Finding it early
Most breast cancers are found as a painless lump. Other warning signs are skin dimpling, nipple inversion or discharge, and persistent redness or thickening. Any new breast lump deserves a triple assessment: examination, imaging (mammogram and/or ultrasound), and a needle biopsy.
- A new lump in the breast or armpit — painful or not
- Skin dimpling, puckering or orange-peel texture
- New nipple inversion or blood-stained discharge
- Persistent redness or thickening of breast skin
Diagnosis and treatment planning
Core needle biopsy confirms the diagnosis and the tumour's biology — hormone receptors and HER2 status drive the whole plan. Treatment may start with surgery or with chemotherapy, depending on stage and subtype; this is decided in a multidisciplinary tumour board.
Surgery: conserving the breast when safe
Breast-conserving surgery removes the tumour with a margin of healthy tissue, using oncoplastic techniques to reshape the breast in the same operation. Sentinel lymph node biopsy checks the armpit with removal of only the first draining nodes. When mastectomy is the safer choice, immediate reconstruction with implant or the patient's own tissue can be performed in the same sitting.
- Breast conservation wherever oncologically safe
- Sentinel node biopsy — less arm swelling, accurate staging
- Oncoplastic reshaping and immediate reconstruction
- Genetic counselling for hereditary breast cancer risk
Recovery and beyond
Breast conservation is often day-care or an overnight stay; mastectomy with reconstruction takes a little longer. Radiotherapy usually follows conservation. Survivorship care covers hormone therapy adherence, arm exercises, and regular clinical and imaging follow-up.
Common questions
- Does a breast lump mean cancer?
- Most breast lumps are benign — cysts and fibroadenomas are common. But no lump should be dismissed without assessment, especially if new, hard, or fixed.
- Is mastectomy safer than breast conservation?
- For suitable candidates, conservation plus radiotherapy gives the same survival as mastectomy. The choice is about tumour size relative to the breast, multiplicity, and personal preference — not safety.
- What is a sentinel node biopsy?
- Dye and a radioactive tracer identify the first lymph nodes draining the tumour. Only these are removed; if clear, the remaining armpit nodes are left alone, greatly reducing the risk of arm lymphoedema.
This page is general education, reviewed by Dr. Ishaan Allahabadi, MCh Surgical Oncology (Edge Hill, UK) · MS Surgery · MBBS (Accredited by the Royal College of Surgeons of England). It is not a substitute for individual medical advice. Treatment decisions are made after reviewing your imaging and pathology, in a multidisciplinary tumour board.