What is breast cancer?

People tend to think a sign of breast cancer is a lump in your breast, and it can be. But there are other things to look out for too: ^{Footnote [1]}  

• Thickening or dimpling around your breast
• A change in the size or shape of one or both breasts
• Changes in your nipple, such as discharge or becoming sunken into your breast
• A lump or swelling in one or both of your armpits
• A rash on or around your nipple

If you check your breasts regularly, you’ll know how they usually feel and be able to spot something different quickly. 

There aren’t any specific causes of breast cancer, but there are things that can increase your risk. ^{Footnote [2]}  

• Your age – the risk increases as you get older
• If you’ve had breast cancer before
• If you’ve had a non-cancerous lump before
• Being overweight
• Smoking and drinking alcohol
• A family history of breast of ovarian cancer
• Certain gene mutations, such as BRCA1, BRCA2, and CHEK2, which can be passed from parents to children and can be identified though a blood test
• Taking hormone replacement therapy (HRT) – the risk increases the older you are and the longer you take it, but the risk lowers over time if you stop taking it

There are two main types of breast cancer, non-invasive and invasive. Most start in the milk ducts or milk producing lobules. Non-invasive cancer stays there, in the ducts or lobules, while invasive cancer spreads into the nearby breast tissue. There are also less common but more aggressive types of breast cancer, which behave differently.  

Doctors often use stages to help them explain how large the cancer is and how far it’s spread.

Stage 1

In stage one, the cancer is still quite small and hasn’t spread outside the breast. That means finding breast cancer at this stage makes it much easier to treat successfully.

Stage 2

At stage two, the tumour is either larger or has spread to a small number of nearby lymph nodes, but it’s still considered an early and treatable stage

Stage 3

Stage three means the tumour has spread more extensively within the breast or to multiple nearby lymph nodes, maybe involving the chest wall or skin. This makes it a more advanced but still potentially treatable stage.

Stage 4

By stage four, the cancer has spread beyond the breast to other parts of the body, such as the bones, lungs, liver, or brain. While it isn’t curable, lots of people live for years with treatment that focuses on controlling the disease, easing symptoms, and helping support quality of life.

If you notice anything different with your breast, such as a new lump, change in shape, skin changes, or unusual discomfort, it’s important to get it checked by your GP.

If they think it’s needed, your GP will refer you for further tests with your local breast clinic. They’ll examine your breasts and arrange imaging, either a mammogram or an ultrasound. A mammogram is an x-ray screening of your breast, while an ultrasound uses high-frequency sound waves to produce an image of the inside of your breast. 

These may be through a standard pathway with tests taking place across multiple appointments, or at a one-stop breast clinic, where assessments, imaging, and any necessary biopsies are done in one visit. 

At the one-stop clinic, a specialist will usually talk you through your imaging results on the same day, often shortly after the scans are completed. With the standard pathway, it may be within one or two weeks.

Regular breast screening

The NHS offers routine mammograms to women aged 50 to 70 every three years. You’ll get a letter inviting you in the post. If they detect anything abnormal, you’ll be referred to a breast clinic for further testing. ^{Footnote [3]}  

Your treatment will depend on the type and stage of breast cancer you have. Early breast cancer is typically treated with a combination of surgery, radiotherapy, and medicines such as hormone therapy or chemotherapy to remove the cancer and lower the chance of it coming back. 

For later‑stage breast cancer, treatment focuses on controlling the disease and managing symptoms, using options like targeted therapies, hormone therapy, chemotherapy, and supportive care to help support quality of life.

You’ll be looked after by a group of breast cancer specialists called a multidisciplinary team (MDT), who will work together to agree the most suitable treatment and care. 

Breast-conserving surgery

This is where the tumour and the surrounding tissue is removed, but not all of your breast. It can range from a small lumpectomy to a wider section of breast tissue being removed.

This depends on factors such as the type of cancer you have, the position and size of the tumour, and the amount of surrounding tissue that needs to be removed.

