A breast cancer diagnosis is one of the most confronting things a person can face. It can bring an immediate flood of fear, uncertainty, and questions. At Breast & Surgical Oncology at The Poche Centre, we understand what this moment feels like — and our role is to be with you from that point forward, providing expert guidance, honest answers, and a clear, personalised treatment plan every step of the way.

Breast cancer is the most commonly diagnosed cancer in Australian women. But it is also one of the most treatable, particularly when detected early. Outcomes have improved dramatically over the past two decades, driven by advances in surgical technique, imaging, genomic testing, and systemic therapies. With the right specialist team and the right treatment, most people with breast cancer go on to live full and healthy lives.

What Is Breast Cancer?

Breast cancer occurs when cells in the breast tissue grow and divide in an uncontrolled way, forming a mass of abnormal cells known as a tumour. The breast is made up of lobules (milk-producing glands), ducts (which carry milk to the nipple), and surrounding fatty and connective tissue. Breast cancer can arise in any of these structures, though the majority begin in the cells lining the ducts (ductal cancers) or the lobules (lobular cancers).

The lymphatic system also plays an important role in breast cancer. The lymph nodes — small glands found primarily under the arm (the axilla) — drain fluid from the breast and can be an early site to which breast cancer spreads. Assessing the lymph nodes is an important part of staging and treatment planning.

How Common Is Breast Cancer in Australia?

Breast cancer is the most commonly diagnosed cancer among Australian women, and the second most common cause of cancer-related death in women. Approximately one in seven Australian women will be diagnosed with breast cancer during their lifetime. In 2024, it is estimated that around 21,000 Australians will be diagnosed with breast cancer — including a small number of men.

Despite these numbers, survival rates have improved significantly. The five-year survival rate for breast cancer in Australia is now over 91%, reflecting the impact of earlier detection, better diagnostics, and more effective treatments.

Types of Breast Cancer

Breast cancer is not a single disease — it encompasses many different types with varying behaviour, prognosis, and treatment implications. Understanding what type of breast cancer you have is one of the first and most important steps after diagnosis.

Ductal carcinoma in situ (DCIS) is a non-invasive or pre-invasive cancer in which abnormal cells are found within the milk ducts but have not spread into the surrounding breast tissue. DCIS is highly treatable, though its management requires careful consideration as not all DCIS will progress to invasive cancer.

Invasive ductal carcinoma (IDC) is the most common type of breast cancer, accounting for around 80% of all cases. Cancer cells originate in the ducts and have broken through into the surrounding breast tissue. IDC can spread to the lymph nodes and other parts of the body if untreated.

Invasive lobular carcinoma (ILC) begins in the milk-producing lobules of the breast. It is the second most common type. ILC can be harder to detect on mammogram than IDC and sometimes requires MRI for full assessment.

Inflammatory breast cancer is a rare but aggressive form of breast cancer in which cancer cells block the lymphatic vessels in the skin of the breast, causing the breast to appear red, swollen, and warm — often without a distinct lump. It requires urgent assessment and treatment.

HER2-positive breast cancer is a subtype in which the tumour produces an excess of the HER2 protein, which drives cancer cell growth. HER2-positive cancers tend to be more aggressive but respond well to targeted therapies such as trastuzumab (Herceptin) that specifically block the HER2 receptor.

Triple-negative breast cancer (TNBC) lacks the three most common receptors (oestrogen, progesterone, and HER2) that drive most breast cancers, meaning it does not respond to hormonal therapies or HER2-targeted treatments. TNBC is typically managed with chemotherapy and, increasingly, immunotherapy.

Hormone receptor-positive breast cancer is the most common molecular subtype, in which cancer cells are fuelled by oestrogen and/or progesterone. These cancers respond to hormonal (endocrine) therapies and generally have a favourable prognosis.

Symptoms of Breast Cancer

Breast cancer does not always cause symptoms — particularly in its early stages, which is why routine screening is so important. When symptoms do occur, they can include:

• A new lump or thickening in the breast or underarm — often painless, hard, and with irregular edges, though not always
• A change in the size, shape, or contour of the breast
• Skin changes — dimpling, puckering, or an "orange peel" texture (peau d'orange)
• Redness, warmth, or persistent swelling of the breast
• Nipple inversion — a nipple that has recently turned inward
• Nipple discharge, particularly if bloodstained or from one side only
• Scaly, flaking, or crusted skin on the nipple or areola
• Swelling or lumps in the armpit

It is important to know that many of these symptoms have benign explanations. However, any new or unexplained change in your breast should always be assessed promptly by a doctor. Do not wait to see if it resolves.

Risk Factors for Breast Cancer

Most breast cancers arise without a clear identifiable cause. However, a number of factors are known to increase a person's risk:

Age — the risk of breast cancer increases significantly with age. The majority of breast cancers are diagnosed in women over 50, though it can occur at any age.

Being female — while men can develop breast cancer, women are around 100 times more likely to be diagnosed.

Family history and genetics — having a first-degree relative (mother, sister, or daughter) with breast cancer increases your risk. Inherited mutations in the BRCA1 and BRCA2 genes significantly elevate lifetime risk, as do mutations in other genes such as PALB2, CHEK2, and ATM. If you have a significant family history, genetic counselling and testing may be recommended.

Dense breast tissue — women with dense breasts have a higher risk of breast cancer and may also find that cancers are harder to detect on mammogram.

Hormonal factors — early menstruation (before age 12), late menopause (after age 55), never having been pregnant, and having a first pregnancy after age 30 all increase lifetime oestrogen exposure and are associated with modestly elevated risk.

