Breast Cancer

What breast cancer is — in plain words

Breast cancer begins when cells in the breast — most often in the milk ducts or the lobules that produce milk — start growing in a disordered way and form a lump. Not every lump is cancer; most are not. But because breast cancer is common and treatable, every persistent lump deserves a proper look.

There isn't one breast cancer — there are several. Your treatment depends not just on the stage, but on the biology of your particular tumour, which we read from the pathology report.

Signs and symptoms to take seriously

Most of these signs turn out to be something benign. But none of them should be ignored for months. A quick clinic visit and a targeted scan settle the question.

"The number of women who come to me apologising for 'wasting my time' after a benign result is wonderful. That's exactly the visit I want — early, while we still have every option."

How breast cancer is diagnosed

The path from a suspicious finding to a clear diagnosis is usually quick — often within a week or two.

• Clinical examination — a careful exam of both breasts and the lymph nodes in the armpit and above the collarbone.
• Imaging — a mammogram and a targeted ultrasound. For younger women or dense breasts, MRI may be added.
• Core-needle biopsy — a small tissue sample taken under local anaesthesia. This is the test that actually makes the diagnosis. Fine-needle aspiration alone is rarely enough.
• Receptor testing — the lab checks the tumour for oestrogen receptor (ER), progesterone receptor (PR), and HER2. These three results shape the entire treatment plan.
• Staging scans — for larger tumours or suspicious nodes, a CT scan and a bone scan (or a PET-CT) tell us whether the cancer has spread.

The main biological subtypes

Stages — what the numbers mean

How we treat breast cancer

Breast cancer is treated by a team. A medical oncologist, a breast surgeon, a radiation oncologist, a pathologist and a radiologist will all weigh in on your plan. The treatments below are usually combined, not chosen between.

Surgery

Either a lumpectomy (removing just the tumour and a margin of normal tissue) or a mastectomy (removing the whole breast). For most early tumours, lumpectomy plus radiation gives the same survival as mastectomy. The lymph nodes in the armpit are sampled at the same time.

Chemotherapy

Given before surgery (neoadjuvant) to shrink larger tumours, or after surgery (adjuvant) to reduce the risk of return. Standard regimens combine an anthracycline and a taxane. Read more about chemotherapy →

HER2-targeted therapy

For HER2-positive cancers, trastuzumab (often with pertuzumab) is given alongside chemotherapy and continued for a year. Newer antibody-drug conjugates such as trastuzumab-deruxtecan have transformed outcomes in advanced disease.

Endocrine (hormonal) therapy

For ER-positive cancers, a daily tablet — tamoxifen or an aromatase inhibitor — for 5 to 10 years lowers the chance of recurrence substantially. This is one of the most effective treatments in all of oncology.

Radiation therapy

Almost always given after lumpectomy, and after mastectomy for larger or node-positive tumours. Modern techniques deliver the dose precisely with minimal effect on the heart and lungs.

Immunotherapy

For triple-negative breast cancer, checkpoint inhibitors added to chemotherapy improve outcomes in selected patients. Read more about immunotherapy →

What the outlook honestly looks like

For stage I and II breast cancer, more than 90% of women are alive and well at five years. For stage III, the figure is around 70%, and modern treatment is pushing it higher. Even for stage IV disease, the average survival has roughly doubled over the last fifteen years; some subtypes now have a median survival measured in many years rather than months.

Numbers are averages — they don't predict any one person's outcome. Age, fitness, the biology of the tumour, and the response to treatment all matter. We'll always be honest with you about what the realistic range looks like for your situation.

Screening — the single most powerful tool

• Self-awareness from age 20 — know what your breasts normally feel like, so you notice a change.
• Clinical breast exam every 1–3 years from age 25–40, and yearly after 40.
• Mammogram every 1–2 years from age 40 — earlier and more often if there is a strong family history.
• Genetic testing (BRCA1/2 and others) for women with a strong family history of breast or ovarian cancer, or with cancer diagnosed before age 45.

Life during treatment

Most women continue much of their normal life through breast cancer treatment. Work is often possible, especially with a supportive employer and a flexible schedule on chemotherapy weeks. Hair loss, when it happens, is temporary. Fatigue is real but manageable. Anxiety and low mood are common and treatable — please raise them with us, they are part of the illness, not a weakness.

Fertility is a serious question for younger women. There are options to protect it, but they need to be arranged before chemotherapy starts. Ask, on day one.

After treatment — survivorship

Finishing active treatment is a real milestone — and the start of a longer chapter of follow-up. Most women on endocrine therapy continue tablets for years. Regular clinic visits, mammograms, bone-health monitoring (for those on aromatase inhibitors), and attention to mental and sexual health are all part of the plan. Read about survivorship care →