Summary
Read the full fact sheet- Breast cancer is the most common cancer in women in Australia (apart from non-melanoma skin cancer) and the second most common cancer to cause death in women.
- It is important for all women to get to know the normal look and feel of their breasts.
- Although most breast changes aren’t caused by breast cancer, you should always consult your doctor if you notice an ‘unusual’ change.
- Treatment for breast cancer may include surgery, radiotherapy, chemotherapy and hormone therapy.
On this page
- Risks and causes of breast cancer
- Other risk factors for breast cancer
- Early detection of breast cancer
- Diagnosis of breast cancer
- Treatment for breast cancer
- Surgery for breast cancer
- Other treatment for breast cancer
- Research into breast cancer- Clinical trials
- Breast cancer and your sexuality
- Caring for someone with breast cancer
- When a cure for breast cancer isn't possible
- Where to get help
Breast cancer is the most common cancer in women in Australia (apart from non-melanoma skin cancer) and the second most common cancer to cause death in women.
The risk of being diagnosed with breast cancer over a lifetime is 1 in 7 for women. Over 20,000 women are diagnosed with breast cancer in Australia each year. This means on average 57 Australian women are diagnosed with breast cancer every day. The chance of surviving at least five years (relative 5-year survival) has increased over the years from 77.3 per cent in 1989-1993 to 92 per cent in 2014-2018.
Breast cancer can occur at any age, but it is most common in women over the age of 50 years. About 80 per cent of breast cancer cases occur over the age of 50 years. Around 1,000 young women under the age of 40 years are diagnosed with breast cancer each year, which equates to three young women each day.
Men can also develop breast cancer, although this is extremely rare. The risk of being diagnosed over a lifetime is 1 in 555 for men. Around 200 men are diagnosed with breast cancer in Australia each year. It is treated in the same way as breast cancer in women.
There are different types of breast cancer, but most begin in the milk ducts or the milk lobules (or both).
Some breast cancers are found when they are ‘in situ’ (in place). These types of breast cancers are called non-invasive breast cancers, precancers or carcinoma insitu This means that they have not spread outside the milk duct or lobule where the cancer began, into the breast tissue. Ductal carcinoma insitu (DCIS) is the most common type of non-invasive breast cancer. Ductal carcinoma insitu and lobular carcinoma insitu (LCIS) are not life-threatening but can increase the risk of developing invasive breast cancer later in life.
‘Early breast cancer’ is the term that refers to invasive cancer that is contained within the breast and may have spread to surrounding lymph nodes in the breast or armpit (axilla) but not anywhere else in the body. Invasive breast cancers have grown beyond the duct or lobule where they began, into surrounding breast tissue, with the potential to spread to other parts of the body. Breast cancer that spreads out of the breast may spread to lymph nodes in the armpit nearest the breast affected by cancer (axillary lymph nodes).
Breast cancer that has spread to other parts of the body, such as the bones, lungs and liver, is called metastatic breast cancer or stage IV (4).
Risks and causes of breast cancer
There are many risk factors for breast cancer – some you can do something about and others you cannot. iPrevent is a tool that can help you understand your level of risk for developing breast cancer compared with the average risk for people your age. Talk to your doctor for more advice.
The exact cause of breast cancer is unknown, but factors that seem to increase risk include:
- gender
- getting older – your risk of breast cancer increases as you get older. About three quarters of breast cancer occur in women aged 50 years and over.
- heredity – most people who develop breast cancer do not have a family history. However, having several close family members (mother, sister or daughter) who have had breast cancer can increase your risk.
- genetics – around five to 10 per cent of breast cancers occur in people who have inherited a gene abnormality (mutation) from their mother or father.
- breast density – people with dense breasts (breasts that have more glandular and fibrous tissue and less fatty tissue) have a greater chance of developing breast cancer than those with less dense breasts.
- certain breast diseases – some types of breast disease that are found through mammograms indicate an increased risk. For example, people who have atypical hyperplasia or lobular neoplasia have an increased risk of breast cancer. Most benign breast conditions do not increase the risk of breast cancer.
- previous history of breast cancer – women who have had breast cancer have a greater risk of developing it again.
