Breast cancer is one of the most common cancers affecting women, but a diagnosis does not automatically mean that life is coming to an end. Breast cancer is a group of different diseases, and its behaviour and treatment can vary considerably depending on the type, stage, hormone receptor status, HER2 status, tumour grade and overall health of the person.

The good news is that breast cancer detected at an early stage is often highly treatable. Current treatment may include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy or immunotherapy, depending on the individual diagnosis.

Understanding the symptoms, stages and treatment options can make the diagnosis a little less frightening and help patients make informed decisions with their healthcare team.

What is breast cancer?

Breast cancer develops when abnormal cells in the breast begin growing and dividing uncontrollably. These cells can form a tumour and, in some cases, spread into nearby lymph nodes or to other parts of the body.

There are several types of breast cancer. Invasive ductal carcinoma starts in the milk ducts and is the most common type. Invasive lobular carcinoma begins in the milk-producing lobules. Other less common forms include inflammatory breast cancer, mucinous breast cancer and triple-negative breast cancer. Ductal carcinoma in situ, or DCIS, is a non-invasive condition in which abnormal cells remain within the milk ducts.

Breast cancer is also classified according to biomarkers such as estrogen receptors, progesterone receptors and HER2. These characteristics are important because they influence both treatment and prognosis.

Breast cancer is one of the most common cancers affecting women worldwide. While it can also occur in men, the incidence is significantly higher in women. Early detection and advances in treatment have significantly improved survival rates, but understanding this complex disease remains crucial. This blog aims to provide a detailed overview of the cancer, including its types, risk factors, symptoms, diagnosis, treatment options, and preventive measures.

Types of Breast Cancer:

It is not a single disease but a group of diseases that develop from breast tissue cells. The main types include:

• Ductal Carcinoma In Situ (DCIS): Non-invasive cancer where abnormal cells are found in the lining of a breast duct but have not spread outside the duct.
• Invasive Ductal Carcinoma (IDC): The most common type of breast cancer, IDC starts in the milk ducts and invades nearby tissues.
• Invasive Lobular Carcinoma (ILC): Begins in the lobules (milk-producing glands) and can spread to other parts of the body.
• Triple-Negative Breast Cancer (TNBC): Lacks estrogen, progesterone, and HER2 receptors, making it harder to treat with hormone therapy.
• HER2-Positive Breast Cancer: Characterized by an overexpression of the HER2 protein, leading to aggressive growth.
• Inflammatory Breast Cancer: A rare and aggressive form causing redness and swelling of the breast.

What are the symptoms of breast cancer?

Early breast cancer may cause no noticeable symptoms. This is one reason screening and appropriate evaluation of breast changes are important.

Possible symptoms include:

• A new lump in the breast or underarm
• Thickening or a firm area in the breast
• A change in breast size or shape
• Nipple discharge that is not breast milk, particularly bloody discharge
• A nipple becoming inverted or changing direction
• Dimpling, puckering or changes in the breast skin
• Redness, swelling, scaling or thickening of the skin
• A rash around the nipple or areola
• Persistent changes affecting one breast
• Breast or nipple pain, although pain is not usually the first symptom of breast cancer

Most breast lumps and breast changes are not cancer. However, a new or persistent change should be assessed rather than assumed to be harmless.

What are 5 signs of breast cancer?

Five important signs to watch for are:

1. A new lump or thickening in the breast or underarm
2. A change in breast size or shape
3. Skin changes such as dimpling, puckering, redness or swelling
4. Nipple changes, including inversion or unusual discharge
5. A persistent change in the breast or nipple, including unexplained pain

These signs do not necessarily mean cancer, but they should be checked by a doctor.

How is breast cancer diagnosed?

If a breast change is detected, a doctor may recommend imaging such as a mammogram, breast ultrasound or breast MRI, depending on the circumstances. A biopsy is usually needed to determine whether abnormal tissue is cancerous.

Once cancer is confirmed, additional tests can determine its type and characteristics. These may include testing for estrogen and progesterone receptors, HER2 and other biomarkers. These results help the oncology team choose the most appropriate treatment.

What are the stages of breast cancer?

Breast cancer is generally described from stage 0 through stage IV.

Stage 0: Abnormal cells are present but have not invaded surrounding breast tissue. DCIS is an example.

