Understanding Breast Cancer
Breast cancer arises when cells within breast tissue begin to grow uncontrollably and can potentially invade other parts of the body. These cells form a mass known as a tumour. Although it can occur at any age, about 80 percent of new cases are found in women aged 50 and older, with the highest incidence among women between 65 and 69 years old. Thankfully, Australia has one of the highest breast cancer survival rates worldwide. The overall five-year survival rate stands at 91 percent. If the disease remains confined to the breast, this rate rises to 96 percent.
Who is at risk of breast cancer?
Both men and women can develop breast cancer, although it is rare in men. Transgender and gender-diverse people are also susceptible. Breast cancer is the most frequently diagnosed cancer among Australian women. Approximately 20,640 individuals are diagnosed with breast cancer each year, 20,428 of them are women and 212 are men. The lifetime risk is 1 in 7 for women and 1 in 555 for men.
Signs and symptoms of breast cancer
Signs depend on the tumour’s location, its dimensions, and how quickly it grows. Some cases produce no noticeable symptoms and are identified through routine mammograms. Typical signs include:,
- A new lump in or near the breast
- Thickening of breast tissue (often on just one side)
- Noticeable change in breast shape or appearance
- Alteration of the nipple’s appearance (such as redness, crusting, sores, or inversion)
- Skin dimpling
- Discharge from the nipple
- Discomfort or swelling in the underarm area
- Persistent breast pain not linked to the menstrual cycle
Men experiencing breast cancer usually report similar signs as women do.
Types of breast cancer
Breast tumours fall into different categories. They may be:
- Non-invasive, confined within the milk ducts or lobules (milk-producing glands)
- Invasive, extending beyond the ducts and lobules into surrounding tissues
In addition, there are rare forms of breast cancer, such as:
- Inflammatory breast cancer
- Paget’s disease of the nipple
- Phyllodes tumour
- Metaplastic breast cancer
What causes breast cancer
No single cause explains why breast cancer develops, but several factors can increase risk. Lifestyle-related risk factors include:
- Alcohol consumption
- Excess body weight
- Leading a sedentary life
- Smoking
How is breast cancer diagnosed?
- Advancing age
- Family history of breast cancer
- A previous breast cancer diagnosis
- History of certain non-cancerous breast conditions
- Inherited mutations in the BRCA1 or BRCA2 genes
- Exposure to female hormones, either naturally occurring or prescribed (for example, transgender women on hormone therapy)
- Beginning menstruation before age 12
Other risk factors comprise:10
Breast cancer diagnosis often involves a “triple test,” which includes:
- Review of personal and family medical history plus a physical breast examination
- Imaging studies, such as mammography (a low-dose X-ray that can detect tiny changes) or ultrasound (used when mammography reveals a tissue change)
- Biopsy (removal of a small tissue sample for laboratory analysis)
If cancer is confirmed, additional imaging may be ordered to determine its stage.
How is breast cancer treated?
Treatment depends on the cancer’s stage and may involve one or more of the following:
- Surgery, to remove the tumour, part or all of the breast, and possibly lymph nodes under the arm. Reconstructive surgery can be an option to restore breast shape.
- Chemotherapy, administration of anti-cancer drugs to destroy cancer cells; often used in conjunction with surgery and radiation
- Radiation therapy, use of high-energy X-rays to kill cancer cells, shrink tumours, or relieve symptoms
- Hormone therapy, prescribed when cancer cells are hormone-sensitive, aiming to slow or halt their growth
- Targeted therapy, use of drugs designed to attack specific cancer cell characteristics
- Palliative care, focused on managing symptoms and improving quality of life rather than curing the disease
What are the stages of breast cancer?
Staging is based on tumour size and the extent of spread. It helps guide treatment decisions and is usually expressed on a scale from 0 to IV. Stage 0 Abnormal cells are present but remain within the milk ducts or lobules. Stage I and II Early breast cancer that has moved beyond the ducts or lobules but remains contained within the breast. Stage III Locally advanced cancer that may be larger than 5 cm, may have spread to lymph nodes, or may involve nearby tissues (e.g. skin, muscle, or rib). Stage IV Metastatic breast cancer, indicating that cancer has spread beyond the breast to other organs such as bones, liver, lungs, or brain.
Complications of breast cancer
Detecting breast cancer early typically leads to better outcomes and higher chances of survival. However, some cases cannot be successfully treated and may be fatal. Treatment can also produce side effects, which may include:
- Lymphoedema, swelling and discomfort in the arm, shoulder, and upper body following lymph node removal
- Early menopause, certain treatments, like chemotherapy and hormone therapy, can induce menopause
- Anxiety and depression, common psychological conditions among breast cancer patients
What can you do?
Spotting breast cancer when it is still small and limited to the breast greatly improves treatment success. Recommended early detection strategies include:
Being breast aware
Learn the normal look and feel of your breasts. There is no single correct method, but you might examine yourself in the shower, in front of a mirror, or while dressing. Include all parts of the breasts, armpits, and up to the collarbone. If you notice any changes, consult your doctor promptly. Note: There is no evidence that one method of self-examination is superior to another. Additionally, clinical breast examinations have not been shown to reduce breast cancer mortality.
Regular screening mammograms
Routine mammography is the most effective early detection tool, particularly for women aged 50–69. In Australia, women aged 50–74 are invited to free biennial screening mammograms through BreastScreen Australia. Women aged 40–49 may also participate but are not automatically invited; those under 40 generally are not offered mammograms because denser breast tissue can make detection difficult. If you have a strong personal or family history of breast or ovarian cancer, talk to your doctor about a tailored screening schedule. Some women might need mammograms more often than every two years or start before age 40.
How to prevent breast cancer
Although breast cancer cannot be completely prevented, adopting healthy lifestyle habits can reduce your risk. These include maintaining a healthy weight, exercising regularly, avoiding tobacco, and limiting alcohol consumption. For individuals at high genetic risk, hormone-blocking medications may help. Those with inherited gene mutations might consider preventive mastectomy. Discuss these options with your doctor.
When should you see your doctor?
If you have concerns about breast cancer risk or a notable family history, consult your doctor to determine the best early detection measures. You should also seek medical advice if you observe any changes in your breasts or experience symptoms associated with breast cancer.