Pink Hope : Understanding Breast Cancer

What is breast cancer?

Breast cancer stages & grades

Breast cancer types & subtypes

How is breast cancer diagnosed?

What are the risk factors?

Common symptoms of breast cancer

Treatment options

Who will be part of my healthcare team

A-Z Glossary: Common Terms for Breast Cancer Patients

Content: What is breast cancer?

What is breast cancer?

Breast cancer is a type of disease where the cells in your breast begin to grow abnormally and rapidly, resulting in cancerous tumours, known as malignant tumours. Breast cancer can start in the lining of the lobules (milk-producing glands) or breast ducts and may spread into the surrounding tissues or distant organs at the more advanced stages.

Though breast cancer is typically combined under one category, the reality is that the complexities surrounding this disease include different stages, grades, types, tumour biology and subtypes and require a variety of treatment options, patient support, and ongoing care.

Image source: https://www.ohsu.edu/sites/default/files/2018-11/female-breast-anatomy.jpg

Content: Breast cancer stages & grades

Breast cancer stages & grades

Because of the complex nature of breast cancer, the severity and progression are categorised by stages and grades to help make a more accurate diagnosis and determine the most effective treatment plan. It's important to note that different stages and grades of breast cancer can affect treatment options and prognosis, but early detection and treatment can improve outcomes.

Stages of Breast Cancer

Your doctor will use the TNM system to determine your staging:

T - relates to the primary tumour, its size, and whether it has spread to nearby tissue
N - identifies if the cancer is in the lymph nodes
M - explains if the cancer has spread beyond the breast into other organs of the body

The different stages specify the size of tumours and if cancer cells have spread to other areas of your body.

Early Breast Cancer (also described as localised)

Stage 0: Non-invasive breast cancer, where the abnormal cells are contained within the ducts or lobules (such as ductal carcinoma in situ)
Stage I (may be divided into IA or IB): Invasive; in IA, the cancer is small, around 2cm or less, and is confined to the breast. In stage IB, the tumour is still small but may have spread to spread to nearby lymph nodes.
Stage II (may be divided into IIA or IIB): Invasive; the tumour is between 2-5 cm and has likely spread to the nearby lymph nodes under the armpit.

Locally Advanced Breast Cancer (also described as regional)

Stage III (may be divided into IIIA, IIIB, IIIC): In this stage, cancer measures larger than 5cm and has spread to many of the lymph nodes, surrounding breast tissue, or into the chest wall, including ribs, muscle, or skin.

Metastatic Breast Cancer (also described as distant, secondary, or advanced)

Stage IV: In this stage, the cancer has spread to distant organs, such as the bones, brain, or lungs.

These descriptions are of a general nature and do not take into account an individuals circumstances in relation to their own breast cancer diagnosis.

Grades of Breast Cancer

The pathologist will use the Nottingham Grading system to describe the abnormality of the tumour cells and discover how quickly they’re growing. This grading system will look at the following:

The size and shape of the nucleus (that “brain” of the cell)
The organisation of the cells and if they look like they’re working together
How many of the cells are dividing and growing

Based upon the above criteria. The cancer is then graded from 1-3:

Grade 1 (low): The cancer cells are relatively normal in appearance and are growing slowly.
Grade 2 (intermediate): The cancer cells are abnormal, but not as much as Grade 3 cells and grow at a moderate rate.
Grade 3 (high): The cancer cells are highly abnormal and growing rapidly.

Content: Breast cancer types & subtypes

Breast cancer types & subtypes

Breast cancer can be classified into different types and subtypes based on the characteristics of the cancer cells and how they look under a microscope.

Types of Breast Cancer

Ductal carcinoma (DCIS)

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Non-invasive; starts in the cells that line the breast milk ducts. This type is an early form of breast cancer and is highly treatable. However, if it is untreated or left undetected, it may spread to a more invasive form of breast cancer – this is why early detection through self- breast checks or yearly checkups is critical.

Invasive ductal carcinoma (IDC)

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A common breast cancer that starts in the milk ducts and spreads to other parts of healthy breast tissue.

