How Staging Guides Treatment
The type of cancer you have, along with the stage, will help determine your treatment. With stage I, II, or III breast cancer, the main goal is to cure the cancer by treating it and keeping it from coming back. With stage IV, the goal is to improve symptoms and prolong life. In almost all cases, stage IV breast cancer cannot be cured.
Mammographic And Ultrasound Features Of Inflammatory Breast Cancer
The typical findings on screening for inflammatory breast cancers are thickening of the skin and connective tissues and an increase in breast density.
In around 30% of inflammatory breast cancers cases there is no lump . Rather IBC usually presents as a diffuse infiltration of cancer cells, so it is not as easily detected on mammogram or ultrasound.
So, the absence of a true breast mass on mammography does not always rule out cancer.
In addition, the high density of the breast might hide an actual tumor deeper within the breast.
Ultrasound can be helpful in the diagnostic process, as it may be able to detect masses hidden at mammography and on clinical examination.
Ultrasound is also useful to detect axillary adenopathy and this can help with taking more accurate biopsy samples. With inflammatory breast cancer, ultrasound images might show edema and skin thickening along with an ill-defined mass of some kind.
How Fast Does Breast Cancer Progress In A Year
In Singapore, approximately five women are diagnosed with breast cancer everyday, making it the highest occurring cancer among females here. If you or someone you know have detected a lump or been diagnosed with breast cancer recently, you must be wondering: how long has the cancer been around? Why did it take so long for me to figure it out? Will it spread to other parts of my body?
The truth is, the answers to these questions really depend on the type of breast cancer you have and other factors like its molecular characteristics. This article looks at how quickly breast cancer can progress, the types of breast cancers and long term outlook.
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for breast cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the breast.
- Regional: The cancer has spread outside the breast to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.
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Bowel Cancer: Symptoms Causes Diagnosis And More
What is bowel cancer? Bowel cancer also known as colorectal cancer, is a general term for cancer that begins in the large bowel. The cancer is usually preceded by growth called polyps, which is not easily detected. Bowel cancer is sometimes called colon cancer or rectal cancer, depending on where …
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Breast Cancer With Possible Spread To Lymph Nodes In Neck
Hi, I have been really worried. Last year I was diagnosed with BC Her2+ and I had chemo Fec-T and radiotherapy. I started zolendronic acid on Friday and I am still on Herceptin. Yesterday I went for an ultrasound to my neck. The radiologist spoke of finding 3 enlarged lymph nodes I think at the base of my neck. I am so worried it has come back and that prognosis will be poor. Has anyone had anything similar? IN other ways I am feeling well. Thank you. Xx
Hi Sunny-day
Im sorry to hear that the radiologist found some enlarge lymph nodes on your recent ultrasound. Its understandable that youre cconcerned about what these may be and what they may mean given that youve had breast cancer.
I would say that we seem to have a lot of posts here on the forum at the moment from people who have swollen lymph nodes so try to stay positive and remember that there could be a number of reasons other than cancer for this problem.
Have you spoken to your GP or Consultant about these findings? Its certainly worth giving them a call to talk things through and see if they feel further investigation is needed.
Keep in touch and let us know how you get on.
Best wishes,
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The Tnm Staging System
The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer . The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.
In the past, stage number was calculated based on just three clinical characteristics, T, N, and M.
The T category describes the original tumor:
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HER2 status: are the cancer cells making too much of the HER2 protein?
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Oncotype DX score, if the cancer is estrogen-receptor-positive, HER2-negative, and there is no cancer in the lymph nodes
Adding information about tumor grade, hormone-receptor status, HER2 status, and possibly Oncotype DX test results has made determining the stage of a breast cancer more complex, but also more accurate.
In general, according to experts, the new staging system classifies triple-negative breast cancer at a higher stage and classifies most hormone receptor-positive breast cancer at a lower stage.
You also may see or hear certain words used to describe the stage of the breast cancer:
-
Distant: The cancer is found in other parts of the body as well.
The updated AJCC breast cancer staging guidelines have made determining the stage of a cancer a more complicated but accurate process. So, the characteristics of each stage below are somewhat generalized.
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Causes Of Triple Negative Breast Cancer
The risk factors for triple negative breast cancer are not clear. Some breast cancers depend on hormones to grow. These can be linked with risk factors to do with hormones and having children. But triple negative breast cancer does not seem to share these risk factors.
Most women with triple negative breast cancer have no strong history of breast cancer in their family . But some women with triple negative breast cancer have an altered BRCA1 gene. This will have been inherited from a parent.
An altered BRCA 1 gene can cause breast cancer to run in families. Most breast cancers caused by BRCA1 are triple negative.
