Overview
Breast cancer occurs when cells in breast tissue grow in an abnormal, uncontrolled way. It is the most common cancer in the UK. Most breast cancers are detected early when they are highly treatable. With modern treatment, survival rates are better than ever.
How common is it?
About 55,000 people are diagnosed with breast cancer in the UK each year. Around 1 in 7 women will develop it during their lifetime. It is rare but not impossible in men.
Causes and risk factors
Most breast cancers result from a combination of ageing, hormonal exposure, lifestyle factors, and genetic susceptibility. Inherited BRCA1 and BRCA2 gene faults carry a significantly elevated lifetime risk.
Common risk factors
- Age (risk rises sharply after 50)
- Family history especially first-degree relatives
- BRCA1 or BRCA2 gene variants
- Previous breast cancer or atypical cells on biopsy
- Long use of combined HRT
- Alcohol consumption
- Obesity after menopause
- Having children late or not breastfeeding
Symptoms
- Painless lump in the breast or armpit
- Change in breast shape or size
- Dimpling or puckering of skin
- Nipple inversion or discharge (especially if blood-stained)
- Rash or redness over the breast skin
- Persistent pain in one area of the breast
When to see a doctor
See a doctor within 2 weeks for any new breast lump, skin change, nipple inversion, or blood-stained discharge. Most lumps are not cancer but all need assessment.
Diagnosis
Triple assessment: clinical examination, mammogram or ultrasound, and core needle biopsy. MRI is used in high-risk women and for staging. Hormone receptor and HER2 status on biopsy determines which treatments will work best.
Treatments
Surgery
Lumpectomy removes the tumour with a margin of normal tissue. Mastectomy removes the whole breast. Sentinel lymph node biopsy checks whether cancer has spread to lymph nodes.
Radiotherapy
Given after lumpectomy to destroy remaining cancer cells and halve the risk of local recurrence.
Systemic therapy
Hormone therapy (tamoxifen, aromatase inhibitors) for oestrogen-positive cancers. Chemotherapy for aggressive or spread cancers. HER2-targeted drugs (trastuzumab) for HER2-positive cancers.
Self-care and lifestyle
- Attend NHS breast screening from age 50 (or earlier if high risk)
- Limit alcohol, maintain healthy weight, and exercise regularly
- Breastfeeding reduces breast cancer risk
- Know what your breasts normally look and feel like so you notice changes promptly
Prevention
Regular exercise, limiting alcohol, maintaining healthy weight, and breastfeeding modestly reduce risk. Women with high genetic risk may be offered risk-reducing surgery or preventive medication.