What is Breast Cancer? Understanding Symptoms, Risks, and Treatments

Stages of Breast Cancer

Breast Cancer Treatment

Breast cancer treatment depends on several factors, including the type of cancer, its stage, hormone receptor status, and the person’s overall health. In Australia, treatment plans are tailored to each individual, often combining multiple approaches for the best outcome. Early breast cancer is typically treated with the aim of curing the disease, while advanced or metastatic breast cancer is managed to control its spread and maintain quality of life.



1. Surgery

Surgery is usually the first line of treatment for breast cancer. The goal is to remove the cancer from the breast while preserving as much healthy tissue as possible. The two main types are:



• Breast-conserving surgery (lumpectomy) – This involves removing the tumour and a small amount of surrounding tissue. It allows most of the breast to be preserved and is usually followed by radiation therapy to reduce the risk of recurrence.
• Mastectomy – This procedure removes the entire breast. In some cases, both breasts may be removed, particularly if there is a higher risk of cancer developing in the other breast.

During surgery, lymph nodes under the arm (axillary nodes) may also be removed or sampled to check if the cancer has spread beyond the breast. This helps guide further treatment.

2. Radiation Therapy

Radiation therapy uses high-energy rays to destroy any remaining cancer cells in the breast area. It's commonly used after breast-conserving surgery to lower the risk of recurrence in the same breast.

Radiation may also be recommended after a mastectomy if there’s a higher risk of breast cancer returning, or to relieve symptoms such as pain or swelling in more advanced cases.



3. Chemotherapy

Chemotherapy uses anti-cancer drugs to target and destroy cells that grow and divide quickly—like cancer cells. It can be given as pills, injections, or through a drip into a vein, and is often used alongside other treatments.

Chemotherapy may be recommended:

• Before surgery (neoadjuvant therapy) – to shrink the tumour and make surgery more effective or allow breast-conserving surgery instead of mastectomy
• After surgery (adjuvant therapy) – to kill any remaining cancer cells and reduce the risk of the cancer coming back
• For advanced or metastatic breast cancer – to help slow the spread, relieve symptoms, and improve quality of life

Because chemotherapy affects healthy fast-growing cells too, side effects are common. These may include fatigue, nausea, hair loss, and increased risk of infection. However, many side effects are temporary and manageable with support from your care team.

4. Hormone Therapy

If the cancer is hormone receptor-positive, it means the cancer cells rely on hormones like oestrogen or progesterone to grow. Hormone therapy works by blocking these hormones or lowering their levels in the body.

The common options in hormone therapy include:

• Tamoxifen – often used in both pre- and postmenopausal women
• Aromatase inhibitors – typically used in postmenopausal women

These medications are usually taken for several years after treatment to reduce the risk of the cancer returning.

5. Targeted Therapy

Targeted therapy focuses on specific features of cancer cells that allow them to grow and survive. A common example is HER2-positive breast cancer, where the cancer has higher levels of the HER2 protein.

For HER2-positive cases, targeted treatments like trastuzumab (Herceptin) or pertuzumab can significantly improve survival and reduce the risk of recurrence. These drugs work by blocking the HER2 protein and helping the immune system destroy the cancer cells more effectively.



6. Immunotherapy

Immunotherapy helps the body’s immune system recognise and fight cancer more effectively. It’s mainly used in certain cases of triple negative breast cancer, which doesn’t respond to hormone or HER2-targeted therapies.

Checkpoint inhibitors, such as atezolizumab, are sometimes combined with chemotherapy to help slow the growth and spread of cancer in eligible patients.



Breast Cancer Survival Rates

Despite advances in screening and treatment, breast cancer continues to take a heavy toll. Understanding the mortality landscape is key to emphasising the importance of early detection and ongoing care.

Here are some key statistics from 2024:

• Around 3,305 deaths from breast cancer are projected in Australia for 2024, representing approximately 6.3% of all cancer deaths.
• In 2022, it was estimated that over 3,200 people died from breast cancer, including around 36 men.
• On average, that's nearly 9 Australians per day losing their lives to breast cancer.
• The absolute number of deaths has gradually increased due largely to the rising number of diagnoses and an ageing population. However, the age-standardised mortality rate is slowly decreasing. It went from about 30 deaths per 100,000 women in 2000 to around 22 per 100,000 in 2024.
• Notably, Indigenous women experience higher mortality (21.2 per 100,000) compared to non‑Indigenous women (19.4 per 100,000).
• Women in inner regional areas and lowest socioeconomic groups also tend to have higher mortality rates.
• The five-year relative survival rate for breast cancer improved from 78% in 1990–1994 to 92% in 2016–2020.
• The ten-year survival rate sits at 87.4% .
• Survival is highest in Stage 1 and 2 cancers (approaching 100% and ~95% respectively), drops to ~81% in Stage 3, and falls significantly to around 32% in Stage 4 metastatic cases.

With all that said, survival rates for breast cancer in Australia have improved dramatically over the past few decades. That is thanks to better awareness, earlier detection, and more effective treatments. A diagnosis today carries far more hope than it did in the past, especially when the cancer is found early.

However, the lower survival rates for advanced and metastatic breast cancer remind us that timely screening, equal access to care, and continued research remain critically important.

Breast Cancer Prevention

While breast cancer can't always be prevented, there are steps you can take to reduce your risk. Making healthy lifestyle choices and being aware of the known breast cancer risk factors can help lower the chances of abnormal breast cancer cells developing over time.



