Breast Cancer

Sometimes when people find out they have breast cancer, they never knew they had a problem until they were diagnosed.

There are a number of symptoms or changes you should look out for, including:

• a new lump or lumpiness in the breast or armpit
• a change in the size or shape of your breast
• a change in the nipple
• discharge from the nipples
• any unusual pain
• a change in the skin of your breast.

Having these symptoms may not mean you have cancer, but it is important to check.

If you find a change in your breast that is new or usual for you, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker. 

The good news is there are things that you can do to find breast cancer early:

1. Get to know the normal look and feel of your breasts.

You don’t need to be an expert or know a special way to check your breasts. You can do this as part of everyday activities such as dressing, looking in the mirror, or showering.

All women should do this regularly; daughters, mothers, sisters, aunties and grandmothers.

2. Breast cancer screening

If breast cancer is found early on, when it’s still small, it’s easier to treat. Finding and treating it early means that up to 9 out of 10 women will survive.

A breast screen is safe, and free.

A BreastScreen Australia test can detect breast cancer before there are any signs, even before you can feel it.  

Women aged 50 to 74 years of age are invited to have a free screening mammogram every 2 years.

If you prefer, your doctor, nurse or health worker can help you to make an appointment at your nearest BreastScreen Australia clinic, or let you know when a mobile clinic is coming to your community.

Or you can call BreastScreen Australia on 13 20 50.

You might have found you have breast cancer through having a breast screen. Or you may have had a symptom and had it checked out. You won’t know if you have breast cancer until your doctor has talked to you, completed a physical examination and carried out some tests. You can request a male or female doctor, nurse or health worker to assist with following Men’s Business and Women’s Business protocols. The tests might include:

• a breast screen (or mammogram), which is a special type of X-ray for the breast
• an ultrasound, which uses soundwaves to build a picture of the inside of the breast
• a biopsy, when a tiny bit is taken from inside your breast with a needle, and this is looked at using a microscope.

Most people who have these tests find out they don’t have breast cancer, but it’s important to check.

There are several types of breast cancer. There are also lots of different words to talk about breast cancer. Here are some of the main ones.

Ductal carcinoma in situ, or DCIS, and lobular carcinoma in situ, or LCIS, are conditions that are not really cancer, but sometimes they can turn into cancer. So if you have DCIS or LCIS, your doctors will want to see you regularly to check how it is going.

Early breast cancer means cancer that is in the breast. It might or might not have gone to the lymph nodes under your arms. If you have early breast cancer, it means there is no sign that it has spread anywhere else in your body.

Locally advanced breast cancer is a cancer that is very big or spread to the nearby areas such as the skin, muscles, ribs or a large number of lymph nodes.

When breast cancer has spread from the breast to other parts of the body (such as the lungs, the bones or the liver) it is known as advanced cancer or metastatic cancer.

With all types of breast cancer, there is plenty of treatment and support that can help you. 

If you have breast cancer, you might be told it’s at a certain stage. This describes whether or not the cancer has spread to other parts of your body, and how far. Knowing the stage of the cancer helps you and your doctors to decide on the best treatment for you.

Stages of breast cancer are numbered from 0 to 4

• Stage 0 refers to pre-invasive breast cancers such as ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS)
• Stage I and some Stage 2 categories refer to early breast cancer
• Stages 3-4 refer to advanced breast cancer (locally advanced breast cancer or metastatic breast cancer).

With all stages of breast cancer, there is plenty of treatment and support that can help you, including traditional medicine and practices like ceremony and being on Country. 

There are many ways to treat breast cancer, depending on the stage of your cancer. The main ones are:

• surgery
• radiotherapy
• chemotherapy
• hormone therapies
• targeted therapies.

If you have breast cancer, you might need one of these, or a combination of them.

Your doctors will yarn with you about what treatments they recommend and what options are best for you.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment you might have and including any traditional healing, bush medicines and cultural practices into your treatment plan.

Surgery

Surgery is a procedure done in hospital to remove the cancer and help to stop it from spreading to other parts of your body.  Surgery involves staying in hospital and having an anaesthetic and an operation to remove the cancer.

Some women just have the lump removed, with a small bit of healthy tissue around it taken too. This is called a lumpectomy, or breast-conserving surgery.

Other women have the whole breast removed, which is called a mastectomy.

Some women also have some of the lymph nodes under their arms taken out.

