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Is Breast Cancer Considered Internal Cancer

How Is Breast Cancer Treated

Breast Cancer and Immunotherapy with Dr. Leisha Emens and Barbara Bigelow

If the tests find cancer, you and your doctor will develop a treatment plan to eradicate the breast cancer, to reduce the chance of cancer returning in the breast, as well as to reduce the chance of the cancer traveling to a location outside of the breast. Treatment generally follows within a few weeks after the diagnosis.

The type of treatment recommended will depend on the size and location of the tumor in the breast, the results of lab tests done on the cancer cells, and the stage, or extent, of the disease. Your doctor will usually consider your age and general health as well as your feelings about the treatment options.

Breast cancer treatments are local or systemic. Local treatments are used to remove, destroy, or control the cancer cells in a specific area, such as the breast. Surgery and radiation treatment are local treatments. Systemic treatments are used to destroy or control cancer cells all over the body. Chemotherapy and hormone therapy are systemic treatments. A patient may have just one form of treatment or a combination, depending on her individual diagnosis.

What Causes Breast Cancer

Doctors don’t know exactly what causes breast cancer. But some things are known to increase the chance that you will get it. These are called risk factors. Risk factors that you cannot change include getting older and having changes to certain genes. Risk factors you may be able to change include using certain types of hormone therapy after menopause, being overweight, and not getting enough physical activity.

But many women who have risk factors don’t get breast cancer. And many women who get breast cancer don’t have any known risk factors other than being female and getting older.

Tnm Classification For Breast Cancer

The American Joint Committee on Cancer provides two principal groups for breast cancer staging: anatomic, which is based on extent of cancer as defined by tumor size , lymph node status , and distant metastasis and prognostic, which includes anatomic TNM plus tumor grade and the status of the biomarkers human epidermal growth factor receptor 2 , estrogen receptor , and progesterone receptor . The prognostic stage group is preferred for patient care and is to be used for reporting of all cancer patients in the United States.

In turn, prognostic stages are divided into clinical and pathological groups. Pathological stage applies to patients who have undergone surgery as the initial treatment for breast cancer. It includes all information used for clinical staging plus findings at surgery and pathological findings from surgical resection. Pathological prognostic stage does not apply to patients who received neoadjuvant therapy . See the tables below.

Table. TNM Classification for Breast Cancer

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There Are Three Ways To Be Found Medically Eligible For Ssdi Or Ssi Disability Benefits When You Have Breast Cancer

By Bethany K. Laurence, Attorney

Breast cancer is the second most common cancer in the world. Although there are many kinds of breast cancer, the most common type of breast cancer for women is mammary ductal carcinoma. Mammary ductal carcinoma comes in two forms: infiltrating ductal carcinoma and ductal carcinoma in situ . The latter, ductal carcinoma in situ, is also known as Stage 0 cancer, because doctors cannot even seem to agree that it is actually cancer. Currently, ductal carcinoma in situ accounts for about 20% of screening-detected breast cancer diagnoses.

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How Do Cancer Cells Differ From Precancerous Cells

Breast Cancer

Precancerous cells may look abnormal and similar to cancer cells but are distinguished from cancer cells by their behavior. Unlike cancer cells, precancerous cells do not have the ability to spread to other regions of the body.

An often confusing condition is that of carcinoma-in-situ Carcinoma in situ consists of cells with the abnormal changes found in cancer cells, but since they have not spread beyond their original location they are not technically cancer. Since CIS can turn into cancer, it is usually treated as early cancer.

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How Is The Stage Determined

The staging system most often used for breast cancer is the American Joint Committee on Cancer TNM system. The most recent AJCC system, effective January 2018, has both clinical and pathologic staging systems for breast cancer:

  • The pathologic stage is determined by examining tissue removed during an operation.
  • Sometimes, if surgery is not possible right away or at all, the cancer will be given a clinical stage instead. This is based on the results of a physical exam, biopsy, and imaging tests. The clinical stage is used to help plan treatment. Sometimes, though, the cancer has spread further than the clinical stage estimates, and may not predict the patients outlook as accurately as a pathologic stage.

In both staging systems, 7 key pieces of information are used:

  • The extent of the tumor : How large is the cancer? Has it grown into nearby areas?
  • The spread to nearby lymph nodes : Has the cancer spread to nearby lymph nodes? If so, how many?
  • The spread to distant sites : Has the cancer spread to distant organs such as the lungs or liver?
  • Estrogen Receptor status: Does the cancer have the protein called an estrogen receptor?
  • Progesterone Receptor status: Does the cancer have the protein called a progesterone receptor?
  • Her2 status: Does the cancer make too much of a protein called Her2?
  • Grade of the cancer : How much do the cancer cells look like normal cells?