Stage I: The cancer is relatively small and has not spread extensively. It may involve nearby lymph nodes in some cases.

Stage II: The tumour is larger and/or there is greater involvement of nearby lymph nodes.

Stage III: The cancer has spread more extensively into nearby tissues or lymph nodes but has not spread to distant organs.

Stage IV: The cancer has spread to distant parts of the body. This is also called metastatic breast cancer.

Staging is more complicated than simply looking at tumour size. Doctors also consider lymph-node involvement, tumour grade and biomarkers such as ER, PR and HER2 when determining prognosis and treatment.

What is the last stage of breast cancer?

The last or most advanced stage is stage IV breast cancer.

Stage IV means the cancer has spread from the breast to distant parts of the body, which may include the bones, liver, lungs or brain. It is also called metastatic breast cancer.

Stage IV breast cancer is generally not considered curable with current treatments, but that does not mean there is nothing doctors can do. Treatment can slow the disease, control symptoms and help people live longer. Some people with metastatic breast cancer live for many years, particularly when the cancer responds well to treatment.

Is breast cancer life ending?

No. Breast cancer is not automatically life-ending.

Many people diagnosed with breast cancer, particularly when it is detected early, complete treatment and live for decades afterward. According to current US SEER-based statistics reported by the American Cancer Society, the five-year relative survival rate for invasive breast cancer that is localized to the breast is greater than 99%. For cancer that has spread to distant sites, the five-year relative survival rate is about 33%.

These figures are population statistics, not individual predictions. A person’s outlook depends on cancer subtype, stage, tumour biology, response to treatment, age, general health and many other factors.

How long can I live with breast cancer?

There is no single answer because breast cancer behaves differently from one person to another.

Someone with stage I breast cancer may have an excellent long-term outlook, while stage IV breast cancer can behave very differently depending on its subtype and response to treatment.

Current NCI statistics show five-year relative survival of approximately 99.3% for localized breast cancer, 86.3% for regional disease and 31% for distant disease in the referenced SEER data.

Importantly, five-year survival does not mean that a person will live only five years. Many people live much longer. In fact, surviving 10, 15 or 20 years after breast cancer is entirely possible, particularly after successful treatment of early-stage disease.

Can I live 20 years after breast cancer?

Yes. Many people live 20 years or considerably longer after a breast cancer diagnosis.

The possibility depends on the original stage and biology of the cancer, treatment received, response to treatment and whether the cancer returns. Early diagnosis and advances in surgery, radiation, hormone therapy, targeted treatment and other therapies have substantially improved outcomes.

After treatment, long-term follow-up remains important because breast cancer can sometimes recur years later.

How much time does breast cancer take from stage 1 to 4?

There is no fixed timeline for breast cancer to progress from stage 1 to stage 4.

Some breast cancers grow slowly and may remain localized for years. Others, particularly certain aggressive subtypes, can grow and spread much more quickly. Some breast cancers never progress to stage IV.

For example, triple-negative breast cancer tends to grow more quickly and has a higher risk of recurrence than many other breast cancer subtypes. HER2-positive cancers can also grow relatively quickly, although highly effective HER2-targeted treatments are available.

This is why doctors do not normally estimate progression using a simple “stage 1 to stage 4” timetable.

Is breast cancer fast growing?

Some breast cancers grow quickly, while others grow slowly.

Tumour grade, hormone receptor status, HER2 status, Ki-67 and other biological characteristics can provide clues about how rapidly the cancer is likely to grow. For example, triple-negative breast cancer generally grows faster than many hormone receptor-positive breast cancers.

The growth rate cannot be determined simply from the size of a lump. A relatively small tumour can sometimes be biologically aggressive, while a larger tumour may grow more slowly.

How is breast cancer treated?

Treatment depends on the stage and biological characteristics of the cancer.

Common treatments include:

• Surgery: Lumpectomy or mastectomy may be used to remove the cancer.
• Radiation therapy: Often used after breast-conserving surgery and in selected patients after mastectomy.
• Chemotherapy: Uses medicines to destroy cancer cells or prevent them from multiplying.
• Hormone therapy: Used for hormone receptor-positive breast cancers.
• Targeted therapy: Used when the cancer has a specific target, such as HER2.
• Immunotherapy: May be used for selected cancers, including some triple-negative breast cancers.

