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← About Breast Cancer

Introduction to Breast Cancer


Breast cancer is the most common form of cancer affecting women in Malaysia. About one in 19 women in this country are at risk, compared to one in eight in Europe and the United States.

Breast cancer occurs when the cells in the lobules (milk producing glands) or the ducts become abnormal and divide uncontrollably. These abnormal cells begin to invade the surrounding breast tissue and may eventually spread via blood vessels and lymphatic channels to the lymph nodes, lungs, bones, brain and liver.


Some statistics for you to digest:

  • Did you know that breast cancer afflicts an estimated figure of more than ONE MILLION women in the world each year and is the 2nd leading cause of cancer deaths among women worldwide, second to lung cancer?
  • Did you know that of the ONE MILLION afflicted women, almost 45% of those women live in developing countries?
  • Did you know that of the new cases of female breast cancer reported in Malaysia in 2003, 64% of these cases were women between the ages of 40 to 60 years old?
  • Did you know that Chinese women seemed to be at greatest risk, with an incidence of 59.7 per 100,000; followed by Indian women (55.8 per 100,000) and Malay women (33.9 per 100,000)?
  • Did you know that early detection and getting appropriate medical attention can help save lives? So it is unfortunate in Malaysia that nearly 40% of the new cases identified each year were already in the very advanced stages of the disease.


As with most cancers, the earlier breast cancer is detected and diagnosed, the better the chances of successful treatment. One of the best ways of ensuring that breast cancer is for you to be breast aware, that is understanding and knowing how your breast look and feel like under normal circumstances, so that you are able to seek early medical advice if there are any changes in either breast.

Find out as much as you can about the subject so you can make an informed choice about your treatment options. Do not be afraid to ask questions from medical practitioners. Be positive and lead a normal life after breast cancer treatment. Take good care of your mind, body and soul.

Source: National Cancer Registry 2003


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What is Breast Cancer


A cancer is a group of cells that have grown in an uncontrollable way, damaging healthy tissues. A group of growing cancer cells forms a lump, which is called a tumor. If the tumor is in the breast, it is called breast cancer. Breast cancer is a malignant growth that begins in the tissues of the breast.


Whether your cancer is non-invasive or invasive will determine your treatment choices and how you might respond to the treatments you receive. The main types of breast cancer:


Non-invasive cancer

  • Ductal Carcinoma In Situ (DCIS)
  • Lobular Carcinoma In Situ (LCIS)

Invasive cancer

  • Invasive Ductal Carcinoma (IDC)
  • Invasive Lobular Carcinoma (ILC)

Non-invasive cancer (Carcinoma in situ)
When abnormal cells grow inside the lobules or milk ducts but have not spread to the surrounding tissue or beyond, the condition is called carcinoma in situ. The term "in situ" means "in place" and is used to describe this condition because the abnormal cells are still "in place" inside the lobules or ducts where they first developed. There are two main categories of carcinoma in situ: ductal carcinoma in situ and lobular carcinoma in situ.

Ductal Carcinoma In Situ (DCIS)
Mainly originates in the milk ducts of the breast. It is the most common form of non-invasive breast cancer (90%).

Lobular Carcinoma In Situ (LCIS)
Mainly originates in the lobules of the breast. It is less common and considered a marker for increased breast cancer risk.
The cells involved in the different carcinomas in situ are not fully cancerous because they have not developed the ability to invade out of the ducts or lobules and metastasize. They are often referred to as pre-cancerous conditions because they can either develop into or raise the risk of invasive cancer.

Invasive cancer
Invasive breast cancer is not the same as metastasis.
Metastasis occurs when the cancer cells break away from the primary tumour and spread into organs in other parts of the body through the bloodstream or the lymphathic system. Most invasive cancers are either ductal or lobular in nature. If
the cancer cells spread outside the ducts or lobules of the breast into the surrounding tissue, this is called invasive breast cancer.
Invasive cancer cells sometimes spread outside the breast area to other parts of the body. They do this by moving through blood vessels, such as veins, or through lymphatic vessels. Lymphatic vessels are next to veins in the body, and are connected to lymph nodes (glands). Lymph nodes collect normal fluid and dead cells from the lymphatic vessels.

Invasive Ductal Carcinoma (IDC)
Accounts for about 80% of all breast cancers. Invasive means that it has "invaded" or spread to the surrounding tissues. It is ductal because the cancer began in the milk ducts—which are the "pipes" that bring milk from the lobules to the nipple.

Invasive Lobular Carcinoma (ILC)
Accounts for about 10%–15% of all breast cancers, in which the cancer has spread from the lobules to the surrounding tissues. It is often found in multiple sites in the breast and can be difficult to detect by physical examination or mammography.



Medullary Carcinoma
It is a rare cancer of ductal origin, accounting for 5% of breast cancers. Distinctive features include large size at detection, soft texture on palpation, mobility due to lack of invasion and the presence of immune system cells at the edges of the tumor. The outlook, or prognosis, for this kind of breast cancer is better than for other types of invasive breast cancer. But these are often hard to distinguish from infiltrating ductal carcinoma and are treated the same way.

Paget's Disease of the Nipple
It is rare, slow-growing cancer producing changes in the nipple and accounts for only 1% of all cases of breast cancer. This type of breast cancer starts in the breast ducts and spreads to the skin of the nipple and then to the areola, the dark circle around the nipple. The skin of the nipple and areola often appears crusted, scaly, and red, with areas of bleeding or oozing. The woman may notice burning or itching. Paget disease may be associated with in situ carcinoma or with infiltrating breast carcinoma. If no lump can be felt in the breast tissue and the biopsy shows DCIS but no invasive cancer, the prognosis is excellent.

Mucinous Carcinoma
This rare type of invasive breast cancer is formed by mucus-producing cancer cells. The prognosis for mucinous carcinoma is better than for the more common types of invasive breast cancer. Colloid carcinoma is another name for this type of breast cancer.

Inflammatory carcinoma
This uncommon type of invasive breast cancer accounts for about 1% to 3% of all breast cancers. It makes the skin of the breast looks red and feels warm and gives the skin a thick, pitted appearance, mimicking an inflammation with no evidence of a lump. Doctors now know that these changes are not caused by inflammation or infection, but by cancer cells blocking lymph vessels or channels in the skin.

