What Are The Types Of Breast Cancer
There are several different types of breast cancer, including:
Can cancer form in other parts of the breast?
When we say breast cancer, we usually mean cancers that form in milk ducts or lobules. Cancers can also form in other parts of your breast, but these types of cancer are less common. These can include:
- Angiosarcoma. This rare type of cancer begins in the cells that make up the lining of blood or lymph vessels.
- Phyllodes tumors. Starting in the connective tissue, phyllodes tumors are rare. Theyre usually benign , but they can be malignant in some cases.
What Is Stage Iv Breast Cancer
Stage IV is the most advanced stage of breast cancer. It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs such as the lungs, liver, or brain or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread.
Symptoms And Diagnosis Of Metastatic Breast Cancer
The most common parts of the body where breast cancer tends to spread are the bones, lungs, brain, and liver. But metastatic breast cancer can affect other parts of the body, as well.
Metastatic breast cancer symptoms can be very different depending on the cancers location, but may include:
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biopsy of any suspicious area
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a tap, removal of fluid from the area with symptoms to check for cancer cells a pleural tap removes fluid between the lung and chest wall a spinal tap removes fluid from around the spinal cord and a tap of fluid in the abdomen removes fluid in the abdominal cavity
These tests may also be used if you have no history of breast cancer and your doctor is having trouble determining the cause of your symptoms.
When breast cancer spreads to other parts of the body, its important to confirm whether the cancer has certain characteristics that may influence your treatment options, such as HER2 status and hormone receptor status. If you have been diagnosed with metastatic breast cancer years after an early-stage breast cancer diagnosis, it may seem logical to assume that the hormone receptor status and HER2 status are the same. But research has shown that the hormone receptor status and HER2 status of early-stage breast cancer can be different than that of a metastatic recurrence.
A biopsy may be done to determine these factors that can influence your treatment, which will be listed in your pathology report.
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Can Metastatic Breast Cancer Be Cured
There is no cure for metastatic breast cancer. Once the cancer cells have spread to another distant area of the body, its impossible to get rid of them all. However, the right treatment plan can help extend your life and improve its quality.
Metastatic breast cancer treatment aims to shrink tumors, slow their growth and improve your symptoms.
Why Does Metastatic Breast Cancer Happen
Most often, metastatic cancer occurs because treatment didnt destroy all the cancer cells. Sometimes, a few cells remain dormant, or are hidden and undetectable. Then, for reasons providers dont fully understand, the cells begin to grow and spread again.
De novo metastatic breast cancer means that at the time of initial diagnosis, the breast cancer has already spread to other parts of the body. In the absence of treatment, the cancer spreads.
There is nothing you can do to keep breast cancer from metastasizing. And metastatic breast cancer doesnt happen because of something you did.
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Data And Patient Selection
Data for this study were drawn from both the Surveillance, Epidemiology, and End Results database and the National Cancer Database . The original SEER 9 registry data, spanning 19732015, were used to analyze long-term population-based incidence trends of the various disease stages. SEER was chosen over NCDB for this analysis, since it contains many more years of incidence data and is population-based and age-adjusted.
NCDB data from 2010 to 2015 were used to explore patient and disease characteristics of Stage IV disease in a large modern population, as well as to compare the tumor biological profiles of Stages IIV. NCDB was chosen over SEER for this analysis since it contains more robust data on disease characteristics and captures a larger population of breast cancer patients in the United States. The NCDB is a joint project of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The data used in this study were derived from a de-identified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed nor for the conclusions drawn from these data by the investigators.
Included in this study were female patients with invasive breast cancer with known disease stage . The analyses of the incidence and patient/disease factors were conducted using targeted statistical methods and software, as outlined below.
What Causes Breast Cancer
Breast cancer develops when abnormal cells in your breast divide and multiply. But experts dont know exactly what causes this process to begin in the first place.
However, research indicates that are several risk factors that may increase your chances of developing breast cancer. These include:
- Age. Being 55 or older increases your risk for breast cancer.
- Sex. Women are much more likely to develop breast cancer than men.
- Family history and genetics. If you have parents, siblings, children or other close relatives whove been diagnosed with breast cancer, youre more likely to develop the disease at some point in your life. About 5% to 10% of breast cancers are due to single abnormal genes that are passed down from parents to children, and that can be discovered by genetic testing.
- Smoking. Tobacco use has been linked to many different types of cancer, including breast cancer.
- Alcohol use. Research indicates that drinking alcohol can increase your risk for certain types of breast cancer.
- Obesity. Having obesity can increase your risk of breast cancer and breast cancer recurrence.
