Quick answer

What is breast cancer?

Breast cancer is the most common cancer in UK women — often detected on screening mammograms before symptoms appear. Warning signs include new lump, nipple change, skin dimpling, or discharge. Most lumps are benign but always need GP assessment within 2 weeks. Treatment combines surgery, radiotherapy, hormone therapy, chemotherapy, and targeted drugs depending on type. Men can get breast cancer too though rare.

Breast cancer — detection and treatment overview

Breast cancer is the most common cancer in UK women — ~55,000 cases yearly — 1 in 7 lifetime risk. Survival has doubled since 1970s through screening, specialist surgery, and targeted systemic therapy.

Men: ~400 cases yearly — 0.5% of breast cancers — often later stage at diagnosis.

See also breast lump symptom guide.

Symptoms — when to worry

See GP (2-week wait referral if suspected cancer):

  • new lump or thickening — breast or axilla
  • change size/shape
  • skin dimpling — peau d’orange
  • nipple inversion — new
  • ** nipple discharge** — blood-stained especially
  • eczema-like rash on nipple — Paget’s disease
  • persistent focal pain — less common presenting feature

Painless lump — does not exclude cancer.

Screening

NHS Breast Screening (mammography):

  • every 3 years
  • women 50–71 England (extensions in progress)
  • detects ~30% of cancers in screened population — not perfect

Between screens: self-know normal — no formal self-exam required — report change.

High risk:

  • BRCA mutations — MRI + mammography from ~30
  • strong family history — genetics clinic

Diagnosis — triple assessment

One-stop breast clinic:

  1. Clinical examination
  2. Imaging — mammogram ± ultrasound (younger denser breasts ultrasound-first)
  3. Core biopsy — histology

Staging if cancer confirmed:

  • CT/bone scan selective
  • sentinel node biopsy

Types and biology

Invasive ductal carcinoma — commonest

Hormone receptors:

  • ER/PR positive — endocrine therapy — tamoxifen or aromatase inhibitors postmenopausal

HER2 positive — trastuzumab, pertuzumab — improved outcomes

Triple negative — chemotherapy main systemic — no hormone/HER2 targets

Grade, stage, lymph node status — prognosis

Treatment overview

Local:

  • breast-conserving surgery (lumpectomy) + radiotherapy
  • mastectomy ± reconstruction
  • axillary surgery — sentinel node

Systemic:

  • chemotherapy — anthracycline, taxane regimens
  • endocrine therapy — 5 to 10 years
  • CDK4/6 inhibitors — advanced ER+
  • ** immunotherapy** — selected triple negative

Radiotherapy — post-lumpectomy standard; post-mastectomy selected.

Multidisciplinary team (MDT) — individual plan.

Living during and after treatment

  • fertility preservation — discuss pre-chemotherapy if relevant age
  • menopausal symptoms from treatment — see menopause
  • ** lymphoedema** risk post-surgery — physiotherapy
  • Breast Cancer Now — support

Prevention and risk reduction

  • alcohol reduction — dose-dependent risk
  • weight management postmenopausal
  • physical activity
  • breastfeeding — modest protection
  • risk-reducing surgery — BRCA carriers — specialist

HRT — small increased breast cancer risk — individual discussion

Breast cancer terrifies — most lumps are not cancer — but 2-week clinic assessment is fast, standard, and life-saving when needed.

Common questions

What are the symptoms of breast cancer?
New lump or thickening in breast or armpit, change in breast size or shape, skin dimpling or puckering, nipple inversion, rash or crusting on nipple, discharge (blood-stained), persistent pain in breast or armpit. Many cancers found on screening before symptoms.
What age does breast cancer screening start?
NHS Breast Screening Programme invites women aged 50 to 71 every 3 years in England — ages vary slightly in Scotland, Wales, NI. Not foolproof — report symptoms between screens. Higher-risk women (BRCA, strong family history) may start MRI/mammography earlier via genetics clinic.
Are all breast lumps cancer?
No — most lumps are benign (cysts, fibroadenomas). Cannot tell by feel alone — GP refers to breast clinic for triple assessment. Never ignore a lump because it is painless — cancer often painless.
How is breast cancer treated?
Depends on stage and biology — surgery (lumpectomy or mastectomy), radiotherapy, chemotherapy, hormone therapy (tamoxifen, aromatase inhibitors for oestrogen receptor positive), trastuzumab (Herceptin) for HER2 positive. Multidisciplinary team plans individual treatment.
Can men get breast cancer?
Yes — about 400 men yearly in UK — usually presents as lump behind nipple. Same referral pathway — often delayed diagnosis due to low awareness.
Does family history mean I will get breast cancer?
Increases risk — especially first-degree relative young onset or multiple relatives. Most breast cancer is sporadic without family history. BRCA1/BRCA2 mutations significantly increase risk — genetic counselling if strong pattern.

Sources