Last updated: Oct 3, 2025Published on: Oct 3, 2025
Table of Contents
Introduction
Breast cancer is a disease where the cells and tissues in the breast change and grow out of control1.This extra growth can form a lump called a tumour. If the tumour keeps growing, it can spread to nearby breast tissue, reach the lymph nodes, and move to other parts of the body2. Breast cancer is the second most common cancer in women, after skin cancer3.
Getting diagnosed early often leads to more effective treatment. In most cases, screening tests like mammograms can detect breast cancer even before a lump forms. Around 99 in 100 women survive 5 years or more when breast cancer is caught early. Survival drops to about 87 in 100 if it spreads nearby, and to about 33 in 100 if it spreads further4,5.After diagnosis, doctors choose treatment by looking at how advanced the cancer is, what signals the cancer cells show (like hormones or HER2), and the person’s overall health. Treatment may include surgery, radiation, or medicines2.
In this blog, we will see what breast cancer is, its types, early signs, and how to lower the risk or manage it.
What Is Breast Cancer?
The breast is an organ in the front of the chest that makes milk after childbirth. It is more developed in women, while in men it stays smaller6.
Breast cancer happens when cells in the breast grow out of control. It usually begins in the milk ducts (tiny tubes that carry milk) or in the lobules (glands that make milk). Sometimes the cancer stays in place, but if it spreads into nearby tissue, it can grow and move to other parts of the body. If the cancer cells stay inside the duct, it is called ductal carcinoma in situ. If they break through the duct wall and spread into nearby tissue, it is called invasive ductal carcinoma. Sometimes, cancer can also begin in the lobules. When it spreads from the lobules into nearby tissue, it is called invasive lobular carcinoma7,9.
Breast cancer is one of the most common cancers worldwide, affecting about 2.3 million women each year. In India, it accounts for about 1 in 8 cancer cases, with around 1.6 lakh women diagnosed in 2020. Breast cancer survival rates depend on how early it is found and treated; about 66 out of 100 women in India live at least five years after diagnosis10,12.
Causes & Risk Factors of Breast Cancer
The reasons for breast cancer could be due to hereditary or lifestyle-related factors.
Hereditary (Genetic factors): BRCA1 and BRCA2 are tumour suppressor genes (genes that repair damaged DNA and keep cells healthy). When these genes undergo changes called mutations, they don’t work properly, leading to breast cancer. This mutated gene is inherited from your parents, and those who have this gene have an 85% risk of getting breast cancer early.
Other causes of breast cancer are:
Age: As you get older, risk increases, mainly after age 50. Most cancers are diagnosed after this age.
If you attain puberty at 12 and menopause after 55: This leads to a longer reproductive span with a longer exposure to hormones like oestrogen. When tissues are exposed to these hormones for a longer period, the risk of cancer can increase.
Breast density: Dense breasts (breasts with more firm tissue and less fat) makes tumour detection difficult during scans or mammograms, so breast cancer can be missed.
History: If you had breast cancer earlier or any other breast diseases in the ducts or lobules, your cancer risk increases. In addition, having a close family member with breast cancer can increase your risk of developing the disease, as genetics also play an important role.
The modifiable risk factors of breast cancer are:
Physical inactivity increases risk, especially if you are obese.
Taking oral contraceptive pills for several years or hormone medicine during menopause may slightly increase the risk of breast cancer. This risk gradually decreases once the pills are stopped.
Those who get pregnant after 30, do not breastfeed, or do not have a full-term pregnancy are at increased risk.
Alcohol consumed in larger quantity increases the risk of breast cancer12,13.
Types of Breast Cancer
There are different types of breast cancer and they vary in tumour behaviour, grade, and treatment response.
1. Non-invasive breast cancer
Ductal carcinoma in situ is an early, non-invasive cancer that stays inside the milk ducts. It is found more often now due to better screening and shows as tiny spots on mammograms. It is considered “stage 0” cancer and, if untreated, can grow into invasive cancer.
