Breast Cancer

Overview

Breast cancer is a disease in which abnormal cells in the breast grow in an uncontrolled way. It can begin in different parts of the breast, most often in the ducts that carry milk or in the glands that produce milk. Breast cancer can affect women and, less commonly, men.

Not every breast lump or breast change is cancer. Many breast conditions are benign, meaning they are not cancerous. However, any new or unusual breast change should be checked by a healthcare professional. Early assessment can help identify the cause and guide the most appropriate care.

Breast cancer is not a single disease. Different types can behave in different ways and may require different treatment approaches. Modern cancer care usually involves a team of specialists, such as medical oncologists, breast surgeons, radiation oncologists, radiologists, pathologists, and specialist nurses.

Symptoms

Breast cancer may not cause symptoms in its early stages, which is why screening can be important for many people. When symptoms occur, they may include:

• A new lump or thickened area in the breast or underarm
• A change in the size, shape, or appearance of the breast
• Skin changes on the breast, such as dimpling, puckering, redness, or thickening
• A nipple that turns inward or changes position
• Discharge from the nipple, especially if it is bloody or occurs without squeezing
• Persistent breast or nipple pain that is not linked to the menstrual cycle
• Swelling of all or part of the breast
• A sore, rash, or scaling on or around the nipple that does not improve

These symptoms can also be caused by non-cancerous conditions. A medical evaluation is needed to understand the cause.

Causes and Risk Factors

Breast cancer develops when changes occur in the DNA of breast cells, causing them to grow and divide abnormally. In many cases, the exact reason these changes happen is not known. A combination of genetic, hormonal, lifestyle, and environmental factors may play a role.

Factors that may increase the risk of breast cancer include:

• Increasing age
• A personal history of breast cancer or certain benign breast conditions
• A family history of breast or ovarian cancer, especially in close relatives
• Inherited gene changes that increase cancer risk
• Early start of menstruation or later menopause
• Having a first pregnancy later in life or never having been pregnant
• Previous radiation exposure to the chest area
• Being overweight after menopause
• Alcohol use
• Physical inactivity

Having one or more risk factors does not mean a person will develop breast cancer. Some people with breast cancer have no obvious risk factors. If there is a strong family history of cancer, genetic counseling may be recommended to assess inherited risk.

Diagnosis

Diagnosis begins with a discussion of symptoms, medical history, family history, and a physical breast examination. If a breast change is found, imaging tests may be recommended.

Common diagnostic tests include mammography, breast ultrasound, and sometimes breast MRI. These tests help doctors assess whether an area looks suspicious and whether further investigation is needed.

If imaging shows an abnormal area, a biopsy may be performed. During a biopsy, a small sample of tissue is removed and examined in a laboratory by a pathologist. A biopsy is the key test used to confirm whether cancer is present and to identify important features of the cancer.

If breast cancer is diagnosed, additional tests may be needed to understand its type, size, location, and whether it has spread. The cancer may also be tested for specific receptors or markers that help guide treatment planning. The healthcare team uses this information to discuss the most suitable options for each individual.

Treatment Options

Treatment for breast cancer depends on several factors, including the type of cancer, its stage, its biological features, the person’s overall health, and personal preferences. Care is usually planned by a multidisciplinary team.

Surgery is often used to remove the cancer. Depending on the situation, surgery may involve removing only the tumor with a margin of healthy tissue or removing the whole breast. Some patients may also have lymph nodes checked or removed to see whether cancer has spread nearby. Breast reconstruction may be discussed when appropriate.

Radiation therapy may be recommended after surgery or in certain other situations. It uses targeted radiation to destroy cancer cells in a specific area and reduce the risk of cancer returning locally.

Systemic treatments are therapies that travel through the body to reach cancer cells. These may include chemotherapy, hormone therapy, targeted therapy, or immunotherapy, depending on the cancer’s characteristics. These treatments may be given before surgery to shrink a tumor, after surgery to reduce the risk of recurrence, or for cancer that has spread.

Supportive care is also an important part of treatment. It may include help with side effects, pain control, nutrition, emotional support, rehabilitation, and guidance for daily life during and after treatment.

When to See a Doctor

It is important to see a doctor if you notice any new breast lump, underarm swelling, nipple discharge, skin change, nipple change, or persistent breast pain. Men should also seek medical advice for any unusual breast or nipple changes.

You should also speak with a healthcare professional about breast cancer screening, especially if you are in an age group where screening is recommended or if you have a family history of breast or ovarian cancer. Screening recommendations can vary depending on personal risk and local medical guidelines.

Seek prompt medical attention if a breast change is rapidly worsening, associated with significant redness or swelling, or accompanied by feeling generally unwell. While many breast changes are not cancer, timely evaluation helps ensure that any necessary care can begin without unnecessary delay.