What Is Invasive Breast Cancer Versus Noninvasive Breast Cancer
Noninvasive cancer means the abnormal cells are contained in the milk ducts of the breast and lack the ability to spread to surrounding tissue or elsewhere in the body. Invasive breast cancer means the cancer has grown beyond its original location into surrounding normal breast tissue and has the potential to spread to other parts of the body.
Personal History Of Breast Disease
Females who have previously had breast cancer are at risk of developing a second breast cancer, either in the other breast or in a different part of the same breast. This is not the same as the first cancer returning.
Having a personal history of certain noncancerous breast conditions can also increase a persons risk of breast cancer. This can include conditions such as atypical hyperplasia, lobular carcinoma in situ, and ductal carcinoma in situ.
People with a history of breast, ovarian, fallopian tube, or peritoneal cancer should ask their doctors about .
History Of Breast Cancer Or Breast Lumps
A person who has had breast cancer is more likely to develop it again than a person with no history of the disease.
Having some types of noncancerous breast lumps increases the risk of developing the cancer later on. Examples include atypical ductal hyperplasia or lobular carcinoma in situ.
People with a history of breast, ovarian, fallopian tube, or peritoneal cancer should ask their doctors about genetic testing.
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Understanding Your Risk Of Breast Cancer
Several breast cancer risk assessment tools have been developed to help a woman estimate her chance of developing breast cancer. The best studied is the Gail model, which is available on the National Cancer Institutes website at www.cancer.gov/bcrisktool. After you enter some personal and family information, including race/ethnicity, the tool provides you with a 5-year and lifetime estimate of the risk of developing invasive breast cancer. Because it only asks for information about breast cancer in first-degree family members and does not include their ages at diagnosis, the tool works best at estimating risk in women without a strong inherited breast cancer risk. For some women, other ways of determining the risk of breast cancer may work better. For example, women with a strong family history of breast cancer risk should consider talking to a genetic counselor.
It is important to talk with your doctor about how to estimate your personal risk of breast cancer and to discuss risk-reducing or prevention options .
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There Are Three Ways That Cancer Spreads In The Body
- TX: Primary tumor cannot be assessed.
- T0: No sign of a primary tumor in the breast.
- Tis: Carcinoma in situ. There are 2 types of breast carcinoma in situ:
- Tis : DCIS is a condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive breast cancer that is able to spread to other tissues. At this time, there is no way to know which lesions can become invasive.
- Tis : Paget disease of the nipple is a condition in which abnormal cells are found in the skin cells of the nipple and may spread to the areola. It is not staged according to the TNM system. If Paget disease AND an invasive breast cancer are present, the TNM system is used to stage the invasive breast cancer.
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Common Sites Of Metastasis
- Brain: 7.3%
- All less common sites: 22.4%
Invasive lobular carcinoma tends to have a significantly different pattern of metastases than ductal breast cancer. In one 2017 study, almost 70% of people with metastases from lobular carcinoma had peritoneal metastases.
For roughly a third of women , cancer spreads to multiple organs at the same time.
Trends In Breast Cancer Deaths
Breast cancer is the second leading cause of cancer death in women. The chance that a woman will die from breast cancer is about 1 in 39 .
Since 2007, breast cancer death rates have been steady in women younger than 50, but have continued to decrease in older women. From 2013 to 2018, the death rate went down by 1% per year.
These decreases are believed to be the result of finding breast cancer earlier through screening and increased awareness, as well as better treatments.
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Causes Of Breast Cancer: How Did This Happen
When youre told that you have breast cancer, its natural to wonder what may have caused the disease. But no one knows the exact causes of breast cancer. Doctors seldom know why one woman develops breast cancer and another doesnt, and most women who have breast cancer will never be able to pinpoint an exact cause. What we do know is that breast cancer is always caused by damage to a cells DNA.
What Are The Signs And Symptoms Of Breast Cancer
The signs and symptoms of breast cancer include:
- A new lump or thickening in or near the breast or in the armpit
- A change in the size or shape of the breast
- A dimple or puckering in the skin of the breast. It may look like the skin of an orange.
- A nipple turned inward into the breast
- Nipple discharge other than breast milk. The discharge might happen suddenly, be bloody, or happen in only one breast.