In addition, Oncotype Dx® Recurrence Score results may also be considered in the stage in certain circumstances.

Medically Qualifying For Benefits With The Blue Book

Whenever the SSA receives an application for benefits, it evaluates the condition and symptoms based on their own guide. This guide, known as the Blue Book. The Blue Book lists hundreds of disabilities that could potentially qualify for benefits, along with the medical test results or symptoms that are necessary to be approved.

Breast cancer is listed along with other cancers in Section 13.00Malignant Neoplastic Diseases.

For breast cancer to qualify, you must have doctors reports or test results that show one of the following:

  • An advanced breast cancer that has extended to the chest, skin, or internal mammary nodes.
  • A carcinoma that has spread above or below the collarbone, has spread to 10+ nearby nodes, or spread to distant regions of the chest.
  • A carcinoma that returns after anticancer therapy.
  • Small-cell carcinoma.

The SSAs listing for breast cancer is very technical. You will need to speak with your doctor to see if your specific cancer has spread to the extent to qualify for disability benefits via the Blue Book. Typically, breast cancer must be stage three or above to qualify for disability benefits medically.

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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.

Risk Factors For Breast Cancer

Treatment Options for Stage Four Breast Cancer

There are several risk factors that increase your chances of getting breast cancer. However, having any of these doesnt mean you will definitely develop the disease.

Some risk factors cant be avoided, such as family history. You can change other risk factors, such as quitting smoking, if you smoke. Risk factors for breast cancer include:

While there are risk factors you cant control, following a healthy lifestyle, getting regular screenings, and taking any preventive measures your doctor recommends can help reduce your risk for developing breast cancer.

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Cancer Cells Vs Normal Cells

There are many important differences between cancer cells and normal cells. Some of these include:

The ability to invade and metastasize is very important in differentiating a cancer cell from a normal healthy cell, but there are many other important distinctions as well.

  • May spread to other regions of the body

  • Can be immortal

  • Has defined lifespan

How Is It Treated

You and your doctor will decide which mix of treatments is right for you based on many things. These include facts about your cancer as well as your family history, other health problems, and your feelings about keeping your breast.

Breast cancer is usually treated with surgery, radiation therapy, chemotherapy, hormone therapy, or targeted therapy.

In some cases, you may need to decide whether to have surgery to remove just the cancer or surgery that removes the entire breast .

Treatments can cause side effects. Your doctor can let you know what problems to expect and help you find ways to manage them.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Talking with other women who are going through the same thing may help. Your doctor or your local branch of the Canadian Cancer Society can help you find a support group.

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Literature Search And Study Identification

A systematic literature search was performed to identify studies that met the predefined eligibility criteria. The search yielded 215 articles. Full texts of 99 articles were retrieved. We defined studies reporting no more than 4 cases as small case series. Small case series and reviews, correspondence and conference posts were excluded. Studies based on the same population or on human cadavers were excluded. Furthermore, studies that enrolled neoadjuvant treatment or did not report enough data were excluded. Finally, 18 studies were included in this systematic review. The process of research screening and selection is shown in a flow chart .

Fig. 1

Top Risk Factors Linked To Breast Cancer

Brachytherapy
  • Aging. Your breast cancer risk increases as you get older. By age group, breast cancer is diagnosed in:footnote 2
  • 4 out of 1,000 women in their 30s.
  • 15 out of 1,000 women in their 40s.
  • 24 out of 1,000 women in their 50s.
  • 36 out of 1,000 women in their 60s.
  • 38 out of 1,000 women in their 70s.
  • Being female. Although breast cancer can occur in men, most breast cancer is found in women.
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    Disabilities Related To Cancer Treatment

    Even if a patients cancer treatment is successful, they can be left with serious impairments. For example, heart, lung, liver, and bone problems have been linked to chemotherapy, while cognitive dysfunction and bone weakness can be long-term effects of radiation.

    If you develop a disabling condition as the result of successful cancer treatment, your disability will be evaluated without considering the cancer diagnosis. The Blue Book criteria for your specific condition can offer insight as to whether your long-term side effects of cancer treatment are severe enough to qualify for SSDI benefits.

    How Is Male Breast Cancer Staged

    Male breast cancer is staged in the same manner as female breast cancer.

    In order to guide treatment and offer some insight into prognosis, breast cancer is staged into five different groups. This staging is done in a limited fashion before surgery, considering the size of the tumor on a mammogram and any evidence of spread to other organs that is found with other tests. It is done again after surgery when the pathologist can look at the entire specimen and lymph nodes to look for signs of cancer. The staging system is very complex. A simplified version is described below. The entire staging system is outlined at the end of this article.

