How Is Invasive Ductal Carcinoma Diagnosed
Same Day Results
At the Johns Hopkins Breast Center, we know how quickly patients want results from a biopsy or scan if there is a suspicion of breast cancer. We follow strict guidelines for biopsies and pathology reports. Most of our patients will receive the probability of cancer immediately following their biopsy procedure and a pathology confirmation within 24 hours.
Learn more about the steps of diagnosis, including:
- Digital mammography
- Biologic targeted therapy
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.
Feeling Unwell Or Tired
Many women do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These changes may be very subtle and happen slowly over time.
Fatigue is another common problem for women who have received chemo. This may last a few months up to several years. It can often be helped, so its important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have sleep problems, they can be treated. Sometimes fatigue can be a sign of depression, which may be helped by counseling and/or medicines.
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What Are The Stages Of Breast Cancer
There are two different staging systems for breast cancer. One is called anatomic staging while the other is prognostic staging. The anatomic staging is defined by the areas of the body where the breast cancer is found and helps to define appropriate treatment. The prognostic staging helps medical professionals communicate how likely a patient is to be cured of the cancer assuming that all appropriate treatment is given.
The anatomic staging system is as follows:
Stage 0 breast disease is when the disease is localized to the milk ducts .
Stage I breast cancer is smaller than 2 cm across and hasn’t spread anywhere including no involvement in the lymph nodes.
Stage II breast cancer is one of the following:
- The tumor is less than 2 cm across but has spread to the underarm lymph nodes .
- The tumor is between 2 and 5 cm .
- The tumor is larger than 5 cm and has not spread to the lymph nodes under the arm .
Stage III breast cancer is also called “locally advanced breast cancer.” The tumor is any size with cancerous lymph nodes that adhere to one another or to surrounding tissue . Stage IIIB breast cancer is a tumor of any size that has spread to the skin, chest wall, or internal mammary lymph nodes .
Stage IV breast cancer is defined as a tumor, regardless of size, that has spread to areas away from the breast, such as bones, lungs, liver or brain.
Medullary Carcinoma Of The Breast
Medullary carcinoma of the breast is another rare subtype of invasive ductal carcinoma . It accounts for around less than 5 percent of all breast cancer cases.
The tumor is typically a soft, fleshy mass rather than a lump in the breast tissue. The mass most often develops in the middle of the breast and is most often found in women with the BRCA1 mutation.
Although these cancer cells often have an aggressive appearance, they dont grow quickly and usually dont spread to the lymph nodes. This makes it easier to treat than some other types of breast cancer.
- the patients preference
Possible treatment options for breast cancer include:
Regular breast self-examinations, and mammograms help detect breast cancer in its early stages. Finding breast cancer that has not yet spread gives you the best chance of remaining healthy and cancer-free for many years.
According to the , on average, when your breast cancer is treated before it has spread, youre 99 percent as likely to be alive in 5 years as someone who does not have breast cancer.
Other steps you can take to lower your risk of getting breast cancer include the following:
- Limit alcohol to no more than one drink a day.
- Maintain a moderate weight throughout your life.
- Stay physically active.
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How Do Tamoxifen Raloxifene Anastrozole And Exemestane Reduce The Risk Of Breast Cancer
If you are at increased risk for developing breast cancer, four medications tamoxifen , raloxifene , anastrozole , and exemestane may help reduce your risk of developing this disease. These medications act only to reduce the risk of a specific type of breast cancer called estrogen receptor-positive breast cancer. This type of breast cancer accounts for about two-thirds of all breast cancers.
Tamoxifen and raloxifene are in a class of drugs called selective estrogen receptor modulators . These drugs work by blocking the effects of estrogen in breast tissue by attaching to estrogen receptors in breast cells. Because SERMs bind to receptors, estrogen is blocked from binding. Estrogen is the fuel that makes most breast cancer cells grow. Blocking estrogen prevents estrogen from triggering the development of estrogen-receptor-positive breast cancer.
Anastrozole and exemestane are in a class of drugs called aromatase inhibitors . These drugs work by blocking the production of estrogen. Aromatase inhibitors do this by blocking the activity of an enzyme called aromatase, which is needed to make estrogen.
Ductal Carcinoma In Situ
DCIS is often curable. Its usually treated with a lumpectomy, followed by radiation therapy or with a mastectomy.
If the cancer is hormone receptor positive, it may be treated with tamoxifen or an aromatase inhibitor for 5 years after surgery. This treatment is thought to lower the risk of DCIS recurrence or invasive cancer developing in either breast.
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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.
Tumor In The Mammary Gland
This is less common than a tumor in the milk duct. About 10% of women with breast cancer have a tumor in the mammary gland. You often only feel swelling of the breast. This tumor is not always clearly visible on a photo or scan.
Breast cancer is further divided into: hormone sensitive triple negative
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Special Invasive Breast Cancers And Carcinoma In Situ
Inflammatory breast cancer is an aggressive locally advanced breast cancer.
The main symptoms of IBC are swelling and redness in the breast. Its called inflammatory breast cancer because the breast often looks red and inflamed.
About 1-5 percent of breast cancers are IBC .
Learn more about IBC.
Paget disease of the breast is a rare carcinoma in situ in the skin of the nipple or in the skin closely surrounding the nipple. Its usually found with an underlying breast cancer.
About 1-4 percent of breast cancers also involve Paget disease of the breast .