Lobular carcinoma (LCIS)

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Starts in the lobules (the glands that produce milk) and does not spread into surrounding breast tissue. This type is also highly treatable if found early and rarely becomes invasive.

Invasive Lobular carcinoma (ILC)

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The second most common type of breast cancer that begins in the lobules. An MRI may diagnose this type as it is difficult to detect with a mammogram.

Inflammatory breast cancer

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A rare and aggressive type of breast cancer that is most common in younger women and doesn’t present with a noticeable lump but causes swelling and redness in the breast due to the cancer cells spreading into the skin and lymphatics of the breast. Symptoms of this type may be similar to mastitis: skin redness & swelling, thickening of breast tissue, fever, and breast tenderness.

Metastatic Breast Cancer (MBC)

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This type of breast cancer is also categorised as Stage 4 and has spread to other body parts, such as the lungs, liver, brain, or bones.

Metastases can happen when:

Cancer cells invade into nearby healthy lymph or blood vessels.
Cancer cells can migrate to a distant area where it gets lodged and invade the surrounding healthy tissue. There is a new (smaller) tumour growth at a distant site.

Paget's disease of the breast or nipple (mammary Paget's disease)

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Paget's disease is a rare type of cancer that affects the skin around the nipple and the areola, causing redness, scaling, and discharge from the nipple. These symptoms may initially be misdiagnosed with other infections or other skin conditions.

Subtypes of Breast Cancer

Subtypes are determined by the presence of certain proteins or hormone receptors found on the tumour/s during pathology.

Hormone receptor-positive (HR+)

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This breast cancer subtype is fuelled by hormones such as estrogen and progesterone. HR+ breast cancer is often treated with hormonal therapy to block the effects of these hormones on the cancer cells.

Estrogen positive (ER+) and progesterone positive (PR+)

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Breast cancers are two subtypes of HR+ breast cancer. Breast cancer with these hormone receptors binds to estrogen and progesterone which facilitate the proliferation of the cancer cells.

ER+ breast cancer makes up about 80% of all breast cancers and has estrogen receptors on the surface of the cancer cells that can attach to the hormone estrogen, while PR+ breast cancer has progesterone receptors on the surface of the cancer cells that can attach to the hormone progesterone. Sometimes, breast cancer cells can have estrogen and progesterone receptors on their surface, referred to as ER+/PR+. Both hormones play a vital role in developing and regulating the female reproductive system, helping maintain bone density, and affecting the skin, brain, and other organs.

The strength of hormone receptor positivity, meaning the number of estrogen or progesterone receptors on the surface of cancer cells, can vary between different breast cancers. All positive results – for either estrogen or progesterone receptors – will be classed as HR+ breast cancers and tend to be more responsive to hormonal therapy, whereas breast cancers that are hormone-receptor-negative with an Allred score of 0 will have little to no effect from hormonal therapy.

The strength of hormone receptor positivity can also affect the prognosis and treatment approach, which is why it’s important for your doctor to test for both hormone receptors after your biopsy to get the most accurate diagnosis and treatment plan.

HER2-positive

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This subtype accounts for two thirds of breast cancers and its growth is fuelled by hormones such as estrogen and progesterone. HR+ breast cancer is often treated with hormone-blocking endocrine therapy to -inhibit the effects of these hormones on the cancer cells.

Triple-negative breast cancer (TNBC)

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TNBC: This type is one of the more aggressive forms of breast cancer with a higher chance of recurrence after initial treatment. It is fast-growing and therefore often first diagnosed when it has reached the later stages.

This subtype is characterised by the absence of the three main proteins that drive most types of breast cancer (HER2, estrogen receptors, and progesterone receptors). Triple-negative breast cancer does not respond to hormonal or targeted therapies but is often treated with chemotherapy and, because it is so rare, it can be more complicated to treat due to less treatment options available than hormone positive cancers. Younger women with this subtype may have a genetic predisposition for their cancer but not always.

Content: How is breast cancer diagnosed?

How is breast cancer diagnosed?

