How Many Types Of Breast Cancer Are There

What Is Invasive Breast Cancer Versus Noninvasive Breast Cancer

Noninvasive cancer means the abnormal cells are contained in the milk ducts of the breast and lack the ability to spread to surrounding tissue or elsewhere in the body. Invasive breast cancer means the cancer has grown beyond its original location into surrounding normal breast tissue and has the potential to spread to other parts of the body.

Prognostic Impact Of Tumor

It has been previously reported that tumor-specific expression of the rate-limiting enzyme, 3-hydroxy-3-methylglutharyl-coenzyme A reductase , in the mevalonate pathway is associated with more favorable tumor parameters in breast cancer. In the present study, it is examined the prognostic value of HMG–CoAR expression in a large cohort of primary breast cancer patients with long-term follow up.

Triple Negative Breast Cancer

Triple negative breast cancer is 3 times negative: the tumor does not grow under the influence of the hormone estrogen the tumor does not grow under the influence of the hormone progesterone the tumor is not HER2-positive

About 15% of breast cancers are triple negative. This species is more common in women of reproductive age.Treatment often consists of chemotherapy, surgery and radiation.

Hormone therapy and most targeted therapies do not work in triple negative breast cancer.A triple negative tumor often grows rapidly and is aggressive.

It also spreads more often and faster than other types of breast cancer. The chance that this breast cancer will come back is also greater. Has the tumor not come back or metastasized after 7 years? Then there is a very good chance that it will not come back or metastasize.

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Nanotechnology In Breast Cancer

The field of nanotechnology has rapidly evolved as evidenced by the fact that there are more than 150 ongoing clinical trials investigating the efficacy of nanotechnology based drug delivery carriers targeting cancer. Various liposomal doxorubicin formulations were developed in an effort to improve the therapeutic index of the conventional doxorubicin chemotherapy while maintaining its anti-tumor activity. For example, the efficacy of three liposomal doxorubicins are currently being used: liposomal daunorubicin , liposomal doxorubicin , and pegylated liposomal doxorubicin . Generally, these agents exhibit efficacies comparable to those of conventional doxorubicin, except with better safety profiles and less cardio toxicity. In addition to liposomal doxorubicin, albumin-bound paclitaxel is another example of an E PR based nanovector application for breast cancer chemotherapy. Paclitaxel is highly hydrophobic and dissolved in cremophor to prevent paclitaxel precipitation. However, cremophor-associated toxicities are severe and challenge the application of paclitaxel. Albumin-bound paclitaxel was developed to improve the solubility of paclitaxel

What Is Inflammatory Breast Cancer

As its name suggests, inflammatory breast cancer often causes the breast to become red, swollen, and inflamed. Some women with IBC also notice thickened or discolored breast skin with tiny dimples, puckers, or ridges that make it look like an orange peel. While the symptoms may sound like an infection, the real culprit is cancer that is blocking lymphatic vessels in the skin and breast tissue, causing a buildup of fluid and, in some cases, pain, discoloration, and sudden swelling of the breast. Also called inflammatory breast carcinoma or locally advanced breast cancer, IBC can spread quickly, making prompt diagnosis and treatment essential.

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Receptor Status And Triple Negative Breast Cancer

Your pathology report and your healthcare providers may describe your breast cancer as estrogen receptor , progesterone receptor or human epidermal growth factor receptor-2 positive or negative. Or, they may say that your breast cancer is triple negative or triple positive.

Estrogen and progesterone receptors are proteins found in some cancer cells that allow a hormone to attach and feed the cancer cells. Hormone receptor status is reported as positive or negative and sometimes a percent is also provided. For example, 90% estrogen receptor positive. ER/PR+ breast cancers will, at a minimum, receive some form of hormone therapy such as Tamoxifen.

HER2 is a protein involved in normal cell growth, which may also be present on breast cancer cells. If too much of the HER2 protein is produced, the tumor is considered HER2+ . Breast cancers that are HER2+ will receive HER2 directed therapy such as Herceptin.

Triple positive breast cancer is positive for HER2, ER and PR. You will receive HER2 directed therapies as well as hormone therapy.

Triple negative breast cancer is negative for HER2, ER and PR. Therefore, HER2 directed therapy and hormone therapy are not utilized. Typical treatment is chemotherapy.

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Physical Emotional And Social Effects Of Cancer

In general, cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

• Music therapy, meditation, stress management, and yoga for reducing anxiety and stress.

• Meditation, relaxation, yoga, massage, and music therapy for depression and to improve other mood problems.

• Meditation and yoga to improve general quality of life.

• Acupressure and acupuncture to help with nausea and vomiting from chemotherapy.

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Frequently Occurring Breast Cancer

Lobular carcinoma in situ : The term, in situ, refers to cancer that has not spread past the area where it initially developed. LCIS is a sharp increase in the number of cells within the milk glands of the breast.

