[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Breast cancer [Conditions](https://durgical.com/en/conditions/) · [thorax_f](https://durgical.com/en/conditions/) # Breast cancer Breast cancer is a malignant tumour that starts in the milk ducts or lobules of the breast; it is the most common cancer in women. Updated 2026-10-30 ## Structures involved Tap one to see what it is and open it in 3D. - [Mammary gland lobes](https://durgical.com/en/anatomy/mammary-gland/) - [Lactiferous ducts](https://durgical.com/en/anatomy/lactiferous-ducts/) - [Breast fat](https://durgical.com/en/anatomy/body-of-breast/) - [Nipple](https://durgical.com/en/anatomy/nipple/) - [Suspensory ligaments of breast](https://durgical.com/en/anatomy/suspensory-ligaments-of-breast/) - [Parasternal lymph nodes](https://durgical.com/en/anatomy/parasternal-nodes/) - [Pectoralis major](https://durgical.com/en/anatomy/pectoralis-major-muscle/) - [Retromammary space](https://durgical.com/en/anatomy/pectoral-fascia/) ## In biochemistry - [Receptor tyrosine kinases](https://durgical.com/en/biochemistry/topics/receptor-tyrosine-kinases/) - [Nuclear receptors](https://durgical.com/en/biochemistry/topics/nuclear-receptors/) - [mTOR (mechanistic target of rapamycin)](https://durgical.com/en/biochemistry/enzymes/mtor/) - [Aromatase (CYP19A1)](https://durgical.com/en/biochemistry/enzymes/aromatase/) - [FISH (fluorescence in situ hybridization)](https://durgical.com/en/biochemistry/topics/fish/) - [Drugs acting on nucleotide metabolism](https://durgical.com/en/biochemistry/topics/drugs-acting-on-nucleotide-metabolism/) - [Thymidylate synthase](https://durgical.com/en/biochemistry/enzymes/thymidylate-synthase/) - [Oncogenes and tumour suppressor genes](https://durgical.com/en/biochemistry/topics/oncogenes-and-tumour-suppressor-genes/) ## In immunology - [Lymph node: cortex, paracortex, medulla](https://durgical.com/en/immunology/lymph-node-cortex-paracortex-medulla/) ## In histology - [Lymphatic vessels](https://durgical.com/en/histology/lymphatic-vessels/) - [Breast: ducts, lobules and changes with life stage](https://durgical.com/en/histology/breast-ducts-lobules-and-changes-with-life-stage/) - [Microscopy and stains: H&E, PAS, trichrome, silver, immunohistochemistry](https://durgical.com/en/histology/microscopy-and-stains-h-y-e-pas-trichrome-silver-immunohistochemistry/) - [From biopsy to slide: fixation, sectioning, frozen section](https://durgical.com/en/histology/from-biopsy-to-slide-fixation-sectioning-frozen-section/) - [Cell junctions: tight, adherens, desmosomes, gap, hemidesmosomes](https://durgical.com/en/histology/cell-junctions-tight-adherens-desmosomes-gap-hemidesmosomes/) ## In the clinical exam - [Lymph node examination](https://durgical.com/en/clinical-exam/lymph-node-examination/) - [Clinical breast examination](https://durgical.com/en/clinical-exam/clinical-breast-examination/) ## In physiology - [Actions of estrogen and progesterone](https://durgical.com/en/physiology/actions-of-estrogen-and-progesterone/) ## Why it happens - [Hereditary cancer syndromes: the table to know](https://durgical.com/en/general-pathology/hereditary-cancer-syndromes-the-table-to-know/) - [Tumour suppressor genes: RB, TP53, APC, BRCA and the two-hit hypothesis](https://durgical.com/en/general-pathology/tumour-suppressor-genes-rb-tp53-apc-brca-and-the-two-hit-hypothesis/) - [Biopsy: excisional, incisional, core needle, punch and fine-needle aspiration](https://durgical.com/en/general-pathology/biopsy-excisional-incisional-core-needle-punch-and-fine-needle-aspiration/) - [From specimen to report: fixation, margins and the pathology report](https://durgical.com/en/general-pathology/from-specimen-to-report-fixation-margins-and-the-pathology-report/) - [Invasion and metastasis: the metastatic cascade, step by step](https://durgical.com/en/general-pathology/invasion-and-metastasis-the-metastatic-cascade-step-by-step/) - [The cell cycle in cancer: cyclins, CDKs and checkpoints](https://durgical.com/en/general-pathology/the-cell-cycle-in-cancer-cyclins-cdks-and-checkpoints/) ## Show 17 more - [Grading and staging: what TNM means](https://durgical.com/en/general-pathology/grading-and-staging-what-tnm-means/) - [Immunohistochemistry: the principle and the markers to know](https://durgical.com/en/general-pathology/immunohistochemistry-the-principle-and-the-markers-to-know/) - [Oncogenes: RAS, MYC, HER2, BCR-ABL and the table to know](https://durgical.com/en/general-pathology/oncogenes-ras-myc-her2-bcr-abl-and-the-table-to-know/) - [Molecular pathology: PCR, FISH, sequencing and liquid biopsy](https://durgical.com/en/general-pathology/molecular-pathology-pcr-fish-sequencing-and-liquid-biopsy/) - [The hallmarks of cancer](https://durgical.com/en/general-pathology/the-hallmarks-of-cancer/) - [Cancer