Types of Breast Cancer

Ductal Carcinoma in-situ: Generally divided into comedo (blackhead, the cut surface of the tumor demonstrates extrusion of dead and necrotic tumor cells similar to a blackhead) and non-comedo types. DCIS is early breast cancer confined to the inside of the ductal system. The distinction between comedo and non-comedo types is important as comedocarcinoma in-situ generally behaves more aggressively and may show areas of microinvasion (small areas of invasion through the ductal wall into surrounding tissue).

The surgical management is the same as for other types of breast cancer except axillary node sampling is not done, as only 1% of these lesions will have axillary metastasis. We recommend, however, that irradiation be given if treated with conservative breast surgery to reduce the recurrence rate from 21% without irradiation, to 5%-10% with irradiation. This is a controversial area of the treatment of breast cancer.

Infiltrating Ductal: The most common type of breast cancer representing 78% of all malignancies. These lesions can be stellate (star like in appearance on mammography) in appearance or well circumscribed (rounded). The stellate lesions generally have a poorer prognosis.

Medullary Carcinoma: Comprise 15% of breast cancers. These lesions are generally well circumscribed and may be difficult to distinguish from fibroadenoma by mammography or sonography. Medullary carcinoma is estrogen and progesterone receptor (prognostic indicator) negative 90% of the time. Medullary carcinoma usually has a better prognosis than ordinary breast cancer.

Infiltrating Lobular: Representing 15% of breast cancer these lesions generally present in the upper outer quadrant of the breast as a subtle thickening and are difficult to diagnose by mammography. Infiltrating lobular can be bilateral (involve both breasts). Microscopically, these tumors exhibit a linear array of cells (Indian filing) and grow around the ducts and lobules (targeting).

Tubular Carcinoma: Orderly or well differentiated carcinoma of the breast. These lesions make up about 2% of breast cancer. They have a favorable prognosis with nearly a 95% 10-year survival.

Mucinous Carcinoma: Represents 1%-2% of carcinoma of the breast and has a favorable prognosis. These lesions are usually well circumscribed (rounded).

Inflammatory Breast Cancer: A particularly aggressive type of breast cancer the presentation is usually noted in changes in the skin of the breast including redness (erythema), thickening of the skin and prominence of the hair follicles resembling an orange peel (peau d' orange). The diagnosis is made by a skin biopsy, which reveals tumor in the lymphatic and vascular channels 50% of the time.

Source: nationalbreastcancer.org

Lymphedema

Occasionally lymphedema follows treatment of a variety of cancers. It is often linked with breast cancer. (The majority of women with breast cancer will never experience lymphedema but some will)

What is Lymphedema?

Lymphedema is swelling from the lymph fluid that builds up in the body tissues. In other words, the lymph fluid is not completely circulating through the body and builds up in one of the body tissues. The buildup (swelling) usually occurs in the arm or leg.

Why Does Lymphedema occur in breast cancer patients?

Lymphedema occurs in breast cancer patients because if the breast is removed, surgeons usually remove groups of lymph nodes and vessels from the underarm. Removing lymph vessels and nodes alters the way fluid drains in the body. In breast cancer patients, the lymphatic system struggles to remove fluid from the arm and breasts.

How can lymphedema be treated?

The patient can wear a custom made elastic pressure sleeve. The sleeve is designed to exert a specific amount of pressure on the limb and aid in fluid movement.

Other Information

Patients with lymphedema or at risk of developing lymphedema need to avoid getting an infection. They need to avoid infection because infection causes the body to make extra lymph fluid. Extra lymph fluid may cause swelling.

Source - mamashealth.com

What is Breast Cancer?

Breast cancer is a type of cancer where cells in the breast tissue divide and grow without the normal control. About 80 percent of breast cancers originate in the mammary ducts, while about 20 percent arise in the lobules . Cancerous tumors in the breast usually grow very slowly so that by the time one is large enough to be felt as a lump, it may have been growing for as long as ten years.