Hormonal medications — prolonged use of combined menopause hormone therapy (MHT or HRT) and, to a lesser extent, the oral contraceptive pill, is associated with a small increase in breast cancer risk.

Lifestyle factors — alcohol consumption, being overweight or obese (particularly after menopause), physical inactivity, and smoking are all modifiable risk factors associated with increased breast cancer risk.

Previous breast conditions — certain high-risk lesions such as atypical ductal hyperplasia (ADH) or lobular carcinoma in situ (LCIS) are associated with an increased future risk of breast cancer.

Prior Mantle Radiotherapy — Mantle radiotherapy to treat lymphoma, which is less common these days, is associated with an increased risk of breast cancer.

Not having any of these risk factors does not mean you are immune to breast cancer, and having several risk factors does not mean you will develop it. Risk assessment is nuanced and best discussed with a specialist.

How Is Breast Cancer Diagnosed?

Breast cancer is most commonly detected in one of two ways: through routine screening (a mammogram in an asymptomatic woman) or through the investigation of a new symptom.

Diagnosis follows the triple assessment process — the gold standard in breast cancer investigation:

Clinical examination — a specialist performs a thorough examination of both breasts and the regional lymph nodes, taking a detailed history of symptoms, risk factors, and family history.

Imaging — a mammogram, ultrasound, or both are performed to characterise the area of concern. MRI may be recommended in specific situations, such as in younger women with dense breast tissue, to assess the extent of disease, or to evaluate the opposite breast.

Biopsy — a core biopsy, performed under local anaesthetic using ultrasound or mammographic guidance, removes a small sample of tissue for pathological analysis. This provides a definitive tissue diagnosis and, critically, determines the receptor status (oestrogen, progesterone, HER2) of the cancer — information that is essential for planning treatment.

If a breast cancer diagnosis is confirmed, staging investigations — typically a CT scan and bone scan, and sometimes a PET scan — are arranged if there is known lymph node involvement to determine whether the cancer has spread beyond the breast and lymph nodes. Staging guides treatment planning and provides important prognostic information.

Treating Breast Cancer

Breast cancer treatment is highly individualised. There is no single approach that is right for every person — your treatment plan will be determined by the type, stage, and molecular characteristics of your cancer, as well as your overall health, preferences, and personal circumstances.

At Breast & Surgical Oncology at The Poche Centre, every patient is discussed at a multidisciplinary team (MDT) meeting attended by breast surgeons, medical oncologists, radiation oncologists, radiologists, pathologists, and breast care nurses. This ensures that every treatment decision is informed by the combined expertise of the full team.

Surgery is typically the cornerstone of breast cancer treatment and may involve breast-conserving surgery (lumpectomy or wide local excision), which removes the tumour and a surrounding margin of healthy tissue while preserving the breast, or mastectomy, which removes the entire breast. Axillary surgery — to assess and manage the lymph nodes under the arm, including sentinel lymph node biopsy — is performed alongside breast surgery in most cases. Breast reconstruction, either immediate or delayed, is available for women undergoing mastectomy. Our surgeons are highly experienced in oncoplastic techniques that combine cancer surgery with aesthetic outcomes.

Radiation therapy (radiotherapy) uses targeted high-energy X-rays to destroy any remaining cancer cells after surgery, reducing the risk of local recurrence. It is most commonly recommended after breast-conserving surgery and in certain cases following mastectomy.

Chemotherapy uses medicines administered through the bloodstream to destroy cancer cells throughout the body. It may be given before surgery (neoadjuvant chemotherapy) to shrink the tumour, or after surgery (adjuvant chemotherapy) to reduce the risk of the cancer returning. The need for chemotherapy is now increasingly guided by genomic testing — molecular tests performed on the tumour biopsy that assess the biological behaviour of the cancer and can indicate whether chemotherapy is likely to provide meaningful benefit.

Hormonal (endocrine) therapy is used for hormone receptor-positive breast cancers and works by reducing oestrogen levels in the body or blocking oestrogen from stimulating cancer cell growth. Medications include tamoxifen, aromatase inhibitors, and ovarian suppression. Endocrine therapy is typically taken for 5 to 10 years after primary treatment.

Targeted therapy is used for HER2-positive breast cancers. Drugs such as trastuzumab (Herceptin) and pertuzumab specifically target the HER2 protein on cancer cells, blocking its ability to drive tumour growth. These therapies have significantly improved outcomes for HER2-positive breast cancer over the past two decades.

Immunotherapy is increasingly being used, particularly for triple-negative breast cancer, to help the immune system recognise and destroy cancer cells.

Genomic Testing — Personalising Your Treatment

One of the most significant advances in breast cancer care in recent years is the use of genomic testing — molecular profiling of the tumour tissue that provides information about the cancer's biological behaviour beyond what traditional pathology can tell us. This is different to genetic testing which refers to a blood test that can identify if you carry a high risk gene for breast cancer.

Tests such as Oncotype DX and Prosigna can predict the likelihood of recurrence and help determine whether chemotherapy is likely to provide meaningful benefit for a particular patient. This means some patients who might previously have received chemotherapy can now safely avoid it — and others can be better targeted for treatment that will genuinely help them.

Our team incorporates genomic testing into treatment planning where appropriate, ensuring every patient receives the most personalised, evidence-based care.

Your Care at Breast & Surgical Oncology at The Poche Centre

Receiving a breast cancer diagnosis is life-changing. Our team is here not just to treat your cancer — but to support you through the entire experience, from your first appointment through surgery, treatment, and beyond.

We offer prompt appointments for anyone with a new breast cancer diagnosis or urgent concern. Our multidisciplinary team, our research expertise, and our commitment to patient-centred care mean that every person who comes to us receives the very best that modern breast cancer medicine has to offer.