Questions people ask us.

Breast cancer starts in the breast as a malignant tumour — a mass of cells that grows out of control. The breast is made up of lobules, which produce milk, and ducts, which carry it to the nipple, and most breast cancers start in one of these. It mainly affects women, but a small number of men develop it too. If a cancer spreads from the breast to other parts of the body, that is called metastasis.

Breast cancers are broadly invasive or non-invasive (also called in situ). Invasive cancer is described as early, locally advanced or metastatic, depending on how far it has spread; the common non-invasive types are ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). Paget's disease of the nipple and inflammatory breast cancer are two rarer forms.

Having one or more of these does not mean you will get breast cancer — and many people who are diagnosed have none of them. Factors that raise the risk include:

• being female
• increasing age
• a personal history of breast cancer, or of LCIS or atypical hyperplasia found on a biopsy
• a family history of breast cancer in your mother, sister or daughter, particularly at a young age — though most people diagnosed have no family history at all
• an inherited gene mutation that increases breast cancer risk
• starting your periods before the age of 12
• reaching menopause at an older age
• radiation to the chest at a young age
• drinking alcohol
• combined oestrogen–progesterone hormone therapy after menopause
• having your first child after the age of 30
• never having been pregnant

It is the most common cancer among women, both worldwide and in India. That is exactly why knowing the signs, and acting on them, matters.

• A lump in the breast or the armpit
• Asymmetry of the breast or the nipple that is new
• Skin dimpling, an ulcer, redness or thickening
• Nipple discharge that is not milk, especially if it is blood-stained
• Nipple inversion, retraction, scaling or ulceration
• An abnormal screening mammogram
• In some cases, pain, appetite loss, weight loss or generalised weakness

Examine yourself once a month, a few days after your period.

Look. Stand in front of a mirror and inspect both breasts three times: with your arms at your sides, then above your head, then pressed firmly against your hips. You are looking for a change in shape, in the skin, or in the nipple.

Feel. Palpate systematically with the flat of your fingers, rather than the tips, using the opposite hand — right hand for the left breast, left hand for the right. Do this standing, then lying down, covering the whole breast and up into the armpit each time.

Check. Finish by checking for nipple discharge.

No. Breast pain — mastalgia — is common and is usually a sign of a benign, non-cancerous condition. But because most malignant lumps are painless, do not wait for pain before getting a lump or a change checked.

If a routine screening mammogram has reported a suspicious finding, see a breast specialist rather than waiting for your next routine check.

We use a mammogram (including 3D tomosynthesis), ultrasound or MRI to look at the breast, but only a biopsy can make the diagnosis certain. Read about how this comes together in one visit at our One Stop Breast Clinic.

Treatment is decided by the type of cancer, its stage, receptor status (hormone receptors and HER2), where it is in the breast, any earlier treatment, your age and general health, and your own preference. Read more about how these come together on the multimodality treatment page.

Not necessarily. Breast-conserving surgery — removing the tumour and some surrounding tissue, usually followed by radiotherapy — is often possible when the tumour is not too large. A mastectomy is used when a tumour is large or centrally placed, and reconstruction can be done at the same time or later. A sentinel lymph node biopsy checks the first draining lymph nodes, so the rest can often be left alone. Read more on our surgical expertise page.

Radiotherapy uses high-energy beams to kill any cancer cells left behind, usually after breast-conserving surgery. Hormone treatments — aromatase inhibitors, oestrogen blockers, GnRH analogues, or ovarian suppression — reduce the hormones that can drive some breast cancers. Chemotherapy may be given before surgery to shrink a tumour, or after surgery to reduce the chance of it returning. Targeted therapy uses drugs aimed at specific features of the cancer cells, for particular cancer subtypes.