Ductal Carcinoma In Situ
Ductal carcinoma in situ refers to an area of abnormal cells on one milk duct.
When a person receives this diagnosis, the cells have not invaded the surrounding breast tissue. However, having ductal carcinoma in situ can increase the risk of developing invasive breast cancer later.
This condition generally does not cause symptoms. Doctors find through mammography. Rarely, a person may notice a lump in the breast or some discharge from the nipple.
Signs Of Inflammatory Breast Cancer
Another type of breast cancer, known as inflammatory breast cancer , will only rarely cause lumps or symptoms. This type of breast cancer does not show up on a mammogram. Symptoms of inflammatory breast cancer may include:
- Red, swollen, itchy breast
- Tenderness of the breast when touched
- A pitted or ridged appearance of the surface of the breast
- Aching, burning, heaviness in one breast
- One breast that is significantly larger than the other breast
- A nipple that faces inward
- Swollen lymph nodes under the arm
- Swollen lymph nodes above the collarbone
- Other symptoms that do not go away after you take a course of antibiotics
It is important to remember that several other conditions besides cancer can cause these changes. Eczema can cause changes to the texture of the skin on your breasts, for example, and many illnesses can cause swollen lymph nodes. Breasts may change size during your menstrual cycle, inverted or flat nipples throughout life are common, and milk leaks are very normal during pregnancy or shortly after you have had a baby.
If you notice changes in the size of only one breast, skin changes not associated with eczema, changes in the size or shape of only one breast, or have nipple discharge when you are not pregnant or during postpartum, however, you should seek a medical opinion. Other signs to look for are nipples that invert or flatten suddenly or a feeling of warmth inside your breast.
What You Should Do Next
If you notice any unusual symptoms or unexpected changes in your nipples or breasts, consult your doctor. Be sure to mention any family history of cancer, as this may affect your risk level.
After assessing your symptoms and performing a physical exam, your doctor might send you for a mammogram. A mammogram is an X-ray used to diagnose breast cancer.
If you do have cancer, catching it early will give you a good chance of successfully treating it.
Your symptoms may also be a sign of another underlying condition. Your doctor will work with you to determine the best course of treatment and care.
No matter the cause, you should get in the habit of regularly checking your breasts for any changes like lumps, swelling, or discoloration. If you notice anything different, make an appointment with your doctor.
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What Increases Your Risk Of Breast Cancer
Factors that can elevate risk breast cancer risk include:
- A personal or family history of breast cancer, including DCIS and LCIS
- Inherited genetic predispositions, most commonly with BRCA1 or BRCA2 gene mutations
- Elevated lifetime estrogen exposure, including:
- Early onset of menstruation
- Late-onset of menopause
- Older age of first childbirth or never having given birth
- Taking estrogen and progesterone after menopause
Metastatic Breast Cancer Symptoms
Metastatic breast cancer symptoms depend on the part of the body to which the cancer has spread and its stage. Sometimes, metastatic disease may not cause any symptoms.
- If the breast or chest wall is affected, symptoms may include pain, nipple discharge, or a lump or thickening in the breast or underarm.
- If the bones are affected, symptoms may include pain, fractures, constipation or decreased alertness due to high calcium levels.
- If tumors form in the lungs, symptoms may include shortness of breath or difficulty breathing, coughing, chest wall pain or extreme fatigue.
- If the liver is affected, symptoms may include nausea, extreme fatigue, increased abdominal girth, swelling of the feet and hands due to fluid collection and yellowing or itchy skin.
- If breast cancer spreads to the brain or spinal cord and forms tumors, symptoms may include pain, confusion, memory loss, headache, blurred or double vision, difficulty with speech, difficulty with movement or seizures.
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How Does Breast Cancer Pain Feel Like
Breast cancer can cause changes in skin cells that lead to feelings of pain, tenderness, and discomfort in the breast. Although breast cancer is often painless, it is important not to ignore any signs or symptoms that could be due to breast cancer. Some people may describe the pain as a burning sensation.
What Are The Breast Cancer Stages
Staging helps describe how much cancer is in your body. Its determined by several factors, including the size and location of the tumor and whether the cancer has spread to other areas of your body. The basic breast cancer stages are:
- Stage 0. The disease is non-invasive. This means it hasnt broken out of your breast ducts.
- Stage I. The cancer cells have spread to the nearby breast tissue.
- Stage II. The tumor is either smaller than 2 centimeters across and has spread to underarm lymph nodes or larger than 5 centimeters across but hasnt spread to underarm lymph nodes. Tumors at this stage can measure anywhere between 2 to 5 centimeters across, and may or may not affect the nearby lymph nodes.
