Breast Cancer

Diagnosis of Breast Cancer

Breast cancer diagnosis usually begins with an exam and discussion of symptoms. Imaging tests and tissue samples help confirm whether cancer is present.

• Breast exam: A healthcare professional checks the breasts for skin changes, nipple changes, or lumps. Lymph nodes along the collarbones and armpits are also examined.

• Mammogram: An X-ray of the breast tissue.

  • Screening mammogram: Routine check to detect early cancer.

  • Diagnostic mammogram: Detailed imaging to closely examine areas of concern.

• Breast ultrasound: Uses sound waves to create images. Helps distinguish between solid masses and fluid-filled cysts.

• Breast MRI: Uses magnetic fields and radio waves to create detailed images.

  • Dye may be injected to highlight tissue.

  • Can detect additional cancer areas in the affected or opposite breast.

• Core needle biopsy: A needle removes a tissue sample for lab testing, often with a marker placed to track the site.

Laboratory Testing

• Determines cancer presence

• Identifies cancer type and growth rate

• Tests for hormone receptors to guide treatment planning

Staging Breast Cancer

Staging shows the extent of cancer and helps plan treatment.

• Tests may include:

  • Blood tests (complete blood count, kidney/liver function)

  • Bone scan

  • CT scan

  • MRI

  • PET scan

Breast cancer stages (0–4):

• Stage 0: Cancer contained within a duct.

• Stage 1–3: Increasing invasion into breast tissue and lymph nodes.

• Stage 4: Cancer has spread to other parts of the body.

Treatment of Breast Cancer

Treatment depends on cancer type, stage, growth rate, hormone sensitivity, and overall health.

Surgery

• Lumpectomy: Removes cancer and surrounding tissue, preserves most of the breast. Often combined with radiation therapy.

• Mastectomy: Removes all breast tissue; includes:

  • Total/simple mastectomy

  • Skin-sparing mastectomy

  • Nipple-sparing mastectomy

• Lymph node removal:

  • Sentinel node biopsy: Removes a few nodes to check for cancer spread.

  • Axillary lymph node dissection: Removes many nodes if cancer has spread.

• Contralateral prophylactic mastectomy: Optional removal of the other breast in high-risk patients.

• Breast reconstruction: Surgery to restore breast shape using implants or tissue.

Risks of surgery: Pain, bleeding, infection, lymphedema (arm swelling).

Radiation Therapy

• Uses X-rays, protons, or brachytherapy to kill remaining cancer cells.

• Often follows surgery to lower recurrence risk.

Side effects: Fatigue, rash, breast swelling, rare heart/lung damage, possible secondary cancers.

Chemotherapy

• Uses strong medicines to kill cancer cells.

• Can be given before or after surgery.

• Helps shrink tumors, treat lymph node involvement, and control metastatic cancer.

Side effects: Hair loss, nausea, vomiting, fatigue, infection risk, premature menopause, nerve damage.

Hormone Therapy

• For cancers sensitive to estrogen and progesterone.

• Blocks hormones from fueling cancer growth.

Types of hormone therapy:

• Selective estrogen receptor modulators (SERMs)

• Aromatase inhibitors

• Surgery or medicines to stop ovarian hormone production

Side effects: Hot flashes, night sweats, vaginal dryness, bone thinning, blood clots.

Targeted Therapy

• Attacks specific cancer cell proteins, e.g., HER2-positive breast cancer.

• Can be used before surgery, after surgery, or for metastatic cancer.

Immunotherapy

• Helps the immune system detect and destroy cancer cells.

• Often used for triple-negative breast cancer.

Palliative Care

• Focuses on relieving pain and symptoms of serious illness.

• Provides an extra layer of support alongside treatments like surgery, chemotherapy, and radiation.

• Can improve quality of life and longevity when combined with standard treatments.