One of the most important distinctions to understand about breast cancer is the difference between invasive cancer and carcinoma in situ (kar-sin-O-ma in SY-too).

Invasive Cancer

The more serious of the two, invasive breast cancer develops when abnormal cells from inside the lobules or ducts break out into the surrounding breast tissue. This opens the opportunity for cancer to spread to the lymph nodes and, in advanced stages, to organs like the liver, lungs and bones.

In the past, breast cancer was thought to grow in an orderly progression from a tiny tumor in the breast tissue to a larger one, sequentially traveling out to the nearby lymph nodes, then distant ones, and finally metastasizing in other parts of the body. Now, however, it is thought that cancer cells are capable of traveling from the breast through the blood and lymphatic system very early in the course of the disease, though these traveling cancer cells do not always survive beyond the tumor

Carcinoma In Situ

When abnormal cells grow inside the lobules or milk ducts but have not spread to the surrounding tissue or beyond, the condition is called carcinoma in situ. The term "in situ" means "in place" and is used to describe this condition because the abnormal cells are still "in place" inside the lobules or ducts where they first developed. There are two main categories of carcinoma in situ: ductal carcinoma in situ and lobular carcinoma in situ.

Although the word carcinoma is used in their titles, the cells involved in the different carcinomas in situ are not fully cancerous because they have not developed the ability to invade out of the ducts or lobules and metastasize. They are often referred to as precancerous conditions because they can either develop into or raise the risk of invasive cancer.

Source - komen.org

Breast cancer stages

Doctors divide breast cancer into four stages. Knowing the stage helps them decide the best treatmentor combinations of treatments for you. There are many different words and phrases used to describe breast cancer staging. The first 3 stages of breast cancer are also called primary breast cancer or early stage breast cancer. This means the cancer has not spread to another part of the body (apart from the lymph nodes under the arm)

Stage 4 is also called secondary breast cancer.Effective treatment makes it less likely the cancer will go on to another stage. Many breast cancers never go beyond stage one or two. The aim of treatment is to cure the cancer and for many women with early disease this is possible.If you would like more information about anything to do with the stages of breast cancer, contact one of the cancer information organisations in Help and Support.They will be happy to help.

Stage 1
The tumour is no more than 2 centimetres across (T1)
The lymph nodes in the armpit are not affected
The cancer has not spread'Tumour' here means either a breast lump or the area of cancer cells found on your scan or mammogram.

Stage 2

The tumour is more than 2 centimetres, but less than 5 centimetres across (T2) Or the lymph nodes in the armpit are affected, or both The cancer has not spread anywhere else'Tumour' here means either a breast lump or the area of cancer cells found on your scan or mammogram.

Stage 3

The tumour is more than 5 centimetres across (T3) The lymph nodes in the armpit are affected There is no further spread'Tumour' here means either a breast lump or the area of cancer cells found on your scan or mammogram.

Stage 4

The tumour can be any size The lymph nodes in the armpit are often affected The cancer has spread or metastasised to other parts of the body (for example, lymph nodes above the collar bone or distant organs such as the lungs, liver or bones)If you only have cancer spread to the lymph nodes under your arm, you do not have stage 4 breast cancer.

Stage 4 only applies to cancer spread to other body organs or to other lymph nodes, apart from those in the armpit. Stage 4 breast cancer is also called secondary breast cancer or 'metastatic breast cancer'. Or your specialist may say your cancer 'has metastasised'.

Locally advanced breast cancer:As defined by NICE, this means the cancer has not spread to another part of the body, but the cancer in the breast is bigger than 5 centimetres across The cancer has grown into the skin or muscle of the chest There is cancer in the lymph nodes under the armLocally advanced breast cancer can be any or all of these. So it could mean either stage 2 or stage 3 breast cancer.

