Signs and symptoms of breast cancer may include a lump in the breast or eczema at the nipple. In symptomatic patients, mammography or breast ultrasound can show a suspicious lump. Breast cancer may also be detected by mammography screening.
A definite diagnosis is made when malignant epithelial cells are found. The most common histologic types are infiltrating ductal, infiltrating lobular and mixed ductal / lobular carcinomas.
To detect breast cancer at an early stage, all Dutch women aged between 50 and 75 years receive an invitation to participate in a mammography screening every two years.
Breast cancer in men occurs very rarely. Factors that are associated with an increased risk of breast cancer – besides female sex – are increasing age, a family history of breast cancer, alcohol consumption, smoking, and having had oestrogen and progesterone circulating for a long time. Examples of long hormonal exposure are early menarche (having your first menstrual period at a young age), late menopause, nulligravidity (never having been pregnant), giving birth for the first time at an older age and using postmenopausal hormone therapy. Breastfeeding and physical activity reduce the risk of breast cancer.
Most women (around 98%) will survive breast cancer for five years or more after diagnosis. Treatment occurs in secondary or tertiary care and depends on the stage of breast cancer at presentation. Specialist treatment may involve surgery, radiation therapy and medical oncology (e.g. chemotherapy, hormonal treatment, immunotherapy).
In the text below, we will focus only on female breast cancer.