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What Is A Breast Papilloma And Is It Cancer
Also called intraductal papilloma, a breast papilloma is a small, wartlike growth in the breasts milk ducts. This benign condition may cause a clear or bloody discharge from the nipple, or you may feel a small lump behind or next to the nipple. Having one papilloma does not raise your breast cancer risk, though having several of these growths has been linked to higher risk.
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How Is Chemotherapy For Breast Cancer Given
Chemo drugs for breast cancer are typically given into a vein , either as an injection over a few minutes or as an infusion over a longer period of time. This can be done in a doctors office, infusion center, or in a hospital setting.
Often, a slightly larger and sturdier IV is required in the vein system to administer chemo. These are known as central venous catheters , central venous access devices , or central lines. They are used to put medicines, blood products, nutrients, or fluids right into your blood. They can also be used to take out blood for testing.
There are many different kinds of CVCs. The most common types are the port and the PICC line. For breast cancer patients, the central line is typically placed on the side opposite of the breast cancer. If a woman has breast cancer in both breasts, the central line will most likely be placed on the side that had fewer lymph nodes removed or involved with cancer.
Chemo is given in cycles, followed by a rest period to give you time to recover from the effects of the drugs. Chemo cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, chemo is given only on the first day of the cycle. With others, it is given one day a week for a few weeks or every other week. Then, at the end of the cycle, the chemo schedule repeats to start the next cycle.
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
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What Are The Four Types Of Breast Cancer
Breast cancer may be called lobular carcinoma if it begins in glands that make milk, or ductal carcinoma if it begins in the ducts that carry milk to the nipple. The cancer may grow and invade other areas around the breast, such as skin or chest wall.
Different types of breast cancer grow and spread at different rates. Both types of breast cancer may be invasive or non-invasive.
- Ductal carcinoma in situ : DCIS is a noninvasive condition. With DCIS, the cancer cells are confined to the ducts in the breast and have not invaded the surrounding breast tissue.
- Lobular carcinoma in situ : LCIS is cancer that grows in the milk-producing glands of the breast. Like DCIS, the cancer cells do not invade the surrounding tissue.
- Invasive ductal carcinoma : It is the most common type of breast cancer. This type of breast cancer begins in the milk ducts and then invades nearby tissue in the breast. Once the breast cancer has spread to the tissue outside milk ducts, it can spread to other nearby organs and tissue.
- Invasive lobular carcinoma first develops in lobules of the breast and then invades nearby tissues.
Apart from above four types, below are few less-common types of breast cancer:
What Is Ductal Carcinoma In Situ
Ductal carcinoma in situ is a very early form of breast cancer thats confined to the milk ducts, which is why its called ductal. Carcinoma is the name for any cancer that begins in cells that line the inner or outer surfaces of tissues, such as the breast ducts. In situ is a Latin term meaning in its original place. DCIS is the most common form of noninvasive breast cancer.
DCIS is classified as low, intermediate, or high grade. Grades are based on what the cells look like under a microscope. The lower the grade, the more closely DCIS resembles normal breast cells. The higher the grade, the more different it is from normal cells. DCIS can sometimes involve the nipple, causing it to look red and scaly. This is a rare form of cancer known as Pagets disease of the breast .
In some women, DCIS may not progress to invasive cancer in their lifetime. This has fueled debate about DCIS about whether women with low-risk disease need any treatment, or if they could be safely checked with annual mammograms and breast exams to see if the cancer is progressing. Currently, the standard treatment for DCIS includes surgery, often a lumpectomy.
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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.
What Is Metaplastic Carcinoma
Also known as metaplastic breast cancer, metaplastic carcinoma is a rare type of invasive breast cancer with a unique characteristic: It contains a mix of two or more types of breast cancer cells, usually carcinoma combined with sarcoma. Metaplastic means that one form is turning into another. Various leading-edge techniques are used to analyze the exact genetics and biology of these confused cancers to find out if the tumor is more similar to carcinoma or sarcoma, since these two types of cancer have very different treatments.
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Can Cancer Form In Other Parts Of The Breast
Cancers can also form in other parts of the breast, but these types of cancer are less common. These can include:
- Angiosarcomas. This type of cancer begins in the cells that make up the lining of blood or lymph vessels. These cancers can start in breast tissue or breast skin. They are rare.
- Inflammatory breast cancer. This type of cancer is rare and different from other types of breast cancer. It is caused by obstructive cancer cells in the skins lymph vessels.
- Paget disease of the breast, also known as Paget disease of the nipple. This cancer affects the skin of the nipple and areola .
- Phyllodes tumors. These are rare, and most of these masses are not cancer. However, some are cancerous. These tumors begin in the breasts connective tissue, which is called the stroma.
What To Know About Breast Cancer Symptoms
The symptoms of breast cancer can vary widely and some types of breast cancer may not have any noticeable symptoms.
Sometimes a lump may be too small to be felt or to cause any changes to your breast or surrounding area. In these cases, cancerous cells are often first detected through screening techniques like a mammogram.
When there are symptoms, they can include:
- a lump or thickening of breast tissue that you can feel with your fingers
- breast swelling or changes to your breast size or shape
- changes to the skin on your breast, such as dimpling, redness, or skin irritation
- the nipple turning inward or nipple pain
- a lump in your underarm area
- nipple discharge other than breast milk
Its important to be familiar with how your breasts usually look and feel. This will help you notice any changes and to follow up with your healthcare professional promptly if anything looks or feels different.
Noninvasive breast cancer develops in the cells of a duct or lobule and remains in that location. Its also referred to as in situ which means in the original place.
There are two types of noninvasive breast cancer:
- ductal carcinoma in situ
- lobular carcinoma in situ
Lets take a closer look at each type.
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