Breast cancer occurs when cells in the breast tissue grow and divide uncontrollably, forming a tumour. It can begin in the milk ducts (ductal carcinoma), the milk-producing lobules (lobular carcinoma), or other breast tissues.

Not all breast lumps are cancerous — many are benign (non-cancerous) — but any lump or change should be evaluated by a doctor promptly.

Yes. Although rare (less than 1% of all breast cancer cases), men do get breast cancer because they have breast tissue too. Men with inherited pathogenic variants in BRCA2 (and less commonly BRCA1) have a significantly increased risk of male breast cancer. Male breast cancer is often diagnosed later because awareness is low, making education important for everyone.

Male breast cancer may also be associated with other hereditary cancer predisposition syndromes, although BRCA2 remains the most common inherited cause.

• Invasive Ductal Carcinoma (IDC): Most common type — begins in the milk duct and invades surrounding tissue.
• Invasive Lobular Carcinoma (ILC): Starts in the lobules; can be harder to detect on imaging.
• Triple-Negative Breast Cancer (TNBC): Lacks three key receptors; more aggressive and is more frequently associated with inherited BRCA1 pathogenic variants compared with other breast cancer subtypes.
• HER2-Positive Breast Cancer: Overexpresses HER2 protein; targeted therapies are very effective.
• Inflammatory Breast Cancer (IBC): Rare but aggressive; presents as redness and swelling rather than a lump.
• Ductal Carcinoma In Situ (DCIS): A non-invasive "Stage 0" cancer confined to the ducts — a non-invasive precursor lesion with an excellent prognosis when appropriately treated.

Risk factors fall into two categories:

Non-modifiable (you cannot change these):

• Being female and ageing (risk rises after 40)
• Family history of breast or ovarian cancer
• Inherited pathogenic variants (BRCA1, BRCA2, PALB2, CHEK2, ATM)
• Dense breast tissue
• Early menstruation (before age 12) or late menopause (after 55)
• Previous breast cancer or benign breast conditions like atypical hyperplasia

Modifiable (lifestyle-related):

• Overweight or obesity, especially after menopause
• Physical inactivity
• Alcohol consumption
• Long-term use of combined hormone replacement therapy (HRT)
• No pregnancies or first pregnancy after age 30
• Not breastfeeding

About 5–10% of breast cancers are hereditary, caused by inherited pathogenic variants in cancer predisposition genes. The most well-known genes are BRCA1 and BRCA2, but other genes (PALB2, CHEK2, ATM, TP53) also increase risk. Other high-risk genes such as PTEN, CDH1, and STK11 may also predispose to hereditary breast cancer.

Having a first-degree relative (mother, sister, or daughter) with breast cancer roughly doubles your personal risk. The magnitude of risk varies depending on the relative's age at diagnosis, the number of affected relatives, and the presence of inherited pathogenic variants. However, the majority of breast cancers occur in people with no family history — so everyone benefits from regular screening.

Yes. Risk increases with age — most breast cancers are diagnosed in women over 50. However, Indian women tend to be diagnosed at a younger age (40–50s) compared to Western populations, making awareness at a younger age especially critical in India.

BRCA1 and BRCA2 are tumour-suppressor genes — they normally help repair damaged DNA and prevent abnormal cell growth. When a pathogenic (or likely pathogenic) variant occurs in either gene, that repair function is impaired, significantly raising cancer risk.

Genetic counsellors typically recommend testing if you have:

• A personal history of breast cancer before age 50
• Bilateral breast cancer or both breast and ovarian cancer
• A known BRCA mutation in your family
• A first- or second-degree relative with breast, ovarian, or pancreatic cancer
• Triple-negative breast cancer at any age
• Ashkenazi Jewish ancestry (higher BRCA mutation frequency)
• Male breast cancer in the family
• Individuals from families with multiple related cancers suggestive of a hereditary cancer syndrome

A positive result does not mean you will definitely develop cancer. It means your risk is elevated and you should take proactive steps:

• Enhanced screening: Annual MRI and mammogram starting at age 25–30
• Risk-reducing medications: Tamoxifen or raloxifene may be prescribed (only for selected individuals after specialist consultation)
• Preventive surgery: In some cases, prophylactic mastectomy or oophorectomy (ovary removal) is considered — a personal decision made with your medical team
• Lifestyle modifications and close monitoring
• Family testing: First-degree relatives should be informed and offered testing following appropriate genetic counselling

Many breast cancers are found through screening before symptoms develop. When symptoms do appear, they can include:

• A new lump or thickening in the breast or underarm
• Changes in breast size, shape, or appearance
• Skin changes — dimpling, puckering, redness, or an "orange peel" texture
• Nipple changes — inversion (turning inward), discharge (spontaneous, unilateral, bloody nipple discharge), or scaling
• Persistent breast pain (though most breast pain is not cancer)
• Swelling of part or all of the breast
• Persistent enlarged lymph node in the armpit or above the collarbone

A monthly breast self-examination helps you become familiar with the normal look and feel of your breasts so you can notice changes quickly. Best done 3–5 days after your period ends (or on a fixed date if post-menopausal):

1. In the mirror: Look for any visual changes in both breasts — size, shape, skin texture, nipple appearance.
2. Arms raised: Repeat the visual check with hands on hips, then arms lifted.
3. Lying down: Place one arm behind your head and use the opposite hand to feel the breast in small circular motions, covering the entire area including the underarm.
4. Standing: Repeat the same motion while standing (often easier in the shower).

Any persistent breast changes should be evaluated by a healthcare professional, regardless of whether they are detected during self-awareness or routine screening.

