Breast Cancer: Understanding a Diagnosis

October 29, 2020
Breast cancer affects so many women that it is the most common cancer in females. Still, an individual diagnosis is a personal issue, affecting each woman differently and bringing up a myriad of questions. These include the type of cancer, the severity and treatment options, as well as prognosis, likelihood of recurrence and what happens next.

Understanding a breast cancer diagnosis is vital so that medical teams can tackle the disease alongside a patient. Aside from anxiety, a breast cancer diagnosis can create a lot of confusion too. Getting information is important, both psychologically and emotionally, as only this way can important decisions be made around treatment.

Types of Breast Cancer

There are different types of breast cancer and descriptions of these can be complex. In situ breast cancers are those that start in a milk duct or milk-producing glands (lobules) and have not spread to the rest of the breast tissue. Invasive tumors, however, are those that have infiltrated this tissue. The vast majority of breast cancers are invasive ductal carcinomas with invasive lobular cancer being the second most prevalent.

Triple-negative breast cancer, while not as common, can affect around 15% of those diagnosed. Its name refers to negative tests on receptors, meaning that the hormones estrogen and progesterone, as well as the protein HER2 are not stimulating the growth of cancer cells. This diagnosis is often due to a gene mutation. Knowing the receptor status of a breast cancer diagnosis is crucial to assess what treatment pathway to follow and also informs in terms of prognosis.

There are many other, rarer types of cancers including inflammatory breast cancer, which is fast growing and causes the skin to look red and sore. Paget’s Disease makes the skin around the nipples look like eczema.

Grades & Stages

The grade of invasive breast cancer refers to how abnormal cells are growing and how far they have traveled from the original source. The staging of breast cancer takes three things into consideration:

T = Tumor, specifically the size of the tumor
Therefore, T1 refers to a size of < 2 cm, T2 is 2 cm to 5 cm, T3 > 5 cm and T4 involves the chest wall or skin.
N = Nodes, based on the presence or absence of cancerous cells in the surrounding lymph nodes
Lymph node staging N0 refers to no lymph node involvement, N1 states 1-3 nodes, N2 states 4-9 nodes and N3 > 10 nodes have the presence of cancerous cells.
M = Metastasis, have cancerous tumors been found in other areas of the body. 

Nuclear imaging or nuclear scans are completed (with or without the use of adjunct imaging techniques such as X-Rays as required) to look throughout the body for metastasis providing an M0 or M1.
Stages of early or localized breast cancer are as follows:
Stage I  T1, N0, M0
Stage II T2, N0, M0 or T0-T1, N1, M0
Stage IIB T3, N0, M0 or T2, N1, M0

Stages of locally advanced breast cancer are as follows:
Stage IIIA   T3, N1, M0 or T0-T3, N2, M0
Stage IIIB   T4 any N, M0 or Any T, N3, M0

The stage of metastatic or advanced breast cancer is as follows:
Stage IV     any T, any N, M1

Treatment for breast cancer

Specialists at the Breast Care Clinic and Horizon Regional Cancer Center within Bumrungrad International Hospital combine disciplines to determine a treatment plan that is personalized to patients, the type of breast cancer and various other factors. The stage and grade of a tumor, as well as location and behavior create a cancer profile, while the health and age of the patient are taken into consideration.

Surgery is just one option, and may be advised in the case of women with a genetic predisposition to breast cancer. Where estrogen and progesterone receptors are stimulating cancer growth, hormone therapy may be applied. Meanwhile, whether a woman is pre- or post-menopausal will be taken into account too. Other options include chemotherapy and/or radiotherapy. Often chemotherapy will follow some type of surgery and impacts the whole body, whereas radiation targets the actual cancerous cells.

Targeted cancer drugs during or following other treatments to prevent recurrence may be administered with bone strengthening medication given as well.  At all times treatment approach is to maintain patient decision making and quality of life.

Recurring, Secondary Primary & Secondary Cancer

Breast cancer that is diagnosed and has not spread is called primary cancer and recurrence refers to this same cancer coming back. This can involve local recurrence when the cancer comes back at or close to the original site or regional/locally advanced recurrence which is where the disease has spread to lymph nodes or tissue nearby.

Secondary primary cancer indicates there is a new tumor, which means is can be a completely different type of cancer to a previous one, unlike recurring cancer. Secondary cancer is when cancerous cells have spread to other parts of the body.


Being aware of what treatment options are available and their impact offers a clearer picture of what living with breast cancer would be like for yourself or a loved one. Ensuring the right support is in place, that good communication with physicians is established, an awareness of treatment times and side effects are known, plus an established support network of friends are family are available makes all the difference. We a Bumrungrad International Hospital we recognize individuals may have unmet needs and have put support systems in place to help with unmet needs. Our multidisciplinary team wants to help.   

Horizon Regional Cancer Center and Chemotherapy Department
8.00-20.00  (BKK Time)
Hot line tel. +66 63 234 7950
tel. +66 65 978 1390 
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