Types Of Breast Cancer And Related Conditions
Read about the different types of breast cancer and conditions related to breast cancer.
Paget’s disease is a rare skin condition of the nipple that is associated with some breast cancers. Find out what it is and how it is diagnosed and treated.
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What Causes Breast Cancer
Breast cancer happens when there are changes in the genetic material . Often, the exact cause of these genetic changes is unknown.
But sometimes these genetic changes are inherited, meaning that you are born with them. Breast cancer that is caused by inherited genetic changes is called hereditary breast cancer.
There are also certain genetic changes that can raise your risk of breast cancer, including changes called BRCA1 and BRCA2. These two changes also raise your risk of ovarian and other cancers.
Besides genetics, your lifestyle and the environment can affect your risk of breast cancer.
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Types Based On Where Cancer Starts Or Spreads
One of the ways doctors describe breast cancer is based on where in your body it starts or spreads.
Carcinoma and Adenocarcinoma. Carcinomas start in the tissues that line your breasts and other organs. Most breast cancers are carcinomas.
Breast cancers are often a type of carcinoma called an adenocarcinoma. These cancers start in the cells lining the milk ducts or the glands that produce milk .
Ductal Carcinoma. Ductal carcinoma is cancer of the cells that line the milk ducts in your breast.
Ductal carcinoma in situ is the earliest form of ductal carcinoma. “In situ” means it’s only in the milk ducts, and isn’t likely to spread to other parts of your body. About 1 in 5 people who are newly diagnosed with breast cancer have DCIS. This type is very curable.
Invasive ductal carcinoma is the most common type of breast cancer, affecting about 80% of people who are diagnosed. “Invasive” means the cancer is able to spread outside of the milk duct where it started.
There are several subtypes of invasive ductal carcinoma:
You might also hear about lobular carcinoma in situ . But LCIS isn’t really cancer, and won’t spread outside of the lobule. Doctors usually find it when they do a breast biopsy.
Phyllodes Tumor of the Breast. These rare tumors grow in the breast’s connective tissue. They’re more common in women who have an inherited condition called Li-Fraumeni syndrome. Only 1 in 4 phyllodes tumors are cancer. The rest are noncancerous .
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Pagets Disease Of The Breast
Pagets disease of the breast accounts for less than 5% of all breast cancers and involves cancer cells gathering in or around the nipple and the skin surrounding it, called the areola. Symptoms can sometimes be mistaken for eczema or dermatitis and can include itchy or tingling feelings in the nipple or areola, flaking or crusting of the skin, and discharge from the nipple. Paget cells are malignant cells found in the surface layer of the skin in the nipple and areola. Under a microscope, they appear large and round and are a sign of Paget’s disease of the breast.
Verywell / Gary Ferster
Angiosarcoma Of The Breast
Angiosarcoma is a rare form of cancer that begins in the endothelial cells, that line the blood and lymph vessels. There are two forms of angiosarcoma of the breast:
Primary angiosarcoma: This occurs in women who have never been treated for breast cancer before.
Secondary angiosarcoma: Thisoccurs in women who have already been treated for breast cancer.
In angiosarcoma, there can be necrosis, as well as hemorrhage.
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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.
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.
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What Are The Risk Factors For Breast Cancer
Like many conditions, risk factors for breast cancer fall into the categories of things you can control and things that you cannot control. Risk factors affect your chances of getting a disease, but having a risk factor does not mean that you are guaranteed to get a certain disease.
Controllable risk factors for breast cancer
- Alcohol consumption. The risk of breast cancer increases with the amount of alcohol consumed. For instance, women who consume two or three alcoholic beverages daily have an approximately 20% higher risk of getting breast cancer than women who do not drink at all.
- Body weight. Being obese is a risk factor for breast cancer. It is important to eat a healthy diet and exercise regularly.
- Breast implants. Having silicone breast implants and resulting scar tissue make it harder to distinguish problems on regular mammograms. It is best to have a few more images to improve the examination. There is also a rare cancer called anaplastic large cell lymphoma that is associated with the implants.
- Choosing not to breastfeed. Not breastfeeding can raise the risk.
- Using hormone-based prescriptions. This includes using hormone replacement therapy during menopause for more than five years and taking certain types of birth control pills.
Non-controllable risk factors for breast cancer
Paget Disease Of The Breast
up to 4 percent of all breast cancer cases.
Paget disease is a rare cancer that forms in the milk ducts and spreads to the skin of the nipple and areola, the skin around the nipple. According to the National Cancer Institute , this type of breast cancer is usually accompanied by DCIS or an invasive tumor within the breast.
The symptoms of Paget disease are often mistaken at first for skin conditions, like eczema or dermatitis. However, the symptoms wont respond to topical treatments.
The typical symptoms of Paget disease include:
- redness, flaking or crusting around the nipple and areola
- a tingling or itching sensation around the nipple area
- thickened skin on or near the nipple
- a flattened nipple
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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.
Advances In Breast Cancer Research
A polyploid giant cancer cell from triple-negative breast cancer.
NCI-funded researchers are working to advance our understanding of how to prevent, detect, and treat breast cancer. They are also looking at how to address disparities and improve quality of life for survivors of the disease.
This page highlights some of the latest research in breast cancer, including clinical advances that may soon translate into improved care, NCI-supported programs that are fueling progress, and research findings from recent studies.
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Staging Inflammatory Breast Cancer
Inflammatory breast cancer is always at least locally-advanced when its first diagnosed because the breast cancer cells have grown into the skin. This means it is at least stage III.
