INVASIVE BREAST CANCER

Breast cancer is very common and will affect one in eight women in the UK over the course of their lifetime. In 2015 there were 55,000 new patients diagnosed. There are 2 main types. Invasive ductal carcinoma of the breast (IDC) makes up over 80% of cases and invasive lobular carcinoma of the breast (ILC) accounts for about 15% of cases. The word “invasive” just means that this is a cancer, not that is has any additional aggressive features.

Patients may identify a change in their breast (below) or may have no symptoms and have their breast cancer diagnosed as a result of undergoing a routine screening mammogram. The following are possible signs of breast cancer that you may notice and should cause you to arrange an appointment with your GP:

• Lump in the breast
• Thickening of the breast skin
• Rash or redness of the breast
• Swelling in one breast
• Nipple turning inward (inversion)
• Nipple discharge
• Lumps in the underarm area
• Skin tethering or distortion on raising arm above head
• New localised pain in one breast

During a clinic appointment, you will be asked all about the breast change or symptom you have noticed, and a full medical history and clinical examination will be carried out. It is very likely that further tests will be arranged on the basis of your symptoms and examination and may include:

• Mammograms (X-ray)
• Breast ultrasound
• Breast MRI
• Breast biopsy

All breast cancers will be assessed for grade, the presence or absence of important cell surface receptors (oestrogen and herceptin) and the characteristics of the lymph nodes in the armpit before treatment begins in order to work out the best treatment plan for you.

Rachel will discuss each step in the treatment pathway at the local breast cancer multidisciplinary team meeting (MDT). This is a weekly meeting with many breast cancer specialists present to ensure that there is agreement on investigations, diagnosis and the best treatment options.

There are many types of treatment available for breast cancer, which may include

• Breast surgery (breast conservation, mastectomy)
• Lymph node surgery (sentinel node biopsy, axillary node dissection)
• Breast reconstruction
• Radiotherapy
• Chemotherapy
• Anti-hormonal therapy in oestrogen sensitive breast cancers
• Targeted Biological therapy in Her 2 receptor positive breast cancers
• Bisphosphonate therapy in ladies who have gone through the menopause with higher risk breast cancers

For most patients, surgery will be the first part of their treatment for breast cancer, but there may be situations where patients are offered either chemotherapy or anti-hormonal tablets before their surgical treatment (neo-adjuvant medical therapy). The reasons for this can vary and should always be thoroughly discussed with the patient before she makes a decision about her treatment.

This will depend on numerous factors including:

• Disease stage (confined to the breast / spread to lymph nodes / distant spread)
• Tumour sensitivity and response to different types of treatment (such as chemotherapy, hormone blocking drugs and herceptin)
• Fitness of the patient to undergo certain types of treatment

It is important to remember that breast cancer is generally a very treatable type of cancer, with survival rates considerably higher than for many other common types of cancers, even for patients with more advanced patterns of disease at diagnosis.

Discussion with Rachel is important to answer any questions that you may have. For information about any additional conditions not featured within the site, please contact us for more information.