Ductal carcinoma in situ : DCIS, the most common type of non-invasive breast cancer, is confined to the ducts of the breast. For example, ductal comedocarcinoma.

Typical Structure associated with ductal carcinoma

Mucinous Carcinoma Of The Breast

Mucinous carcinoma, also known as colloid carcinoma, is a rare form of invasive ductal carcinoma . About 2 percent of breast cancers are pure mucinous carcinoma, while up to 7 percent of breast cancers have some component of mucinous carcinoma cells.

With this type of cancer, the tumor consists of abnormal cells that appear to float in pools of mucus when looked at under a microscope.

Its typically a less aggressive type of cancer that has a lower probability of spreading to the axillary lymph nodes than some other types of IDC.

Mucinous carcinoma tends to be more common in post-menopausal women, with the average age at diagnosis being around 60 to 70 years of age.

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How Can I Protect Myself From Breast Cancer

Follow these three steps for early detection:

• Get a mammogram. The American Cancer Society recommends having a baseline mammogram at age 35, and a screening mammogram every year after age 40. Mammograms are an important part of your health history. Recently, the US Preventive Services Task Force came out with new recommendations regarding when and how often one should have mammograms. These include starting at age 50 and having them every two years. We do not agree with this, but we are in agreement with the American Cancer Society and have not changed our guidelines, which recommend yearly mammograms starting at age 40.
• Examine your breasts each month after age 20. You will become familiar with the contours and feel of your breasts and will be more alert to changes.
• Have your breast examined by a healthcare provider at least once every three years after age 20, and every year after age 40. Clinical breast exams can detect lumps that may not be detected by mammogram.

Life Style And Dietary Cause

Sedentary life style, high dietary intake of fat obesity particularly in postmenopausal women may cause breast cancer. The use of alcohol is also another one cause of breast cancer. The risk increases with the amount of alcohol consumed. Women who consume two to five alcoholic beverages per day have a risk about one and a half times that of nondrinkers for the development of breast cancer.

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How Is Breast Cancer Diagnosed

During your regular physical examination, your doctor will take a thorough personal and family medical history. He or she will also perform and/or order one or more of the following:

• Breast examination: During the breast exam, the doctor will carefully feel the lump and the tissue around it. Breast cancer usually feels different than benign lumps.
• Digital mammography: An X-ray test of the breast can give important information about a breast lump. This is an X-ray image of the breast and is digitally recorded into a computer rather than on a film. This is generally the standard of care .
• Ultrasonography: This test uses sound waves to detect the character of a breast lump whether it is a fluid-filled cyst or a solid mass . This may be performed along with the mammogram.

Based on the results of these tests, your doctor may or may not request a biopsy to get a sample of the breast mass cells or tissue. Biopsies are performed using surgery or needles.

After the sample is removed, it is sent to a lab for testing. A pathologist a doctor who specializes in diagnosing abnormal tissue changes views the sample under a microscope and looks for abnormal cell shapes or growth patterns. When cancer is present, the pathologist can tell what kind of cancer it is and whether it has spread beyond the ducts or lobules .

Hormone And Protein Receptors

Breast cancer can sometimes be described by the types of hormones or protein receptors on the surface of the cancer cells.

For example:

• Oestrogen receptor and progesterone receptor positive cancers are encouraged to grow by the female hormones oestrogen or progesterone. Read more about ER positive breast cancer.
• HR2 positive breast cancer means that the tumour produces too much of a protein called HER2, which helps breast cancer to grow. Read more about HER2+ breast cancer.
• Triple negative breast cancer doesnt have receptors for HER2, oestrogen or progesterone. More about triple negative breast cancer.

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Living With Breast Cancer

Being diagnosed with breast cancer can affect daily life in many ways, depending on what stage it’s at and the treatment you will have.

How people cope with the diagnosis and treatment varies from person to person. There are several forms of support available, if you need it.

Forms of support may include:

• family and friends, who can be a powerful support system
• communicating with other people in the same situation
• finding out as much as possible about your condition
• not trying to do too much or overexerting yourself
• making time for yourself

Find out more about living with breast cancer.

Expert Review And References

• American Cancer Society. Breast Cancer. 2015: .
• de Boer M, van Dijck JA, Bult P, Borm GF, Tjan-Heijnen VC. Breast cancer prognosis and occult lymph node metastases, isolated tumor cells, and micrometastases. Journal of the National Cancer Institute. Oxford University Press 2010.
• Lonning PE. Breast cancer prognostication and prediction: are we making progress?. Annals of Oncology. Oxford: Oxford University Press 2007.
• Morrow M, Burstein HJ, and Harris JR. Malignant tumors of the breast. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins 2015: 79: 1117-1156.
• Tripathy D, Eskenazi LB, Goodson, WH, et al. Breast. Ko, A. H., Dollinger, M., & Rosenbaum, E. Everyone’s Guide to Cancer Therapy: How Cancer is Diagnosed, Treated and Managed Day to Day. 5th ed. Kansas City: Andrews McMeel Publishing 2008: pp. 473-514.