- Radiation exposure. If youve had prior radiation therapy especially to your head, neck or chest youre more likely to develop breast cancer.
- Hormone replacement therapy. People who use hormone replacement therapy have a higher risk of being diagnosed with breast cancer.
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Demographic And Disease Characteristics Of Stage Iv Patients
Between 2010 and 2015, there were 992,687 women in the NCDB with staged invasive breast cancer. Of these, 939,903 were Stages IIII, and 52,784 were Stage IV. Univariable analysis of the demographic and tumor characteristics is depicted in Table 2. Analysis of demographic data showed that women with Stage IV disease were more likely to be black, younger than 40 years of age, uninsured or on Medicaid, and living in zip codes where median household income was < $48,000, and where 13% of adult residents did not have a high school degree. Strikingly, Stage IV disease affected 8.0% of blacks, 8.8% of women under 30 years of age, and 14.2% of uninsured. Analysis of tumor data showed that women with Stage IV were more likely to have larger tumors, non-ductal or lobular undifferentiated histologies , negative ER or PR status, positive Her2 status, LVI, and poorly differentiated grade. Conspicuously, Stage IV affected 19.0% of tumors > 5cm and 10.9% of tumors with undifferentiated histologies.
Diagnostic Tests That Inform The Clinical Stage
Many methods are used to detect and stage cancer. Some of the common tests include:
Biopsy: The doctor uses a needle to extract breast tissue or fluid, which is then sent to a lab. There, various techniques are used to examine different attributes, such as hormone receptor or HER2 status.
Tumor markers: Rapidly dividing cancerous cells interrupt some of the normal mechanisms of cell growth. This causes the cell to overproduce certain molecules. Lab tests detect these compounds, known as tumor markers, in blood or tissue samples.
Imaging techniques: Several different scans are used to examine characteristics of your cancer. Below are some of the noninvasive imaging techniques you might encounter:
- MRI scans use magnets and radio waves to generate detailed pictures of your tissues.
- CT scans use X-rays to look at your organs. Nuclear scans trace the flow of an injected safe radioactive dye in your body.
- PET scans are similar to nuclear scans but specifically examine glucose consumption in the bodysince cancer cells use more glucose than normal cells.
- Ultrasound imaging uses sound waves to see inside your body.
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Systemic Treatments For Stage Iv Breast Cancer
Treatment often continues until the cancer starts growing again or until side effects become unacceptable. If this happens, other drugs might be tried. The types of drugs used for stage IV breast cancer depend on the hormone receptor status, the HER2 status of the cancer, and sometimes gene mutations that might be found.
Local Or Regional Treatments For Stage Iv Breast Cancer
Although systemic drugs are the main treatment for stage IV breast cancer, local and regional treatments such as surgery, radiation therapy, or regional chemotherapy are sometimes used as well. These can help treat breast cancer in a specific part of the body, but they are very unlikely to get rid of all of the cancer. These treatments are more likely to be used to help prevent or treat symptoms or complications from the cancer.
Radiation therapy and/or surgery may also be used in certain situations, such as:
- When the breast tumor is causing an open or painful wound in the breast
- To treat a small number of metastases in a certain area, such as the brain
- To help prevent or treat bone fractures
- When a cancer is pressing on the spinal cord
- To treat a blood vessel blockage in the liver
- To provide relief of pain or other symptoms anywhere in the body
In some cases, regional chemo may be useful as well.
If your doctor recommends such local or regional treatments, it is important that you understand the goalwhether it is to try to cure the cancer or to prevent or treat symptoms.
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Study Design And Populations
This study considered three subpopulations, depicted in Figure 1A: all women, women diagnosed with breast cancer, and all members with incident cancer. The first two subpopulations were analyzed for screening mammogram utilization and all three subpopulations were analyzed for PCE utilization within the two years prior to each members index date, defined as the date of diagnosis for incident cancer members or date of last enrollment for non-cancer members. Mammograms were identified by CPT/HCPCS codes for mammography and breast tomosynthesis, and were further subdivided into diagnostic and screening procedures. PCEs were identified by CPT/HCPCS codes for initial or established comprehensive preventive visits .
Advanced Cancer That Progresses During Treatment
Treatment for advanced breast cancer can often shrink the cancer or slow its growth , but after a time, it tends to stop working. Further treatment options at this point depend on several factors, including previous treatments, where the cancer is located, a woman’s menopause status, general health, desire to continue getting treatment, and whether the hormone receptor status and HER2 status have changed on the cancer cells.
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Why Is Staging Important
During your initial diagnosis, you and your cancer team will work together to develop a treatment plan. Staging allows you to answer the following questions:
- How does this cancer typically progress?