Lobular carcinoma in situ occurs when abnormal cells are found inside the lobules of the breast. It is not cancer, but it does mean a higher chance of developing invasive breast cancer later in some women. Regular check-ups and close monitoring are usually recommended14.
2. Invasive breast cancer
Invasive ductal carcinoma is the most common type (70-80%) of breast cancer. It starts in the ducts and can spread to other parts of the body. Symptoms include a lump or nipple changes. It usually responds well to chemotherapy.
Invasive lobular carcinoma accounts for about 10-15% of all breast cancers. It grows in the lobules and can be harder to detect. It often responds well to hormone therapy but less to chemotherapy and may return years later7,15.
Breast cancer is also divided into different subtypes depending on certain proteins called receptors. These include oestrogen and progesterone receptors and another called HER2. Some breast cancers use these proteins to grow faster.
Triple-negative breast cancer: This type doesn’t have oestrogen, progesterone, or HER2 receptors. Its growth and spread tends to be faster than other types.
HER2-positive breast cancer has too much of the HER2 protein, which helps the cancer grow quickly. Targeted medicines like trastuzumab and pertuzumab can now block HER2 and yield much better outcomes than before.
Most breast cancers called luminal types have hormone receptors. Luminal A type grows slowly, can be treated with hormone medicine, and usually has a good outcome, while luminal B type grows faster, may need hormone medicines plus chemotherapy, and has a slightly higher risk16.
Breast Cancer Stages
Breast cancer is divided into 5 stages based on how much the cancer has grown and its spread to other parts.
Stage 0 means cancer cells are only in one place and haven’t spread outside the ducts, not including lobular carcinoma in situ.
Stage 1 means the tumour is small (≤2 cm) and may have spread to the nearby lymph nodes, but not to other organs.
Stage 2 includes a larger tumour (≤5 cm) and/or more nearby lymph nodes, but still no distant spread.
Stage 3 means the cancer has spread more in the breast, nearby lymph nodes, or to the chest wall/skin.
Stage 4 means the cancer has spread to other parts of the body (metastatic disease) and is not curable but treatment can control the symptoms and help patients live longer17,18.
Doctors use the TNM system to decide the cancer stage. T stands for the size of the tumour, N shows if lymph nodes have cancer, and M indicates whether the cancer has spread to distant parts.
The higher the stage, the more advanced the cancer is. Staging the cancer helps to formulate the best treatment plan and predict how likely it is that the patient will recover. It also helps track how the cancer changes over time during breast cancer treatment and predict the outcomes18.
Early Signs & Symptoms
Many individuals who have breast cancer don’t show symptoms in the early stage, so how to identify breast cancer? You can check for lumps in the breasts yourself or get them checked during regular checkups or screening from a doctor. Symptoms may be seen only when the cancer grows or spreads.
The common signs and symptoms of early and advanced breast cancer are:
Early Signs of Breast Cancer: The breast early cancer findings are a small lump or thick area in the breast or underarm. Other signs include skin puckering, nipple changes like pulling in, unusual fluid discharge, or uneven size of the breasts8,19.
Advanced Signs: When cancer grows, more serious symptoms appear like swollen lymph nodes in the armpit or ongoing pain in the breast area and general symptoms like losing weight without reason, feeling tired, or sharp pain. The cancer can also spread to the bones, lungs, liver, or brain, causing other symptoms.
The table below gives more clarity on breast cancer symptoms in early and advanced stages19,20.
Symptoms
Early Stage
Advanced Stage
Lump or thickening in breast
Yes
Yes
Skin changes (redness, dimpling)
Yes
Yes
Nipple changes (pain, discharge)
Yes
Yes
Swollen lymph nodes
No
Yes
Breast pain
Rare
Yes
Bone pain or aches
No
Yes (bone involvement)
Weight loss or tiredness
No
Yes (liver involvement)
Shortness of breath or cough
No
Yes (lung involvement)
Headache or vision changes
No
Yes (brain involvement)
How to Check for Breast Cancer
Breast cancer can be checked by different methods. You can check your breasts for changes yourself, or a doctor can do a breast examination to feel for any lumps or unusual signs.
