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What Is Primary Breast Cancer

What Is Her2 Positive Cancer

Dr. Fuqua on ESR1 Mutations in Primary Breast Cancer

Some breast cancer cells have a protein on their surface called human epidermal growth factor receptor 2 . Some cancer cells make more of this protein than they should and use it to grow quickly and spread. These are called HER2 positive breast cancers. Approximately one in five invasive breast cancers is HER2 positive.

There are effective treatments available for HER2 positive breast cancers. These are often called targeted therapy, monoclonal antibody or biological therapies.

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.

What Is Stage 1 Breast Cancer

This breast cancer is the earliest stage of invasive breast cancer. In stage 1, the tumor measures up to 2 cm and no lymph nodes are involved. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue.

Because a stage 1 tumor is small, it may be difficult to detect. However, breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.Stage 1 breast cancer is divided into two categories:

Stage 1A: The tumor measures 2 cm or smaller and has not spread outside the breast.

Stage 1B: Small clusters of cancer cells measuring no more than 2 mm, are found in the lymph nodes, and either there is no tumor inside the breast, or the tumor is small, measuring 2 cm or less.

At stage 1, TNM designations help describe the extent of the disease. For example, there may or may not be cancer cells in the lymph nodes, and the size of the tumor may range from 1 cm to 2 cm. Most commonly, stage 1 breast cancer is described as:

  • T: T1, T2, T3 or T4, depending on the size and/or extent of the primary tumor
  • N0: Usually, cancer has not spread to the lymph nodes.
  • M0: The disease has not spread to other sites in the body.

Stage 1 breast cancer survival rate

The survival rate for stage 1A breast cancer may be slightly higher than for stage 1B. However, all women with stage 1 breast cancer are considered to have a good prognosis.

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What Is Breast Cancer

Cancer occurs when changes called mutations take place in genes that regulate cell growth. The mutations let the cells divide and multiply in an uncontrolled way.

Breast cancer is cancer that develops in breast cells. Typically, the cancer forms in either the lobules or the ducts of the breast.

Lobules are the glands that produce milk, and ducts are the pathways that bring the milk from the glands to the nipple. Cancer can also occur in the fatty tissue or the fibrous connective tissue within your breast.

The uncontrolled cancer cells often invade other healthy breast tissue and can travel to the lymph nodes under the arms. The lymph nodes are a primary pathway that help the cancer cells move to other parts of the body.

Stage 4 Breast Cancer

Know The Signs And Symptoms Of Primary Breast Cancer

Stage 4 breast cancer can have a tumor of any size, and its cancer cells have spread to nearby and distant lymph nodes as well as distant organs.

The testing your doctor does will determine the stage of your breast cancer, which will affect your treatment.

Although they generally have less of it, men have breast tissue just like women do. Men can develop breast cancer too, but its much rarer.

According to the ACS , breast cancer is 100 times less common in white men than in white women. Its 70 times less common in black men than in black women.

That said, the breast cancer that men develop is just as serious as the breast cancer women are diagnosed with. It also has the same symptoms.

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How Breast Cancer Spreads

Breast cancer can spread when the cancer cells get into the blood or lymph system and then are carried to other parts of the body.

The lymph system is a part of your body’s immune system. It is a network of lymph nodes , ducts or vessels, and organs that work together to collect and carry clear lymph fluid through the body tissues to the blood. The clear lymph fluid inside the lymph vessels contains tissue by-products and waste material, as well as immune system cells.

The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:

  • Lymph nodes under the arm
  • Lymph nodes inside the chest near the breastbone
  • Lymph nodes around the collar bone

If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have traveled through the lymph system and spread to other parts of your body. Still, not all women with cancer cells in their lymph nodes develop metastases, and some women with no cancer cells in their lymph nodes might develop metastases later.

What Are The Symptoms Of Breast Cancer

Breast pain can be a symptom of cancer. If you have any symptoms that worry you, be sure to see your doctor right away.