Phyllodes tumor
This very rare breast tumor develops in the stroma (connective tissue) of the breast, in contrast to carcinomas, which develop in the ducts or lobules. Phyllodes (also spelled phylloides) tumors are usually benign but on rare occasions may be malignant.
Benign phyllodes tumors are treated by removing the mass and a narrow margin of normal breast tissue. A malignant phyllodes tumor is treated by removing it along with a wider margin of normal tissue, or by mastectomy. These cancers do not respond to the usual treatments for invasive ductal or lobular breast cancer. In the past, both benign and malignant phyllodes tumors were referred to as cystosarcoma phyllodes.

Tubular carcinoma
Is another special type of infiltrating breast carcinoma, in which the cells looks like a tubular under the microscope. Tubular carcinomas account for about 2% of all breast cancers and have a better prognosis than infiltrating ductal or lobular carcinomas.


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Cause of Breast Cancer


No one knows for certain what causes breast cancer. However, a number of risk factors are known to increase the chance of developing breast cancer - but these does not necessarily mean that a person will get the disease.

There are different kinds of risk factors. Some of these factors are beyond control, while some are linked to cancer-causing factors in the environment or due to lifestyle and personal choices such as pregnancy, smoking, and drinking.


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How Breast Cancer Spreads


The breast is considered the primary tumor site where the first cancer lump is diagnosed stemming from the breast duct or lobe. Breast cancer probably spreads through the bloodstream. The lymph nodes in the arms act as signals as to how likely a particular breast cancer is spread. Affected lymph nodes become swollen and enlarged.

When cancer comes back after treatment, it may return in the same place. This is called a "recurrence," because it is not a new cancer. But a recurrence can also appear in a place not directly related to the first breast cancer. This is called a "metastasis". If cancer is detected in several areas, these are called "metastases” or secondary tumors.

Cancers from other parts of the body rarely spread to the breast or the chest wall. If you have a tumor in your lymph nodes, lungs, liver, bones, or brain, it probably is a re-growth or recurrence of the original breast cancer rather than a new and different cancer. In other words, if you had breast cancer and you now have cancer in your bones, liver, or other places, it is probably not bone or liver cancer, but breast cancer that has spread to the bones or the liver. This is important because breast cancer—even when it has spread—is usually more treatable that a cancer that starts in the bones or liver.

Breast cancer that returns in other parts of the body is invasive cancer. However, cancer that comes back in the breast after surgery and/or radiation therapy can be either non-invasive or invasive. If you have developed a cancer in the opposite breast from the one that was originally treated, it is probably not a recurrence. Most cancers that develop on the other side represent a new cancer rather than a recurrence.


Breast cancer can return in three general locations. It can be:

  • Local - in the breast where it started, or in the skin and underlying tissues where the breast used to be.
  • Regional - in the lymph nodes next to the breast.
  • Metastatic - in another part of the body, such as the lung, liver, bone, ovary or brain, or in lymph nodes far from the breast.


The spread of cancer is often termed as local, regional or distant.

  • Local means that the spread of cancer is confined within the breast, even though there may be multiple sites in the breast.
  • Regional means the cancer has spread to the lymph nodes, mainly to the axillary nodes under the arm.
  • Distant means that the cancer has spread to other organs in the body.



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Risk Factors with Uncertain, Controversial or Unproven Effect



Internet e-mail rumors have suggested that chemicals in underarm antiperspirants are absorbed through the skin, interfere with lymph circulation, and cause toxins to build up in the breast and eventually lead to breast cancer. There is very little experimental or epidemiological evidence to support this rumor.

Chemicals in products such as antiperspirants are tested thoroughly to ensure their safety. One small study recently found trace levels of parabens (used as preservatives in antiperspirants), which have weak oestrogen-like properties, in a small sample of breast cancer tumors. However, the study did not look at whether parabens caused the tumors.

This was a preliminary finding, and more research is needed to determine what effect, if any, parabens may have on breast cancer risk. On the other hand, a recent large epidemiological study found no increase in breast cancer in women who used underarm antiperspirants or shaved their underarms.


Underwire bras

Internet e-mail rumors have suggested that bras cause breast cancer by obstructing lymph flow. There is no scientific or clinical basis for that claim.


Induced abortion

Several studies have provided very strong data that induced abortions have no overall effect on the risk of breast cancer. Also, there is no evidence of a direct relationship between breast cancer and spontaneous abortion (miscarriage) in most of the studies that have been published.


Breast implants

Several studies have found that breast implants do not increase breast cancer risk, although silicone breast implants can cause scar tissue to form in the breast. Implants do make it harder to see breast tissue on standard mammograms, but additional x-ray pictures called implant displacement views can be used to more completely examine the breast tissue.


Environmental pollution

A great deal of research has been reported and more is being done to understand environmental influences on breast cancer risk. The goal is to determine their possible relationships to breast cancer. Currently, research does not show a clear link between breast cancer risk and exposure to environmental pollutants, such as the pesticide DDE (chemically related to DDT) and PCBs (polychlorinated biphenyls).



No studies have conclusively linked cigarette smoking to breast cancer, although some studies suggest it might increase breast cancer risk for women who start smoking in early adolescence. Of course, smoking affects overall health and increases the risk for many other cancers, as well as heart disease.


Night work

A few recent studies have suggested that women who work at night, for example, nurses on a night shift, have an increased risk of developing breast cancer. However, this increased risk has not yet been proven, and when further studies are conducted, this factor may be found to be unimportant.



A recent study found that women who took antibiotics for any reason had a slightly higher risk of breast cancer. It is too early to tell if this association will hold up after other studies are done. Women who need to take antibiotics frequently may also have other health problems, and some researchers have suggested that it is these other conditions, rather than the antibiotics, that increase breast cancer risk.



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What To Ask Your Doctor


If you have received a positive or possible diagnosis of breast cancer, there are a number of questions that you should ask your doctor. The answers you receive to these questions should give you a better understanding of your specific diagnosis and the corresponding treatment.

In addition, your doctor's ability to address your questions will give you some assessment as to the quality of care to be provided.