A diagnosis will help tell us several things: the stage, type, the speed at which the cancer is growing, which receptors it has, or if the cancer has spread. Testing will depend on your situation, and not everyone requires the same examinations to determine a diagnosis, but in many cases, a combination of these tests will be used to ensure the most accurate treatment plan. For the most accurate diagnoses, tests may include:

Physical examination: If you notice any changes in your breasts, a physical exam will be your first test. Your doctor will check your breasts and lymph nodes in the armpit and above the collarbone for lumps or other changes. If your GP is concerned that the changes may relate to breast cancer, you will be sent for further tests.
Mammogram: This low-dose x-ray can detect small changes in the breast tissue that may not be felt during a physical examination. This exam may feel uncomfortable as your breasts will be placed between two x-ray plates and pressed together to help get a clear picture of the breast tissue.
Tomosynthesis: This test is useful in denser breast and may pick up smaller cancers which conventional 2D mammogram may miss. During this exam, the tomosynthesis machine uses slightly more radiation time and 3D reconstruction of the Xray images to produce better quality pictures which will increase cancer detection rate and reduce false positive rate.
Breast MRI: This test involves injecting a contrast dye to illuminate any cancerous cells during the scan. It uses magnets and radio waves to produce an image of the breast tissue and show any abnormalities in the blood vessels. Your breast specialise usually requests an MRI if you have implants or highly dense breast tissue.
Ultrasound: This non-invasive, painless test without radiation is used if your doctor feels a lump during the physical examination or a Mammogram picks up unusual changes in the breast tissue. An ultrasound uses high-frequency sound waves to create an image of the inside of the breast and the armpit. It can help determine whether a lump is solid or filled with fluid.
Biopsy: A biopsy will only be required if a mammogram shows abnormalities or your GP suspects you have breast cancer after undergoing other examinations. This test involves the removal of a tiny sample of breast tissue for examination under a microscope. A biopsy is the only way to confirm the presence of breast cancer and may include a few different methods:
- Fine needle aspiration (FNA) - This is a test where a doctor uses a thin, long needle to take a small sample of cells from a lump or growth in your body. The cells are then looked at under a microscope to see if they are cancerous. FNA is usually done quickly and easily in the doctor's office or by radiologist under imaging guidance.
- Surgical biopsy - Surgical removal of abnormal tissue is done if the needle biopsy is unsuccessful or the results are unclear. During this procedure, a doctor removes all or part of a lump or growth to see if it's cancerous. This test is usually done in a hospital or outpatient centre and will be done under general anaesthesia.
- Core biopsy - A doctor uses a slightly longer and wider needle than the FNA to take a small sample of cells from a lump or growth. This method allows for a larger sample and is guided by ultrasound, mammogram, or MRI scan. The cells are then looked at under a microscope to see if they are cancerous. This test is done in the radiology department and the doctor uses a local anaesthetic to numb the area.
- Vacuum-assisted core biopsy - Uses a suction-equipped needle inserted through a small cut in the breast to remove tissue for examination. It's more accurate than a fine needle aspiration in some cases, and a mammogram, ultrasound or MRI guide the needle placement. The procedure is performed with a local anaesthetic, but some discomfort may be felt.

Additional Tests

If previous tests confirm breast cancer, your doctor may refer you for some or all of the below to determine whether the cancer has spread.

Blood tests: Help identify specific tumour markers and check your overall health.
Bone, CT, or PET scan: Each scan is relatively similar but checks for cancer cells slightly differently. Each scan involves a large scanning machine and the injection of contrast dye to help make the image clearer and illuminate any cancerous cells within the body.

Content: What are the risk factors?

What are the risk factors?

Certain risk factors may increase a woman’s chance of developing breast cancer, but it does not always mean it will happen. There are many cases where women have no apparent risk factors and still develop breast cancer. This is why regular screening and being proactive about your health can help detect breast cancer early when it is most treatable. Common risk factors include:

1. Personal Factors

Age: Statistically, the risk of breast cancer increases as a woman ages and is typically diagnosed in women 50 years and older. However, we now see about 5% of diagnoses in women under 30.
Gender: Both women and men are at risk for breast cancer, but 1 in 7 Australian women will develop breast cancer in their lives and are 100 times more likely to develop the disease than men.
Breast density: Dense breast tissue makes it difficult to detect breast lumps and may lead to a missed diagnosis, increasing the risk for more advanced stages of breast cancer.
Personal history of breast cancer: Women with breast cancer in one breast are at increased risk of developing cancer in the other breast.