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Does Breast Cancer Affect Women Of All Races Equally

All women, especially as they age, are at some risk for developing breast cancer. The risks for breast cancer in general arent evenly spread among ethnic groups, and the risk varies among ethnic groups for different types of breast cancer. Breast cancer mortality rates in the United States have declined by 40% since 1989, but disparities persist and are widening between non-Hispanic Black women and non-Hispanic white women.

Statistics show that, overall, non-Hispanic white women have a slightly higher chance of developing breast cancer than women of any other race/ethnicity. The incidence rate for non-Hispanic Black women is almost as high.

Non-Hispanic Black women in the U.S. have a 39% higher risk of dying from breast cancer at any age. They are twice as likely to get triple-negative breast cancer as white women. This type of cancer is especially aggressive and difficult to treat. However, it’s really among women with hormone positive disease where Black women have worse clinical outcomes despite comparable systemic therapy. Non-Hispanic Black women are less likely to receive standard treatments. Additionally, there is increasing data on discontinuation of adjuvant hormonal therapy by those who are poor and underinsured.

In women under the age of 45, breast cancer is found more often in non-Hispanic Black women than in non-Hispanic white women.

Phyllodes Tumors Of The Breast

A phyllodes tumor is a very rare type of breast cancer that accounts for less than

75 percent of cases, phyllodes tumors arent cancerous, so they usually dont spread beyond the breast. But they can grow quickly and some can be considered borderline, which means they have properties that could make them cancerous at a later stage.

Phyllodes tumors form in the connective tissue of the breast. The most common symptoms include:

• a smooth lump in or around the breast
• a lump that grows quickly and stretches the skin
• breast skin that looks red and feels warm

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Tubular Carcinoma Of The Breast

Tubular carcinoma is a subtype of invasive ductal carcinoma . This type of breast cancer gets its name due to the tube-shaped structures, which can be seen under a microscope, that make up the tumor. The tumors are usually small and tend to grow slowly.

Tubular carcinoma is rare, accounting for up to 2 percent of invasive breast cancers.

Because these tumors are small, they are most often detected during a routine mammogram. They tend to be low grade with good prognosis.

Who Gets Breast Cancer

Breast cancer is the most common cancer among women other than skin cancer. Increasing age is the most common risk factor for developing breast cancer, with 66% of breast cancer patients being diagnosed after the age of 55.

In the US, breast cancer is the second-leading cause of cancer death in women after lung cancer, and it’s the leading cause of cancer death among women ages 35 to 54. Only 5 to 10% of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The majority of breast cancer cases are “sporadic, meaning there is no definitive gene mutation.

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Kinds Of Breast Cancer

The most common kinds of breast cancer are

• Invasive ductal carcinoma. The cancer cells begin in the ducts and then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
• Invasive lobular carcinoma. Cancer cells begin in the lobules and then spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.

Types Of Invasive Breast Cancers

Invasive ductal breast cancer

About 8 out of 10 invasive breast cancers are this type. The cancer develops in the milk ducts of your breast, but breaks out of the duct tubes, and invades, or infiltrates the surrounding tissue of the breast and possibly other areas of the body.

It is usually treated with surgery, often followed by chemotherapy or radiotherapy. Read more about how breast cancer is treated.

The best treatment plan for you will also depend on if your cancer is helped to grow by hormones or particular proteins .

• Oestrogen receptor and progesterone receptor positive cancers are encouraged to grow by the female hormones oestrogen or progesterone. Read more about ER positive breast cancer.
• HER2 positive breast cancer means that the tumour produces too much of a protein called HER2, which helps breast cancer to grow. Read more about HER2+ breast cancer.
• Triple negative breast cancer doesnt have receptors for HER2, oestrogen or progesterone. More about triple negative breast cancer.

Other types of invasive breast cancer:

• Paget’s disease of the breast

Rarer types of invasive breast cancer:

Medullary breast cancer, mucinous breast cancer, tubular breast cancer and malignant phyllodes tumours are rare types of breast cancer.

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What Happens After The Local Breast Cancer Treatment

Following local breast cancer treatment, the treatment team will determine the likelihood that the cancer will recur outside the breast. This team usually includes a medical oncologist, a specialist trained in using medicines to treat breast cancer. The medical oncologist, who works with the surgeon, may advise the use of the drugs like tamoxifen or anastrozole or possibly chemotherapy. These treatments are used in addition to, but not in place of, local breast cancer treatment with surgery and/or radiation therapy.

After treatment for breast cancer, it is especially important for a woman to continue to do a monthly breast examination. Regular examinations will help you detect local recurrences. Early signs of recurrence can be noted in the incision area itself, the opposite breast, the axilla , or supraclavicular region .

Maintaining your follow-up schedule with your physician is also necessary so problems can be detected when treatment can be most effective. Your health care provider will also be able to answer any questions you may have about breast self-examination after the following procedures.