The healthy tissue surrounding the tumour that’s been removed will be tested to see if there’s any traces of cancer in it. If there is, more tissue may need to be removed from your breast.

Mastectomy

Having a mastectomy involves removal of the whole breast, including the nipple. The operation is carried out under general anaesthesia and takes about 90 minutes ^{Footnote [4]}. You’ll usually be ready to go home the following day.

In some cases, your skin or nipple may be saved, depending on the cancer and where it is.

If you’ve got any cancer in your armpit lymph nodes, these are also likely to be removed.

Reconstruction

If you need a mastectomy, you’ll be offered a reconstruction, either at the same time, or at a later date. This is where your breast will be reconstructed to look as similar as possible to your old breast. Doctors may use an implant or some of your own tissue to create the shape. ^{Footnote [4]}  

Chemotherapy

Chemotherapy is drug treatment to destroy cancer cells in the body by stopping them dividing and growing.

It can be used before surgery, to allow breast conservation, but is more often given after surgery for tumours with a high risk of recurrence.

Chemotherapy can be given in several different ways depending on the type of medicine you need. Lots of people receive it through a drip into a vein in the arm or hand, which slowly delivers the medication over a set period of time.

You could also get chemotherapy by injection, or as tablets or capsules you take at home. You’ll usually be treated at a hospital or specialist chemotherapy unit, where nurses monitor you closely, but some types can be given at home by specially trained nurses. The length of each session varies from minutes to hours, depending on the drugs you’re being given.

Like all treatments, chemotherapy can cause side effects, which vary from person to person. They may include tiredness, feeling sick, hair loss, changes in appetite, or a higher risk of infections. Your team will explain what to expect and how these can be managed. Your doctor may prescribe some medicines to help ease these side effects. ^{Footnote [5]}  

Targeted therapies

Targeted therapies are cancer treatments that work by specifically attacking the molecules or pathways that help cancer cells grow, divide, or survive, while aiming to cause less harm to healthy cells than traditional chemotherapy.

Different targeted drugs may block signals that tell cancer cells to grow, cut off their blood supply, or help the immune system recognise and destroy them. These therapies are often used alongside other treatments and will be chosen based on the type of breast cancer you have. ^{Footnote [5]}  

Radiotherapy

Radiotherapy uses high‑energy beams, such as X‑rays, to destroy cancer cells in a specific area without affecting the rest of the body. It may be recommended after surgery to reduce the risk of cancer coming back, before surgery to shrink a tumour, or at any stage to help relieve symptoms like pain or pressure.

You’ll usually be given radiotherapy as a series of short daily sessions over several weeks, with each session lasting only a few minutes. But you may be in the hospital or clinic for a bit longer for preparation and positioning. The procedure itself is painless. During radiotherapy, you lie still on a treatment bed while a machine moves around you to deliver the beams precisely to the area that needs treatment. ^{Footnote [5]}  

Hormone treatment

You might be offered hormone therapy if you have the type of breast cancer that’s stimulated to grow by oestrogen and progesterone. These hormones are found naturally in your body.

Hormone treatment lowers their levels and therefore could help stop the tumour(s) from growing and even shrink them.

This treatment is usually given after surgery and chemotherapy but can also be given if your general health stops you from having other treatments.

This treatment is usually given for five years, or more. You may get Tamoxifen, or an aromatase inhibitor such as Anastrozole, Exemestane and Letrozole. These are taken as a tablet or liquid, once a day. ^{Footnote [5]}  

You could claim for treatment for breast cancer using your health insurance cover. First, get a referral from your GP, or through the Aviva Digital GP app^. Then make a claim through MyAviva, online or call us.

If we confirm your claim meets the terms of your policy, we’ll pay for the treatment directly. Just be sure to tell us if you need more tests or treatment, or if your hospital or specialist changes.

That way, you can focus on taking care of yourself and recovery.  

^ This service is non-contractual and can be withdrawn or amended by Aviva at any time.