epidemiology: age, environment, predisposing conditions (and Colombia)](https://durgical.com/en/general-pathology/cancer-epidemiology-age-environment-predisposing-conditions/) - [Frozen section: the intraoperative consultation](https://durgical.com/en/general-pathology/frozen-section-the-intraoperative-consultation/) - [Ionizing radiation injury](https://durgical.com/en/general-pathology/ionizing-radiation-injury/) - [Pathways of spread and the usual metastatic sites](https://durgical.com/en/general-pathology/pathways-of-spread-and-the-usual-metastatic-sites/) - [Translocations, amplifications and epigenetic changes in cancer](https://durgical.com/en/general-pathology/translocations-amplifications-and-epigenetic-changes-in-cancer/) - [Dysplasia and carcinoma in situ](https://durgical.com/en/general-pathology/dysplasia-and-carcinoma-in-situ/) - [Sex chromosome disorders: Klinefelter and Turner](https://durgical.com/en/general-pathology/sex-chromosome-disorders-klinefelter-and-turner/) - [Cytology: the Pap test, fine-needle aspiration and body fluids](https://durgical.com/en/general-pathology/cytology-the-pap-test-fine-needle-aspiration-and-body-fluids/) - [Genomic instability: mismatch repair, BRCA and xeroderma pigmentosum](https://durgical.com/en/general-pathology/genomic-instability-mismatch-repair-brca-and-xeroderma-pigmentosum/) - [Radiation and cancer: ultraviolet and ionizing](https://durgical.com/en/general-pathology/radiation-and-cancer-ultraviolet-and-ionizing/) - [Benign vs malignant tumours: the comparison table](https://durgical.com/en/general-pathology/benign-vs-malignant-tumours-the-comparison-table/) - [Tumour markers: serum and tissue, and what each one is for](https://durgical.com/en/general-pathology/tumour-markers-serum-and-tissue-and-what-each-one-is-for/) ## What it is Malignant tumour arising from the epithelial cells of the breast's ducts or lobules. It is the most common cancer in women; it also occurs, rarely, in men. ## Who gets it The most frequent cancer and a leading cause of cancer death in women in Colombia and Latin America; incidence rises with age. In a meta-analysis of 63 studies (221,255 women diagnosed 1966–2017), 40.8% of cases in Latin America and the Caribbean were found at stage III–IV. About 1% of cases occur in men. ## Causes - Accumulated genetic and epigenetic changes in ductal or lobular cells - Hormonal stimulation (oestrogen and progesterone) of breast tissue - Inherited mutations (e.g. BRCA1, BRCA2) in a minority of cases ## Risk factors - Female sex and older age - Family history or inherited mutations (BRCA1/2) - Early menarche, late menopause, no pregnancies or first pregnancy after 30 - Menopausal hormone therapy - Obesity after menopause, alcohol and physical inactivity - Previous [chest](https://durgical.com/en/anatomy/region/chest/) radiation or atypical hyperplasia ## Pathophysiology Breast cancer usually begins in the terminal duct–lobular unit. Carcinoma in situ stays within the basement membrane; invasive carcinoma breaks through it and can spread by lymphatics to the axillary and internal mammary (parasternal) nodes and by blood to bone, lung, [liver](https://durgical.com/en/anatomy/liver/) and brain. Hormone receptor and HER2 status define biological subtypes that guide treatment. ## Classification - In situ (ductal, DCIS) vs invasive (ductal/no special type, lobular) - Molecular subtypes: luminal A and B (hormone receptor positive), HER2-positive, triple negative - TNM staging (0–IV) ## Symptoms and signs - Painless, hard, irregular lump - [Skin](https://durgical.com/en/anatomy/skin/) dimpling or retraction (Cooper ligament involvement) - [Nipple](https://durgical.com/en/anatomy/nipple/) retraction or bloody discharge - Peau d'orange skin or redness (inflammatory breast cancer) - Axillary lump - Often no symptoms when found on screening ## Red flags - New hard, fixed breast lump - Skin changes: dimpling, peau d'orange, ulceration - Bloody nipple discharge or new nipple retraction - Breast lump in a man - Bone pain, breathlessness or neurological symptoms in a known case (metastases) ## Diagnosis **Clinical** Triple assessment: clinical examination, imaging and tissue biopsy. History includes family history and hormonal factors. **Tests** Core needle biopsy with histology and receptor status: oestrogen receptor (ER), progesterone receptor (PR) and HER2. Genetic counselling and testing in selected patients; staging bloods. **Imaging** Mammography (and ultrasound, especially in young women or dense breasts); MRI in selected cases. Staging with CT and bone scan in advanced disease. Screening mammography starts at ages that vary between guidelines. ## Differential diagnosis - Fibroadenoma - Breast cyst - Fibrocystic breast changes - Fat necrosis - Breast abscess or mastitis - Phyllodes tumour ## Goal of treatment Remove the tumour with clear margins, stage and treat the axilla, lower the risk of recurrence with systemic therapy chosen by subtype, and preserve quality of life and body image. ## Treatment **Surgical** Breast-conserving surgery (followed by radiotherapy) or mastectomy, with breast reconstruction when appropriate. **Surgical** Axillary staging with sentinel lymph node biopsy; axillary dissection when nodes are involved, per guidelines. **Medical** Endocrine therapy for hormone-receptor–positive tumours (selective oestrogen receptor modulators, aromatase inhibitors). **Medical** Chemotherapy and HER2-targeted antibodies by subtype and stage, before (neoadjuvant) or after surgery. **Procedure** Radiotherapy after breast-conserving surgery and in selected cases after mastectomy. **Follow-up** Multidisciplinary follow-up with clinical review and annual mammography, plus survivorship and psychological support. ## Drugs for this condition - [Methotrexate](https://durgical.com/en/pharmacology/methotrexate/) - [Fluorouracil](https://durgical.com/en/pharmacology/fluorouracil/) - [Anastrozole](https://durgical.com/en/pharmacology/anastrozole/) - [Letrozole](https://durgical.com/en/pharmacology/letrozole/) - [Tamoxifen](https://durgical.com/en/pharmacology/tamoxifen/) - [Raloxifene](https://durgical.com/en/pharmacology/raloxifene/) - [Exemestane](https://durgical.com/en/pharmacology/exemestane/) - [Goserelin](https://durgical.com/en/pharmacology/goserelin/) - [Everolimus](https://durgical.com/en/pharmacology/everolimus/) - [Doxorubicin](https://durgical.com/en/pharmacology/doxorubicin/) - [Epirubicin](https://durgical.com/en/pharmacology/epirubicin/) - [Paclitaxel](https://durgical.com/en/pharmacology/paclitaxel/) - [Docetaxel](https://durgical.com/en/pharmacology/docetaxel/) - [Vinblastine](https://durgical.com/en/pharmacology/vinblastine/) - [Dexrazoxane](https://durgical.com/en/pharmacology/dexrazoxane/) ## Complications - Local recurrence - Metastases to bone, lung, liver and brain - Lymphoedema of the arm after axillary treatment - Treatment effects: cardiotoxicity, bone loss, early menopause - Psychological impact ## Prognosis Early-stage, hormone-receptor–positive disease has a very good prognosis. Outlook depends on stage, nodal status, grade and subtype; triple-negative and late-diagnosed disease do worse. ## Prevention - Screening mammography in eligible women per national guidelines - Healthy weight, physical activity and limited alcohol - Breastfeeding - Genetic counselling and risk-reducing options for high-risk carriers ## Test yourself Think of the answer, then tap the question to see it. ## What is the triple assessment of a breast lump? Clinical examination, imaging (mammography and/or ultrasound) and tissue biopsy, usually core needle biopsy. ## Which three receptors are tested in breast cancer and why? Oestrogen receptor, progesterone receptor and HER2; they define subtype, prognosis and eligibility for endocrine or HER2-targeted therapy. ## Which lymph nodes receive most of the breast's lymphatic drainage? The axillary nodes; medial parts of the breast also drain to the internal mammary (parasternal) nodes. ## What causes skin dimpling over a breast cancer? Tumour infiltration and shortening of the suspensory (Cooper) ligaments, which pulls the skin inwards. ## Can men develop breast cancer? Yes. It is rare (about 1% of cases), often presents as a lump behind the nipple, and is linked to BRCA2 mutations and high oestrogen states. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/conditions/breast-cancer/) ## Related conditions - [Breast fibroadenoma](https://durgical.com/en/conditions/breast-fibroadenoma/) - [Obesity](https://durgical.com/en/conditions/obesity/) - [Fibrocystic breast changes](https://durgical.com/en/conditions/fibrocystic-breast-changes/) - [Breast abscess](https://durgical.com/en/conditions/breast-abscess/) - [Ovarian cancer](https://durgical.com/en/conditions/ovarian-cancer/) - [Gynaecomastia](https://durgical.com/en/conditions/gynaecomastia/) - [Acute mastitis](https://durgical.com/en/conditions/acute-mastitis/) Educational information, not medical advice. For any symptom, see a health professional. Sources: [Breast Cancer](https://www.ncbi.nlm.nih.gov/books/NBK482286/) (StatPearls (NCBI Bookshelf), 2024); [Stage at diagnosis and stage-specific survival of breast cancer in Latin America and the Caribbean: A systematic review and meta-analysis](https://europepmc.org/article/PMC/PMC6799865) (PloS one, 2019) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/). [← All conditions](https://durgical.com/en/conditions/) ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/conditions/breast-cancer/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/breast-cancer/