1. Checking Your Breasts for Changes
Stand in front of a mirror and relax with your arms by your side. Look closely if there are any changes in the size, shape, or skin texture of the breasts. Raise your arms and check again for changes.
While lying down or taking a bath, use the pads of your fingers and gently feel your entire breast and underarm area in a circular motion. Use light, medium, and firm pressure while checking for any thickness or lumps in those areas.
Check the nipple for any lump or discharge other than milk or any other changes21,22.
If you notice any changes in these areas, see a doctor promptly so that even small changes can be checked thoroughly.
2. Clinical Breast Examination
This is done by a doctor who will gently feel and check the breasts and underarms for any lumps or unusual signs. They carefully look for anything different in the breast like changes in size, shape, or texture23.
There are certain screening tests available to check for breast cancer, as below:
3. Imaging Tests
Besides exams done by you or your doctor, there are imaging tests that can give a clearer picture of breast cancer.
Mammogram is an x-ray image of your breast. It helps find breast cancer early, even before you can feel any lumps.
Breast MRI uses magnets and radio waves to create detailed images of the breast. 21
Ultrasound tests use sound waves to get pictures of the inside of the breast. They are used for people with dense breasts or those at higher risk of getting breast cancer.
Biopsy: A small piece of breast tissue is taken and examined under a microscope to check for cancer cells23.
The type of screening required for breast cancer depends on your medical condition and risks, as the doctor advises. It is recommended that women aged 40 to 74 years with average breast cancer risk get a mammogram every 2 years. Those who have risks like BRCA1 and BRCA2 gene mutation, or have had chest radiation at a young age, need more frequent screening as advised by the doctor21,23.
Is Breast Cancer Curable?
The treatment of breast cancer depends on the stage of breast cancer. No two patients are exactly the same, and treatment and responses to treatment can vary a lot.
Around the world, about 92 out of 100 women live at least 5 years after being diagnosed with breast cancer.In India, the numbers are lower because many women find out late or don’t get full treatment.
If breast cancer is found early and before it spreads to other parts, the survival rate increases. Therefore, regular checks and timely screening for women at increased risk can help find cancer early. In India, many women do not get routine mammograms, so doctors mainly use careful breast exams and special imaging tests to detect cancer early and make it easier to treat24,26.
Breast Cancer Treatment Options
There are various treatment options for breast cancer, the choice of which depends on the type of breast cancer and its stage, as follows:
Surgery: This is often the first step for breast cancer. However, not all patients have surgery first; sometimes chemotherapy or hormone therapy is given before surgery to shrink the tumour (neoadjuvant treatment). Lumpectomy removes only the tumour and some nearby tissue and is done in early stages. Mastectomy, which removes the whole breast, is mostly done when cancer is of significant size, but the decision also depends on tumour location, number of tumours, patient choice, and gene changes.
Radiation: Radiation uses strong rays to kill cancer cells after surgery. It helps stop cancer from coming back in the breast or nearby areas. Radiation may be given after lumpectomy or sometimes after mastectomy.
Chemotherapy: Chemotherapy medicines are given to kill cancer cells in the body. It is used for higher-risk hormone-positive cancers and also when cancer is very aggressive, like triple-negative or HER2-positive breast cancer. Common chemotherapy medicines include cyclophosphamide, methotrexate, doxorubicin (Adriamycin), epirubicin, and docetaxel.
Hormone therapy: Hormone therapy blocks certain hormones that help the breast cancer grow. Medicines like tamoxifen, exemestane, and letrozole block or lower these hormones. Tamoxifen can be used in both younger and older women. Letrozole and exemestane are usually used in older women, especially after menopause, however, they can also be used in younger women if their ovaries are temporarily shut down (ovarian suppression).