- Scaly, red, or swollen skin in the nipple area or the breast
- Pain in any area of the breast
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What Is Different About Breast Cancer In Younger Women
- Diagnosing breast cancer in younger women is more difficult because their breast tissue is generally denser than the breast tissue in older women, and routine screening is not recommended.
- Breast cancer in younger women may be more aggressive and less likely to respond to treatment.
- Women who are diagnosed with breast cancer at a younger age are more likely to have genetic mutations predisposing them to breast and other cancers.
- Younger women who have breast cancer may ignore the warning signssuch as a breast lump or unusual dischargebecause they believe they are too young to get breast cancer. This can lead to a delay in diagnosis and poorer outcomes.
- Some healthcare providers may also dismiss breast lumps or other symptoms in young women or adopt a wait and see approach.
- Breast cancer poses additional challenges for younger women as it can involve issues concerning sexuality, fertility, and pregnancy after breast cancer treatment.
What Are The Types Of Breast Cancer
The most common types of breast cancer are:
- Infiltrating ductal carcinoma. This cancer starts in the milk ducts of the breast. It then breaks through the wall of the duct and invades the surrounding tissue in the breast. This is the most common form of breast cancer, accounting for 80% of cases.
- Ductal carcinoma in situ is ductal carcinoma in its earliest stage, or precancerous . In situ refers to the fact that the cancer hasn’t spread beyond its point of origin. In this case, the disease is confined to the milk ducts and has not invaded nearby breast tissue. If untreated, ductal carcinoma in situ may become invasive cancer. It is almost always curable.
- Infiltrating lobular carcinoma. This cancer begins in the lobules of the breast where breast milk is produced, but has spread to surrounding tissues in the breast. It accounts for 10 to 15% of breast cancers. This cancer can be more difficult to diagnose with mammograms.
- Lobular carcinoma in situ is a marker for cancer that is only in the lobules of the breast. It isn’t a true cancer, but serves as a marker for the increased risk of developing breast cancer later, possibly in both or either breasts. Thus, it is important for women with lobular carcinoma in situ to have regular clinical breast exams and mammograms.
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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.
Blood Tests For Tumor Markers
In some cases, blood tests for tumor markers may be used to help monitor metastatic breast cancer.
For example, you may have blood tests every few months for cancer antigen 15-3 or cancer antigen 27.29 . These tests are similar. Health care providers usually check one, but not both of these blood tests.
Whether the tumor marker test score rises or falls over time may give some information on tumor response to a drug or tumor spread.
Tumor marker tests are not helpful in every case. Some people with rising tumor marker levels dont have tumor growth, and some people with tumor growth have normal or unchanged tumor marker levels.
Health care providers dont make treatment decisions based on serum tumor marker testing alone. They may combine findings from a tumor marker test with information on symptoms and findings from imaging tests . This combined information can help your health care providers understand if a treatment is working well for your cancer.
Talk with your health care provider about whether tumor marker testing is right for you.
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Hormone And Protein Receptors
Breast cancer can sometimes be described by the types of hormones or protein receptors on the surface of the cancer cells.
For example:
- Oestrogen receptor and progesterone receptor positive cancers are encouraged to grow by the female hormones oestrogen or progesterone. Read more about ER positive breast cancer.
- HR2 positive breast cancer means that the tumour produces too much of a protein called HER2, which helps breast cancer to grow. Read more about HER2+ breast cancer.
- Triple negative breast cancer doesnt have receptors for HER2, oestrogen or progesterone. More about triple negative breast cancer.
How Common Is Breast Cancer
Breast cancer is the most common cancer in women in the United States, except for skin cancers. It is about 30% of all new female cancers each year.
The American Cancer Society’s estimates for breast cancer in the United States for 2021 are:
- About 281,550 new cases of invasive breast cancer will be diagnosed in women.
- About 49,290 new cases of ductal carcinoma in situ will be diagnosed.
- About 43,600 women will die from breast cancer.
Breast cancer mainly occurs in middle-aged and older women. The median age at the time of breast cancer diagnosis is 62. This means half of the women who developed breast cancer are 62 years of age or younger when they are diagnosed. A very small number of women diagnosed with breast cancer are younger than 45.
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Breast Examination After Treatment For Breast Cancer
After surgery
The incision line may be thick, raised, red and possibly tender for several months after surgery. Remember to examine the entire incision line.
If there is redness in areas away from the scar, contact your physician. It is not unusual to experience brief discomforts and sensations in the breast or nipple area .