Other risk factors for breast cancer
Other factors that seem to increase risk include:
- not having children or having children after the age of 30
- early age at first period
- later age of natural menopause (55 years or older)
- alcohol intake – regular (drinking of alcohol is associated with an increased risk of breast cancer. Limiting the amount of alcohol your drink can reduce this risk)
- obesity or gaining a lot of weight after menopause – fatty tissue is the main source of oestrogen after menopause. Having more fatty tissue means higher oestrogen levels that can increase breast cancer risk
- smoking
- using the contraceptive pill – the risk is higher while taking the pill and for about ten years after stopping use
- using hormone replacement therapy (HRT) – also known as hormone therapy (HT) – the risk increases the longer you take it but disappears within about two years of stopping use.
Having some of these risk factors does not mean that you will get breast cancer. Most women with breast cancer have no known risk factors, aside from getting older. More research needs to be done before we can be definite about risk factors.
In men, the main risk factor is abnormal enlargement of the breasts (gynaecomastia) due to drug, chemical or hormone treatments. Men with Klinefelter’s syndrome (a sex chromosome disorder) can also be at risk. A man’s risk increases where there is a family history of male breast cancer or a strong family history of breast cancer.
The risk of breast cancer for transgender individuals varies depending on their situation. Transwomen’s risk factors are the same as for men, unless they have had or are having hormonal supplements, in which case, their risk of developing breast cancer is the same as the general population of Australian women. Transmen’s risk factors remain the same as for the general population of Australian women, unless they have had a mastectomy and then their risk is reduced.
Early detection of breast cancer
Check your breasts
Breasts undergo many changes during a woman’s life. These changes can be due to puberty, the menstrual cycle, pregnancy, breastfeeding or changes in weight or ageing. It is important for all women to get to know the normal look and feel of their breasts.
By regularly checking your breasts, you may be able to recognise changes that could be a sign of breast cancer. Such changes include:
- thickening of the tissue
- a lump or lumpiness
- discharge from the nipple
- an inverted or ‘turned-in nipple’ (unless the nipple has always been turned in)
- puckering or dimpling of the skin
- a change in the shape of the breast or nipple
- a painful area
- anything that is not ‘usual’ for you.
Some of these symptoms can occur without any serious disease being present. Nine out of 10 breast changes are not breast cancer. However, just to be sure, your doctor should check any unusual breast change.
Screening mammography
Screening mammography every two years is provided as a free service for women aged 50 to 74 through the BreastScreen Australia program. It is used to detect breast cancer early, when you are well and have no obvious breast symptoms. Screening mammograms can detect breast cancers that are too small to be felt by you or your doctor. The earlier breast cancer is found provides the best chance of effective treatment and survival.
Mammograms taken at different times can later be compared to show changes in breast tissue over time. Screening is open to women from the age of 40 years and can continue after the age of 74 years, however, reminders are only sent to those who are between the ages of 50 and 74 years.
Diagnosis of breast cancer
Breast changes are investigated through a series of tests organised by your doctor or specialist. Most breast changes are diagnosed as benign (non-cancerous). If your tests show that you may have cancer, your GP (doctor) will refer you to a specialist who will advise you about treatment options.
Initial tests you may have include:
- physical examination – breasts and armpits are examined
- diagnostic mammogram – an X-ray of the breast tissue
- ultrasound – a device that uses sound waves to scan the breast
- Breast MRI – a magnetic resonance imaging (MRI) scan creates pictures of breast tissue on the computer and is mainly used for people who are at high risk of breast cancer, who have dense breasts or breast implants.
If further tests are required, one or more procedures may be used, including:
- Fine needle aspiration – a very narrow needle is used to withdraw cells from the testing area.
- Core biopsy – a larger needle is used to take a tissue sample for testing.
- Vacuum-assisted core biopsy –a needle is attached to a suction-type instrument and removes a larger amount of tissue
- Surgical biopsy – surgery is performed under general anaesthetic to remove the whole area for testing.
- Tests on breast tissue – if a cancer is found, it can be checked for special features to help plan treatment. This may include:
- Hormone receptor status – normal breast cells have oestrogen and progesterone receptors. Breast cancers that have too many of these receptors are known as hormone-positive breast cancers and are treated with hormone-blocking drugs.
- HER2 status – HER2 is a protein found on the surface of all cells and controls how cells grow and divide. Breast cancers that have too many HER2 receptors are called HER2-positive and are often treated with chemotherapy and targeted treatments.
