that isn’t related to your cycle

Diagnosis

If you’re concerned about any of these symptoms, it’s important to see your GP for a full examination. If you have noticed visible breast changes over time, taking pictures to show your doctor could also be helpful. Usually, they’ll take a thorough family history, ask you questions about your lifestyle, and perform an examination where they’ll check your lymph nodes and breast tissue.

Depending on the outcome of this visit, your GP might refer you to a specialist for further testing. These might include:

  • Mammogram – a low-dose x-ray of the breast that can not only investigate any lumps or bumps found during a physical exam, but can also pick up smaller lumps that might be difficult to pick up otherwise
  • Breast cancer ultrasound – an imaging test that uses sound waves to get a picture of the soft tissue in your body
  • MRI scan – a non-invasive scan of your body that can produce three-dimensional images of your anatomy
  • Biopsy – a small amount of breast tissue removed and tested to see whether it contains cancer cells
  • Bone scan – if cancer is confirmed, doctors might do this to see if the cancer has spread from your breast tissue to your bones
  • Blood test – this can not only give you important information about your general health but also test the function of organs like your liver, to see whether the cancer may have spread
  • Chest x-ray – this can help to confirm or rule out lung cancer
  • CT scan

You might need these tests once, or doctors might repeat them at various stages of your treatment to check how your body is responding. For a lot of people going through cancer, waiting for the results of tests can be a challenging and stressful time. It can resurface the trauma of when you were first diagnosed and can make friends and loved ones feel incredibly anxious.

Treatment

When it comes to treating breast cancer, whether it is early, locally advanced or advanced, there is no one-stop solution to suit everyone. Everyone is as different as their circumstances, so your treatment plan will be tailored to you, possibly with several steps of breast cancer treatment.

Some of the deciding factors on how doctors treat your cancer are:

  • Where the cancer is located in your breast
  • The stage and grade of your cancer
  • Whether the cancer is hormone receptor and/or HER2 positive or triple negative
  • How old you are and your general health
  • Your personal wishes regarding how your cancer is treated

That said, here are some treatment options you might encounter:

  • Surgery – where a tumour or mass is removed from your breast, or one or both breasts are removed (mastectomy)
  • Radiation – where doctors use radiation (usually x-rays or gamma rays) to kill cancer cells, or to damage them in a way that means they can no longer grow and multiply.
  • Chemotherapy – often simply called ‘chemo’, this is the process of using drugs to kill or slow the growth of cancer cells
  • Hormone therapy – where doctors can manipulate or stop certain hormones in your body that might be making your cancer grow

Prognosis

It can be a daunting word to use, and one that causes a lot of anxiety in people going through cancer, but in its simplest terms, ‘prognosis’ just means the outcome of the disease.

Remember, over time, breast cancer survival rates have increased significantly. Australian breast cancer statistics have shown this is because the quality of testing has improved, allowing earlier detection. Treatment options have also increased with further research and technology. Most people with early or locally advanced breast cancer can now be treated successfully.

While it’s understandable to want some certainty in such a vulnerable process, it’s important to remember doctors can’t predict the outcome of your treatment or your disease. They can, however, give you information on the likely outcomes of various options, and how the type of breast cancer you have typically progresses in certain situations.

Questions you might have

Can men get breast cancer?

Yes, they can, however, breast cancer is uncommon in men. In Australia, it is estimated approximately 221 men will be diagnosed with breast cancer in 2024. The average age at diagnosis is 71 years. Symptoms of breast cancer in men are like those for women.

What does a breast cancer tumour feel like?

A breast cancer tumour often feels like a lump, lumpiness, or thickening, especially in just one in one breast. However, not all lumps are cancerous. Benign tumours usually grow slowly and don’t spread, while cancerous (malignant) tumours can spread to other parts of the body.

Regular self-checks are important, but breast cancer can sometimes show no symptoms. That’s why women aged 40 and over should prioritise regular screenings. BreastScreen Queensland offer free breast screening for women in this age group who haven’t noticed any breast changes.

What does breast cancer look like?

Breast cancer may not always show visible symptoms, so it’s important to remember that not only what we see, but also what we feel, can indicate you should see a doctor.

However, breast cancer sometimes has no symptoms, so regular screening is important for women aged 40 and over. BreastScreen Queensland provide free breast screening to women who are 40 and over and haven’t noticed any changes to their breasts.

How to check for breast cancer?

Breasts come in all shapes and sizes, and it’s normal for them to have differences, like lumpiness or one being larger than the other. You don’t need a special technique to check your breasts. Simply get to know how they normally look and feel during everyday activities, like showering, dressing, or applying lotion. This will help you notice any unusual changes.

Be sure to check all areas, including your armpits and up to your collarbone. You can do this while looking in the mirror with your arms by your sides or raised, or by feeling your breasts in the shower. Choose a method that feels right for you and see a doctor if you notice any changes that seem unusual.

Is breast cancer genetic?

Most breast cancer cases are not linked to a strong family history. However, some people may inherit a gene mutation that increases their risk.

The most common mutations are in the BRCA1 and BRCA2 genes, which raise the risk of breast and ovarian cancers in women, and breast and prostate cancers in men. Other genes, like ATM, PALB2, and TP53, are also linked to breast cancer, and more are being discovered.

If you’re concerned about inherited risk, talk to your doctor or a breast cancer nurse about genetic testing. A referral to a family cancer clinic or genetic oncologist may help. Medicare covers genetic testing for certain groups, so ask your doctor if you’re eligible.

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