Breast Cancer: Signs, Tests and Care

Breast cancer develops when abnormal breast cells grow without normal control and may invade nearby tissue or spread elsewhere.

It can arise in milk ducts, lobules or other breast tissue. Its subtype reflects features such as hormone receptors and HER2 status. These findings, together with the extent of disease, guide an individual treatment plan. Breast cancer can affect women and, less often, men.

Breast cancer commonly presents with a new breast lump or thickening. It can also present with an armpit lump, a change in breast size or shape, skin dimpling or redness, nipple inversion, a persistent localised pain, or discharge that is not breast milk. Some cancers are found on imaging before symptoms develop.

Many breast changes have non-cancerous causes, but a new or persistent change deserves clinical assessment. Seek prompt care for rapidly increasing swelling, marked redness with illness, or a new lump accompanied by concerning skin or nipple changes.

Breast cancer begins after genetic changes disrupt the controls that normally govern cell growth, repair and death. Those changes can accumulate over time or, in a smaller group of people, be inherited. A diagnosis is not caused by touching the breast, an injury or ordinary contact with someone who has cancer.

Cancer may remain within a duct, grow into nearby breast tissue, reach regional lymph nodes or spread through blood or lymph to distant organs. Grade describes how abnormal and active the cells appear, while stage describes the cancer's extent. Receptor and molecular features add information about likely behaviour.

Risk is influenced by ageing, breast tissue density, family history, certain inherited variants such as BRCA changes, previous breast conditions, some hormone exposures, alcohol use and prior chest radiation. A risk factor does not mean cancer will develop, and breast cancer can occur without an obvious risk factor.

A clinician asks about the change, personal history and family history, then examines both breasts and nearby lymph-node areas. A mammogram and ultrasound can characterise an abnormal area. Breast MRI is useful in selected situations, including clarifying the extent of a known cancer.

Imaging alone cannot confirm breast cancer. A breast biopsy removes cells or tissue for examination. The pathology report identifies whether cancer is present, its type and grade, and biomarkers that may shape treatment.

Treatment depends on stage, tumour size, lymph-node findings, grade, receptor status, general health and personal priorities. Surgery may conserve the breast or remove it. Radiotherapy can treat remaining cancer cells in a defined area. Drug options include hormone therapy, chemotherapy, HER2-targeted therapy and other targeted medicines when the tumour's features support their use.

Medicines may be given before surgery to shrink or assess the response of a tumour, or afterward to reduce the chance of recurrence. When cancer has spread, treatment commonly focuses on controlling disease, maintaining function and relieving symptoms. Supportive care belongs alongside cancer-directed care at any stage.

Treatment can affect energy, sleep, body image, sexual wellbeing, arm movement and emotions. Rehabilitation may include shoulder exercises, scar care and management of lymphoedema symptoms. Discuss fertility goals before treatment if relevant, and report persistent low mood, pain or difficulty managing daily activities.

The condition or its treatment may cause arm swelling, infection, nerve discomfort, restricted shoulder movement, bone thinning, heart effects or early menopause, depending on the therapies used. Cancer that spreads can affect organs such as bone, lung, liver or brain. New breathlessness, weakness, confusion or severe uncontrolled pain needs urgent assessment.

No approach prevents every breast cancer. Limiting alcohol, staying physically active and maintaining a weight suited to your health can help reduce risk. Screening aims to find disease before symptoms appear; the appropriate schedule depends on age, personal history, family history and local guidance. People with strong inherited risk may be offered enhanced surveillance, medicines or risk-reducing surgery.

A breast clinic can coordinate imaging and biopsy for a concerning change. Confirmed cancer care may involve a breast surgeon, medical oncologist, radiation oncologist, radiologist, pathologist, specialist nurse and reconstructive surgeon. Ask who will explain the pathology results, treatment sequence, side-effect support and follow-up plan.