Australian women have a 1 in 8 chance of developing breast cancer by the age of 85. The good news is that in Australia the overall five year survival rate for women is 90% making breast cancer largely survivable if caught early.

It’s extremely important for both women and men to be informed about breast cancer. In this article I, Dr Rob Paterson, will outline the facts about this prevalent disease.

What is breast cancer?

Breast cancer occurs when cells in the breast grow abnormally. Normally, cells in our bodies replace themselves through an orderly process of growth and death. But sometimes, healthy cells can develop mutations that make them grow uncontrollably, form tumours, and potentially spread to other parts of the body.

Types of breast cancer

Breast cancers can be classified by different aspects that influence their treatment and prognosis. These include:

• The type of cell they occur in within the breast
• The size of the cancer and whether it has spread
• The status of receptors that promote the growth of cancer cells (specifically estrogen, progesterone, and HER2/neu receptors)
• How the cancer looks at its genetic level

There are many types of breast cancer, but the most common types are carcinomas. Carcinomas start in the epithelial cells of the glands, milk ducts, or the lobules of the breast. However, other less common types of cancers can start in the cells of the breast’s muscle, fat, or connective tissue.

The following terms are also used to describe the extent of the cancer:

In situ – Breast cancers that have not spread

Invasive – Breast cancers that have spread into surrounding tissue

In situ cancers

In situ cancers are non-invasive or ‘pre-breast cancer’ conditions where abnormal cells have been found in the lining of the milk duct or within the lobules. These conditions actually aren’t considered to be cancer, although their name can be confusing and unnecessarily alarming.

The two types of non-invasive breast cancers are called ductal carcinoma in situ (DCIS), and lobular carcinoma in situ (LCIS).

DCIS (Ductal Carcinoma In Situ):

A non-invasive condition where cells in the breast’s milk ducts have developed abnormally. DCIS is not technically cancer, however it can sometimes develop into invasive breast cancer in the future if not treated. Therefore, surgical removal of the abnormal cells is usually recommended.

LCIS (Lobular Carcinoma In Situ):

An overgrowth of cells within the lobules of the breast. LCIS is not actually considered to be cancer either, and does not need to be treated if there are no other abnormal changes in the breast. Unlike DCIS, it is not a potential precursor to cancer. However, it can be a warning sign of an increased cancer risk in the future, and so women with LCIS should regularly monitor their breast health.

Invasive breast cancer

Invasive cancers are cancers that have spread to other cells and potentially metastasized to other organs in the body. They may originate in the milk ducts or the glandular tissue of the breast, and then invade surrounding healthy tissue.

The most common types of invasive breast cancers are invasive ductual carcinoma, and invasive lobular carcinoma.

Breast cancer in men

Breast cancer does not only affect women. Around 120 Australian men are diagnosed with breast cancer each year.

Common risk factors for men include a strong family history of breast cancer, age, radiation exposure, high oestrogen levels, Klinefelter syndrome, and some testicular disorders.

Although breast cancer in men accounts for less than 1% of all breast cancers, it’s still important to see a doctor if you notice a change in your breasts or armpits. Any lumps, discharge from the nipple, pain, swelling, or other noticeable changes should be examined by a doctor without delay.

Approximately 85% of men diagnosed with early breast cancer in Australia beat the disease. As with women, early detection is the key to a successful treatment.

Breast cancer risk factors

There are some things every person can do to lower their cancer risk. Eating a healthy diet, exercising regularly, avoiding alcohol and not smoking are all lifestyle factors that can lower your risk of breast cancer.

Other factors that might influence cancer risk include:

• Your age
• Family history and genetics
• Pregnancy history
• Radiation to the upper body before the age of 30
• Menstrual history
• Breast density

Symptoms of breast cancer

It’s important to be familiar with how your breasts normally look and feel, and examine them regularly for any changes.
Symptoms may include:

• A lump or thickened area, especially if only in one breast
• Any change in the size or shape of your breast
• Changes in your nipple including sores, redness, or discharge
• A change in the shape of your nipple
• Swelling or discomfort in your breast or armpit
• Changes in the skin of your breast including redness, irritation, puckering or dimpling
• Persistent pain not related to your period

Many breast changes aren’t necessarily a sign of cancer. However, if you notice any of these changes, see your doctor for a professional examination.

Women between 50 and 75 years of age are encouraged to have a mammogram every two years through BreastScreen Australia, our national breast cancer screening program.

Diagnosing breast cancer

If you have symptoms of breast cancer, your doctor will take a full medical history (including your family history), and perform a physical examination of your breasts and lymph nodes.

Your doctor may then refer you to a specialist for further tests that may include:

• Mammogram: A low dose x-ray of your breast tissue to find any changes that are too small to be felt during a physical examination.
• Ultrasound: A scan that uses soundwaves to create a digital image of your breast.
• MRI: A scan that involves injecting a contrast dye to make cancerous breast tissue easier to see, then using a large magnet and radio waves to create images of your breast.
• Biopsy: Removing a small sample of cells or tissue from your breast for examination by a pathologist.

Breast cancer treatment options

Your oncologist will recommend a treatment with the aim of removing the cancer, and also reducing the risk of it returning.
Common treatment options may include:

SURGERY

There are a number of different types of surgery that involve removing part of, or the entire breast. Women may choose to have reconstructive surgery after the breast’s removal.

CHEMOTHERAPY

Treatment with cancer-killing drugs given either by mouth or intravenously.

RADIOTHERAPY

Using high-energy rays to destroy any cancer cells that remain in the breast or armpit after surgery.

TARGETED THERAPY

Using drugs that block the growth of breast cancer cells by targeting specific genes or proteins.

HORMONE THERAPY

Treatments to slow or stop the growth of hormone-sensitive tumours by lowering the level of certain hormones in the body.
Treatment varies from person to person, and a combination of different treatments is often applied. Your oncologist will recommend the most suitable treatment for you based on your personal circumstances.

Where to get further advice

If you have concerns about your breast cancer risk, consider speaking to your GP for a referral to see one of our qualified and caring Oncologists at Hunter Valley Oncology.
Our holistic Oncology service fulfils the needs of patients in Newcastle NSW and surrounds. To make an appointment, please call (02) 4941 8424 or (02) 4942 2600 or use our online contact form.