Early detection

  1. What is my risk of breast cancer?
  2. How often should I perform breast self-examinations? What exactly am I looking for?



  1.  What type of breast cancer do I have? How many tumors do I have, and how large are they?
  2. What is the stage of my breast cancer?
  3. Has my breast cancer spread to my lymph nodes or other areas of my body?
  4. Have my slides been reviewed by more than one pathologist?
  5. Can I have my biopsy reviewed by a pathologist at another diagnostic center?
  6. Is my family history relevant to my diagnosis?
  7. What other studies should be done on my tissue biopsy?



  1. What are the best treatment options for my cancer?
  2. What are the more and less aggressive treatment options available?
  3. If I need surgery, will I need a mastectomy or lumpectomy?
  4. What are the risks and benefits of immediate breast reconstruction?
  5. Will I need radiation therapy or chemotherapy, or both? If so, will I start before or after my surgery?
  6. What will the schedule be for my radiation and/or chemotherapy?
  7.  What side effects can I expect from my treatment?
  8. Will hormone therapy help me?
  9. How urgent is it that I make decisions and begin treatment?
  10. Are there controversies in the recommended treatments among reputable experts?
  11. How might my treatment affect future risks and follow-up treatment?
  12. Should I stop taking hormone replacement therapy (HRT)?
  13. What are the chances of my cancer returning after treatment?


Other relevant questions

  1. Am I at higher risk for other cancers as a result of the breast cancer or breast cancer treatments?
  2. Are there any changes I should make in my lifestyle to help prevent a recurrence of the cancer?
  3. How will treatment affect my fertility? What if I want to have children after my treatment?
  4. How does having reached (or not) reached menopause affect my treatment?
  5. What is my overall chance of survival based on my breast cancer?
  6. Should I undergo any genetic testing since/if I have daughters?
  7. Can you recommend some support groups?


Know the disease!

It’s important for you to have a good understanding of how your breast cancer is diagnosed and for you to be able to talk openly with your doctor about your test results. Just remember to have all your questions ready!


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← About Breast Cancer

The Breast Structure


The breast is a mass of glandular, fatty, and fibrous tissues positioned over the pectoral muscles of the chest wall and attached to the chest wall. A layer of fatty tissue surrounds the breast glands and extends throughout the breast. The fatty tissue gives the breast a soft consistency.

The breast is responsive to a complex interplay of hormones that cause the tissue to develop, enlarge and produce milk. The three major hormones affecting the breast are oestrogen, progesterone and prolactin, which cause glandular tissue in the breast and the uterus to change during the menstrual cycle.

The glandular tissue of the breast consists of lobules (milk producing glands at the ends of the lobes) and ducts (milk passages). During lactation (breast feeding), the lobules fill with milk which then flows along the ducts leading to the nipple. Toward the nipple, each duct widens to form a sac (ampulla).

Arteries carry oxygen rich blood from the heart to the chest wall and the breasts and veins take de-oxygenated blood back to the heart. This draining of blood through the veins sometimes provides a route for breast cancer to spread through the body.

This information is not intended to replace the advice of a doctor.


The breast is composed of:

  • Milk glands (lobules) that produce milk
  • Ducts that transport milk from the milk glands (lobules) to the nipple
  • Nipple
  • Areola (pink or brown pigmented region surrounding the nipple)
  • Connective (fibrous) tissue that surrounds the lobules and ducts
  • Fat

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Fear of Getting Cancer Again


Many people who have been treated for breast cancer are afraid that the cancer is still there or that it will come back. These fears are normal and reasonable. Getting support from friends, family, therapists or support groups are all ways to help handle this anxiety. If you find that your fears are not easing overtime, or that it interferes with your quality of life, you should talk to your doctor.

On average, 5 to 10 percent of women with early breast cancer have a local recurrence after treatment, meaning the cancer will return to the breast, chest or lymph nodes in the armpit – this is called a second primary breast cancer. This risk is even higher for women who have a very strong family history or a mutation in one of the BRCA genes. In addition the risk actually reaches beyond breast cancer to include an increased risk of certain other cancers as well, particularly ovarian cancer.

Fortunately, there are steps survivors can take to lower their risk of getting cancer again. For all survivors, the most important step is to get regular medical care after treatment. For those who are being treated with tamoxifen or aromatase inhibitors, one of the best things to do is to continue to take the drugs regularly for the prescribed time. Tamoxifen and aromatase inhibitors not only lower the risk of having the cancer come back but also lower the risk of second primary breast cancers.


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Having Children After Cancer


Various studies have found that women who survived breast cancer then subsequently had children did not have a greater risk of dying from breast cancer. This is reassuring for women who want to start a family or have more children after being diagnosed of breast cancer.

However, there are still no solid answers as to the risk in pregnancy after breast cancer treatment.


Waiting period advised

Breast cancer is relatively rare in young women; more than three-quarters of cases occur in women over age 50. As improved treatments help more young women survive breast cancer, the question of whether to have a child later becomes increasingly important.

Indeed, many doctors still advise a waiting period. Patients are usually told to wait two years if they have negative [lymph] nodes, and five years if they have positive nodes, so that the really aggressive disease will become known before they get pregnant.


Factors to consider

Although few studies have been done, none have found evidence that pregnancy after successful breast cancer treatment increases the risk of the disease coming back. But as breast cancer is strongly influenced by hormones, the changing hormonal levels during pregnancy could have some effect on a woman who has already had the disease.

Further research is also needed to determine what risk pregnancy may pose to breast cancer survivors, and if that risk is influenced by factors like age, race or disease characteristics.


Careful consideration critical

  • The decision for breast cancer survivors who are thinking about getting pregnant is a very complex and personal one.
  • Breast cancer survivors who need to discuss the issue thoroughly with their families and their doctors. Women should talk to their doctors about:
  • Their breast cancer prognosis – including the chance of having a recurrence.
  • The appropriate duration of the waiting period to prevent the risk of relapse.
  • Other related health problems such as heart damage from chemotherapy drugs that could be exacerbated by pregnancy.
  • Managing breast cancer if it were to return.


