Breast Cancer

Breast cancer is a common type of cancer that develops in the cells of the breasts.  It is the most common cancer among women in Aotearoa New Zealand, affecting 1 in 9 women over their lifetime. On average, 9 people in NZ will hear the news today that they have breast cancer.

Māori women experience higher rates of breast cancer, and Māori and Pasifika women more commonly get breast cancer at a younger age. Trans-people, intersex and non-binary people can also get breast cancer.

‍Symptoms of Breast Cancer

Breast cancer symptoms can vary widely. Common signs and symptoms include:

• A lump in the breast or underarm, this is often the first noticeable symptom
• Changes in breast size or shape
• Dimpling or puckering of the breast skin
• Redness or flaky skin in the nipple area or breast
• Nipple discharge other than breast milk, possibly including blood
• Pain in any area of the breast

Risk factors

Several factors may increase the likelihood of developing breast cancer:

• Gender: Women are more likely to develop breast cancer than men
• Age: Risk increases with age
• Family history: A close relative with breast cancer increases risk
• Genetic mutations: Inherited mutations in genes, such as BRCA1 and BRCA2
• Personal history of breast cancer
• Radiation exposure, especially to the chest area
• Obesity
• Smoking tobacco
• Postmenopausal hormone therapy

‍Diagnosis

Breast cancer is diagnosed by a combination of:

• physical examination of your breast tissue
• diagnostic imaging such as mammogram and ultrasound
• diagnostic tests such as biopsy and testing of cell samples.

Your healthcare provider will talk to you about your medical history and symptoms and will do a physical examination. They may arrange more tests or you may be referred directly to a specialist for a mammogram and/or ultrasound scan. 

Further testing may be required including taking a sample of cells from the lump, biopsy or removal of the lump, and laboratory testing on any breast tissue samples. 

When to see a doctor

• Detection of a lump in the breast or underarm
• Significant changes in the appearance of breasts
• Any of the symptoms mentioned above
  

Treatment options

Medical treatments:

Breast cancer is treated by 4 different methods: surgery, radiation treatment (radiotherapy), chemotherapy and hormone treatment.

The treatment, or combination of treatments, used will depend on the type and size of the breast cancer and whether or not it has spread

It will also depend on the age, general health and personal choice of the person with breast cancer.

• Surgery: Options include lumpectomy (removal of the tumour) or mastectomy (removal of the breast)
• Radiation therapy: Uses high-energy rays to target and kill cancer cells
• Chemotherapy: Uses drugs to destroy cancer cells, often used before (neoadjuvant) or after (adjuvant) surgery
• Hormone therapy: Blocks hormones that fuel certain types of breast cancer
• Targeted therapy: Focuses on specific proteins or genes that contribute to cancer growth
• Immunotherapy: Helps the immune system fight cancer

Self-help and support:

• Routine screenings and doctor visits: Regular mammograms and self-exams are crucial for early detection
• Healthy lifestyle choices: Including a balanced diet, regular exercise, and limiting alcohol intake, and being smokefree
• Support groups: Connecting with others for emotional and psychological support
• Follow-up care: Regular follow-up appointments post-treatment to monitor for recurrence

Tips for talking to your doctor

• Make a list of what you are feeling and how often it happens, including as much detail as possible
• Think about your family/whānau history of cancer and tell your doctor
• Go back to your doctor if you don't feel better, even if tests show you don't have a problem - you can ask for a second opinion if you want one 
• Take a family/whānau member or friend with you to the appointment for support

‍Conclusion

Breast cancer can often be successfully treated if detected early. Awareness, breast screenings, and prompt consultation with healthcare professionals if symptoms appear are crucial. Understanding symptoms, risk factors, and treatment options can empower women to take proactive steps for their health. If you observe any symptoms or have a family history of breast cancer, seeking medical advice promptly is important.