    • Stage 0: These are very rare in men.
    • Lobular carcinoma in situ refers to abnormal cells lining a gland in the breast. This is a risk factor for the future development of cancer, but this is not felt to represent a cancer itself.
    • Ductal carcinoma in situ refers to abnormal cells lining a duct. Treatment options are similar to patients with Stage I breast cancers.
  • Stage I: early-stage breast cancer where the tumor is less than 2 cm and hasn’t spread beyond the breast.
  • Stage II: early-stage breast cancer in which the tumor is either less than 2 cm across and has spread to the lymph nodes under the arm or the tumor is between 2 and 5 cm , or the tumor is greater than 5 cm and hasn’t spread outside the breast.
  • Stage IV: metastatic breast cancer in which cancer has spread outside the breast to other organs in the body.
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    How Do They Start

    Cancer cells appear through a series of genetic and epigenetic changes. Some of these changes may be either inherited or more often, caused by carcinogens in our environment. In general, solid tumors, contain multiple mutations. Interestingly, the metastatic process that is the main culprit for the high mortality of advanced cancers is thought to be caused mostly by epigenetic changes as no specific genetic alterations have been found in metastases. It also helps explain a genetic predisposition to cancer. A genetic predisposition does not mean you will get cancer, but, simplistically, if a few mutations are already in place, it will likely take fewer acquired mutations for a cell to become cancerous.

    The process of normal cells becoming cancer often goes through stages in which the cell becomes progressively more abnormal appearing. These stages may include hyperplasia, dysplasia, and finally cancer. You may also hear this described as differentiation. Early on a cell may look much like normal cells of that organ or tissue, but as progression occurs, the cell becomes increasingly undifferentiated. This is, in fact, why sometimes the original source of cancer cannot be determined.

    What Causes Male Breast Cancer And Am I At Risk

    Mission of the National Breast Cancer Coalition

    There are about 2,670 cases of male breast cancer diagnosed annually. Age is a risk factor in men for the development of breast cancer. The average age of men diagnosed with breast cancer is 68. African-American men have a higher incidence of male breast cancer.

    The risk of breast cancer is also increased in men with a family history of breast cancer. Other risk factors for the development of male breast cancer include Klinefelter’s syndrome , men from families with known BRCA 1 and 2 mutations, being of Jewish descent, mumps orchitis , estrogen treatment, obesity, liver disease, radiation exposure, and heavy alcohol consumption.

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    Breast Cancer Cell Lines

    Part of the current knowledge on breast carcinomas is based on in vivo and in vitro studies performed with cell lines derived from breast cancers. These provide an unlimited source of homogenous self-replicating material, free of contaminating stromal cells, and often easily cultured in simple standard media. The first breast cancer cell line described, BT-20, was established in 1958. Since then, and despite sustained work in this area, the number of permanent lines obtained has been strikingly low . Indeed, attempts to culture breast cancer cell lines from primary tumors have been largely unsuccessful. This poor efficiency was often due to technical difficulties associated with the extraction of viable tumor cells from their surrounding stroma. Most of the available breast cancer cell lines issued from metastatic tumors, mainly from pleural effusions. Effusions provided generally large numbers of dissociated, viable tumor cells with little or no contamination by fibroblasts and other tumor stroma cells.Many of the currently used BCC lines were established in the late 1970s. A very few of them, namely MCF-7, T-47D, MDA-MB-231 and SK-BR-3, account for more than two-thirds of all abstracts reporting studies on mentioned breast cancer cell lines, as concluded from a Medline-based survey.

    Metabolic markers

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  • Diagnosis Of Breast Cancer

    To determine if your symptoms are caused by breast cancer or a benign breast condition, your doctor will do a thorough physical exam in addition to a breast exam. They may also request one or more diagnostic tests to help understand whats causing your symptoms.

    Tests that can help diagnose breast cancer include:

    • Mammogram. The most common way to see below the surface of your breast is with an imaging test called a mammogram. Many women ages 40 and older get annual mammograms to check for breast cancer. If your doctor suspects you may have a tumor or suspicious spot, they will also request a mammogram. If an abnormal area is seen on your mammogram, your doctor may request additional tests.
    • Ultrasound. A breast ultrasound uses sound waves to create a picture of the tissues deep in your breast. An ultrasound can help your doctor distinguish between a solid mass, such as a tumor, and a benign cyst.

    Your doctor may also suggest tests such as an MRI or a breast biopsy.

    If you dont already have a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.

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    Breast Exam By Your Doctor

    The same guidelines for self-exams provided above are true for breast exams done by your doctor or other healthcare professional. They wont hurt you, and your doctor may do a breast exam during your annual visit.

    If youre having symptoms that concern you, its a good idea to have your doctor do a breast exam. During the exam, your doctor will check both of your breasts for abnormal spots or signs of breast cancer.

    Your doctor may also check other parts of your body to see if the symptoms youre having could be related to another condition.

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