Other relevant issues

  • Fear of recurrence or dying and its effect on caring for a child.
    Some women may not want to risk becoming pregnant when they may not live long enough to raise the child. Others, however, may believe that, even if they do die while their child is young, they will be able to give their child the love and care it needs to grow up to be a well-adjusted adult.
  • Passing on family traits.
    Some breast cancer survivors with a strong family history of the disease may not want to pass on a potentially high risk of cancer to future generations. Others may feel very positive about passing on a range of family traits and believe that a child deserves the chance to enjoy life even if the child may, as an adult, face the possibility of illness.
  • Going through early menopause.
    Another important issue for survivors to consider is the potential for early menopause. Caused by chemotherapy, early menopause essentially ends a woman's chance for a natural pregnancy and childbirth. The closer a woman is to her natural menopause, the more likely it is that chemotherapy will hasten menopause.
  • Breastfeeding.
    Certain treatments for breast cancer can have an impact on a woman’s ability to breastfeed. For women who have had a mastectomy or breast conserving surgery plus radiation, breastfeeding from the untreated breast should be relatively normal. More problematic is feeding from the treated breast following breast conserving surgery plus radiation. Both the surgery and radiation therapy can harm tissue that is critical to breastfeeding. While studies show that feeding from the treated breast is possible (and that the milk produced is safe for the infant), they also show that it is uncommon.

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← About Breast Cancer

Breast Cancer in Men


Just how common is it?

In men, breast cancer is a rare disease. There are about 300 cases diagnosed each year in the UK, compared with almost 42,000 cases of breast cancer in women. That's about one man for every 140 women diagnosed.


Should the information be the same?

Some men with breast cancer feel that the information available is biased towards women. That is understandable, but when you look at the figures, you can see why breast cancer information is aimed at women.

The important thing is that most of the information men with breast cancer need is the same. The symptoms, diagnosis and treatment are all very similar to women with breast cancer. The risks and causes do vary slightly and we've covered that below. Obviously there are areas where women need different information to men - on reconstruction or the different types of breast shapes (prostheses) available. As with women, some of the treatments can affect men's fertility and sex life. There is information in our living with cancer section on the effect of cancer treatment on sex for men and women. There is important information below on finding support, as this can be much more difficult for men with breast cancer, simply because there are fewer of them around.

For all other information areas, men with breast cancer should be able to use this whole section freely, picking and choosing where they feel the information will be of use to them.


Risks and causes

As with women, the single biggest risk factor for male breast cancer is increasing age. Most cases are diagnosed in men between the ages of 60 and 70. Other risk factors are:

  • High oestrogen levels
  • Exposure to radiation
  • Family history or recognised breast cancer gene in the family
  • A rare genetic condition called Klinefelter's syndrome

All men produce some oestrogen. This is perfectly normal. But high oestrogen levels have been linked to breast cancer. High oestrogen levels can occur in

  • Obesity –oestrogen is partly made in the fat (adipose) tissues of the body
  • Chronic liver conditions, such as cirrhosis
  • Genetic conditions

Men who have been exposed to radiation repeatedly, over a long period of time, are more likely to develop male breast cancer. This is particularly true if they were young when the radiation exposure took place.

There is an increased risk of breast cancer in men with women in their family who have already been diagnosed with breast cancer. This is particularly true if the women are close relations (mother or sisters). And if the women were diagnosed at a young age (below 40). Men, as well as women, can inherit faulty genes that can cause breast cancer. Between 5 and 10 out of every 100 (5 – 10%) breast cancers diagnosed in women are thought to be due directly to an inherited faulty gene. In men, this may be more common. We think that between 10 and 20 out of every 100 diagnosed (10 – 20%) are due to inherited faulty genes.

Klinefelter's syndrome is a rare genetic condition where a man is born with an extra female chromosome. So he is XXY instead of XY. Men with Klinefelter's are about 20 times more likely to get breast cancer than the average man. This makes their breast cancer risk the same as for the average woman.



The commonest symptom for men with breast cancer is a lump in the breast area. This is nearly always painless. Other symptoms can include

  • Oozing from the nipple (a discharge) that may be blood stained
  • Swelling of the breast
  • A sore (ulcer) in the skin of the breast
  • A nipple that is pulled into the breast (called nipple retraction)
  • Lumps under the arm



The tests used to diagnose breast cancer in men are much the same as for women.  You may have a painless scan using sound waves, called an ultrasound.  Or you may have a mammogram.  If your scan shows up a suspicious area, your specialist will want to take a sample (biopsy) of breast tissue for examination under a microscope.  If these tests show you have breast cancer, you will probably have other tests to make sure the cancer has not spread.  These are covered in the page on further tests for breast cancer.

There are different types of breast cancer.  The commonest type of breast cancer in both women and men is invasive ductal carcinoma.  The early, precancerous condition called 'ductal carcinoma in situ' (DCIS) is diagnosed in men quite rarely.  DCIS means that there are cancer cells in the breast.  But they are all still contained inside the ducts of the breast and cannot spread.  Inflammatory breast cancer and Paget's disease are also found rarely in men.


The same treatments are used for breast cancer in men as for women.  These are all covered in detail in the CancerHelp UK section on treating breast cancer.  Treatment is decided by the stage of your cancer.  This means how far the cancer has grown by the time it is diagnosed.  The staging for men's breast cancer is the same as in female breast cancer.

To treat your cancer, you may have

  • Surgery      
  • Radiotherapy      
  • Hormone therapy      
  • Chemotherapy

Mastectomy is the most common operation.  There is not very much breast tissue in men, so it isn't usually possible (or desirable) to leave any behind.  Usually, you will have the lymph nodes removed from under the arm on the same side.  This is to check them for cancer cells.

As the cancer will always be close to the chest wall in men (because there is so little breast tissue), your specialist is likely to suggest radiotherapy after surgery.  This is to reduce the risk of the cancer growing back in the chest wall in the future.

Chemotherapy and hormone therapy treat the whole body – the drugs circulate through the bloodstream and will attack breast cancer cells wherever they are.  Both these treatments can be used to try to lower the risk of the cancer coming back.  Or to treat breast cancer that has spread.

