Breast cancer is present when cells in the breast divide and grow uncontrollably. This most commonly begins in the milk duct cells of the breast (ductal carcinoma). Cancer can also develop in the milk-producing glands, known as lobules (lobular carcinoma).  

Breast cancer can be non-invasive, invasive or metastatic. 

Types of breast cancer   

Non-invasive breast cancer 

This is the earliest form of breast cancer, where the cancer has not spread into the surrounding breast tissue. Possible forms include:  

• Ductal carcinoma in situ (DCIS) – requires treatment as it can develop into invasive cancer  
• Lobular carcinoma in situ (LCIS) – does not always require treatment, but carries an increased risk of developing into breast cancer. 

Invasive breast cancer   

At the point of diagnosis, it is often invasive breast cancer that is present. This is when the cancer has spread into the surrounding breast tissue.  

The two main types are:

• Invasive ductal carcinoma (no special type, “NST"), in which the cancer has spread from the milk ducts into the surrounding breast tissue. About eight in ten cases are of this type.
• Invasive lobular carcinoma, in which the cancer has spread from the lobules into the surrounding breast tissue. About one in ten cases are of this type.

Other types of invasive breast cancer are rare. These include tubular breast carcinoma, inflammatory breast cancer and Paget's disease. 

Metastatic breast cancer 

Metastatic breast cancer means that the cancer has spread to other parts of the body, such as the bones, brain or lungs. This is also referred to as advanced or stage 4 breast cancer. 

Types of breast cancer by receptor 

Types of breast cancer are classified into categories based on characteristics such as hormones or growth factors. These include oestrogen (ER), progesterone (PR) and “human epidermal growth factor 2 (HER2)”. Breast cancer tissue is tested for these characteristics. In about eight out of ten cases, breast cancer is hormone receptor-positive. This means that oestrogen and/or progesterone are responsible for the cancer’s growth. Only about one in ten cases is HER2-positive.

Triple-negative breast cancer cells do not possess any of these characteristics.  

The exact cause of breast cancer is usually unknown in individual cases. However, there are certain factors that can increase the risk of developing the disease.

These risk factors include:

• Increasing age
• Family history of breast cancer
• Certain genetic mutations such as BRCA1 or 2  
• A previous breast cancer diagnosis
• Long-term combined hormone replacement therapy (oestrogen and progesterone) during or after the menopause
• Lifestyle factors, e.g. regular alcohol consumption, smoking or being overweight  

It can take a long time before symptoms of breast cancer become noticeable. That is why it is important to check your breasts regularly so that you know how they normally look and feel.   

Signs to look out for include: 

• Lumps or swelling in the breast, upper chest area or armpit
• Skin changes: thickened or puckered areas, dimpling or rashes
• Inflammation of the skin or nipple, e.g. redness or darkened areas  
• An inverted or swollen nipple or bloody discharge 

Pain or discomfort without other symptoms is not a typical sign of breast cancer, but should not be ignored. If you notice changes in your breasts that do not go away, you should consult your doctor without delay.

Learn more about the signs and symptoms of breast cancer and how to check your breasts, or take our short online check for a comprehensive initial assessment.  

Most cantons in Switzerland have a breast cancer screening programme offering women aged 50 and over an examination every two years. It includes a mammogram (X-ray examination) of the breast to check for signs of breast cancer before symptoms appear.  

The canton of Ticino offers such a programme. The canton of Zurich does not currently offer a breast cancer screening programme. If you live in Zurich, you can still have a mammogram for early detection. You can either make an appointment with us directly or ask your doctor for a referral.

If the mammogram shows signs of changes in the breast, this does not automatically mean that cancer is present. Further tests will help to clarify the cause.    

Approximately one in twenty breast cancer cases is hereditary. This means that the patient has a genetic mutation such as BRCA1 and BRCA2, which increases the risk of breast cancer.

In principle, anyone can seek genetic counselling at Affidea brustCare. Counselling and subsequent genetic testing is advisable and recommended for individuals with a family history of cancer, those who have had cancer at a young age, or those with other factors that indicate a genetic risk. We would like to help you understand the tests and results, your options, and the next steps for you and your family.

You can find further information on breast cancer screening and prevention by visiting our prevention page.  

How is breast cancer diagnosed? 

If you notice any symptoms or changes in your breast, your doctor can perform various tests to determine the cause.   