Not everyone needs every treatment.

Is breast cancer treatment painful?

Breast cancer treatment can cause discomfort or pain, but it does not necessarily mean constant severe pain.

Surgery naturally causes soreness while the body heals. Radiation can cause skin irritation, tenderness and fatigue. Chemotherapy may cause side effects such as fatigue, nausea, mouth sores and nerve-related symptoms.

The chemotherapy infusion itself is not usually described as painful, although inserting an IV or accessing a port can be uncomfortable.

Pain should never simply be tolerated in silence. Cancer-related and treatment-related pain can usually be managed with appropriate medicines and other supportive approaches.

Which stage of breast cancer is painful?

There is no particular stage that is always painful.

Early breast cancer often causes no pain. Pain may occur at any stage and can also be caused by conditions unrelated to cancer.

Advanced breast cancer can be more likely to cause pain when it spreads to areas such as the bones. However, the amount of pain does not reliably indicate the stage of cancer.

Why are nipples removed for breast cancer?

In a traditional total mastectomy, the entire breast, including the nipple and areola, is removed. This may be recommended when the tumour is close to or involves the nipple or when the surgical plan requires removal of the nipple-areola complex.

However, the nipple does not always have to be removed.

A nipple-sparing mastectomy preserves the nipple and areola while removing the breast tissue. Whether this is safe depends on factors such as the tumour’s size and location and whether cancer cells are found near the nipple or areola.

How many hours is chemo for breast cancer?

There is no standard number of hours for a breast cancer chemotherapy session.

Some chemotherapy infusions may take a few hours, while others can take longer depending on the medicines, pre-treatment drugs, hydration, monitoring and whether other targeted treatments are given at the same visit. Treatment schedules can also involve oral medicines rather than an infusion.

Chemotherapy is usually given in cycles. Depending on the regimen, cycles may occur weekly or every two, three or four weeks.

How many rounds of chemo are normal for stage 1 breast cancer?

There is no single “normal” number of chemotherapy rounds for stage I breast cancer.

Some people with stage I breast cancer do not need chemotherapy at all. Others may be advised to have it because of factors such as tumour biology, grade, lymph-node involvement or a higher predicted risk of recurrence.

When chemotherapy is recommended, the number of cycles depends on the specific regimen. Courses commonly last several months, but the exact number can vary considerably.

This is one area where treatment should not be compared solely with another patient’s experience. Two people with the same stage can receive different treatments because their cancers may have different biological characteristics.

Can I live a normal life during chemo?

Yes, many people continue parts of their normal routine during chemotherapy, although it is common to need adjustments.

Some people continue working, exercising gently, socialising and managing household responsibilities. Others experience significant fatigue, nausea, weakness or other side effects and need more rest.

Chemotherapy side effects vary widely. Fatigue is particularly common, while nausea, hair loss, mouth sores and other problems can also occur.

The key is to listen to your body. Rest when necessary, stay physically active within the limits recommended by your medical team, eat adequately and report troublesome symptoms promptly.

What happens after breast cancer is removed?

Removing the tumour or breast does not necessarily mean treatment is finished.

After surgery, the removed tissue is examined by a pathologist. The report provides important information about the tumour, margins, lymph nodes, grade and biomarkers. This information helps determine whether additional treatment is recommended.

Depending on the diagnosis, treatment after surgery may include radiation, chemotherapy, hormone therapy, targeted therapy or a combination of these.

After active treatment, regular follow-up is important. Follow-up may include clinical examinations, mammograms and other tests when clinically appropriate.

What is life like after breast cancer?

Life after breast cancer can be surprisingly normal, but it may also take time to adjust.

Some people return to work, family responsibilities, exercise, travel and hobbies. Others may experience changes in body image, menopause-related symptoms, fatigue, nerve symptoms, lymphoedema or anxiety about recurrence.

The emotional impact can last longer than the physical treatment. It is completely normal to feel relief and worry at the same time.

Survivorship care is not simply about checking whether cancer has returned. It also focuses on managing long-term treatment effects, maintaining general health and supporting emotional wellbeing.

What foods should I avoid after having breast cancer?

There is no universal list of foods that every breast cancer survivor must completely avoid. Instead, focus on an overall healthy eating pattern.