Your specialist will arrange tests on your cancer cells when you are first diagnosed.  This will show if they have hormone receptors on the surface of the cancer cells.  If they do, the breast cancer is likely to respond to hormone therapy.  Breast cancer cells can have oestrogen receptors or progesterone receptors.  You may seen 'hormone receptor status' written as ER or PR positive.  Most male breast cancer cells do have hormone receptors.  The commonest drug specialists prescribe is the same as for women - tamoxifen.  The side effects are much the same as in women.  Tamoxifen can make you feel sick when you first start taking it, but this usually wears off quite quickly.  The commonest side effect for men and women is hot flushes.  There are also reports of weight gain, difficulty sleeping, low mood and depression.  In men, tamoxifen may also cause a loss of sex drive.  This has been reported in up to 3 out of 10 men taking tamoxifen.  There is information about how to cope with the effects of cancer treatment on your sex life in the section of CancerHelp UK on living with cancer.

There are other hormone therapies that are used to treat advanced breast cancer.  These are covered in the hormone therapy pages of our secondary breast cancer section.

You may have chemotherapy if there are cancer cells in your lymph nodes.  Or if your cancer does not have hormone receptors and so is not thought to be sensitive to hormone therapy.  You may also have chemotherapy if your cancer is advanced and has spread to another part of your body.


Finding support

Of course it is difficult for anyone diagnosed with breast cancer.  But it can be particularly difficult for men, as they may feel very confused and isolated.  It is so common to hear about breast cancer in women.  But not at all common to hear about it in men.  So it can be difficult even to believe that the diagnosis is right.  As male breast cancer is rare, men are often treated in large, specialist centres where there is expertise in dealing with the disease.  So your consultant may know other men with breast cancer that you could talk to about it.  Or you could try the charity Breast Cancer Care.  They have male volunteers you can talk to on the phone.  Or you could try one of the web-based contact networks, such as MyWavelength.  This is a free support network where you can get in touch with other people with the same cancer type as you.


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Concern For Family Members


In addition to being worried about their own health, survivors who have had breast cancer are often concerned about the health of others in their family. This is a valid concern since their family members, in particular, their sisters, daughters and mothers, do have an increased risk of developing the disease.


How susceptible are you?

In general, the younger a woman is when she develops breast cancer, the more likely it is that another member of her family will develop it too. The risk tends to be highest in families where two or more immediate family members (mother, sister, daughter) have had breast cancer. In these families, the history of breast cancer can usually be attributed to a genetic susceptibility.

In some families, a genetic risk for breast cancer can be inherited through the father’s side, so relatives on both sides of the family should be well informed about their family history and risks.

The sisters and daughters of survivors who developed the disease at an early age or who are from a high-risk family may want to consider getting tested for mutations in genes linked to breast cancer. The person known to have had breast cancer usually needs to be tested first. Family members should be aware that the possibility of testing raises many complex issues that should be carefully considered with the help of a skilled genetic counsellor.


What to tell sisters, daughters and mothers

First, that the family members should consider seeing a health care provider to get their risk of breast cancer assessed. Most women overestimate their risk of breast cancer and are reassured by such an evaluation.

For those who find out that they are at higher risk, the drug tamoxifen may be an option for lowering their risk. In addition, women with a family history of breast cancer should talk to their health care providers about getting screened for breast cancer at an early age. While this will not lower the chance of the disease occurring, it may increase the chance of finding any disease that develops at its earliest, most treatable stage.

Family members should also be told that certain changes in diet and other health behaviors can promote overall health and might also help lower their breast cancer risk. Not only may the following behaviors reduce the risk of cancer, but they also protect against other major disorders, such as heart disease and diabetes.



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Talking To Children


You may feel want to protect your children by not telling them about your breast cancer for as long as possible, but you should avoid this temptation. Even young children know when something is wrong and if they are not told the truth they can feel isolated and more anxious. Children also have an amazing capacity for dealing with unpleasant facts.


When to tell your children

Talk to your children as soon as you have been diagnosed with breast cancer. They have the right to know. The amount of detail you go into will depend on their ages and how easy you find it to talk about your cancer. Explain what is wrong and what your treatment will involve, including any possible side effects. You may find it easier to talk to your children individually at this stage.


Talk about your treatment

Keep your children informed as your treatment progresses, without going into too much detail. If you are going to have chemotherapy, warn your children that your hair will fall out and that you will be very tired while your treatment is happening.


Children’s worries

You need to be sensitive to your children’s reactions. Younger children may worry that they have caused your cancer or that they might catch it. Reassure them that cancer is an illness that is not caused by anyone, neither is it contagious.


What to do and not to do

  • Avoid medical jargons by using language that children can easily understand.
  • Be truthful and honest about your illness, treatment and feelings.
  • Listen to your children and correct any misconceptions they have.
  • Don’t be afraid to cry or say “I don’t know”.
  • Be careful not to make promises you’re not sure you can keep.
  • Accentuate the positive as much as you can.
  • Inform your children’s school about the situation.


Do look out for Breast Cancer Foundation programmes in the future, especially for children, on our website!



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A localized collection of pus that forms in tissues, organs or confined spaces as the body tries defending itself against infection-causing germs.

Adjuvant therapy:
A treatment given in addition to the primary treatment (usually surgery) to make treatment more successful.

A substance made by the body to fight infection.

The circular area of coloured skin surrounding the nipple.

Removal of fluid from a cyst or cells from a lump, using a needle and syringe.

Atypical hyperplasia:
Cells that are both abnormal (atypical) and increased in number. This may moderately increase a woman's risk of developing breast cancer.

Average risk (for breast cancer):
A measure of the chances of getting breast cancer without the presence of any specific factors known to be associated with the disease.

The armpit.

Axillary dissection:
Surgery in which a sample of the lymph nodes from the armpit are removed in order to find out if the cancer has spread. 

Axillary lymph node:
Located in the armpit, these glands help the body fight infection.



Non-cancerous; has not invaded nearby tissues or spread to other parts of the body.

Benign breast changes:
Non-cancerous changes in the breast. May cause pain or lumpiness. 

A procedure that involves the removal of a tissue sample of tissue or cells for microscopic analysis for purposes of diagnosis. Biopsies can be accomplished with a biopsy needle or open surgical incision.   

BRCA1 and BRCA2 genes:
The principal genes that, when altered, indicate an inherited susceptibility to breast cancer and possibly ovarian cancer. These gene alterations have been found to be present in 80 to 90 percent of hereditary cases of breast cancer.

