Breast Cancer

Stage 3 tumours: these are larger than five centimetres and may be attached to surrounding structures such as the muscle or skin. The lymph glands are usually affected, but there are no signs that the cancer has spread beyond the breast or the lymph glands in the armpit.

Stage 4 tumours: these are of any size, but the lymph glands are usually affected and the cancer has spread to other parts of the body. This is secondary breast cancer.

Grading of breast cancer
Grading refers to the appearance of the cancer cells under the microscope. The grade gives an idea of how quickly the cancer may develop. There are three grades:

• grade 1 (low grade),
• grade 2 (moderate grade) and
• grade 3 (high grade).

Treatment of breast cancer
The mainstay of treatment for breast cancer is surgery. The type of surgery you will receive will depend upon many considerations, including your own preferences. The most common for invasive cancer are lumpectomy with axillary lymph node dissection and modified radical mastectomy.

Types of surgery include:

• Lumpectomy is known as a breast-conserving surgery, and it has become more common in the last 10 years as a means of treating early-stage cancer. In this procedure, a surgeon removes just the tumour along with a margin of healthy tissue, leaving the remainder of the breast intact. An axillary lymph node dissection should be performed for invasive forms of the disease. Radiotherapy is almost always given following lumpectomy for an invasive cancer.
• Simple mastectomy - this is where the entire breast is removed
• Modified radical mastectomy - the most common breast cancer surgery whereby the entire breast is removed along with the underarm lymph nodes
• Radical mastectomy - once the only surgical procedure for breast cancer, this extremely invasive surgery is rarely performed today
• Reconstruction - this is often an option after a mastectomy, either immediately or at some later date, but in some cases immediate reconstruction during the same operation as the mastectomy is appropriate