Symptoms and Diagnosis

In this section you can find out more about:

Remember, everyone is different and your symptoms and experience may be different from that described below. If you have any further questions, be sure to ask your medical professional.

Symptoms

There may be no symptoms of early stage breast cancer and it is often picked up during a regular mammogram screening. However, some women may notice changes in their breasts, such as a lump, redness or pain in the breasts.

Signs that you could have breast cancer include:

  • A lump in the breast or under the arm
  • A change in the size or shape of the breasts, including dimples or dents
  • A discharge from the nipple
  • Changes in the appearance of the breast skin so that it resembles orange peel
  • Pain in the breast
  • An inverted nipple.

It’s important to see your doctor if you notice any of these signs or any changes or anything strange in your breasts. It’s also important to get regular mammograms. These are free through BreastScreen Aotearoa if you’re aged between 45 and 69.

These symptoms may not necessarily indicate that you have breast cancer. This is the reason to see your doctor for further investigation.

A Diagnosis of Breast Cancer

If you have regular mammograms, your breast cancer may be diagnosed after a screening. If you visit your doctor to get a lump or some other change in your breast checked, your GP is likely to begin by performing a breast examination.

To help determine if your breast lump or breast changes are breast cancer, your doctor will organise further tests, which may include:

  • A mammogram: This is a special x-ray that takes pictures of the breast.
  • An ultrasound: This uses high-frequency sound waves to detect any lumps or irregularities. It can sometimes pick up changes that are not identified in a mammogram.
  • An MRI (magnetic resonance imaging) scan: This uses magnetic resonance to view tumours or abnormalities and is more often used in younger women or those with denser breast tissue.
  • Fine needle aspiration: If a tumour has been identified in scans, then your specialist may perform this procedure. He or she will insert a fine needle into your breast and withdraw some of the cells from the tumour for analysis
  • Breast biopsy: A biopsy is when a sample of tissue is taken from the tumour for analysis. This may be done using a needle or it may be done during surgery.
  • Tumour analysis: The biopsy tissue will be analysed by a pathologist to determine whether the cancer contains certain hormone or HER2 receptors.

The Grading and Staging of Breast Cancer

The results of your biopsy will be used to determine what grade and stage of breast cancer you have.

The “grade” of cancer is simply a measure of how different the cancer cells are compared with normal cells. There are three grades of breast cancer :

Grade

Definition

Grade 1

The cells are still quite similar to normal breast cells and are slow growing.

Grade 2

The cells are slightly different to normal breast cells and are faster growing.

Grade 3

The cells are very different to normal breast cells and are fast growing and more likely to spread.

If the results of your biopsy reveal the presence of cancer cells, then your doctor will also need to understand what “stage” of breast cancer you have. The staging of cancer is simply a way of determining how far the cancer has spread. There are four stages of breast cancer and these are :

Stage

Definition

Stage I

The tumour is small (up to 2cm wide) and the cancer has not spread to nearby lymph nodes.

Stage II

This includes small (up to 2cm) tumours that have may have spread to nearby lymph nodes and larger tumours (up to 5cm wide) that have not yet spread.

Stage III

The tumour is large (more than 5cm wide) and has spread to nearby lymph nodes, including those on the breast bone or chest wall.

Stage IV

The cancer has spread to nearby organs and other parts of the body. (Metastatic, advanced or secondary)

In early breast cancer, the uncontrolled cancer cell growth is occurring in the area of the breast and/or armpit. Nowhere else in the body is affected. Early breast cancer is often written as eBC.

Advanced breast cancer is also known as metastatic or secondary cancer. This means the cancer cells from the original tumour have spread beyond the breast, underarm, and internal mammary (breast) lymph nodes. These cells have appeared in other parts of the body such as the lungs, liver, bone, or brain. Advanced breast cancer is often written as mBC.

Your doctor will make treatment decisions based on the grade and stage of cancer you have, the size and location of the tumour, and your general health.

You can find more useful information about understanding your pathology report here.




References
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