Breast density:
Glandular tissue in the breast common in younger women, making it difficult for mammography to detect breast cancer. 

Breast implants:
Silicone rubber sacs, which are filled with silicone gel or sterile saline, used for breast reconstruction after mastectomy.

Breast Self-Examination. An exam in which you feel for any changes in the breast. Regular BSE can help women to detect small changes in the look and feel of their breasts. Women over the age of 20 should perform this exam every month.



The process by which organic tissue becomes hardened by a deposit of calcium salts. These small calcium deposits can be seen on mammograms.

A general name that comprises more than 100 diseases, characterized by an uncontrollable and abnormal growth of cells. Cancer cells invade and destroy healthy tissues, and may spread through the bloodstream and the lymphatic system to other parts of the body.  

Cancer that begins in tissues lining or covering the surfaces (epithelial tissues) of organs, glands, or other body structures. Most cancers are carcinomas.

Carcinoma in situ:
Cancer that is found confined to the cells where it began, and has not spread into surrounding tissues.

The use of drugs or vitamins to prevent cancer in people who have precancerous conditions or a high risk of cancer, or to prevent the recurrence of cancer in people who have already been treated for it.   

The use of anticancer drugs to kill cancer cells, which may have spread to other parts of the body. It is administered intravenously or given as pills.

Structures located in the nucleus of a cell, containing genes.

Clinical breast exam:
A physical exam performed by a doctor or nurse of the breast, underarm and collarbone area to feel for any changes in the breast.  

Computed tomography (CT) scanning:
An imaging technique that uses a computer to organize the information from multiple x-ray images to construct two dimensional cross-sectional image of areas inside the body. This can help reveal many soft tissue structures not shown by conventional radiography.

Computer-aided diagnosis (CAD):
The use of special computer programs to scan mammographic images and flag areas that look suspicious.

Core needle biopsy:
A procedure where use of a small cutting needle to remove a core of tissue for microscopic examination.  

Cyclic breast changes:
Normal tissue changes that occur in response to the changing levels of female hormones during the menstrual cycle, which can cause swelling, tenderness and pain.

A fluid-filled sac, usually benign.



Diagnostic mammogram: The use of a breast x-ray to evaluate the breasts of a woman who has symptoms of disease such as a lump, or whose screening mammogram shows an abnormality.

Digital mammography: A technique for recording x-ray images in computer code, which allows the information to enhance subtle, but potentially significant, changes.

Ducts: Channels that carry body fluids – excretions or secretions. Breast ducts transport milk from the breast's lobules out to the nipple.

Ductal carcinoma in situ (DCIS): Cancer that is confined to the ducts of the breast tissue and has not spread to surrounding tissue.

Ductogram: A test that helps determine the cause of a nipple discharge.

Dysplastic cells: Abnormal cells which could eventually become cancerous.



Excisional biopsy:
The surgical removal (excision) of an abnormal or suspicious area of tissue, or lump by cutting the skin and removing the tissue for microscopic examination. Excisional biopsies remove the entire lump from the breast.

The female sex hormone which develops the female secondary sex characteristics and has a variety of functions during the menstrual cycle.

Estrogen replacement therapy:
The use of estrogen in order to lessen the effects of being deficient in this hormone. (see Hormone replacement therapy)



False negative (mammograms):
Breast x-rays that miss cancer when it is present.

False positive (mammograms):
Breast x-rays that indicate breast cancer is present when the disease is truly absent.

Fat necrosis:
Lumps of fatty material that forms in response to a bruise or blow to the breast.

Benign breast tumor made up of both structural (fibro) and glandular (adenoma) tissues.

Fibrocystic changes:
Benign changes in the breast.

Fine needle aspiration:
A method in which fluid is removed from a cyst or cluster of cells from the affected area of the breast using a slender needle.

Fine needle aspiration biopsy:
A biopsy which uses a syringe with a thin needle to remove small tissue fragments from a tumor.

Five-year survival rate:
This refers to the percent of patients who live at least five years after their cancer is found.

Frozen section:
A sliver of frozen biopsy tissue. A frozen section provides a quick preliminary diagnosis but is not 100 percent reliable.



Generalized breast lumpiness:
Breast irregularities and lumpiness, commonplace and noncancerous. Sometimes called "fibrocystic disease" or "benign breast disease.

Segment of a DNA molecule and the fundamental biological unit of heredity. It is responsible for the inherited characteristics that make beings different from one another.

Genetic testing:
A method by which a woman learns if she is carrying a mutated gene which may increase her risk of breast cancer.

Genetic change:
An alteration in a segment of DNA, which can disturb a gene's behavior and sometimes leads to disease.

Organs in the body which secrete a substance.


Higher risk (for breast cancer):
A measure of the chances of getting breast cancer when factor(s) known to be associated with the disease are present.

Hormone replacement therapy:
Hormone-containing medications taken to offset the symptoms and other effects of the hormone loss that accompanies menopause.

A substance secreted by various glands in the body, which produce specific effects on specific target organs and tissues.

Hormone receptors:
Structures on cells to which hormones attach themselves, affecting the activity of that cell. If cancer cells have hormone receptors, they will usually respond to hormone therapy.

Hormonal therapy:
A type of cancer therapy which prevents natural hormones from stimulating the growth of tumors.

Excessive growth of cells. Several types of benign breast conditions involve hyperplasia. 



Incisional biopsy:
The surgical removal of a portion of an abnormal area of tissue, by cutting into (incising) it, for microscopic examination.  

Invasion of body tissues by microorganisms such as bacteria and viruses.

Infiltrating cancer:
Cancer that has spread to nearby tissue, lymph nodes under the arm, or other parts of the body.

Infiltrating ductal carcinoma (IDC):
Cancer that begins in a duct of the breast and spreads to the surrounding fatty tissue.

Infiltrating lobular carcinoma (ILC):
Cancer that begins in the lobules of the breast and spreads to other parts of the body.

The body's protective response to injury (including infection). Inflammation is marked by heat, redness, swelling, pain and loss of function.

Intraductal papilloma:
A small wart-like growth that projects into a breast duct.

