Breast cancer

Stand in front of a mirror and compare one breast to the other.

Look out for:

• Skin changes – thickening, rashes, or many small pinprick dimples like orange peel (peau d’orange)
• Colour changes in your skin or nipples such as redness if you have white skin, or darkening if you have brown or black skin
• Appearance – changes in breast size, shape or texture, especially when comparing one breast to the other
• Swelling – a change in the size or contour of the breast
• Pain – any kind of tenderness or discomfort lasting more than a few days, including aching, burning, prickly sensation, or sharp pain
• Nipple changes – differences in the shape or position of the nipples, nipple inversion, or crustiness on the nipple or skin around it
• Discharge from the nipple that stains your bra/clothing without squeezing, especially if blood-stained
• Lump in your breasts or armpit

If you notice any change in your breasts, get yourself checked by a doctor as soon as possible to rule out anything serious that might need investigating.

Never ignore a change to your breasts. It’s usually nothing serious, but getting checked is the only way to be sure.

If you notice any breast changes, contact your doctor straight away. This includes lumps, skin or nipple changes, or pain in your breasts that doesn’t go away. They’ll check your breasts and refer you to the specialist, so that you can get the care you need.

You can contact your doctor or visit one of our One Stop Breast Clinics where you can book a same-day diagnostic appointment, including a mammogram and/or ultrasound, and discuss the findings with a specialist breast surgeon on the same day.

Invasive breast cancer is the most common form of breast cancer diagnosed by screening and in people presenting with symptoms. Most cases are treatable and diagnosed at early stages.

Early invasive breast cancer is when the cancer has grown into the breast tissue surrounding the ducts or lobes where it started. It’s only found in the breast or nearby lymph nodes and hasn’t spread elsewhere in the body.

There are two main types:

• Invasive ductal breast cancer – cancer that begins in the milk ducts and then spreads into the surrounding breast tissue
• Invasive lobular breast cancer – cancer that begins in the lobes (the milk-producing glands) and then spreads into the surrounding breast tissue

Sometimes, breast cancer cells don’t have any particular features when looked at under a microscope. This is called NST – which means ‘no special type’.

Inflammatory breast cancer is a less common invasive cancer where breast cancer cells have spread to lymph vessels in the skin. Skin symptoms of this can sometimes be misdiagnosed as breast infection. This is an aggressive type of cancer and is usually treated with systemic therapy first.

If left untreated, most invasive breast cancers will progress and spread elsewhere in the body. 

Metastatic breast cancer is when the cancer has spread outside of the breasts to other parts of the body, such as the bones, brain, liver, or lungs. This is also called advanced, stage 4, or secondary breast cancer. 

Your consultant will tell you the receptor status of your cancer cells, including HER2, oestrogen (ER), and sometimes the progesterone (PR) receptor status. This will help decide your treatment.

Your cancer could be:

• HER2 negative or HER2 positive (Human Epidermal Growth Factor Receptor 2)
• ER-negative or ER-positive (Estrogen Receptor)
• PR negative or PR positive (Progesterone Receptor)

The most common type of breast cancer is ER/PR positive and HER2 negative.

If your cancer is missing all three types of hormone receptors, it’s called triple-negative breast cancer.

The first step to finding breast cancer is either through screening or by having further tests to investigate a breast symptom, like a lump.

Screening for breast cancer is when you are checked for cancer even though you don’t have any signs or symptoms. The main way to screen for breast cancer is a mammogram, which is an X-ray.

If you have signs of breast cancer, such as breast changes noticed by yourself or picked up by a mammogram, the next step is to have further tests, such as an ultrasound, MRI, and biopsy.

Diagnostic tests assess whether your breast changes are benign (non-cancerous), like a cyst or benign tumour, or whether they are caused by breast cancer.

Diagnostics used for breast cancer include:

• Mammogram – a scan usually offered to women above 40 years of age and helps to screen both breasts for any abnormality
• A breast ultrasound – a scan to assess breast changes to determine the nature of lump and to decide if a biopsy is needed
•  A biopsy – takes a very small sample of tissue from a breast lump to look for cancer cells under a microscope
• A breast MRI – the need for breast MRI will be determined by the specialist. One in two people has dense breasts, and for these people, a breast MRI is more effective than a mammogram for finding breast changes

There are several treatment options for breast cancer, which depend on the type, stage, and grade of cancer, as well as your overall health and personal treatment preferences.

Treatment can be personalised by considering your risk of cancer coming back after treatment. Genomic assays help predict the likelihood of recurrence, to help decide how intensive treatment should be.

Treatments for breast cancer include:

• Surgery, including breast-conserving surgery, is offered through our partner hospitals and is usually the first step in treatment
• Radiotherapy, which is usually done after surgery to either try to cure the cancer completely; reduce the risk of the cancer coming back after surgery; or, rarely, relieve symptoms if a cure is not possible.
• Chemotherapy, which is given as the first treatment for certain types of cancer, or after surgery for other types, to destroy any cancer cells that might have spread
• Endocrine (hormone) therapy to reduce the risk of cancer returning
• Targeted therapies, including monoclonal antibodies and immunotherapy

The treatment is personalised to you and your cancer. You and your specialist will review your options after a multidisciplinary team (MDT) has met to discuss a dedicated plan for you.

Learn more about our treatments for every type of breast cancer.