- Stage III. At this stage, the cancer has spread beyond the point of origin. It may have invaded nearby tissue and lymph nodes, but it hasnt spread to distant organs. Stage III is usually referred to as locally advanced breast cancer.
- Stage IV. The cancer has spread to areas away from your breast, such as your bones, liver, lungs or brain. Stage IV breast cancer is also called metastatic breast cancer.
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Be Aware Of Your Breasts To Detect Breast Cancer Symptoms Early
Studies show that regular breast self-exams are not the best way to detect breast cancer early.
What does work? Being aware of how your breasts look and feel and seeing a doctor as soon as you notice changes or abnormalities.
The vast majority of breast cancers are found during daily activities like showering, applying deodorant or even scratching, says Therese Bevers, M.D., medical director of the Cancer Prevention Center.
Bevers advises women to see a doctor if they have one or more symptoms of breast cancer, no matter how mild they may seem.
You dont need to wait for any particular size or severity of symptoms to get checked out, she says. “The earlier that breast cancer is detected, the better our chances of treating it successfully.”
And you shouldnt ignore symptoms just because you breasts don’t hurt. Pain is rarely a symptom of breast cancer, she says.
The vast majority of breast cancers are found during daily activitieslike showering, applying deodorant or even scratching.
Therese Bevers, M.D.
Breast Cancer Types And Symptoms
There are several kinds of breast cancer. Many of them share symptoms.
Symptoms of ductal carcinoma
This is the most common type of breast cancer. It begins in your ducts. About 1 in 5 new breast cancers are ductal carcinoma in situ . This means you have cancer in the cells that line your ducts, but it hasnât spread into nearby tissue.
You may not notice any symptoms of ductal carcinoma. It can also cause a breast lump or bloody discharge.
Symptoms of lobular carcinoma
This kind begins in the glands that make milk, called lobules. Itâs the second most common type of breast cancer. Symptoms include:
- Fullness, thickening, or swelling in one area
- Nipples that are flat or point inward
Symptoms of invasive breast cancer
Breast cancer thatâs spread from where it began into the tissues around it is called invasive or infiltrating. You may notice:
- A lump in your breast or armpit. You might not be able to move it separately from your skin or move it at all.
- One breast that looks different from the other
- A rash or skin thatâs thick, red, or dimpled like an orange
- Loss of appetite and weight loss
- Muscle weakness
Symptoms of triple-negative breast cancer
Breast cancer is called triple-negative if it doesnât have receptors for the hormones estrogen and progesterone and doesnât make a lot of a protein called HER2. This kind tends to grow and spread faster than other types, and doctors treat it differently.
Symptoms of male breast cancer
Learn more about breast cancer in men.
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What Is A Histological Work
Determining your type of breast cancer begins with a histological workup, a summary prepared by the pathologist after you undergo a biopsy. Essentially, the histological evaluation is the microscopic analysis of the chemical and cellular properties associated with a suspicious breast tumor. The pathologists here at Providence Saint Johns will also confirm the size of the breast tumor where necessary for breast cancer staging purposes. The histological evaluation is essential to determine the most effective treatment recommendations following surgery.
How Does A Breast Lump Feel
What does a breast lump feel like? Breast tissue in and of itself can feel somewhat lumpy and sponge-like, so it can be hard to know if what you’re feeling is an actual lump or just normal breast tissue. “A breast lump will feel like a distinct mass that’s noticeably more solid than the rest of your breast tissue.
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What Is Male Breast Cancer
Breast cancer in men is very rare, with less than 1 percent of all breast cancers found in men. The risk increases for older men and those with high estrogen levels, low male-hormone levels or a family history of breast cancer. Increased risk is also associated with those who have been exposed to radiation, heavy drinkers, and those with liver disease or who are obese. Treatment options include surgery, radiation therapy, chemotherapy, hormone therapy and drugs that target genetic changes in cells that cause cancer.
Signs Of Invasive Breast Cancers
Invasive breast cancers can cause specific signs and symptoms, such as:
- Itchy or irritated breasts
- Changes in the color of your breasts, such as redness
- A rapid change in the shape of your breast or an increase in breast size over a short period
- Changes in the way your breasts feel when you touch them they may be hard, tender, or warm to the touch
- Flaking or peeling or flaking of the nipple skin
- Feeling a lump in your breast or thickening of the breast tissue
- Pitting of the skin on your breast, making it look somewhat like the skin of an orange
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Your Nipples Have Changed
Only mannequins have perfect, pointy, well-behaved nipples. Real, human women have to deal with different colors and sizes, positions, textures, and hair.