Invasive cancer:
Cancer that has spread to nearby tissue, lymph nodes under the arm, or other parts of the body. (Same as Infiltrating cancer.)



Laser beam scanning:
A technology being studied in research for breast cancer detection that shines a laser beam through the breast and records the image produced, using a special camera.

Lobes, lobules, bulbs:
Milk-producing tissues of the breast. Each of the breast's 15 to 20 lobes branches into smaller lobules and each lobule ends in scores of tiny bulbs. Milk originates in the bulbs and is carried by ducts to the nipple.  

Lobular carcinoma in situ (LCIS):
Cancer that is found only in the lobules of the breast and that has not spread to the surrounding fatty tissue.

Localization biopsy:
The use of mammography to locate tissue containing an abnormality that can be detected only on mammograms, so it can be removed for microscopic examination.

Local radiation:
The insertion of a pellet of radioactive material into the cancer in order to shrink or kill cancer cells.

Local therapy:
A type of therapy use to treat the main or primary tumor and the area around it.

Surgery to remove only the cancerous breast lump and some of the surrounding tissue; usually followed by radiation therapy. Also called a partial mastectomy.

Lymphatic system:
The tissues and organs that produce, store, and transport cells that fight infection and disease.

Lymph nodes:
Glands that are part of the body’s defence system.

Lymphatic tissue:
Tissue made up of white blood cells in the lymphatic system.

A condition which occurs when the lymph node system is not draining enough fluid after some of the lymph nodes have been removed, resulting in fluid retention and swelling of the arm or hand.



Magnetic resonance imaging (MRI):
A technique that uses a powerful magnet linked to a computer to create detailed pictures of areas inside the body.

State of being cancerous. Malignant tumors can spread to surrounding tissues and other parts of the body.

Malignant growth:
A cancerous growth that has the potential to spread.

Mammary duct ectasia:
A benign breast condition in which ducts beneath the nipple become dilated and sometimes inflamed, and which can cause pain and nipple discharge.

A low-dose x-ray used to examine unusual changes in the breast or to screen for abnormalities where no changes has been found.

The examination of breast tissue using x-rays.

Surgery to remove the entire breast (or as much of the breast as possible).

Infection of the breast. Mastitis is most often seen in nursing mothers.

The time when a woman's monthly menstrual periods cease, usually around the age of 50.

Cancer which has spread through blood vessels or lymphatic channels to distant sites in the body.

Menstrual cycle:
The monthly cycle of discharge, during a woman's reproductive years, of blood and tissues from the uterus.

Tiny deposits of calcium in the breast, which can show up on a mammogram. Certain patterns of microcalcifications are sometimes a sign of breast cancer.

Modified radical mastectomy:
The removal of all breast tissue including the nipple, as well as some of the lymph nodes under the arm in order to see whether or not the cancer has spread.

A change in the number, arrangement or molecular sequence of a gene.



Needle biopsy:
Use of a needle to extract cells or bits of tissue for microscopic examination.

Nipple discharge:
Fluid coming from the nipple.

Non-invasive cancer:
Cancer that has not spread to surrounding tissue.

Nonpalpable cancer:
Cancer in breast tissue that can be seen on mammograms but that cannot be felt.



One-step procedure:
Biopsy and surgical treatment combined into a single operation.

Open biopsy:
A lump or mass is removed along with the surrounding tissue.

Outpatient basis:
Medical  care provided to a patient who is not hospitalized.

A condition of mineral loss that causes a decrease in bone density and an enlargement of bone spaces, producing bone fragility. Certain treatments for breast cancer can impact a woman's risk of developing osteoporosis.



Use of the fingers to press body surfaces, so as to feel tissues and organs underneath. Palpating the breast for lumps is a crucial part of a physical breast examination.

Partial mastectomy:
Surgery in which the breast lump and some of the surrounding tissue is removed, also called a lumpectomy.

A doctor who specializes in the diagnoses disease by studying cells and tissues changes under a microscope.

Permanent section:
Biopsy tissue specially prepared and mounted on slides so that it can be examined under a microscope by a pathologist.

Naturally occurring chemicals found in plants that may be important nutrients for reducing a person's cancer risk.

Positron emission tomography (PET scanning):
A technique that uses signals emitted by radioactive tracers to construct images of the distribution of the tracers in the human body.

Prophylactic mastectomy:
Surgery to remove a breast that is not known to contain breast cancer, for the purpose of reducing an individual's cancer risk.

An artificial substitute for a missing part of the body, for example the breast.



Radiation therapy:
Radiation is energy carried by waves or by streams of particles. In radiation therapy, various forms of radiation can be used in low doses to diagnose disease and in high doses to treat disease. See X-rays.

Radical mastectomy:
Removal of the entire breast, lymph nodes and the chest wall muscles.

A doctor with special training in the use of diagnostic imaging such as CT, MRI, PET and ultrasound, to image body tissues and to treat disease.

Reconstruction surgery:
An operation in which a breast’s normal appearance is restored after a mastectomy.

A measure of the likelihood of some uncertain or random event with negative consequences for human life or health.

Risk factors (for cancer):
Conditions or agents that increase a person's chances of getting cancer. Risk factors do not necessarily cause cancer; rather, they are indicators, statistically associated with an increase in likelihood.



Saline implant:
A sac filled with sterile saltwater inserted under the skin of the chest wall to restore or improve the shape of the breast.

Sclerosing adenosis:
A benign breast disease that involves the excessive growth of tissues in the breast's lobules.

The use of tests to detect a disease in people who do not have symptoms of that disease.

Screening mammogram:
Breast x-ray used to look for signs of disease such as cancer in people who are symptom-free.

Sentinel lymph node biopsy:
A new procedure which is used to find the lymph nodes that drain lymph fluid from the area where a cancer has developed. The lymph nodes are then checked for any spread of cancer.

The image produced by ultrasound.

Specimen x-ray:
An x-ray of tissue that has been surgically removed (surgical specimen).

A system for analyzing a tumor to determine the extent or risk of spread or recurrence, and appropriate treatment choices. 

Stereotactic localization biopsy:
A technique that employs three-dimensional x-ray to pinpoint a specific target area. It is used in conjunction with needle biopsy of nonpalpable breast abnormalities.