2. Family History Factors

Genetics: A family history of breast cancer, especially in a mother, sister, or daughter, increases the risk of developing the disease, which increases even further if a relative is diagnosed before fifty.
Gene mutations: These changes in the DNA sequence happen during cell division when cells make copies of themselves, leading to illness or other genetic disorders. Commonly known genetic mutations that increase breast cancer risk include:
- BRCA1 and BRCA2 genes - are the most widely known and discussed mutations and are seen more frequently in certain ethnic populations such as Ashkenazi Jewish. Those with a BRCA gene mutation have a 45%-85% chance of developing breast cancer and 10%-46% of ovarian cancer.
- PALB2 (Partner And Localiser of BRCA2) - the third most common gene mutation after BRCA1 & BRCA2. Approximately 35% of women with a PALB2 mutation will develop breast cancer before 70.
- TP53 (P53) - this mutation causes Li-Fraumeni syndrome, which increases the chance of breast cancer by 54% by age 70.
- PTEN (Phosphatase and TENsin homolog) - this mutation may cause Cowden syndrome, which can increase the chance of breast cancer by 25% to 50%.
- CHEK2 (Checkpoint Kinase 2) - this gene mutation doubles the risk of breast cancer in women and makes it 10x more likely for it to occur in males.
- CDH1 (CaDHerin 1) - those with this mutation have a 39% lifetime risk of developing invasive lobular breast cancer.
- STK11 (Serine/Threonine Kinase 11) - this mutation causes Peutz-Jeghers syndrome and carries a 32% risk of developing breast cancer by age 60.
Other genetic mutations include:
- ATM
- BARD1
- BRIP1
- NBN
- NF1
- MSH2
- PIK3CD
- DSPP
- CTCF

Along with many more that are continuously being discovered and studied.

It’s important to note that not everyone with gene mutations will develop breast cancer, but it may be beneficial to test for genetic links if there is a known family history to help reduce risk and take preventive measures.

*More information about gene mutations and genetic testing is available here.

3. Hormonal factors

Women who have started menstruating before age 12, started menopause after 55 years of age or never gave birth are at increased risk.

4. Lifestyle factors

Alcohol consumption, lack of physical activity, poor diet, smoking, and being overweight or obese have all been linked to an increased risk of breast cancer.

5. Medical history & medications

Previous breast conditions, Hodgkin’s disease, previous radiation to the chest, long-term use of combined oral contraceptives and menopausal hormone therapy have all been linked to an increased risk of breast cancer.

*More information about breast cancer risks can be found here.

Content: Common symptoms of breast cancer

Common symptoms of breast cancer

Breast cancer symptoms can vary for each individual, and some may not have any obvious signs, but here are the most common:

Lump or thickening in the breast or underarm area - often the first symptom of breast cancer, and it may feel like a hard or painless lump.
Changes in the breast size or shape include swelling, redness, or skin irritation.
Nipple discharge - may be a clear, milky, or bloody fluid that leaks from one or both nipples.
Inverted nipple - the nipple may turn inward instead of sticking out.
Changes in the breast’s skin texture - may include dimpling, puckering, or a rash on the nipple or surrounding area and may resemble the same texture as an orange peel.
Swelling in all or part of the breast - may occur even if there is no distinct lump.

It’s critical to be vigilant about your breast health. Make sure you incorporate regular self-breast checks into your self-care routine and see your doctor immediately if you see or feel any unusual changes in your breasts. Early detection can ensure the best possible outcome.

