Table of Contents
What is breast cancer?
Breast cancer is a disease where cells in the breast grow abnormally and in an uncontrolled way to form a lump, known as a tumour. If left untreated, lumps may spread from breast tissue to other parts of the body, such as the bones, liver or lungs. Breast cancer affects both men and women, although it is less common in men.
Some breast cancers, known as ‘pre-invasive’ or ‘carcinoma in situ’ breast cancers, appear inside the milk ducts or milk-producing lobules of the breast. Other ‘invasive’ breast cancers grow within normal breast tissue and may spread to elsewhere in the body. There are various types, including Paget’s disease, inflammatory breast cancer, ductal carcinoma, lobular carcinoma, hormone receptor positive breast cancer, HER-2 positive breast cancer and triple negative breast cancer (which tests negative for oestrogen, progesterone and HER-2).
What Is Triple-Negative Breast Cancer?
Triple-negative breast cancer is a kind of breast cancer that does not have any of the receptors that are commonly found in breast cancer.
Think of cancer cells as a house. The front door may have three kinds of locks, called receptors—
One is for the female hormone estrogen.external icon
One is for the female hormone progesterone.external icon
One is a protein called human epidermal growth factor (HER2external icon).
If your cancer has any of these three locks, doctors have a few keys (like hormone therapy or other drugs) they can use to help destroy the cancer cells.
But if you have triple-negative breast cancer, it means those three locks aren’t there. So doctors have fewer keys for treatment.
Think of a cancer cell as a house. To get inside to destroy the cancer, we must bypass three locks on the front door: estrogen, progesterone, and HER2.
If your cancer tests positive for these three locks, which are known as receptors, then doctors have a few keys they can use to get inside the cell to destroy it.
If you have triple-negative breast cancer, those locks aren’t there. So the keys doctors usually use won’t work.
What are the symptoms of breast cancer?
Symptoms of breast cancer can include:
- a lump or area of thickened tissue in the breast (especially if only on one side)
- a change in the size or shape of one or both breasts
- a change in the shape or appearance of the nipple, such as crusting, sores, redness or inversion (where the nipple turns in instead of pointing out)
- changes to the skin of the breasts, such as dimpling (looking like an orange peel), rash, or redness
- discomfort or swelling in either armpit
Symptoms of breast cancer in men are similar to those that women experience.
If you have any unusual symptoms, such as the above, you should see your doctor to get them checked.
What causes breast cancer?
While there is no specific cause for breast cancer, some lifestyle factors are associated with a higher risk of developing the condition:
- Drinking alcohol may raise oestrogen levels in the body and is associated with a 30 to 50% increased risk of breast cancer.
- Unhealthy weight — Being obese is associated with a 20 to 40% increased risk of breast cancer in post-menopausal women.
- Smoking, particularly if you started as a teenager, increases your breast cancer risk.
Other factors that can’t be changed also impact your likelihood of getting breast cancer:
- Your age — The older you get, the more likely it is your cells become damaged and progress to cancer. Nearly 4 in 5 new breast cancers are diagnosed in women over 50 years.
- Your family history — Women with a first-degree relative with breast cancer are twice as likely to get it themselves than women without one.
- Having BRCA1, BRCA2 or other gene mutations — Up to 1 in 10 breast cancers are due to a strong family history of these genetic mutations.
- Dense breasts — Women with more dense tissue in their breasts (visible only using an X-ray or mammogram) may have a higher risk of breast cancer.
- Previous radiation exposure — Women who were exposed to radiation therapy in the chest region (for example, for childhood cancers) may have 5 times the risk of breast cancer as women who were not.
When should I see my doctor?
See your doctor or healthcare professional if you notice symptoms of possible breast cancer, such as a lump, pain, itch, nipple discharge or dimpling, or if you have any concerns about your breast cancer risk.
Your doctor or healthcare professional will assess you and work out if you need further tests. If required, they can refer you to a local service and provide necessary follow-up care.
Tests to find breast cancer
To find the cause of a breast change, your doctor will typically use an approach called the ‘triple test’, which includes:
- a medical history and clinical breast examination
- imaging tests, such as a diagnostic mammogram or ultrasound
- a biopsy, which involves taking a sample of tissue cells from the breast and testing them for signs of cancer.
Most women don’t show any abnormal results in these tests.
Staging and further tests
If breast cancer is confirmed, you will be referred for further tests, such as a CT scan, blood tests, bone scans or a PET scan, to see what stage your cancer is at.
Your healthcare team may use a 4 stage system:
- Stage 0 (in situ) refers to pre-invasive breast cancer that’s only in the milk ducts or lobules of the breast.
- Stage I to IIB (early) refer to early breast cancer of a small size (5cm or less).
- Stage IIB to Stage IIIC cancers (advanced, localised) have spread to nearby lymph nodes in the breastbone or armpit.
- Stage IV cancer (advanced, metastatic) have spread to other parts of the body.
There may also be further tests for hormone receptors (to see if your cancer cells have receptors for estrogen or progesterone), HER-2 (a protein that promotes cancer cell growth) or other genetic markers. These tests help decide the best treatment for your type of breast cancer.
How is breast cancer treated?
Depending on the features of the breast cancer, there are several treatment options.
–Surgery
This treatment involves removing localised cancer from the breast. A lumpectomy (“breast conserving surgery”) involves removing the cancer and some healthy tissue but keeping the breast intact. A mastectomy involves removing the whole breast affected by cancer. During breast surgery, lymph nodes under the arm may also be removed.
–Radiation therapy
Radiotherapy is often used to destroy any breast cancer cells left following a lumpectomy or lymph node removal. It is sometimes used after a mastectomy if there is a risk of cancer recurring in the chest area.
–Chemotherapy
Chemotherapy involves using anti-cancer drugs to kill the remaining cancer cells in the body. It may be used before or after surgery or radiation therapy, or together with radiation therapy.
–Hormone therapy
Hormone therapy involves drugs that reduce your body’s oestrogen and progesterone levels, to stop or slow hormone receptor positive cancer cells.
–Palliative care
In some cases, the medical team will talk to a patient about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.