At first, you may not know how to interpret what you feel, but soon you will become familiar with what is now normal for you.
After breast reconstruction
Following breast reconstruction, breast examination for the reconstructed breast is done exactly the same way as for the natural breast. If an implant was used for the reconstruction, press firmly inward at the edges of the implant to feel the ribs beneath. If your own tissue was used for the reconstruction, understand that you may feel some numbness and tightness in your breast. In time, some feeling in your breasts may return.
After radiation therapy
After radiation therapy, you may notice some changes in the breast tissue. The breast may look red or sunburned and may become irritated or inflamed. Once therapy is stopped, the redness will disappear and the breast will become less inflamed or irritated. At times, the skin can become more inflamed for a few days after treatment and then gradually improve after a few weeks. The pores in the skin over the breast also may become larger than usual.
What to do
Differences By Race And Ethnicity
Some variations in breast cancer can be seen between racial and ethnic groups. For example,
- The median age of diagnosis is slightly younger for Black women compared to White women 63 years old).
- Black women have the highest death rate from breast cancer. This is thought to be partially because about 1 in 5 Black women with breast cancer have triple-negative breast cancer – more than any other racial/ethnic group.
- Black women have a higher chance of developing breast cancer before the age of 40 than White women.
- At every age, Black women are more likely to die from breast cancer than any other race or ethnic group.
- White and Asian/Pacific Islander women are more likely to be diagnosed with localized breast cancer than Black, Hispanic, and American Indian/Alaska Native women.
- Asian/Pacific Islanders have the lowest death rate from breast cancer.
- American Indian/Alaska Natives have the lowest rates of developing breast cancer.
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Will The Nhs Fund An Unlicensed Medicine
Its possible for your doctor to prescribe a medicine outside the uses its licensed for if theyre willing to take personal responsibility for this off-licence use of treatment.
Your local clinical commissioning group may need to be involved, as it would have to decide whether to support your doctors decision and pay for the medicine from NHS budgets.
Page last reviewed: 28 October 2019 Next review due: 28 October 2022
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What Are The Symptoms Of Invasive Ductal Carcinoma
Like other breast cancers, IDC may present as a lump that you or your doctor can feel on a breast exam. But in many cases, at first, there may be no symptoms, Wright says.
That is why it is important to have screening mammograms to detect breast cancers such as invasive ductal carcinoma. A mammogram may detect a lump that is too small for you to feel, or suspicious calcifications in the breast, either of which will lead to further testing.
According to Wright, the following are possible signs of invasive ductal carcinoma and other breast cancers. If you notice any of these, you should contact your doctor right away for further evaluation:
- Lump in the breast
- Nipple discharge, other than breast milk
- Scaly or flaky skin on the nipple or an ulceration on the skin of the breast or nipple. These can be signs of Pagets disease, a different kind of breast cancer that can occur along with IDC.
- Lumps in the underarm area
- Changes in the appearance of the nipple or breast that are different from your normal monthly changes
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Treatment Of Breast Cancer Stages I
The stage of your breast cancer is an important factor in making decisions about your treatment.
Most women with breast cancer in stages I, II, or III are treated with surgery, often followed by radiation therapy. Many women also get some kind of systemic drug therapy . In general, the more the breast cancer has spread, the more treatment you will likely need. But your treatment options are affected by your personal preferences and other information about your breast cancer, such as:
- If the cancer cells have hormone receptors. That is, if the cancer is estrogen receptor -positive or progesterone receptor -positive.
- If the cancer cells have large amounts of the HER2 protein
- How fast the cancer is growing
- Your overall health
- If you have gone through menopause or not
Talk with your doctor about how these factors can affect your treatment options.
How Breast Cancer Spreads
Breast cancer can spread through the lymphatic system, the bloodstream, or by local invasionfor instance, when cancer cells actually invade nearby tissues, such as the chest wall or ribs.
When breast cancers spread and enter the lymphatic system, they usually first arrive at nearby lymph nodes and may still be early-stage.
Metastatic breast cancer is the same thing as stage 4 breast cancer and is considered the most advanced stage. It refers to breast cancers that have spread beyond the breast and nearby lymph nodes to other regions of the body, which are called distant metastases.
While treatment options for metastatic breast cancer are similar no matter where cancer has spread, some treatments are used for specific sites of metastasis as well .
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