Source - cancerhelp.org.uk

Breast Cancer basics

Breast cancer is cancer of breast tissue. Worldwide, it is the most common form of cancer in females, affecting approximately one out of eleven to twelve women at some stage of their life in the Western world. Although significant efforts are made to achieve early detection and effective treatment, about 20% of all women with breast cancer will die from the disease, and it is the second most common cause of cancer deaths in women.

Epidemiologic risk factors

It is important to have a model of causation of a disease in order to distinguish epidemiological risk factors or associations with disease, from the biological etiology and primary cause, secondary co-factors, and simple promoters of the disease given the underlying cause. By analogy in peptic ulcer disease, the cause is Helicobacter pylori, a co-factor is stomach acidity, a promoter may be aspirin which altogether produce a stomach ulcer. Each is a risk factor associated with disease, and one is the primary cause. The cause of breast cancer is not known.

Age

The risk of getting breast cancer increases with age. For a woman who lives to the age of 90 the chances of getting breast cancer her entire lifetime is about 12.5% or one in eight. Men can also develop breast cancer, but their risk is less than one in 1000 (see sex and illness). This risk is modified by many different factors. In a very small (~ 5%) proportion of breast cancer cases, there is a strong inherited familial risk. Some racial groups have a higher risk of developing breast cancer - notably, women of European and African descent have been noted to have a higher rate of breast cancer than women of Asian origin. However, these apparent racial differences diminish when geography is altered, as Asian women migrating to the western world, gradually acquire risk approaching that of western women.

The probability of breast cancer rises with age but breast cancer tends to be more aggressive when it occurs in younger women. One type of breast cancer that is especially aggressive and disproportionately occurs in younger women is inflammatory breast cancer. It is initially staged as Stage IIIb or Stage IV. It also is unique because it often does not present with a lump so that it often is not detected by mammography or ultrasound. It presents with the signs and symptoms of a breast infection like mastitis.

Genes

Two genes, BRCA1 and BRCA2, have been linked to the rare familial form of breast cancer. Women in families expressing mutations in these genes have a much higher risk of developing breast cancer than women who do not. Not all people who inherit mutations in these genes will develop breast cancer. Together with Li-Fraumeni syndrome (p53 mutations), these genetic aberrations determine around 5% of all breast cancer cases, suggesting that the remainder is sporadic. Genetic counseling and genetic testing should be considered for families who may carry a hereditary form of cancer.

Alcohol

Alcohol is another risk factor for the development of breast cancer. Women who drink half a glass of wine everyday have 6% increased risk of developing breast cancer.

Hormones

The International Agency for Research on Cancer (IARC) in Lyon, France invited 21 scientists from eight countries in June 2005, to evaluate the risk of cancer for humans of combined estrogen-progesterone contraceptives and combined estrogen-progesterone menopausal therapy. The working group found that there is a small increase in the relative risk of breast cancer in current and recent users of combined oral contraceptives.

The risk decreases to that of those who have never used such combined therapy ten years after cessation of use. The scientists described combined oral estrogen-progesterone contraceptives as "carcinogenic to humans." They also found an increased risk of breast cancer in women under treatment with combined menopausal therapy, which is confined mostly to current or recent users, increases with duration of use and exceeds that in women taking estrogen-only therapy.

Other

Other established risk factors include not having children, delaying first childbirth, not breastfeeding, early menarche (the first menstrual period), late menopause, obesity and taking hormone replacement therapy.

Unproven

It has been hypothesized that abortion may increase the risk of breast cancer because of hormones in early pregnancy. Recent large studies do not support this association.

Although not well quantified there has long been a concern about risk associated with environmental estrogenic compounds, such as dioxins, or phytoestrogens such as found in soy beans.

Aluminum salts such as those used in anti-perspirants have recently been classified as metalloestrogens. In research published in the Journal of Applied Toxicology, Dr. Philippa D. Darby of the University of Reading has shown that aluminum salts increase estrogen-related gene expression in human breast cancer cells grown in the laboratory.

Source - Wikipedia