Cancers are an overgrowth of cells and tissue that starts in one organ e.g. the breast, and then spreads (metastasizes) to other parts of the body where it usually leads to death. There are many different types of breast cancers and they don’t necessarily behave in the same way or respond to the same treatments. These days, a diagnosed cancer is studied in great detail so that the treatments are tailored to best destroy that particular cancer.


In 99.9% of breast cancer, there is NO known cause. There are risk factors that increase a person’s chances of developing a cancer but almost never an actual cause. The risk factors include family history, hormone replacement, obesity, smoking and having not had children.


Feeling a lump in the breast is the single most important symptom of a breast cancer! A lump usually feels like a pea / stone / marble under the skin. Any time that a woman feels a lump in the breast she must come in for a mammogram and/or ultrasound immediately. Nonetheless, the vast majority of palpable lumps are not breast cancer. Benign growths, cysts and normal lumpy breast tissue may all present as lumps.


Skin thickening and dimpling (looks like the peel of an orange), or a newly developed asymmetry of the breasts – one is higher/pulled up or has a dent in it. These signs always need to be further evaluated with mammogram and ultrasound.


Nipple discharge – the most concerning discharges are bloody or clear. Green/yellow/milky discharges are usually harmless. A discharge that comes out on its own is more worrying than one that comes out only when the nipple is squeezed. Discharges from both nipples are almost always harmless.

Pulling in of the nipple can be a sign of cancer but only if it is something new (weeks – months)

A peeling, dry rash of the nipple and areola is always a concern. Itching of the nipple without any visible change is harmless – usually due to hormonal change.

Even though most nipple problems are benign, evaluation with imaging is advised in all cases.


The purpose of a breast examination is to try find breast cancer as early as possible. Regular (monthly) self examination is an extremely valuable tool, although many women find it difficult on account of naturally lumpy breasts. If this is the case, do not stress. Make sure you come for your annual mammogram in addition to visiting your gynaecologist or general practitioner who will also perform a manual breast examination.


A breast cyst is a bubble of water that can vary in size from several millimetres to 5 centimetres in diameter. They are extremely common and almost always benign. Breast cysts can occasionally be painful, particularly if very large or inflamed. In that case, we will aspirate (draw out) the fluid from the cyst. If they are asymptomatic, we leave cysts alone.