Click here to make an urgent appointment for a new confirmed or highly suspicious breast cancer diagnosis
〰️
Click here to make an urgent appointment for a new confirmed or highly suspicious breast cancer diagnosis 〰️
BREAST CANCER
Understanding The Basics
Breast Cancer Statistics
Breast cancer is the most common cancer in women affecting 1 in 7 Australian women by age of 85. A woman’s risk of developing breast cancer increases with age, with the average age of first diagnosis in women being 61 years. 79% of new cases of breast cancer develop in women over the age of 50. Breast cancer can also affect men but with much less incidence (1 in 668 men by the age of 85).
Over the last decades breast cancer survival rate has significantly improved. The chance of surviving at least five years (five-year relative survival) after breast cancer diagnosis in Australia is 92% and 87.4% of women diagnosed with breast cancer will be alive at least 10 years (ten-year relative survival) after their diagnosis. However, it is still the second leading cause of cancer death in women after lung cancer.
Breast Cancer Stages
When women are given the diagnosis of breast cancer, often their first question is about the stage of the disease. It is a common knowledge that earlier stage cancers have a better prognosis and survival. However, as cancer surgeons we don’t often have the answer at the outset and sometimes we only know after the surgery. Having experienced this situation first-hand myself and helping many patients through their cancer journey, I can tell you that your best strategy is to have patience and keep faith! Trust your treating doctor who is trained to follow through with the information as they come in and take you on this voyage as smooth as possible. No matter what stage disease, we are always going to have treatment for it, and in the case of breast cancer, very effective treatments indeed!
Without getting into too much technical details, we can roughly describe the 5 stages of breast cancer as follows:
Stage 0: This is the earliest stage of breast cancer which is also called ‘in situ’ disease. At this stage the cancer cells are still within the milk ducts (called ductal carcinoma in situ or DCIS) or lobules (called lobular carcinoma in situ or LCIS) and have not invaded into the normal breast tissue. At this stage the cancer cells won’t spread to the lymph nodes or distant sites and simply removal of cancer is curative without the need for systemic therapies.
Stage 1: At this stage we are dealing with a so-called ‘invasive’ breast cancer. The term invasive simply means that the cancer cells have come outside the ducts (invasive ductal carcinoma) or lobules (invasive lobular carcinoma). At this stage the cancer is < 2cm in size and has not gone to the armpit lymph nodes. This is considered very early cancer, and it has an excellent prognosis.
Stage 2: At this stage the cancer is >2cm and/or has spread to 1-3 armpit lymph nodes.
Stage 3: At this stage the cancer is >5cm and/or has spread to >3 armpit lymph nodes.
Stage 4: This stage is marked by the presence of so called ‘distant metastasis’, i.e. the cancer has spread outside the breast and armpit lymph nodes. The most common distant sites for breast cancer spread are lung, liver, bone and brain. It is important to note that surgery is not the first line of treatment at this stage. Systemic therapy options that can treat cancer cells in the entire body are commenced first. In some cases, local control with surgery may be discussed once the distant disease has been controlled.
Staging studies–CT (Computerised Tomography) and bone scan or more recently PET (Positron Emission Tomography) scan–are often done once it is known that the cancer has spread to the lymph nodes, or the tumour is >5cm in size.
Breast Cancer Subtypes
Breast cancer is not just one disease, but several. It includes different subtypes and treatments are becoming increasingly personalised based on the tumour characteristics. Therefore, once a cancer is diagnosed on the needle biopsy, further laboratory tests on the biopsy specimen are necessary to define the cancer subtype which will often dictate the next step in the treatment. We have a dedicated blog on breast cancer subtypes that will hopefully give you the knowledge you need for a more informed discussion with your treatment team.
Blog: Breast Cancer Subtypes
Breast Cancer Surgery
Surgery for breast cancer often involves surgery of the breast as well surgery of the armpit(axillary) lymph nodes. It is important to note that the type of surgery performed on the breast is independent of the type of surgery performed on the armpit lymph nodes. Table below summarises the different types of breast cancer surgery.
For a full discussion on lumpectomy vs mastectomy please refer to our dedicated blog on this topic. Similarly for a detailed discussion on axillary (armpit) lymph node surgery please refer to our dedicated blog.
Blog: Lumpectomy vs Mastectomy
Blog: Axillary (armpit) Lymph Node Surgery
Additional Resources
Breast cancer statistics: https://www.breastcancertrials.org.au/breast-cancer-resources/breast-cancer-statistics/?srsltid=AfmBOoq4dT-mHGitVJz4CPx14MwVO5eiBUbNds2jBnH20Nzjv--8nPbT
Breast cancer types: https://www.breastcancertrials.org.au/breast-cancer-resources/breast-cancer-types/?srsltid=AfmBOoq4dT-mHGitVJz4CPx14MwVO5eiBUbNds2jBnH20Nzjv--8nPbT
Breast cancer stages: https://www.breastcancertrials.org.au/breast-cancer-resources/breast-cancer-stages/?srsltid=AfmBOoq4dT-mHGitVJz4CPx14MwVO5eiBUbNds2jBnH20Nzjv--8nPbT
Click here to make an urgent appointment for a new confirmed or highly suspicious breast cancer diagnosis
〰️
Click here to make an urgent appointment for a new confirmed or highly suspicious breast cancer diagnosis 〰️