For patients and families, breast cancer can feel overwhelming because care often involves several specialists and multiple stages. A patient may need imaging, biopsy, surgery, chemotherapy, radiotherapy, endocrine therapy, targeted therapy or long-term follow-up.

This guide explains how breast cancer is diagnosed, how staging works and what treatment options may be recommended.

How Breast Cancer Is Diagnosed

Breast cancer diagnosis usually begins with symptoms, screening findings or abnormal imaging. Some patients notice a lump, nipple changes, skin changes, breast pain or discharge. Others are diagnosed after a mammogram or ultrasound.

Common diagnostic steps include:

Clinical Breast Examination

A doctor examines the breast and underarm area to check for lumps, skin changes, nipple changes and enlarged lymph nodes.

Mammogram

A mammogram is commonly used to detect breast abnormalities, including early changes that may not be detected during a physical examination.

Breast Ultrasound

Ultrasound is often used to assess lumps, guide biopsy and evaluate breast tissue, especially in younger women or those with dense breasts.

Breast MRI

MRI may be recommended in selected cases, such as for high-risk patients, dense breast tissue, complex findings or treatment planning.

Core Needle Biopsy

A biopsy is needed to confirm whether a breast abnormality is cancerous. It also provides important information about tumour type, grade and receptor status.

Understanding Breast Cancer Subtypes

Breast cancer treatment depends heavily on receptor testing. The biopsy sample is usually tested for:

• - Oestrogen receptor
• - Progesterone receptor
• - HER2 status
• - Proliferation marker, where relevant

These results help doctors classify breast cancer into broad groups.

Breast Cancer Staging

Staging helps doctors understand how far the cancer has spread and plan treatment. Staging may consider:

• - Tumour size
• - Lymph node involvement
• - Whether cancer has spread to other organs
• - Tumour biology
• - Grade and receptor status

Breast Cancer Surgery

Surgery is commonly part of treatment for early and locally advanced breast cancer.

Breast-Conserving Surgery

Also known as lumpectomy, this procedure removes the cancer and a margin of surrounding tissue while preserving most of the breast. Radiotherapy is commonly recommended afterwards.

Mastectomy

Mastectomy removes the whole breast and may be recommended depending on tumour size, tumour location, multiple areas of disease, genetic risk, previous radiotherapy or patient preference.

Lymph Node Surgery

Sentinel lymph node biopsy or axillary lymph node surgery may be performed to check whether cancer has spread to nearby lymph nodes.

Breast Reconstruction

Some patients may consider reconstruction after mastectomy. This should be discussed with the surgical team based on the treatment plan, body type, cancer stage and patient preference.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells or reduce their ability to grow. It may be given:

• - Before surgery to shrink the tumour
• - After surgery to reduce recurrence risk
• - As part of treatment for more advanced disease

The need for chemotherapy depends on cancer stage, subtype, grade, lymph node involvement, patient age, general health and recurrence risk.

Targeted Therapy

Targeted therapy may be recommended for cancers with specific biological features. For HER2-positive breast cancer, anti-HER2 medicines may be used alongside chemotherapy or as part of adjuvant treatment.

Other targeted medicines may be used in selected cases of advanced breast cancer, depending on receptor status, genetic testing and prior treatment. Patients should ask their oncologist which treatments are suitable for their specific cancer subtype.

Endocrine Therapy

Endocrine therapy may be recommended for hormone receptor-positive breast cancer. It is often taken for several years after initial treatment to reduce recurrence risk. The choice depends on whether the patient is premenopausal or postmenopausal, recurrence risk, side effects and treatment goals.

Radiotherapy

Radiotherapy uses targeted radiation to reduce recurrence risk in the breast, chest wall or lymph node areas. It is commonly used after breast-conserving surgery and may also be recommended after mastectomy in selected higher-risk cases. The radiation oncologist will advise on the number of sessions and treatment area based on the surgery findings and cancer stage.

Genetic Testing and Family Risk

Some patients may be advised to consider genetic counselling and testing, especially if they are diagnosed at a young age, have triple-negative breast cancer, have bilateral breast cancer or have a strong family history of breast or ovarian cancer. Genetic testing can guide treatment decisions and help family members understand their own risk.

When to See an Oncology Specialist

Patients should consider seeing an oncology specialist if they have:

• - A confirmed breast cancer diagnosis
• - An abnormal biopsy result
• - Concern about breast cancer recurrence
• - A need for chemotherapy, targeted therapy or radiotherapy
• - A request for a second opinion
• - A strong family history and concern about genetic risk

Early referral helps the care team plan treatment in the correct sequence.

How KPJ Healthcare Can Help

KPJ Healthcare’s oncology and breast care teams can support diagnosis, staging, treatment planning, surgery referrals, chemotherapy, radiotherapy coordination where available, and follow-up care across selected hospitals.

Breast cancer treatment should be individualised. The right plan depends on the cancer subtype, stage, patient health and treatment goals.

Final Thoughts

Breast cancer treatment in Malaysia involves more than one treatment type. Surgery, chemotherapy, radiotherapy, endocrine therapy, targeted therapy and follow-up may all play a role depending on the patient’s diagnosis.

A clear treatment plan starts with accurate diagnosis, staging, receptor testing and discussion with an oncology specialist.