Targeted Therapy: Some breast cancers are associated with a protein called HER2 that makes the cancer cells grow faster. Medicines like trastuzumab and pertuzumab block this protein to stop cancer growth. HER2-positive cancers are usually treated with chemotherapy and targeted medicines, but the amount and type of chemotherapy can vary depending on the patient. Other drugs like PARP inhibitors (e.g., olaparib and talazoparib) help people who have BRCA gene changes. CDK4/6 inhibitors such as palbociclib slow down cancer cells in breast cancer associated with hormones.
Immunotherapy: For some difficult or advanced breast cancers, new medicines help the body’s immune system fight cancer better. These include medicines that help the body’s own immune system find and attack cancer cells. For example, pembrolizumab is one such drug used in some cases of triple-negative breast cancer that test positive for a marker called PD-L1.
Some patients may receive a combination of therapies to improve their chances of recovery. When breast cancer is diagnosed early, treatment can be planned to get the best outcome and help prevent cancer from coming back2,8.
How to Prevent Breast Cancer
Breast cancer cannot be completely prevented, but healthy lifestyle choices and certain measures may help lower the risk. These include:
Keep your weight within a healthy range.
Regular physical activity.
Avoid or limit alcohol use.
Breastfeed your children if possible.
Get a mammogram every two years for women aged 50 to 74, or sooner if risk is higher27,28.
Take preventive medicines like tamoxifen orraloxifene (if prescribed by the doctor) in women at high risk of breast cancer.
Consider medicines such as anastrozole or letrozole after menopause, as they lower oestrogen levels and help in breast cancer prevention.
Discuss preventive surgery with your doctor if you are at very high risk.
Ask about genetic testing for BRCA1 and BRCA2 if you have a family history; if results are positive, your doctor will guide you on next steps29,30.
When to See a Doctor?
You must see a doctor if you have any of these signs, which could possibly indicate breast cancer:
Breast cancer can be managed well if found in the early stages. Knowing the early signs and acting promptly helps early detection and treatment initiation. Many types of breast cancer respond well to advanced medicines, especially when diagnosed early, leading to better outcomes and improved recovery.
Frequently Asked Questions (FAQs)
What are the first signs of breast cancer?
Most people don’t show any early signs of breast cancer. As the cancer grows, you might feel a lump in the breast. Other signs include changes in breast size or shape, nipple redness or sores, skin dimpling, swelling in the armpit, or persistent breast pain not related to periods8,27.
How is breast cancer diagnosed?
Breast cancer is diagnosed by checking the breast for lumps or changes, getting imaging tests like mammograms, and confirming with a biopsy27.
Is breast cancer hereditary?
Some types of breast cancer are hereditary. The BRCA1 and BRCA2 genes, which control cell growth, can undergo mutations causing cancer. The child can get cancer if it is passed from parents, but not everyone with this gene will develop cancer12.
How to reduce breast cancer risk?
You cannot completely prevent breast cancer, but healthy eating, exercise, and limiting alcohol use can lower the risk. High-risk individuals can talk to a doctor about hormone therapy or surgery to reduce cancer risk27.
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Yersal O, Barutca S. Biological Subtypes of Breast cancer: Prognostic and Therapeutic Implications. World Journal of Clinical Oncology. 2014;5(3):412. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4127612/
Teichgraeber DC, Guirguis MS, Whitman GJ. Breast Cancer Staging: Updates in the AJCC Cancer Staging Manual 8th Edition and Current Challenges for Radiologists, From the AJR Special Series on Cancer Staging. American Journal of Roentgenology. 2021 Feb 17;217(2). Available from: https://www.ajronline.org/doi/10.2214/AJR.20.25223
Mehrotra R, Yadav K. Breast cancer in India: Present scenario and the challenges ahead. World Journal of Clinical Oncology [Internet]. 2022 Mar 24;13(3):209–18. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8966510/
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