Recommendations vary by individual risk:

• Average risk: Annual mammography from age 40–45 (Women at average risk should discuss the appropriate age and frequency of mammography with their healthcare provider, based on national guidelines and individual risk factors)
• High risk (BRCA mutation, strong family history): Annual mammogram plus breast MRI starting at age 25–30, or 10 years before the youngest affected relative's diagnosis
• Dense breasts: May need ultrasound or MRI in addition to mammography

In India, where women often present at younger ages, do not wait until 50 — begin discussions with your gynaecologist or oncologist in your late 30s.

• Mammogram: X-ray imaging — the gold standard for screening
• Ultrasound: Differentiates fluid-filled cysts from solid masses; helpful for dense breasts
• MRI: Detailed imaging; primarily used as an adjunct to mammography in selected high-risk individuals and for evaluating disease extent in specific clinical scenarios
• Biopsy: The only definitive way to diagnose cancer — a tissue sample is examined under a microscope. Histopathological examination remains the gold standard for confirming a diagnosis of breast cancer
• Tumour genomic profiling: Guides treatment decisions (e.g., Oncotype DX, tumour genomic profiling)

• Stage 0 (DCIS): Non-invasive; confined to the milk ducts
• Stage I: Small tumour (≤2 cm), limited or no lymph node involvement
• Stage II: Tumour is 2–5 cm, or has spread to a few lymph nodes
• Stage III: Larger tumour or more extensive lymph node involvement; locally advanced
• Stage IV (Metastatic): Cancer has spread to distant organs (lungs, liver, bones, brain)

Treatment depends on the type, stage, hormone receptor status, HER2 status, and the patient's overall health and preferences. Options include:

• Surgery: Lumpectomy (breast-conserving) or mastectomy (removal of the breast)
• Radiation therapy: Uses high-energy rays to destroy cancer cells; often follows lumpectomy
• Chemotherapy: Drugs given before surgery (neoadjuvant) or after (adjuvant) to kill cancer cells
• Hormone therapy: Tamoxifen, aromatase inhibitors — for hormone receptor-positive cancers
• Targeted therapy: HER2-targeted therapies such as trastuzumab and other anti-HER2 agents
• Immunotherapy: Recommended for selected patients (e.g., PD-L1-positive early-stage or metastatic triple-negative breast cancer), depending on current treatment guidelines
• PARP inhibitors: Olaparib, talazoparib — specifically for selected patients with germline BRCA1/BRCA2 pathogenic variants, depending on disease stage and current treatment guidelines

Treatment is increasingly personalised — your tumour's genomic profile now guides what therapy is most likely to work for you.

Overall, breast cancer outcomes have improved dramatically thanks to earlier detection and better treatments:

• Stage I: ~99% 5-year survival rate
• Stage II: ~86–90%
• Stage III: ~72–86%
• Stage IV: ~28% (but improving with new therapies)

Survival is strongly influenced by the stage at diagnosis, tumour biology, and access to timely treatment, with early-stage disease having an excellent prognosis.

In India, survival rates have been historically lower due to late-stage diagnosis — reinforcing the critical importance of early and regular screening. Improving awareness, access to screening, and advances in treatment continue to improve outcomes.

Not all breast cancers can be prevented, but you can meaningfully reduce your risk through lifestyle choices and, for high-risk individuals, medical interventions:

• Maintain a healthy weight, especially after menopause
• Be physically active (at least 150 minutes of moderate exercise per week)
• Limit or avoid alcohol
• Breastfeed if possible (6–12 months has a protective effect)
• Avoid or limit post-menopausal hormone therapy
• Do not smoke
• Eat a diet rich in fruits, vegetables, whole grains, and lean protein

Research suggests several dietary patterns matter:

• Protective: Mediterranean diet, cruciferous vegetables (broccoli, cauliflower), soy (in moderate food-form), fibre-rich foods, turmeric (curcumin)
• Risk-increasing: Alcohol (even moderate consumption), high-fat processed diets, red and processed meats, excessive sugar intake

No single food prevents or causes breast cancer, but overall dietary patterns across years of life have a measurable effect on risk.

Genomic testing is valuable in two distinct ways:

1. Pre-diagnosis (Risk Assessment): Tests like MapMyGenome's Genomepatri analyse your germline DNA to identify inherited pathogenic or likely pathogenic variants (BRCA1/BRCA2 and other genes) that significantly increase your lifetime risk. This allows for earlier, more intensive screening and preventive strategies.

2. Post-diagnosis (Tumour Profiling): Molecular profiling of the tumour itself (its somatic mutations, gene expression patterns) helps oncologists choose the most effective treatments and even identify whether chemotherapy is likely to benefit you — avoiding unnecessary side effects. This is not routinely indicated for every patient with breast cancer and is performed when it is expected to influence treatment decisions.

MapMyGenome offers comprehensive genomics solutions tailored to Indian genetics:

• BRCA1/BRCA2 testing with full sequencing and large rearrangement analysis
• Expanded hereditary cancer panels covering PALB2, CHEK2, ATM, TP53, PTEN, CDH1, and more
• Genomepatri — a whole-genome ancestry, wellness, and disease risk report that includes breast cancer predisposition
• Pre- and post-test genetic counselling to help you understand results and plan next steps

Consider genetic testing if:

• You have a personal or family history of breast, ovarian, or other BRCA-related cancers
• You are curious about your inherited cancer risk even without a family history
• You want to take a proactive, science-driven approach to your long-term health
• You are planning a family and want to understand mutation inheritance risk for your children

Genetic counselling — available from MapMyGenome — helps you determine which test is appropriate and how to act on the results.