Surgical biopsy:
The surgical removal of tissue for microscopic examination and diagnosis. Surgical biopsies can be either excisional or incisional. (See Excisional biopsy and Incisional biopsy.)

Surgical breast oncologist:
A doctor who specializes in the diagnosis and treatment of breast cancer.

Surgical oncologist:
A physician specializing in the use of surgery to treat cancer.

A group of symptoms and findings detected by examinations or test.

Systemic disease:
A disease affecting the whole body.

Systemic therapy:
A type of therapy given through the bloodstream in the form of injections or pills in order to reach cancer cells that may have spread.



A drug prescribed to women with estrogen receptive tumors, in order to stop estrogen from entering the breast tissue. It is also being tested as a possible preventive strategy. Women on this medication should have regular ultrasounds of the endometrium (lining of the uterus) because of potential changes there.

An abnormal growth of tissue resulting from excessive cell division. Tumors may be either benign or cancerous.

Tumor markers:
Proteins (either amounts or unique variants) made by altered genes in cancer cells that are involved in the progression of the disease.

Two-step procedure:
Biopsy and treatment done in two stages, usually a week or two apart.



A diagnostic technique using sound waves produce images of body tissues, especially internal organs.

Ultrasound guided needle biopsy:
A procedure where tissue is removed through a needle guided by ultrasound.



A high-energy form of radiation. X-rays form an image of body structures by traveling through the body and striking a sheet of film. Breast x-rays are called mammograms.





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Online Resources


Here’s our list of recommended websites on breast cancer. If you know of a useful or interesting website which you’d like to share with us, please contact us.

Set up by the US National Institute of Health (NCI), this site, like the one by the American Cancer Society, contains broad and reliable information about all forms of cancer. What sets it apart from other websites is its huge section on the latest research and clinical trials, where you’ll find a comprehensive database of all NCI-supported research, searchable by type of cancer and by type of cancer research. You’ll also find a listing of ongoing clinical trials and trial results. In addition, this site allows you to search for cancer literature from the PubMed database.

Information found here is not only targeted for the general public and patients only but also health professionals. Scientists will be able to find detailed information on specific areas of research interest and NCI-supported funding opportunities. Among the topics covered are types of treatment, male breast cancer treatment, breast cancer and pregnancy, breast cancer prevention, genetics and risk factors as well as new imaging technologies. There’s also cancer statistics (in US only) and what these figures mean, plus you can calculate your risk of breast cancer with their assessment tool.

A US site, is a nonprofit organization dedicated to providing reliable, complete and most up-to-date information about breast cancer. Founded by oncologist Dr Marisa Weiss, its mission is “to help women and their loved ones make sense of the complex medical and personal information about breast cancer, so they can make the best decisions for their lives.”

And they have done that quite well. All the information provided is easy to read, offering excellent practical information. The content often addresses common concerns that a reader may have in mind. Its section on “Research News” covers new developments in the field of breast cancer research and clinical trials. Within this section, you’ll find summaries written on new studies and best of all, each of them comes with a take-home message which is relevant to the reader and easy to understand. There’s also a section on breast cancer diagrams if you’re interested.

A website by the American Cancer Society, this site covers all types of cancer. Its section on breast cancer is easy to navigate and packed with useful information, and it is divided into three main topics – All About Breast Cancer, Treatment Decision Tool for Breast Cancer and Other Information Sources. Simple yet comprehensive.

Interesting sections include “Stories of Hope” and “Talking About Cancer”, which offer advice on how one copes and deals with cancer. Check out the many stories of cancer survivors can be found here, all of them equally compelling.

For more than 20 years, The Susan G. Komen Breast Cancer Foundation has been one of the forerunners in the fight against breast cancer. It supports innovative research and community-based outreach programmes. One day, it hopes to eradicate breast cancer as a life-threatening disease by funding research grants and supporting education, screening and treatment projects in communities around the world.

The Komen website has a user-friendly layout, with interactive tools (such as quizzes), educational resources (which you can print out as an educational tool) and well presented information in concise and simple language. It prides itself as a source for up-to-date information on breast cancer. You'll find the latest on diagnosis and treatment, risk factors and screening, and a host of other topics such as complementary therapies, life after treatment and quality medical care.

As one of the leading charities for breast cancer support and information in the UK, this site is invaluable for its choices of publications, which are booklets, some over 100 pages long, on useful topics such as Breast Cancer in Young Women, Men and Breast Cancer and Breast Cancer Care, and all of which are downloadable in PDF format.

There’s also an educational section on breast development, breast awareness and finding the right fit for your bra. The site clearly and carefully defines stages and types of breast cancer into various categories: Benign Breast Conditions, Non-Invasive Cancer, Invasive (primary) Cancer and Secondary Breast Cancer.

WebMD is a site reputed for its information on all types of diseases – combining its expertise in medicine with journalism on consumer health. This means that the health information you find on this site is always timely, reliable and yet appealing and reader-friendly. You’ll find here, for example, “10 questions to ask your doctor about breast cancer”.

This site publishes its own news on the latest in research and findings, on its WebMD Medical News pages. Other top picks include its section on Hot Topics, with articles on the latest in breast cancer treatment or detection, finding the right treatment or the link between chemicals and breast cancer. If you’ve been diagnosed with cancer, it’s worth checking out “Ask the Expert”, where you can ask a question or read hundreds of questions that have been answered by a doctor. A Frequently Asked Questions section provides insights from other women with breast cancer on difficult questions such as How I’m going to Look After Treatment, How do I Tell The Kids, Am I going to Make It and How Do I Deal with My Job. Well presented, practical information.

Read articles such as “The First 48 Hours: The Ten Most Important Questions to Ask Your Doctor” if you’ve been diagnosed of breast cancer on this website. Here, you’ll find a wealth of information, from its very up-to-date news on Breast Cancer research and development, to its practical guide on Managing Breast Cancer – great for valuable pointers on how to cope with breast cancer as a husband or partner, the do’s and don’ts of a breast cancer husband and more.

There are several blogs on this site by breast cancer patients and survivors who share their experience battling the disease. You can also connect with and find support from other breast cancer husbands and partners through its discussion forums. 


Can you help?

Please help us with creating awareness about breast cancer and empowering and supporting people that are affected by it.

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