These may include the following:

• Physical examination – palpation of the breasts and armpits to check for abnormalities in size, shape or texture  
• Mammogram – an X-ray examination of your breast to detect changes that are too small to feel by touch  
• Other imaging tests such as ultrasound or MRI
• Biopsy– a sample of breast tissue is taken and tested for cancer cells
• Further laboratory diagnostics such as blood tests

We use a range of diagnostic methods, including digital 3D tomosynthesis and contrast-enhanced mammograms, which use a medical dye to produce more detailed images. These help us to identify suspicious results and early stages of breast cancer, even in dense mammary gland tissue.  

You can find more information about our comprehensive breast cancer testing methods by visiting our diagnostics page.  

The main treatment for breast cancer is surgery, often followed by radiotherapy. As breast cancer is often sensitive to female hormones, hormone therapy is used in such cases. For some patients, chemotherapy or other targeted therapy may be appropriate.  

At Affidea brustCare, we offer you the highest standard of breast cancer detection, treatment and aftercare from world-leading specialist doctors. Discover the full range of treatments available. 

Surgery 

The surgical techniques aim to remove the diseased tissue, but also take cosmetic considerations into account.  

The main procedures are:

• Breast-conserving surgery – This is possible in most cases, often using oncoplastic surgical techniques.
• Mastectomy – All breast tissue is removed. In some cases, the skin covering and nipple can be preserved for subsequent breast reconstruction. Most patients choose to have breast reconstruction after a mastectomy. This can be done during the same procedure or at a later date.
• Lymph node removal – If necessary, sentinel lymph nodes or other lymph nodes in the armpit are removed to be tested for cancer cells.

In some cases, it may be advisable to start treatment with chemotherapy or another drug treatment in order to shrink the tumour prior to surgery and assess the tumour's response to drug treatment. 

Chemotherapy can be used before surgery to shrink the tumour or after surgery to combat any remaining circulating cancer cells. In the treatment of an advanced breast cancer, it can help to control the disease, ease symptoms and improve quality of life.  

In targeted therapy, the drugs act on specific features of certain cancer cells. There are different types of targeted therapy, including “monoclonal antibodies” and “kinase inhibitors”. They can be administered alone or in combination with chemotherapy or hormone therapy.  

Immunotherapy harnesses the immune system to specifically target and destroy cancer cells. It is primarily suitable for advanced breast cancer or tumours with specific characteristics.

Hormone therapy is one of the most important forms of treatment for hormone receptor-positive breast cancer. Specific medicines can block hormone receptors or reduce hormone production in order to inhibit tumour growth.   

Radiotherapy uses high-energy radiation to target cancer cells. It is most commonly used after breast-conserving surgery to eliminate any remaining cancer cells or pre-cancer cells in the breast and reduce the risk of cancer recurrence. 

Supportive care is an essential part of breast cancer treatment. This is provided by a team of non-medical specialists from various disciplines who have extensive knowledge and experience in caring for cancer patients. These include, for example, breast care nurses, physiotherapists, psycho-oncologists, dietitians, nursing staff and others.  

At Affidea brustCare, we provide comprehensive integrative support for our patients, including psycho-oncology, nutrition consultancy, traditional Chinese medicine (TCM), mind-body medicine and more besides.  

Our care team works hand in hand with your doctor – not only to treat the cancer, but also to support patients as individuals every step of the way.

Forms of supportive care   

Psycho-oncology is a form of counselling and therapy that offers psychological, emotional and social support. It helps those affected to cope with a diagnosis, supports them through therapy decisions and accompanies them through the emotional challenges of cancer.

Physiotherapy and nutrition consultancy provide tailor-made exercise programmes and individual nutrition plans. Research shows that regular exercise and a nutritionally balanced, tailored diet can help improve quality of life, reduce side effects and lower the risk of cancer recurrence.

Traditional Chinese medicines (TCM) include acupuncture and herbal medicine, which promote mindfulness and relaxation. For some patients, this contributes to improving their quality of life, among other things by reducing treatment-related side effects.  

Mind-body medicine utilises the connection between thoughts, emotions and the body. Relaxation and mindfulness techniques such as yoga, meditation or breathing exercises help many patients to sleep better, reduce their stress levels and manage the side effects or symptoms.

Find out more about the supportive care we provide at Affidea brustCare.