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker to learn more about your surgery.

Read more about surgery.

Radiotherapy

Radiotherapy (or radiation therapy) uses X-rays to destroy cancer cells in one part of your body.

Most people who have radiotherapy have it 5 days a week for 4-6 weeks, and each session can take 15 minutes. But it might be different for you.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, assistance with travel and accommodation is available for you and your family if you need to travel away from home for treatment.

Yarn with your doctor, nurse or  Aboriginal and/or Torres Strait Islander health worker.

Read more about radiotherapy.

Chemotherapy

Many people have chemotherapy or “chemo” in cycles – such as once every 2-3 weeks or once a week. Some people have chemotherapy tablets at home, but most need to go to a hospital or clinic. But you usually don’t need to stay in hospital for chemo.

Most chemo comes as injections into your arm or hand that drip in over a few hours and some need you to take home a small bottle home for two days then come back to take it off again. Some chemo comes as tablets. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo can make people feel sick for a while, but there are things they can take and do to help. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker. Mob who have had chemo before say that being on Country, traditional healing and bush medicines, Women’s Business and Men’s Business as well as cultural practices can help with relieving symptoms from treatment.

Read more about chemotherapy and side effects.

Hormone therapy

Some women have a type of breast cancer that thrives on the hormones in your body. If you have this type of cancer, then your doctor might suggest drugs to affect your body’s hormones. It can slow, and maybe stop, the growth of the cancer.

Hormone therapy usually means that you take tablets every day for months or years. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Read more about hormone therapy.

Targeted therapies

Targeted therapies are newer drugs that try to stop the cancer growing.

Targeted therapy is usually used in combination with other treatments, such as radiation therapy, chemotherapy or surgery. If your doctor thinks they might help, click here for some questions to ask.

Read more about targeted therapy.

It is important for you to understand why you are getting the treatment your doctor recommends and how it is supposed to help you.  Different treatments try to do different things. It depends on what cancer you have, and whether it has spread, and what you want. Ask your doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it spreading, or
• won’t cure you, but is meant to prolong your life, or make you feel better.

Your doctors will yarn with you and explain this. You can yarn with them and tell them what you think, and what you want. Some people will want to try everything possible to stay alive. Others want simpler treatments, or don’t want to leave Country for treatment, or don’t want any treatment. It’s your choice. You can also talk to another doctor to help you decide.

It can take time to decide about treatment. There are usually some options to hear about and choices to make.

It can be helpful to write things down and have someone else come to appointments to help remember information.

Yarn with your doctor, specialist, nurse or Aboriginal and/or Torres Strait Islander health worker. Our mob who have had cancer also recommend yarning with trusted family, friends and Elders to help make decisions.

Read more about treatment.

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Learn more about financial support.

It all depends on the type of treatment you’re having. Some women only have surgery alone, whereas some others can have treatments such as hormone therapy for more than a year. It is different for everyone. Each treatment plan is created uniquely for that person.

After treatment is finished, your doctors will keep in touch with you to check how you’re going. Your cancer journey gives you an opportunity to build trust and safe relationships with your doctors and medical team that may last for many years.

It is not possible to say what causes breast cancer in a single person. We do know there are some features that are more common in people who develop breast cancer. These features are called ”risk factors”.

But it is usually hard to be sure whether a risk factor contributed to the development of the cancer. And having one or more risk factors for breast cancer does not mean that someone will develop this cancer. In fact, many people with breast cancer have no obvious risk factors.

Some factors can even lower your risk of developing breast cancer.

Risk factors for breast cancer you can change:

• being overweight
• lack of exercise and not being physically active
• drinking alcohol

Risk factors for breast cancer you can’t change:

• getting older – your risk increases with age
• being a woman
• having a family history of breast or ovarian cancer
• inheriting a gene fault , such as BRCA1, BRCA2 and CHEK2, from either parent
• taking the ‘pill’ (oral contraceptive pill)
• taking HRT (hormone replacement therapy)
• starting periods early or going through menopause late
• having breast cancer in the past
• having non-cancerous (benign) breast conditions in the past.

If you have any of these risk factors or you’re worried about your risk for breast cancer, yarn with your doctor, nurse, Aboriginal and/or Torres Strait Islander health worker.

Clinical trials might be an option for you. Talk to your doctor to help you decide if taking part is a good option. Read more about clinical trials.

Read more detail on breast cancer here.