Content: Treatment options

Treatment options

The treatment options for breast cancer depend on several factors, including the stage, type of breast cancer (invasive or non-invasive), overall health, and personal preferences. A patient will likely have combined treatments. Here are some of the most common treatment options for breast cancer:

Lumpectomy (breast-conserving surgery): This procedure may also be called wide local excision and removes only the cancerous tumour and a small amount of surrounding normal tissue.
Mastectomy/ Bilateral Mastectomy: This is a surgical procedure that removes one or both of the entire breast and the nipple (though a nipple-sparring surgery may be an option.)
Removal of lymph nodes: This procedure helps check for the spread of cancer from the breast to other body parts. The axillary lymph nodes, which are located in and around the armpit, are the first place that breast cancer cells often spread to and may require one or both of the below procedures:
- Sentinel lymph node biopsy (SLNB) - during a sentinel lymph node biopsy, lymph nodes are removed to be tested for cancer cells. The rest of the lymph nodes are left in place if no cancer cells are present. More information on this procedure is outlined here.
- Axillary lymph node dissection (ALND) - Also known as axillary clearance, this procedure is done when a woman presents with nodal disease or has a positive node on their sentinel node biopsy. A majority of the lymph nodes (10-25) will be removed to reduce the risk of recurrence and will help determine the appropriate treatment plan.
Radiation therapy: This uses high-energy beams of radiation to destroy cancer cells. It breaks up abnormal cells, stopping them from growing and dividing.
Endocrine or hormonal therapy: This type of systemic therapy works by blocking hormones that can activate the growth of certain types of breast cancer.
Chemotherapy: This systemic treatment uses cytotoxic drugs with the aim to destroy cancer cells throughout the body, as well as healthy cells.
Targeted therapy - drugs that target specific cancer cell features to stop growth.
Bone-directed therapy - to help prevent or treat bone fractures and other complications.
Palliative care - to manage symptoms and improve quality of life during treatment for secondary breast cancer.
Immunotherapy - immunotherapy is a type of cancer treatment that assists the body's immune system to fight cancer.

Triple-Negative Breast Cancer

This breast cancer does not respond to endocrine or targeted therapies, so patients will often have different treatment options to other types of breast cancer. It is treated aggressively, even in the early stages, because it can progress quickly. The most common treatments are:

Chemotherapy - is usually the first line of treatment to try to shrink the tumours and lower the risk of the cancer returning.
Surgery - includes a mastectomy or lumpectomy after chemotherapy is completed.
Radiation - may be used to treat the tumours, depending on their characteristics.
Immunotherapy and PARP inhibitors - this treatment is not used for each case but has been used in treating later stages of TNBC.

Breast reconstruction

Breast reconstruction surgery may be done at any stage of breast cancer once all diagnostic tests are completed. This surgery rebuilds the shape of the breast after a total or partial mastectomy, and the goal is to restore the appearance of the breast, helping patients feel more confident and comfortable with their bodies.

Reconstruction can be immediate or delayed, and may involve more than one surgery:

Immediate breast reconstruction: This type of reconstruction is performed at the same time as the mastectomy, during the same surgical procedure. This can minimise the number of surgeries needed and provide a smoother transition.
Delayed breast reconstruction: This type of reconstruction is performed after the patient has recovered from their mastectomy and completed any additional treatments, such as radiation therapy.

There are several types of breast reconstruction, including:

Reconstruction using implants: This type of reconstruction uses either silicone or saline implants to rebuild the shape of the breast. The implants can be inserted either above or below the chest muscle.

Reconstruction using tissue from the patient's body: Also known as ‘flap’ reconstruction, this type of reconstruction uses tissue from the abdomen, back, thigh or buttocks to rebuild the shape of the breast.

Breast reconstruction is not for everyone. Some patients may choose not to have their breast/s reconstructed if they want to avoid implants, for example, or a longer surgery needed for a 'flap' reconstruction.

Patients can have a ‘flat’ closure during their mastectomy, when no breast mound is reconstructed but excess skin and pockets of fat or tissue are removed from the chest wall, and it is tightened to create a smooth and flat chest without folds of skin. This procedure is sometimes referred to as an aesthetic flat closure. More than one surgery may be needed to achieve the optimal ‘flat’ result for the patient.

It’s important to note that the type of reconstruction suitable for a particular patient will depend on several factors, including their overall health, treatment pathway and personal preferences. The patient's healthcare team, which often includes a breast surgeon and a plastic surgeon, will work together to develop a personalised treatment plan that considers the patient's specific needs and goals.

The decision to have breast reconstruction is a personal one and should be made in consultation with a healthcare professional, including a FRACS-qualified surgeon.