In about 30% of cases, the inflammatory breast cancer has already spread to parts of the body away from the breast when it is diagnosed. This means the cancer is metastatic or stage IV.
After inflammatory breast cancer is diagnosed, your doctor will do more tests to collect information on the characteristics of the cancer. These tests, as well as the results of your biopsy and any imaging tests, make up the parts of your pathology report.
Other information commonly collected on inflammatory breast cancer includes:
Survivorship care after inflammatory breast cancer treatment
Because of treatments theyve received, many breast cancer survivors have a higher risk of developing other diseases as they age, including high blood pressure, heart disease, and osteoporosis. To make sure breast cancer survivors are regularly screened for these and other diseases, experts have developed the idea of survivorship care planning.
Survivorship care plans are written documents made up of two parts.
The first part is a treatment summary, a record of all the breast cancer treatments youve received.
Inoperable Breast Cancer Is Often Still Treatable
Stage 3C breast cancer is divided into operable and inoperable stage 3C breast cancer. However, the term inoperable is not the same as untreatable.
If your physician uses the word inoperable, it may simply mean that a simple surgery at this time would not be enough to get rid of all the breast cancer that is within the breast and the tissue around the breast. There must be healthy tissue at all of the margins of the breast when it is removed. Keep in mind that the breast tissue goes beyond the breast mound it goes up to the clavicle and down to a few inches below the breast mound. There must also be tissue to close the chest wound after the surgery is performed.
Another treatment method may be used first to shrink the breast cancer as much as possible before surgery is considered.
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How Is Breast Cancer Treated
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.
The Future Of Breast Cancer Treatmentis Here
At Harold C. Simmons Comprehensive Cancer Center,our doctors already use a molecular approach to guide cancer care, testingevery patients tumor for certain proteins and hormone receptors.
We also perform specific genomic tests basedon a patients overarching cancer type and the size and stage of his or her tumor. For example, patientswith hormone receptor positive breast cancer are screened with OncotypeDX, a genomic test that helps us predict a patients benefit fromchemotherapy based on tumor traits associated with recurrence. We also frequentlytest for genomic and protein alterations in patients with stage IV or locallyadvanced cancer and use this information to provide the highest quality andtargeted clinical trials for our patients.
As genomic testing becomes more advanced with easier tests, less expensive equipment, and the need for smaller breasttissue samples more patients will be genomically tested as a standard ofcare. Subsequently, more patients will get personalized care plans based ontheir individual genomic data.
Data-driven, personalized medicine is the wayof the future, and clinical trials will help determine the effectiveness of newtests and treatments. Under the guidance of Carlos Arteaga, M.D., we areprioritizing molecular and immunotherapy research and clinical trials tofurther uncover drivers and potential new therapies for all types of breastcancer.
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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.
Cosmetic Implants And Breast Cancer Survival
The general agreement, based on , is that silicone breast implants do not increase the risk of breast cancer. A 2015 meta-analysis of 17 studies that included participants who had undergone cosmetic breast augmentation discovered no increase in the risk of breast cancer associated with the procedure. In fact, the research showed that the incidence among these participants was lower than expected.
In 2021, another study found that women with cosmetic implants have significantly lower rates of breast cancer than those who do not have them.
Meanwhile, a 2013 meta-analysis found that women who received a diagnosis of breast cancer after getting cosmetic breast implants may have a higher risk of dying from the disease.
However, this research did not factor in other variables that may influence breast cancer mortality, such as body mass index, age at diagnosis, or cancer stage at diagnosis. And at least one of the studies in the analysis looked at overall mortality, instead of breast cancer-specific mortality, thereby potentially skewing the results. As such, a person should consider the finding with caution.
most common type is ductal carcinoma, which begins in a milk duct. Another type is lobular carcinoma, which begins in a lobule, one of the tiny glands that produce milk.
Invasive breast cancer involves cancerous cells spreading to nearby tissue. It is then more likely that the cancer will spread to other parts of the body.
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What Is Estrogen Receptorpositive Breast Cancer And Progesterone Receptorpositive Breast Cancer
Cells from your breast cancer can be tested for receptors on two hormones that can fuel cancer growth: estrogen and progesterone. Receptors are special proteins on cells that attach to certain substances, such as estrogen and progesterone, much like a key entering a lock. Breast cancer can contain receptors for one of these hormones, both, or neither.
- Breast cancer with receptors for estrogen is called estrogen receptor positive, or ER positive.
- Breast cancer with no receptors for estrogen is called estrogen receptor negative, or ER negative.
- Breast cancer with receptors for progesterone is called progesterone receptor positive, or PR positive.
- Breast cancer with no receptors for progesterone is called progesterone receptor negative, or PR negative.
If your cancer is ER positive, PR positive, or positive for both estrogen and progesterone receptors, your treatment may include a hormone therapy a drug or drugs that keep these hormones from plugging into their receptors. The idea is to cut off the cancers access to the fuel that would otherwise power its growth, much like putting a child safety cap on an electrical outlet.
Types Of Breast Cancer
There are many types of breast cancer, and many different ways to describe them. Its easy to get confused over a breast cancer diagnosis.
The type of breast cancer is determined by the specific cells in the breast that are affected. Most breast cancers are carcinomas, which are tumors that start in the epithelial cells that line organs and tissues throughout the body. When carcinomas form in the breast, they are usually a more specific type called adenocarcinoma, which starts in cells in the ducts or the lobules .
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