It is sensible to limit:

• Processed meats such as bacon, sausages and luncheon meats
• Large amounts of red meat
• Sugary drinks and sweets
• Highly processed foods
• Refined grains
• Excess calories that contribute to unhealthy weight gain
• Alcohol, particularly if your oncology team recommends avoiding it

Instead, emphasise vegetables, fruits, whole grains, beans, lentils, fish, poultry and other nutritious foods.

There is also no need to automatically avoid soy foods because of a breast cancer diagnosis. Dietary decisions should be discussed with your oncologist or a qualified oncology dietitian if you have specific concerns.

What should I avoid after breast cancer?

Beyond food, the most useful approach is to avoid habits that can undermine overall health.

Try to avoid smoking, excessive alcohol consumption, prolonged physical inactivity and unnecessary weight gain. Regular physical activity and maintaining a healthy weight can be beneficial for breast cancer survivors.

Avoiding follow-up appointments is also something to take seriously. Regular follow-up gives your healthcare team an opportunity to identify recurrence or manage treatment-related problems.

Is stage 4 cancer 100% death?

No. Stage 4 cancer is not 100% fatal.

Stage IV breast cancer means that the cancer has metastasised to distant parts of the body, and it is generally treated as a chronic, treatable disease rather than a cancer that can usually be permanently eliminated.

Some people respond extremely well to treatment and live for years. Survival varies significantly according to subtype, sites of spread, previous treatment, response to therapy and overall health. Current population data show that distant breast cancer has a five-year relative survival rate of about 33%, demonstrating that many people live at least five years after diagnosis.

Statistics cannot predict an individual patient’s future.

What are the top 3 deadliest cancers?

Globally, when cancers are ranked by the number of cancer deaths, the top three in 2022 were:

1. Lung cancer – approximately 1.8 million deaths
2. Colorectal cancer – approximately 900,000 deaths
3. Liver cancer – approximately 760,000 deaths

Breast cancer was responsible for approximately 670,000 deaths worldwide in the same year.

This ranking is based on the number of deaths worldwide, not necessarily the percentage of people who die after receiving a diagnosis. Those are two very different measures.

Frequently asked questions about breast cancer

Can breast cancer be cured?

Many early-stage breast cancers can be treated successfully and may never return. Doctors may use the term “no evidence of disease” or “in remission” rather than promising an absolute cure because recurrence can occasionally happen years later.

Can breast cancer come back after treatment?

Yes. Breast cancer can recur locally, regionally or at distant sites. The risk depends on factors including the original stage, tumour biology, lymph-node involvement and treatment response.

Does breast cancer always require chemotherapy?

No. Chemotherapy is only one part of breast cancer treatment, and many patients do not need it. Treatment decisions depend on the cancer’s stage and biological characteristics.

Is a breast lump always cancer?

No. Breast cysts, fibroadenomas, hormonal changes and other benign conditions can cause lumps. However, a new or unusual lump should be evaluated rather than diagnosed at home.

Can breast cancer be painless?

Yes. Breast cancer often does not cause pain, particularly in its early stages. That is why a painless lump or other breast change should not be ignored.

When should I see a doctor?

See a healthcare professional if you notice a new breast lump, persistent breast or nipple changes, unexplained nipple discharge, skin dimpling, redness or swelling, or another unusual change. Most breast changes are not cancer, but proper evaluation is the safest way to find out.

The bottom line

Breast cancer is not one single disease, and neither is its outcome. Some breast cancers grow slowly and are detected at an early stage, while others can be more aggressive. The stage, tumour biology and response to treatment are far more informative than simply knowing that someone has “breast cancer.”

Early detection remains important, but even advanced breast cancer is not automatically a death sentence. Modern treatment has given many patients more options and, in some cases, substantially longer survival.

If you notice a new breast lump or any persistent change in your breast or nipple, don’t wait for it to disappear on its own. Get it evaluated by a qualified healthcare professional and follow the recommended diagnostic pathway, which may include clinical examination and breast imaging such as mammography or ultrasound.

Medical disclaimer: This article is intended for general health education and should not replace medical advice, diagnosis or treatment from a qualified healthcare professional. Breast cancer treatment must be individualised according to the patient’s pathology, stage, biomarkers, overall health and treatment goals.

To get USG of Breast done or consult a Doctor at Sparsh Diagnostic Centre, call our helpline number 9830117733.

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