Content: Who will be part of my healthcare team?

Who will be part of my healthcare team?

Depending on your type of breast cancer, treatment plan, and how you respond to treatment, a standard care team or a multidisciplinary team can include:

Breast care nurse - this nurse is assigned to a patient once diagnosed with breast cancer. She will provide information and additional personalised support throughout the entire process.

*Some patients may not be offered a breast care nurse straight away. If this is the case for you, ask your treatment team to appoint one for you as soon as possible.
Breast surgeon - a breast surgeon may or may not be your first point of contact before an oncologist depending on your individual circumstances. Surgery can involve a lumpectomy, partial or total mastectomy and lymph node removal, which may be followed immediately by reconstruction.
Plastic surgeon – depending on the type of reconstruction you have, a reconstructive plastic surgeon may carry out the surgery. For example, when having a ‘flap’ reconstruction.
Medical oncologist - specialises in cancer drug therapies; chemotherapy, targeted therapy, hormone therapy and immunotherapy.
Chemotherapy nurse - specialises in administrating chemotherapy drugs and provides support throughout treatment.
Clinical oncologist - uses both drug therapy and radiotherapy to treat disease.
Radiation therapist - if your treatment plan requires radiotherapy, you will usually see this specialist after you finish the course of chemotherapy. The number of radiotherapy sessions required is based on each patient.
Pathologist - collects and examines tissues and blood samples.
Radiographer - specialises in performing mammograms, x-rays, and a variety of other necessary scans.

Additional team members

Not all patients will require every health care practitioner to be part of their team; depending on your diagnosis and current treatment plan, your care team may also include:

Genetic counsellor - a specialist that may be recommended for you if you have a strong history of breast cancer in your family or test positive for the BRCA gene mutation.
Fertility specialist - provides advice and support about fertility preservation and possible pregnancy before, during, and after treatment.
Exercise physiologist - specialises in prescribing exercise plans to improve a patient’s quality of life, strength, overall health, and energy levels.
Nutritionist/Dietician - provide advice regarding nutrition during and post-treatment, which can help to alleviate discomfort with treatment side effects.
Lymphoedema practitioner/ Physiotherapist - educates patients about the prevention and management of lymphoedema and may offer treatment.
Psychologist, Psychiatrist, or Counsellor - these practitioners specialise in helping patients manage emotional responses to diagnosis and treatment.
Hair loss advisor - provides support during and after treatment regarding hair loss, i.e. cold-capping or wig fittings.

Content: A-Z Glossary: Common Terms for Breast Cancer Patients

A-Z Glossary: Common Terms for Breast Cancer Patients

A

Adjuvant Therapy: Additional treatment after primary treatment to reduce cancer recurrence risk.
Advanced Cancer: Cancer that has spread and is unlikely to be cured, but treatment may help manage symptoms.
Areola: Coloured rim around the nipple.
Aromatase Inhibitors: Drugs to reduce the body's estrogen production.
Atypical Ductal Hyperplasia: A non-cancerous condition of milk duct cells.
Axilla: The underarm area (armpit.)
Axillary Dissection/Surgery: Removal of some armpit lymph nodes.
Axillary Lymph Nodes: Lymph nodes in and around the armpit.
Axillary Web Syndrome (also known as cording): Tight cords of tissue down the arm.

B

Benign: Non-cancerous.
Biopsy: Removal of tissue samples to examine and diagnose disease.
BRCA1/BRCA2 Mutation: Gene fault that increases the risk of breast, ovarian, or prostate cancer.
Breast Oedema: Swelling due to fluid build-up in breast tissue.
Breast Prosthesis (also called breast form): Artificial breast to recreate natural breast shape.

C

Cancer-Related Cognitive Impairment: Thinking and memory problems after treatment, also known as chemo brain.
Cellulitis: Skin infection that can occur after lymph gland removal.
Chemotherapy: Cancer treatment using drugs to kill or slow cancer cell growth.
Clear Margin: Surrounding tissue removed during surgery does not contain cancer cells.
Clinical Trials: studies involving eligible patients to determine if there is a more effective treatment option than currently offered.
Cold Cap: Cap worn during chemotherapy connected to a cooling system to prevent hair loss.
Complimentary Therapies: Additional therapies used alongside conventional medicine treatments may include massage, acupuncture, and yoga.

