🎀 Breast Cancer

What is Breast Cancer?

Breast cancer occurs when cells in the breast grow uncontrollably and form a tumour. It is the most commonly diagnosed cancer in Filipino women. While it predominantly affects women, men can also develop breast cancer — though this is rare.

Breast cancer is highly treatable, especially when caught early. With modern medicine — including targeted therapies and advanced surgical techniques — many women go on to live full, healthy lives after treatment.

Types of Breast Cancer

Invasive Ductal Carcinoma (IDC)

The most common type, accounting for about 80% of all breast cancers. It starts in the milk ducts and grows into surrounding breast tissue.

Invasive Lobular Carcinoma (ILC)

Starts in the milk-producing glands (lobules) and spreads to nearby tissue. It is the second most common type.

HER2-Positive Breast Cancer

A subtype where cancer cells have too many copies of the HER2 protein, causing faster growth. Targeted therapies (like trastuzumab/Herceptin) are highly effective for this type.

Triple-Negative Breast Cancer (TNBC)

A subtype that does not respond to hormonal therapy or HER2-targeted drugs. It is more common in younger women and tends to grow faster, but it does respond well to chemotherapy. Immunotherapy is also emerging as an option.

Hormone Receptor-Positive Breast Cancer

The most common subtype overall, where tumour cells respond to the hormones oestrogen and/or progesterone. Hormone therapy is highly effective for this type.

Common Symptoms to Watch For

• A new lump or thickening in the breast or underarm area
• Changes in the size, shape, or appearance of the breast
• Dimpling, puckering, or skin that looks like orange peel on the breast
• A newly inverted (pulled inward) nipple
• Nipple discharge (other than breast milk), especially if bloody
• Redness, soreness, or rash on the skin covering the breast
• Swelling of all or part of the breast, even without a distinct lump

Diagnosis

If symptoms are present or a screening mammogram is abnormal, your doctor may recommend:

• Diagnostic mammogram — A more detailed X-ray of the breast
• Ultrasound — Uses sound waves to determine if a lump is solid or filled with fluid
• MRI (Magnetic Resonance Imaging) — Provides detailed images of breast tissue
• Biopsy — Removal and examination of tissue to confirm cancer. The biopsy also reveals the cancer's receptor status (ER, PR, HER2) which guides treatment.

Staging

Breast cancer is staged from 0 to IV based on tumour size, lymph node involvement, and whether it has spread.

• Stage 0: Ductal Carcinoma In Situ (DCIS) — non-invasive, highly treatable
• Stage I–II: Early-stage, often treated with surgery, possibly followed by radiation and/or systemic therapy
• Stage III: Locally advanced. Multi-modal treatment including chemotherapy, surgery, and radiation
• Stage IV (Metastatic): Has spread to other organs. Treatment focuses on controlling the disease and maintaining quality of life

Treatment Options

Surgery

Options include lumpectomy (removing only the tumour and a small margin) or mastectomy (removing one or both breasts). Sentinel lymph node biopsy checks whether cancer has spread to lymph nodes.

Radiation Therapy

Often used after lumpectomy to reduce the risk of recurrence. It targets any remaining cancer cells in the breast area.

Chemotherapy

May be given before surgery (neoadjuvant) to shrink a tumour, or after surgery (adjuvant) to lower recurrence risk. Also used for metastatic breast cancer to slow progression.

Hormone (Endocrine) Therapy

For hormone receptor-positive cancers, drugs like tamoxifen and aromatase inhibitors block hormones that fuel cancer growth. This is often taken for 5–10 years after primary treatment.

Targeted Therapy

For HER2-positive cancers, drugs like trastuzumab (Herceptin), pertuzumab, and T-DM1 target the HER2 protein. CDK4/6 inhibitors are also highly effective for hormone receptor-positive, metastatic disease.

Immunotherapy

For triple-negative breast cancer, immunotherapy drugs like pembrolizumab (Keytruda) have shown promising results in combination with chemotherapy.

Life After Treatment

Many breast cancer survivors go on to live long, healthy lives. Follow-up care typically includes regular mammograms, check-ups, and in some cases, ongoing hormonal therapy. Psychological support, nutrition guidance, and survivorship programmes are also important parts of recovery.