Breast cancer develops when abnormal cells in breast tissue begin growing uncontrollably. Although the term “breast cancer” sounds like one diagnosis, there are several different biological types of breast cancer.

Understanding the exact tumour type is extremely important because modern treatment depends on much more than the size of a breast lump.

What Are the Possible Symptoms of Breast Cancer?

Possible breast changes that should be medically evaluated include:

A new lump in the breast or underarm
Change in breast size or shape
Skin dimpling or thickening
New nipple inversion
Unexplained nipple discharge
Persistent nipple or breast changes
Swelling involving part or all of the breast

Many breast lumps are benign, but new or persistent breast changes should not be ignored.

How Is Breast Cancer Diagnosed?

Evaluation may involve:

Clinical breast examination
Mammography
Breast ultrasound
MRI in selected cases
Biopsy

A biopsy allows a pathologist to examine tissue and establish whether cancer is present.

Why Is the Pathology Report So Important?

A breast cancer pathology report provides important information about the biological characteristics of the tumour.

It may include:

Histological type
Tumour grade
Estrogen receptor status
Progesterone receptor status
HER2 status
Other biomarkers when required

What Are ER and PR in Breast Cancer?

ER stands for estrogen receptor and PR stands for progesterone receptor.

If breast cancer cells contain these hormone receptors, the tumour may depend partly on hormones for its growth. Hormonal or endocrine treatments may therefore be helpful.

What Is HER2-Positive Breast Cancer?

HER2 is a protein involved in cell growth.

Some breast cancers produce an excessive amount of HER2. These cancers may respond to medicines specifically designed to target HER2.

What Is Triple-Negative Breast Cancer?

Triple-negative breast cancer does not have significant estrogen receptors, progesterone receptors or HER2 expression.

Because these common treatment targets are absent, treatment strategies differ from those used for hormone-receptor-positive or HER2-positive breast cancers.

How Is Breast Cancer Staged?

Breast cancer staging considers several factors, including:

Size of the breast tumour
Involvement of nearby lymph nodes
Whether cancer has spread to distant organs
Certain biological characteristics of the tumour

What Are the Main Treatment Options?

Breast-Conserving Surgery

Breast-conserving surgery removes the tumour along with a margin of healthy surrounding tissue while preserving most of the breast.

Mastectomy

Mastectomy involves removal of the breast and may be recommended in certain situations.

Radiation Therapy

Radiation is commonly recommended after breast-conserving surgery and may also be required after mastectomy in selected patients.

Chemotherapy

Chemotherapy may be given before or after surgery depending on the stage and biology of the cancer.

Hormone Therapy

Hormone therapy can be effective for hormone-receptor-positive breast cancer.

HER2-Targeted Treatment

HER2-positive tumours may respond to medicines specifically directed against HER2.

Immunotherapy and Other Targeted Treatments

Selected patients may benefit from immunotherapy or other targeted treatments depending on tumour subtype and biomarkers.

Is Mastectomy Always Better Than Breast-Conserving Surgery?

No. Removing more breast tissue does not automatically mean better cancer control.

For appropriately selected patients, breast-conserving surgery combined with other indicated treatments is an established treatment strategy.

When Is Genetic Testing Considered?

Genetic counselling and testing may be recommended when there is concern about an inherited cancer predisposition.

Factors may include:

Young age at diagnosis
Strong family history
Multiple relatives with breast or ovarian cancer
Certain tumour subtypes
Cancer affecting both breasts

Conclusion

Breast cancer is not one single disease. Stage, pathology, hormone receptors, HER2 status, other biomarkers and the patient’s overall health all contribute to treatment planning.

Patients should therefore discuss their complete pathology report with their cancer specialist rather than focusing only on tumour size.

This article is intended for educational purposes and does not replace personalised medical consultation.