- riple negative breast cancer – this type of breast cancer does not have any of the three receptors commonly found on breast cancer cells (oestrogen, progesterone or HER2). Chemotherapy is generally recommended for triple negative breast cancer.
- Ductogram (also known as a galactogram) or discharge test – this is for breast cancers that are causing a discharge from the nipple.
If tests show that you may have breast cancer, you may have further tests to see if the breast cancer has spread. Other tests may include blood tests, bone scans, CT scans and PET scans (computerised tomography and positron emission tomography, respectively). Not everyone will have all these tests.
Test results can take a few days to come back. It is very natural to feel anxious while waiting to get your results. It can help to talk to a close friend or relative about how you are feeling.
You can also contact the Cancer Council Helpline on Tel. 13 11 20 and speak with a cancer nurse or call Breast Cancer Network Australia’s (BCNA) helpline for information, support and referral on Tel. 1800 500 258.
Treatment for breast cancer
Treatment options for breast cancer include surgery, radiotherapy, chemotherapy, targeted therapy and hormone-blocking therapy. Usually, more than one is used. Treatment for breast cancer in men is similar to (and as effective as) the treatment for breast cancer in women.
Treatment depends on several factors, including:
- whether you have had your menopause
- the type of breast cancer you have
- the size of your breast tumour in relation to your breast
- the stage of your breast cancer (whether or not the cancer is confined to the breast or has spread to other parts of the body)
- the grade of your cancer cells – there are three grades of invasive breast cancer. Grade 1 (low grade) – the cancer cells look a bit different to normal cells and are slow growing); Grade 2 (intermediate grade) – the cancer cells grow faster than grade 1 and do not look like normal cells; Grade 3 (high grade) – the cancer cells look very different from normal cells and are fast growing.
- the results of tests on your cancer cells (e.g. hormone receptor status, HER2 receptor status or triple negative)
- your age, general health and personal preferences.
Surgery for breast cancer
An operation to remove the cancer, surrounding breast tissue and often, the nearby lymph nodes, is usually the preferred first treatment.
Surgery options include:
- Breast-conserving surgery – a small operation removes the cancer and some of the surrounding tissue (lumpectomy), and usually some lymph nodes, leaving the bulk of the breast intact. Breast-conserving surgery is often followed by a course of radiotherapy.
- Mastectomy – the entire breast is removed, along with some or all of the lymph nodes from the armpit.
- Breast reconstruction surgery – women who have a mastectomy may choose to have reconstruction surgery (at the time of the mastectomy or later), whereas some women choose not to undergo breast reconstruction. Options for breast reconstruction include silicone gel or saline-filled implants, or the use of your own muscle and skin to create a breast-like shape. Women who choose not to undergo breast reconstruction may use a breast form or prosthesis. These are pads worn inside your bra to help restore balance and are designed to look like a normal breast under clothes.
All surgery has some risks. Possible side effects of breast surgery include infection, bleeding, blood clots in the leg (deep vein thrombosis), nerve damage and swelling of the arm (lymphoedema). These side effects are not common, but you need to understand the risks.
Other treatment for breast cancer
Depending on the cancer, other treatment options can include:
- Radiotherapy – use X-rays (radiation) to kill any remaining cancer cells. Women who have had breast-conserving surgery often have a course of radiotherapy. Side effects can include a short-term reddening of the skin, which looks like sunburn, or longer-term thickening of skin.
- Chemotherapy – cancer-killing medication is given intravenously (directly into a vein). Chemotherapy can be offered to women with early breast cancer as an extra treatment to surgery, radiotherapy or both. Chemotherapy has side effects that will depend on the type of medication you have, but can include nausea, vomiting and hair loss.
- Hormone-blocking treatments – many breast cancers are influenced by the sex hormones oestrogen and progesterone. Hormone-blocking treatment can reduce the chances of breast cancer developing again.
- Targeted therapies – uses specific drugs that are known to target the specific proteins or enzymes that play a role in the growth of cancer cells. For example, targeted treatments such as trastuzumab are used to treat HER2-positive breast cancer.
- Immunotherapies – these are medicines that strengthen the immune system to fight cancer. Some types of immunotherapies are now being used to treat breast cancer. Research is continuing and various types of immunotherapies are being tested in clinical trials.