If you have triple negative breast cancer, you may be offered genetic testing. This is even if you do not have a family history of breast cancer. Your cancer doctor or breast care nurse can explain more about this to you.
The tests are the same as for any type of breast cancer. You usually have a:
- Mammogram
A mammogram is an x-ray of the breast.
- Ultrasound scan
An ultrasound scan uses sound waves to produce a picture of the breast tissue and the lymph nodes in the armpit.
- Breast biopsy
When you have a breast biopsy, your cancer doctor or breast care nurse takes small samples of cells or tissue from your breast. The samples are looked at under a microscope to check for cancer cells. They also do other tests to find out if the cells have receptors for hormones, or for HER2.
See also
Cancer In Nearby Lymph Nodes
Sometimes cancer is found in lymph nodes that are near to where the cancer started. For example, breast cancer cells may travel to lymph nodes in the armpit or above the collar bone .
If a surgeon removes a primary cancer, they often remove some of the nearby lymph nodes. The lymph nodes are examined to see if there are any cancer cells in them.
The risk of the cancer coming back may be higher if the nearby lymph nodes contain cancer cells. Your doctors may suggest you have more treatment after surgery to reduce the risk.
Cancer in lymph nodes that are further away is called secondary cancer. Cancer found in nearby lymph nodes is usually treated differently to cancer in lymph nodes that are further away from the primary cancer.
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What Is The Prognosis For Triple Negative Breast Cancer
Triple negative breast cancer can be more aggressive and difficult to treat. Also, the cancer is more likely to spread and recur. The stage of breast cancer and the grade of the tumor will influence your prognosis. Research is being done currently to create drug therapies that are specific for triple negative breast cancer.
Interested in learning more? i3Health is hosting an upcoming webinar Metastatic Triple-Negative Breast Cancer: Applying Treatment Advances to Personalized Care. Learn more here.
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How Is Metastasis Detected
If your doctor suspects that your melanoma may have spread, there are several tools available to verify the diagnosis. These include a blood test for lactate dehydrogenase , which increases when melanoma metastasizes, and imaging studies, such as chest X-ray, computed tomography , magnetic resonance imaging , positron emission tomography and ultrasound.
The doctor may also need to take a sample of your lymph nodes, using a procedure called sentinel lymph node mapping. If confirmed, there are many treatments available, including chemotherapy, immunotherapy, radiation therapy and surgery.
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Red Flag #: Unexplained Weight Loss And Loss Of Appetite
Unintentional weight loss is a common side effect of any cancer. When it comes to melanoma, extreme weight loss usually only happens after the cancer has spread from the skin to other parts of the body. Dr. Zaba says she can sometimes tell if a patients melanoma has metastasized because it looks like they have cachexia, a syndrome marked by drastic loss of fat and muscle and increased weakness. Cachexia can also cause loss of appetite, which further contributes to the problem.
Clinical Symptoms Of Inflammatory Breast Cancer
The symptoms of inflammatory breast cancer are not typical symptoms of breast cancer. Indeed, the symptoms are very similar to breast mastitis or a breast infection.
The Symptoms include:-
- Skin Changes: Patches of skin on the breast appear red or pink in color, or appear bruised
- The texture of the affected area of the breast may also change and appear dimpled or pitted, a little like the skin of an orange
- Itchy breasts: Itchiness around the affected area can occur
- Swelling of the breast: You may notice that one breast is larger than the other
- Breast pain: The affected breast may be tender, painful or feel heavier
- The breast feels hot to the touch or there can be a burning sensation
- Ridges or welt like marks may appear on the skin
- Inverted nipple, dimpling or flattening of the nipple
- Nipple Discharge
- Swollen lymph nodes under the arm or in the neck
Women with inflammatory breast cancer will typically present to a physician with a rapidly progressing, firm, tender, and enlarged breast. If you have even a small patch of inflamed, red skin on breast self-exam it is important to see your physician straight away.
Notably, women with inflammatory breast cancer will tend not to have a fever. Because it is a cancer that spreads very rapidly into and around the breast tissue, women with IBC might present with axillary adenopathy . This can be a sign that cancer has spread .
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What Is Triple Negative Breast Cancer
TNBC is:
- Progesterone receptor-negative
- HER2-negative
Triple negative/basal-like tumors are a molecular subtype of breast cancer. Basal-like tumors have cells that look similar to those of the outer cells surrounding the mammary ducts.
Most triple negative tumors are basal-like .
About 10-20 percent of all breast cancers are TNBC or basal-like tumors .
These tumors tend to occur more often in :
- Younger women
- Black, non-Hispanic Black and African American women
TNBC may also be more common among Hispanic women compared to white and non-Hispanic white women .
Why You Shouldnt Delay Treatment
Being proactive with your health is important for many reasons, especially when it comes to breast cancer. Diagnosing cancer at an early stage will provide you with a better prognosis, as will receiving treatment in a timely manner.