Different people have different symptoms of breast cancer. Some people do not have any signs or symptoms at all.

Some warning signs of breast cancer are

  • New lump in the breast or underarm .
  • Thickening or swelling of part of the breast.
  • Irritation or dimpling of breast skin.
  • Redness or flaky skin in the nipple area or the breast.
  • Pulling in of the nipple or pain in the nipple area.
  • Nipple discharge other than breast milk, including blood.
  • Any change in the size or the shape of the breast.
  • Pain in any area of the breast.

Keep in mind that these symptoms can happen with other conditions that are not cancer.

If you have any signs or symptoms that worry you, be sure to see your doctor right away.

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How Much Do Anastrozole And Exemestane Lower The Risk Of Breast Cancer

Studies have shown that both anastrozole and exemestane can lower the risk of breast cancer in postmenopausal women who are at increased risk of the disease.

In one large study, taking anastrozole for five years lowered the risk of developing estrogen receptor-positive breast cancer by 53 percent. In another study, taking exemestane for three years lowered the risk of developing estrogen receptor-positive breast cancer by 65 percent.

The most common side effects seen with anastrazole and exemestane are joint pains, decreased bone density, and symptoms of menopause .

Last reviewed by a Cleveland Clinic medical professional on 12/31/2018.

References

Additional Markers For Breast Cancer Staging

Optum Primary Care talks about key risk factors for breast cancer

Additional markers specific to breast cancer will further define your stage, which may be helpful in choosing targeted treatments to fight the cancer.

  • ER: The cancer has an estrogen receptor. Estrogen is a hormone, and some cancers have receptors that respond to estrogen.
  • PR: The cancer has a progesterone receptor. Progesterone is also a hormone.
  • HER2: The cancer makes the protein HER2 .
  • G: Grade of cancer refers to how different the cells look from normal. Grade 1 indicates that the cells look fairly normal, while grade 2 cells are growing a little faster, and grade 3 cells look markedly different than normal breast tissue.

These markers, along with the TNM measurements, define your stage.

A cancer recurrence refers to cancer that returns in the same breast, and it requires new staging. This new stage is marked by an R at the end to indicate restaging. If it develops in the other breast, its considered a new cancer.

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Factors That Put You At Risk

Factors that put you at

If a diagnosis cant be made based on a clinical exam and imaging tests, youll need a breast biopsy. This is the only way to rule out or confirm cancer.

In this procedure, the doctor uses a needle to remove samples of the suspicious tissue. The samples then go to a laboratory, where a pathologist uses a microscope to look for cancer cells.

The pathology report will state whether the sample is benign or malignant . If cancer is found, it will also provide information such as:

Tumor grade describes how the cells look and behave. Grade 1 means the cells look and behave similar to normal breast cells. Grade 3 means the cells look very different from normal cells and are growing aggressively. Papillary breast cancer is

Reconsidering The Meaning Of Curing Primary Breast Cancer As A Systemic Disease

  • 1Department of Breast Surgery, Hiroshima Mark Clinic, Hiroshima, Japan
  • 2Department of Breast Surgery, Hiroshima City Hospital, Hiroshima, Japan

Since the initiation of breast cancer control by surgery alone in a prospective randomized controlled trial conducted 50 years ago, such trials have led to dramatic advances in AC and endocrine therapy, with the de-escalation of breast cancer surgery and escalation of adjuvant treatment providing significant survival benefits for patients with all types of breast cancer. Recent advances in molecular targeted therapy and genomic analysis may make the development of personalized and tailored adjuvant therapies more accessible, but it is doubtful whether such strategies can achieve 0% distant recurrence of breast cancer. Prospective randomized controlled trials cannot detect small survival benefits in specific populations due to tumor heterogeneity and differences in treatment response. Strategies for the identification of residual tumor cells and targeted therapy to eradicate them, and, more importantly, the development of effective treatment for tumors resistant to adjuvant therapy and the elucidation of the host immune defense mechanisms involved in residual tumor cell eradication are needed to achieve a complete cure for breast cancer after surgical treatment.