- Complementary and alternative therapies – when used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve quality of life. Others may not be so helpful and in some cases may be harmful. The Cancer Council Victoria booklet called Understanding complementary therapies can be a useful resource.
All treatments can cause side effects. Many of these are only temporary, but some may be permanent. Your medical team will discuss these with you before you begin treatment.
Research into breast cancer- Clinical trials
Early detection and better treatment have improved survival for people with breast cancer. Research for breast cancer is ongoing. The Cancer Research UK website has information about research into breast cancer.
Clinical trials can test the effectiveness of promising new treatments or new ways of combining cancer treatments and care. Clinical trials can also investigate the emotional and physical side effects of breast cancer and its treatment and explore ways of improving the quality of life for people affected by cancer. For more information about clinical trials you can visit the Breast Cancer Trials Australia website or the Australian Government Clinical Trials website and talk to your doctor about whether a particular trial may be suitable for you. It is important to always discuss treatment options with your doctor.
Breast cancer and your sexuality
Having breast cancer and its treatment can affect the way you feel about your body, who you are, your relationships, the way you express yourself sexually and your sexual feelings (your ‘sexuality’). These changes can be very upsetting.
Your medical team should discuss these issues with you before and during your treatment. If you feel you would like to discuss things further, ask your doctor for a referral to a counsellor or speak to a cancer nurse on the Cancer Council Information and Support Service (Tel. 13 11 20). The Cancer Council Victoria booklet called Sexuality, intimacy and cancermay also be helpful to read.
Cancer Council Victoria also provides cancer patients with a psychosexual counselling service, for those with concerns about body image, intimacy, sexual confidence or relationships after cancer. The free sessions are held with an experienced medical practitioner with a speciality in psychosexual oncology.
Caring for someone with breast cancer
Caring for someone with breast cancer can be a difficult and emotional time. If you or someone you know is caring for someone with breast cancer, there is support available. The Cancer Council Victoria booklet called Caring for someone with cancer may also be helpful to read.
When a cure for breast cancer isn't possible
If breast cancer has been diagnosed in its later stages, the cancer may have spread to the point where a cure is no longer possible. Treatment may be given to slow the growth of the cancer as well as improving quality of life by relieving the symptoms (this is called ‘palliative’ treatment) with medication to relieve pain, nausea and vomiting. The Cancer Council Victoria booklet called Advanced Cancer: Living with Advanced Cancer may be helpful to read.
Where to get help
- Your GP (doctor)
- Breast cancer specialists (e.g. breast surgeon, breast reconstructive/plastic surgeon [breast reconstruction] medical oncologist, radiation oncologist)
- Breast Cancer Network Australia (BCNA)
- BCNA Helpline team is available to provide support, information, resources and a referral service for people affected by breast cancer, at all stages of the breast cancer experience. Open from 9:00am to 5:00pm Monday to Friday, Tel: 1800 500 258
- BCNA My Care Kit – the My Care Kit is for free for women who have recently had breast surgery. It contains a specially designed Berlei bra and soft form(s). talk to your health professional or call BCNA’s Helpline team on Tel. 1800 500 258 or email mycarekit@bcna.org.au
- Find services, government programs and support groups at the BCNA website
- BCNA Online Network – online peer-to-peer support community for people affected by breast cancer, a safe space to connect with others.
- Breast care nurse (BCN) or cancer nurse – to find a BCN near you visit the McGrath Foundation website.
- BCNA has a series of free resources, booklets and fact sheets in a number of languages.
- Cancer Council Victoria, Information and Support Service Tel. 13 11 20
- Multilingual Cancer Information Line, Victoria Tel. 13 14 50
- WeCan website helps people affected by cancer find the information, resources and support services they may need following a diagnosis of cancer.
- Counterpart - Women supporting women with cancer.
- Incidence of breast cancer, New South Wales Breast Cancer Institute.
- Breast cancer and screening, BreastScreen Victoria.
- Breast cancer awareness, Cancer Australia, Australian Government.
- Living with breast cancer, Cancer Australia, Australian Government.
- Going through treatment for breast cancer, Breast Cancer Care UK.
- Breast cancer in Australia: an overview, Australian Institute of Health and Welfare (AIHW)
- Breast Cancer Network Australia (BCNA).