Fortunately, all of these things are totally normal and not a problem as long as theyre your normal, says Dr. Denduluri. For example, if your nips have always been inverted, thats just how youre shaped, but if they change suddenly, going from pointy to fully or partially inverted, call your doctor stat. Bottom line: Any changes in your nipplesincluding their color and textureneed to be checked to rule out cancer, Dr. Denduluri says.
Oh, and BTW, hairy nipples on women have nothing to do with cancer and are totally normalone in three women have nipple hair, she adds.
What Do Lumps In My Breast Mean
Many conditions can cause lumps in the breast, including cancer. But most breast lumps are caused by other medical conditions. The two most common causes of breast lumps are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, tender, and sore. Cysts are small fluid-filled sacs that can develop in the breast.
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Tests To Determine Specific Types Of Treatment
You’ll also need tests that show whether the cancer will respond to specific types of treatment. The results of these tests can give your doctors a more complete picture of the type of cancer you have and how best to treat it. The types of test you could be offered are discussed below.
In some cases, breast cancer cells can be stimulated to grow by hormones that occur naturally in your body, such as oestrogen and progesterone.
If this is the case, the cancer may be treated by stopping the effects of the hormones, or by lowering the level of these hormones in your body. This is known as ‘hormone therapy’.
During a hormone receptor test, a sample of cancer cells will be taken from your breast and tested to see if they respond to either oestrogen or progesterone. If the hormone is able to attach to the cancer cells , they’re known as ‘hormone receptor positive’.
While hormones can encourage the growth of some types of breast cancer, other types are stimulated by a protein called human epidermal growth factor receptor 2 .
These types of cancer can be diagnosed using a HER2 test, and treated with medication to block the effects of HER2. This is known as ‘biological’ or ‘targeted’ therapy.
Other Types Of Breast Cancer
Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget’s disease of the breast.
It’s possible for breast cancer to spread to other parts of the body, usually through the lymph nodes or the bloodstream. If this happens, it’s known as ‘secondary’ or ‘metastatic’ breast cancer.
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Invasive Breast Cancer Symptoms
Most breast cancers start in the ducts, or the tubes that carry milk to the nipple, or in the lobules, the little clusters of sacs where breast milk is made. Invasive breast cancer refers to breast cancer that spreads from the original site to other areas of the breast, the lymph nodes or elsewhere in the body. In these cancers that form in the ducts or lobules, invasive ductal carcinoma or invasive lobular carcinoma , the cancer spreads from the ducts or lobules to other tissue. Depending on the stage, you may notice symptoms.
Invasive breast cancer symptoms may include:
- A lump or mass in the breast
- Swelling of all or part of the breast, even if no lump is felt
- Skin irritation or dimpling
- A lump or swelling in the underarm lymph nodes
The Reports Of Your Radiology Exams Usually Contain Three Sections:
- Exam description and history the type of exam, day it was performed, the reason it was performed and any important patient information
- Findings a detailed description of the important findings on the exam including size, shape, location and changes
- Impression a summary of the findings, what they mean and what to do about them Radiologists use standard terms in reports to describe the appearance of important findings.
Some examples of those terms include mass, architectural distortion and calcifications. The radiologist will also describe the size, shape and location of important findings. The size and location can be critical to making decisions about the kind of operation and other treatments you might have.
Radiologists will use a clock face or quadrant to describe the location. There is a separate clock for each breast and they are oriented as if the doctor is looking at you during an examination. In the diagram below, the nipple is in the center of the clock for both breasts. The outer left breast is at 3 oclock and the outer right breast is at 9 oclock. In the left breast the upper outer quadrant is between 12 and 3 oclock.
The radiologist will also describe the size and location of a finding by indicating the distance from the nipple in centimeters. Centimeters are smaller than an inch. There are 2.54 centimeters in an inch.
For example:
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Signs And Symptoms Of Breast Cancer Recurrence
Despite initial treatment and success, breast cancer can sometimes come back. This is called recurrence. Recurrence happens when a small number of cells escape the initial treatment.
Symptoms of a recurrence in the same place as the first breast cancer are very similar to symptoms of the first breast cancer. They include:
- a new breast lump
- redness or swelling of the breast
- a new thickening near the mastectomy scar
If breast cancer comes back regionally, it means that the cancer has returned to the lymph nodes or near to the original cancer but not exactly the same place. The symptoms may be slightly different.
What Are The Signs That Breast Cancer Has Spread
Metastatic breast cancer is a secondary cancer the cancerous cells originate in breast tissue and then travel to other parts of the body. The most common areas of breast cancer metastasis are the bones, lungs and liver.
Following an initial breast cancer diagnosis, a patient will receive a personalized monitoring plan for metastatic reoccurrence from their care team. Depending on the specific parts of the body affected, the symptoms of metastatic breast cancer can vary.
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