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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:

  • back, bone, or joint pain that does not go away

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    difficulty urinating , which can be a sign that the cancer is pinching nerves in your back

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    numbness or weakness anywhere in your body

  • shortness of breath or difficulty breathing

  • abdominal bloating, pain, or tenderness

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    constant nausea, vomiting, or weight loss

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    jaundice

  • vision problems

  • 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.

A biopsy may be done to determine these factors that can influence your treatment, which will be listed in your pathology report. Learn more about Understanding Your Pathology Report.

What Is A Breast Cancers Grade

Primary Causes of Breast Cancer Every Woman Needs to Know

Cancer cells are given a grade when they are removed from the breast and checked in the lab. The grade is based on how much the cancer cells look like normal cells. The grade is used to help predict your outcome and to help figure out what treatments might work best.

A low grade number usually means the cancer is slower-growing and less likely to spread.

A high grade number means a faster-growing cancer thats more likely to spread.

An intermediate grade number means the cancer is growing faster than a grade 1 cancer but slower than a grade 3 cancer.

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What Is A Normal Breast

No breast is typical. What is normal for you may not be normal for another woman. Most women say their breasts feel lumpy or uneven. The way your breasts look and feel can be affected by getting your period, having children, losing or gaining weight, and taking certain medications. Breasts also tend to change as you age. For more information, see the National Cancer Institutes Breast Changes and Conditions.external icon

What Should A Person With Stage 3 Breast Cancer Expect From Treatment

Stage 3 treatment options vary widely and may consist of mastectomy and radiation for local treatment and hormone therapy or chemotherapy for systemic treatment. Nearly every person with a Stage 3 diagnosis will do best with a combination of two or more treatments.

Chemotherapy is always given first with the goal to shrink the breast cancer to be smaller within the breast and within the lymph nodes that are affected. This is known as neoadjuvant chemotherapy.

Other possible treatments include biologic targeted therapy and immunotherapy. There may be various clinical trial options for interested patients with Stage 3 breast cancer.

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M Categories For Breast Cancer

M followed by a 0 or 1 indicates whether the cancer has spread to distant organs — for example, the lungs, liver, or bones.

M0: No distant spread is found on x-rays or by physical exam.

cM0: Small numbers of cancer cells are found in blood or bone marrow , or tiny areas of cancer spread are found in lymph nodes away from the underarm, collarbone, or internal mammary areas.

M1: Cancer has spread to distant organs as seen on imaging tests or by physical exam, and/or a biopsy of one of these areas proves cancer has spread and is larger than 0.2mm.

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What Is Stage 2 Breast Cancer

Also known as invasive breast cancer, the tumor in this stage measures between 2 cm to 5 cm, or the cancer has spread to the lymph nodes under the arm on the same side as the breast cancer. Stage 2 breast cancer indicates a slightly more advanced form of the disease. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue, and the tumor is larger than in stage 1 disease. However, stage 2 means the cancer has not spread to a distant part of the body.

At stage 2, a tumor may be detected during a breast self-exam as a hard lump within the breast. Breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.

Stage 2 breast cancer is divided into two categories:

Stage 2A: One of the following is true:

  • There is no tumor within the breast, but cancer has spread to the axillary lymph nodes, or
  • The tumor in the breast is 2 cm or smaller and cancer has spread to the axillary lymph nodes, or
  • The tumor in the breast measures 2 cm to 5 cm but cancer has not spread to the axillary lymph nodes.

Stage 2B: One of the following is true:

  • The tumor measures 2 cm to 5 cm and cancer has spread to the axillary lymph nodes, or
  • The tumor is larger than 5 cm but cancer has not spread to the axillary lymph nodes.

At stage 2, TNM designations help describe the extent of the disease. Most commonly, stage 2 breast cancer is described as:

Stage 2 breast cancer survival rate

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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