- Which treatments may work?
Some of the staging may be even more in-depth, but in general, its designed to prepare a more tailored approach to your disease. Your care team will be able to explain any new terms and what they mean for you.
Expert cancer care
Association Of Breast Cancer Screening Behaviors With Stage At Breast Cancer Diagnosis And Potential For Additive Multi
- 1Thrive, An Exact Sciences Company, Cambridge, MA, United States
- 2Blue Health Intelligence, Chicago, IL, United States
- 3Deverka Consulting, LLC, Apex, NC, United States
Purpose: To evaluate mammography uptake and subsequent breast cancer diagnoses, as well as the prospect of additive cancer detection via a liquid biopsy multi-cancer early detection screening test during a routine preventive care exam .
Methods: Patients with incident breast cancer were identified from five years of longitudinal Blue Health Intelligence® claims data and their screening mammogram and PCE utilization were characterized. Ordinal logistic regression analyses were performed to identify the association of a biennial screening mammogram with stage at diagnosis. Additional screening opportunities for breast cancer during a PCE within two years before diagnosis were identified, and the method extrapolated to all cancers, including those without recommended screening modalities.
The study used claims data to demonstrate the association of cancer screening with cancer stage at diagnosis and demonstrates the unmet potential for a MCED screening test which could be ordered during a PCE.
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Comparisons With Nationally Representative Data
Cancer incidence in the BHI claims data determined using the published methods described above was compared with the incidence data from the SEER 18 database submitted in November 2018 and retrieved using SEER*Stat 8.3.8 software . Comparisons were made by age and cancer type.
Mammogram utilization in the BHI data, which was defined by the presence of a mammography claim within 24 months of the last date of enrollment, were compared with the results from the 2015 NHIS .
What Is Metastatic Breast Cancer
Metastatic breast cancer is the most advanced stage of breast cancer. Breast cancer develops when abnormal cells in the breast start to divide uncontrollably. A tumor is a mass or collection of these abnormal cells.
Metastasis refers to cancer cells that have spread to a new area of the body. In metastatic breast cancer, cells may spread to the:
Healthcare providers name cancer based on its primary origin. That means breast cancer that spreads to other body parts is still considered breast cancer. The cancer cells are still breast cancer cells. Your care team will use breast cancer therapies, even if the cancer cells are in other areas.
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Coping With Stage 4 Breast Cancer
It is natural to feel depressed, anxious, or even angry when you have been diagnosed with stage 4 breast cancer. It can leave you feeling as if you have no control over your health or future. Moreover, you may find that certain people will withdraw from you or suggest that you have metastatic cancer because you “left it too long.”
It is important to shield yourself from these negative emotions and embrace people who can provide you with genuine support. These include loved ones, support groups, and your oncology team. If you are unable to cope, ask for a referral to a therapist who can provide you counseling or a psychiatrist able to dispense treatment.
With that being said, there are women who experience positive emotional growth after being diagnosed with stage 4 breast cancer. It is not uncommon to hear someone say that cancer helped prioritize their life, allowing them to pursue what is truly important and connect with people on a deeper, more profound level.
Whatever your experience, don’t go it alone. Seek support and work with your medical team as a full partner in your care.
Stomach Upset Loss Of Appetite And Weight Loss
Cancer can cause nausea, vomiting, diarrhea, and constipation. Anxiety and lack of sleep can also upset the digestive system.
It can be more difficult to eat a healthy diet as these symptoms occur, setting up a vicious cycle. As women avoid certain foods because of stomach upset, the digestive system may lack the fiber and nutrients it needs to function optimally.
Over time, women may lose their appetite and have difficulty taking in the calories they need. Not eating regularly may cause significant weight loss and nutritional imbalances.
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La’bounty Will Need A Surrogate To Have Children
Right before her first round of chemo, La’Bounty learned through a video that the treatment could render her infertile.
“I freaked out,” she said.
When she confronted her oncologist, she said the doctor said, “I’m trying to save your life. I don’t have time to discuss every option.”
So after that treatment, La’Bounty found a new doctor, who gave her a few weeks to pursue egg freezing before continuing with a less-toxic form of chemo.
La’Bounty now has 10 eggs in storage but will need a surrogate when she and Maggard are ready for a family because pregnancy hormones would be too dangerous for her body.
That reality is “devastating,” La’Bounty said on TikTok.
“I’ve always wanted to carry my own children,” she told Insider. “That’s something I’m still in therapy for today.”
Where Do These Numbers Come From
The American Cancer Society relies on information from the Surveillance, Epidemiology, and End Results 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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