D

Ductal Carcinoma in Situ (DCIS): Abnormal cells in breast ducts that increase invasive cancer risk.
Ducts: Tubes carrying milk to the nipple.

E

Early Menopause: Typically a side effect of cancer drugs, this means that a woman will be put into menopause under 45 years of age.
Estrogen: A sex hormone primarily produced by the ovaries and, after menopause, by fat cells.

G

Genomic Assay: Test providing information on cancer recurrence risk and benefit of chemotherapy.

H

Hormone Receptors: Proteins on the cell surface that bind to specific hormones.

I

Intravenous Infusion: The injection of treatment drugs or other necessary fluids into the bloodstream via a needle.

K

Klinefelter syndrome: A genetic disorder in males characterised by the presence of two X chromosomes instead of one.

L

Lymphatic System: A network of vessels, nodes, and organs that remove excess fluid, absorb fatty acids, transport fat, and produce immune cells.
Lymph Nodes: Small structures that collect and destroy bacteria and viruses.
Lymphoedema: Swelling caused by a build-up of lymph fluid.
Lymph Vessels: Thin tubes that carry lymph fluid throughout the body.

M

Mammogram: A low-dose X-ray of the breast tissue.
Margin/Surgical Margin: The edge of tissue removed during surgery, with a clear or negative margin meaning no cancer cells found and a positive margin meaning further surgery is needed.
Menopause: The end of menstruation.
Metastasis (Metastases): Cancer that has spread from the primary site to another part of the body.
Multidisciplinary team: A group of healthcare professionals who specialise in different areas of care, collaborate and coordinate with patients, and regularly meet and work together to ensure their patients achieve the best possible outcome.

N

Neoadjuvant Therapy: Therapy given before surgery to enhance its success, such as chemotherapy.

O

Osteoporosis: A condition characterised by thinning and weakening bones, leading to pain and fractures.
Ovarian Ablation: The stopping of estrogen production by surgically removing the ovaries or giving a dose of radiation to them.

P

Pathologist: A doctor who interprets test results.
Pharmaceutical Benefits Scheme (PBS): A government-funded program in Australia that provides financial assistance for eligible individuals to cover the cost of selected medications.
Peripheral Neuropathy: Numbness, weakness, tingling, or pain in the hands and feet caused by damage to peripheral nerves.
Progesterone: A sex hormone primarily produced by the ovaries that prepares the uterus for pregnancy.

R

Radiation Therapy: Targeted radiation to kill or damage cancer cells.
Recurrence: The return of a disease after a period of improvement.

S

Secondary Breast Cancer: Also known as Stage 4, advanced or metastatic, this cancer has spread to different parts of the body such as the liver, bones or brain.
Seroma: A fluid collection under a wound that may need draining after surgery.
Systemic therapy: Treatments such as hormone therapy and chemotherapy are considered systemic because they can travel through the bloodstream and reach all cells throughout the body. Surgery and radiation would not be classified as systemic because they only treat one area of the body.

T

Targeted therapy: Drugs that target specific cancer cell features to stop growth
Tomosynthesis: 3D digital x-ray mammogram
Tumour: New or abnormal tissue growth

W

Wide local excision: Surgical removal of cancer & some surrounding healthy tissue

Understanding

Breast Cancer

Beyond Awareness: Understanding Breast Cancer

An evidence-based resource helping empower our community with knowledge and confidence to navigate the complexities of this disease.

What’s our hope?

What is breast cancer?

Breast cancer stages & grades

Stages of Breast Cancer

Grades of Breast Cancer

Breast cancer types & subtypes

Types of Breast Cancer

Subtypes of Breast Cancer

How is breast cancer diagnosed?

What are the risk factors?

Common symptoms of breast cancer

Treatment options

Who will be part of my healthcare team?

A-Z Glossary: Common Terms for Breast Cancer Patients

It is important to note that breast reconstruction is not for everyone, and some patients may choose not to have a reconstruction. The decision to have breast reconstruction is personal and should be made in consultation with a healthcare professional.

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