A recent study from the Cleveland Clinic found an increase in survival rates when breast cancer treatments were completed within 38 weeks from diagnosis. Research for the study, which included more than 28,000 patients, found people who completed treatment within 38 weeks had a 90 percent five-year survival rate compared to an 83.3 percent five-year survival rate for people whose treatment lasted longer than 38 weeks.
Of course, sometimes delays in treatments are uncontrollable. You may need to schedule many appointments before treatment can begin, such as seeing a surgical oncologist or a medical oncologist followed by a radiation oncologist when it comes time for radiation.
Contact the INTEGRIS Cancer Institute if you or a loved one was recently diagnosed with breast cancer and want to learn more about the available treatment options. If you suspect you may have breast cancer or want to schedule a mammogram, call 1-855-MY-MAMMO .
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How Long Is Chemo For Breast Cancer
Chemotherapy is often administered after surgery to remove any undetected breast cancer cells. Chemotherapy can also help reduce your risk of the cancer returning.
Chemotherapy should usually be given within 30 days of surgery and less than 120 days from the initial diagnosis. One study showed women who started chemotherapy two months after surgery had a 19 percent lower chance to survive compared to women who began chemotherapy a month after surgery.
Treatment comes in cycles that can occur once a week or once every three weeks. Following a period of recovery, this process can continue for up to six months. Women with more aggressive forms of cancer may receive chemotherapy for longer than that.
Not all stages of cancer require chemotherapy. Depending on the results of pathology from surgery, your doctor will decide the best plan for adjuvant treatment. You may also be a candidate for hormonal therapy.
Doubling Time Of Small Cell Lung Cancer
Doubling time with small cell lung cancer has been studied less than that of NSCLC, but appears to be both rapid and dependent on stage. Unlike NSCLC and its four stages, small cell lung cancer has only two stages: limited stage and extensive stage.
In a study looking at initial CT image scans, the average doubling time for small cell lung cancer was 70 days for the primary tumor, and 51.1 days for affected lymph nodes. The doubling time was much faster with extensive stage disease when compared with limited stage disease .
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Types Of Invasive Breast Cancer
Most breast cancers are invasive, meaning the cancer has spread from the original site to other areas, like nearby breast tissue, lymph nodes or elsewhere in the body. Invasive breast cancer cells break through normal breast tissue barriers and spread to other parts of the body through the bloodstream and lymph nodes. The two most common types of invasive breast cancer are invasive ductal carcinoma and invasive lobular carcinoma.
Invasive ductal carcinoma
The most common type of breast canceraccounting for roughly 70 to 80 percent of all casesis called invasive ductal carcinoma . IDC is a cancer that starts in a milk duct and grows into other parts of the breast. With time, it may spread further, or metastasize, to other parts of the body.
Invasive lobular carcinoma
Invasive lobular carcinoma is the second most common type, accounting for roughly 5 to 10 percent of all breast cancers. ILC starts in lobules and then spreads into nearby breast tissue. Like IDC, it may metastasize. However, this cancer is harder to detect on mammograms and other exams than IDC. One in five women with ILC have both breasts affected.
Inflammatory breast cancer
Pagets disease of the breast
Angiosarcoma of the breast
Phyllodes tumors
Other, even more rare, types of invasive breast cancer include adenoid cystic carcinoma, low-grade adenosquamous carcinoma, medullary carcinoma, mucinous carcinoma, papillary carcinoma and tubular carcinoma.
How Does Distant Recurrence Occur
Many patients find it hard to understand how they can be apparently cancer free one day and be diagnosed with recurrent cancer the next. If surgery got all of the cancer out and chemotherapy and radiation were supposed to have mopped up the rest, how can recurrence even happen?
In most cases, even the smallest breast cancer detected has been growing for some time before it was caught. During this period of growth, the cancer cells multiplied and divided over and over again, and some cancer cells may splinter off from the main tumour and escaped into the surrounding blood and lymphatic vessels. Cells that spread to lymph nodes can certainly be trapped in those lymph nodes and removed at the time of surgery, but cells can also go into the circulatory system. Even early-stage cancers that originally had no lymph node involvement can recur and develop metastatic disease.
While its less common, cancer cells can bypass lymphatics and lymph nodes and travel via surrounding blood vessels. Cancer cells can continue to circulate and go anywhere the blood vessels will take them, or they can home in on other organs in the body, where they take up residence and continue to grow and divide in that one particular spot.
If and when cancer comes back, the cancer cells that escaped the breast are to blame. Obviously if your recurrence is ten years after your diagnosis, we assume that the cells have been dormant all that time and missed the treatments aimed at dividing cells.
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