Patient information from BMJ

Breast cancer, locally advanced: what is it?

Last published:Dec 21, 2023

It can be frightening to be told that you have breast cancer. But good treatments are available. If you are diagnosed with breast cancer now, you have a much better chance of surviving your illness than people did in the past.

What is locally advanced breast cancer?

When your body's cells are healthy they divide, grow, and are replaced in an orderly way. But if you get cancer some of your cells grow too fast and don’t develop properly. These abnormal cells form a lump called a tumour. This gradually gets bigger.

Breast cancer usually starts in thin tubes in the breast, called ducts. When women breastfeed, the ducts carry breast milk from the milk-producing glands to the nipple.

If you have invasive breast cancer it means that cancer cells have spread beyond the ducts into the fatty tissue of your breast. From there it can spread around your body.

Early breast cancer is cancer that is still within your breast. It might also be in glands called lymph nodes, that are in your armpit. But early breast cancer has not spread to many of these lymph nodes, and is not elsewhere in your body.

If the tumour is large (5 centimetres or more across) or has spread to the skin or the front of the chest, this is locally advanced breast cancer. The lymph nodes under the armpit might also have become matted together by the tumour.

What causes breast cancer?

The first question you may ask is: "Why me?" A few people get breast cancer because they have inherited a gene that makes it much more likely. But for most people there is no obvious cause. 

You are more likely to get breast cancer when you are older. There are some other things that are linked to a greater chance of getting breast cancer, such as being a female and not having had children (or having your first child at an older age), never having breastfed, drinking alcohol, and being very overweight (obese). But you may not have any of these 'risk factors'. 

What are the symptoms?

You may learn that you have breast cancer before you get any symptoms. Many breast cancers are found only by routine mammogram. A mammogram is an x-ray of the breast. Mammograms can reveal lumps or changes in your breast that are too small to feel. 

Symptoms of breast cancer include:

• A lump or thickening in your breast

• A change in how your breast feels or looks. For example, it may feel heavy, warm, or uneven, or the skin may look pitted

• Changes in your nipple. For example, the nipple might be pulled back into the breast (known as an inverted nipple)

• Discharge from your nipple, such as blood.

Before you are diagnosed with breast cancer, you may have an ultrasound scan of your breast. Your doctor might also remove some tissue from your breast lump, often by using a needle. This is called a biopsy. The doctors will examine the tissue for cancer cells.

What will happen to me?

It’s hard to predict what will happen to you, because everyone responds differently to treatment. The type of tumour you have and how far it has spread will also affect what happens. The good news is that more women are now living longer after being diagnosed with breast cancer.

Breast cancer can sometimes come back, so you will probably always need to be aware of checking for symptoms and have regular check-ups as advised by your doctor.

However, if breast cancer is going to come back, it's most likely to do so within the first 3-5 years. 

Where to get more help

There are many charities and support groups for people with breast cancer. For example, in the UK, Breast Cancer Care (breastcancernow.org) is a charity that provides advice and practical support to people with breast cancer.

You can ask your doctor about support in your area.