Some breast cancer risk factors, like age, gender, and family history, can’t be changed. However, other factors are linked to lifestyle and environment. These include:

• Lack of physical activity
• Excess alcohol consumption
• Being overweight or obese after menopause
• Hormone replacement therapy (HRT) use
• Late pregnancy or never having children

People with a family history of breast or ovarian cancer may have an increased risk due to inherited gene mutations, such as BRCA1 or BRCA2. If you fall into this category, your doctor may refer you for genetic counselling or more frequent screening.

While you can't change your genetics, these steps may help reduce your chances of developing breast cancer cells in the first place:

• Maintain a healthy weight
• Exercise regularly
• Limit alcohol intake
• Avoid smoking
• Breastfeed if possible
• Limit or avoid HRT unless medically necessary

For people at increased risk, such as those with strong family histories or known gene mutations, risk-reducing medication or surgery may be discussed with a specialist.

The Role of Breast Cancer Screening

Breast cancer screening aims to detect breast cancer cells before symptoms appear. This makes treatment more likely to be successful. As mentioned above, BreastScreen Australia offers free mammograms every two years. They especially invite women aged 50 - 74, but women in their 40s and above 74 can also participate. Regular screening is one of the most effective ways to reduce breast cancer mortality through early detection.



Effects on Breastfeeding Mums

Breast cancer during breastfeeding is rare, but it can happen, and when it does, it often raises difficult and unexpected questions for new mums. Many women wonder, “Can I continue to breastfeed if I’m diagnosed?” or “Will breastfeeding worsen my condition?”

The good news is that breastfeeding is known to slightly lower breast cancer risk, especially when continued for 12 months or longer. This protective effect is believed to come from hormonal changes that reduce lifetime exposure to oestrogen and help the body clear potentially abnormal breast cancer cells.

However, it’s still possible to be diagnosed with breast cancer while breastfeeding. Because lactating breasts naturally feel full or lumpy, some symptoms may be harder to detect. That’s why any new lump or persistent change should be checked by a doctor as soon as possible. That's is especially when the lump does not go away after feeding.



Can You Breastfeed During Cancer Treatment?

In most cases, breastfeeding is not recommended during active breast cancer treatment. Medications such as chemotherapy, radiation, hormone-blocking drugs, and targeted therapies can pass into breast milk and may harm your baby. When treatment begins, you’ll likely need to pause or stop breastfeeding.

Surgery and radiotherapy can also affect your ability to breastfeed. A mastectomy removes all breast tissue from the affected side, making breastfeeding from that breast impossible. Meanwhile, breast-conserving surgery or radiation may reduce milk supply or affect nipple sensation,. The latter can make latching or feeding more difficult.

The good news is that many women are still able to breastfeed from the unaffected breast. In some cases, one breast can produce enough milk to nourish a baby fully. With the right support, expressing milk or using donor milk are also possible options.

That said, breastfeeding after cancer treatment is considered safe. It does not increase the risk of recurrence, even in women with BRCA gene mutations. If breastfeeding is part of your goals after recovery, speak with your care team early so your options can be preserved and supported where possible.



Screening and Monitoring During Breastfeeding

Breastfeeding changes the texture and density of the breasts, which can make cancer harder to detect on a mammogram. However, breast cancer screening can still be safely performed during breastfeeding, often using ultrasound as a first step. Expressing milk before imaging can help improve comfort and clarity of results. Any new lump or change that doesn’t resolve with time or feeding should be promptly checked by a doctor.



Can Breast Cancer Come Back?

Yes, breast cancer can return after treatment. This is known as a recurrence, and while it doesn’t happen to everyone, it remains a possibility—even years after the initial diagnosis. The risk varies from person to person and depends on several factors, including the type of breast cancer, stage at diagnosis, the treatments received, and individual breast cancer risk factors.

In some cases, tiny groups of breast cancer cells may survive initial treatment and stay in the body at levels too small to detect. These cells can become active again over time, leading to a recurrence. This risk may be higher when:

• The original tumour was large or aggressive
• Cancer had already spread to lymph nodes
• The cancer was hormone receptor-negative
• There was a delay in diagnosis or starting treatment

Recurrences are classified into three types:

• Local recurrence – cancer comes back in the same breast or chest wall
• Regional recurrence – it appears in nearby lymph nodes, such as under the arm or near the collarbone
• Distant recurrence (metastatic breast cancer) – the cancer spreads to organs like the bones, liver, lungs, or brain. This is considered stage 4 and is the most serious form of recurrence.

To help prevent recurrence, your care team may recommend steps such as:

• Continuing hormone therapy if recommended
• Completing the full course of treatment
• Keeping up with regular follow-up appointments and breast cancer screening
• Making healthy lifestyle choices, including staying active, maintaining a healthy weight, limiting alcohol, and avoiding smoking.



Breast Cancer in Men

Although breast cancer is far more common in women, men can develop it too. Roughly 1 in every 550 Australian men is expected to be diagnosed with breast cancer at some point in their lifetime. Most cases occur in older men, but it can happen at any age—particularly in those with a strong genetic or family history.

Men have a small amount of breast tissue behind the nipple, where breast cancer cells can develop. The most common type is invasive ductal carcinoma, which starts in the milk ducts and spreads to surrounding tissue. Symptoms may include a firm lump in the chest area, changes to the nipple (such as inversion or redness), or nipple discharge. In some cases, there may also be swelling or pain.

Because many men are unaware they can get breast cancer, diagnosis is often delayed. This can lead to cancer being found at a later stage, which may affect treatment outcomes.

Risk factors include a family history of breast cancer, BRCA1 or BRCA2 gene mutations, radiation exposure to the chest, and genetic conditions such as Klinefelter syndrome. While routine breast cancer screening is not recommended for men, those at increased risk should speak with their doctor about personalised monitoring and early detection strategies.



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