Breast Cancer Services at Kathmandu Cancer Center

• Skin changes, such as swelling, redness, or other visible differences in one or both breasts
• An increase in size or change in shape of the breast(s)
• Changes in the appearance of one or both nipples
• Nipple discharge other than breast milk
• General pain in/on any part of the breast
• Lumps or nodes felt on or inside of the breast

Even if you don’t have any symptoms, it is better to do screening test regularly. See the guideline for screening here.

For screening package in KCC hospital, please click here.

Research shows that there are several risk factors that may increase your chances of developing breast cancer. These include:

Age: Being 55 or older increases your risk for breast cancer.
Sex. Women are much more likely to develop breast cancer than men.
Family history and genetics. If you have parents, siblings, children or other close relatives who’ve been diagnosed with breast cancer, you’re more likely to develop the disease at some point in your life. About 5% to 10% of breast cancers are due to single abnormal genes that are passed down from parents to children, and that can be discovered by genetic testing.
Smoking. Tobacco use has been linked to many different types of cancer, including breast cancer.
Alcohol use. Research indicates that drinking alcohol can increase your risk for certain types of breast cancer.
Obesity. Being fat can increase your risk of breast cancer and breast cancer recurrence.

The stages of breast cancer are used to describe the extent of your cancer at the time of diagnosis. Your doctor will base the stage of your cancer on a physical exam and other diagnostic tests. This is known as clinical stage. The final, or pathologic, stage is determined after surgery when the size of the cancer is measured under a microscope and it is definitely known if there is cancer in the lymph nodes.

Stage I– Small tumor localized to breast only
Stage II– Tumor in breast and axillary nodes on the same side
Stage III– Locally advanced Breast cancer ( LABC)- Large tutor in breast which may involve skin or chest wall or multiple fixed nodes in axilla, neck or inside the chest.
Stage IV– The cancer has spread to other parts of body like liver, lung, bone, brain etc.

Breast cancer subtypes
There are 3 main subtypes of breast cancer that are determined by doing specific tests on biopsy or surgical sample. Treatment and outcome depend on this subtype.

Hormone receptor positive. Breast cancers expressing estrogen receptors (ER) and/or progesterone receptors (PR) are called “hormone receptor positive.” These receptors are proteins found in cells. Tumors that have estrogen receptors are called “ER positive.” Tumors that have progesterone receptors are called “PR positive.” This type of cancer may depend on the hormones estrogen and/or progesterone to grow. Hormone receptor-positive cancers can occur at any age, but are more common in older woman who already had menopause . Cancers without these receptors are called “hormone receptor negative.”

HER2 positive. About 20% of breast cancers depend on the gene called human epidermal growth factor receptor 2 (HER2) to grow. These cancers are called “HER2 positive” and have many copies of the HER2 gene or high levels of the HER2 protein. These proteins are also called “receptors.” The HER2 gene makes the HER2 protein, which is found on the cancer cells and is important for tumor cell growth. HER2-positive breast cancers grow more quickly. They can also be either hormone receptor positive or hormone receptor negative. These cancer are treated with Anti-Her2 targeted drugs like Herceptin.

Triple negative. If a tumor does not express ER, PR, and HER2, the tumor is called “triple negative.” Triple-negative breast cancer makes up about 15% of invasive breast cancers. Triple-negative breast cancer seems to be more common among younger women,. Triple-negative breast cancer is also more common in women with a mutation in the BRCA1 gene. These tumor are very fast growing but usually shrink after chemotherapy. So they are usually treated with chemotherapy before surgery.