Types of Breast Cancer
Types list: The list of types of Breast Cancer mentioned in various sources includes:
- Breast carcinoma
- Breast sarcoma
- Paget's Disease
- Lobular carcinoma in situ (LCIS) - a benign tumor; often called "Stage 0 breast cancer".
- Ductal carcinoma in situ (DCIS) - also called "intraductal carcinoma"; also sometimes called "Stage 0 breast cancer".
- Ductal carcinoma - starts in the lining of the ducts.
- Lobular carcinoma - starts in the lobules.
- Estrogen receptor-positive breast cancer - tumors that react to estrogen.
- Stages of breast cancer:
- Stage 0 breast cancer - also called "noninvasive carcinoma" or "carcinoma in situ"; may also refer to LCIS or DCIS.
- Stage I breast cancer - early-stage small tumor that has spread beyond the lobule but is less than an inch across; has not spread beyond the breast (i.e. not to underarm lymph nodes)
- Stage II breast cancer - early-stage tumor that has spread to underarm lymph nodes, or is more than 2 inches without spreading to lymph nodes, or is too large for Stage I.
- Stage III breast cancer - also "locally advanced cancer"; either the tumor is more than 2 inches, or the underarm lymph involvement is extensive, or the cancer has spread further (e.g. around the chest area).
- Stage IV breast cancer - metastatic breast cancer that has spread to other parts of the body.
- Inflammatory breast cancer - a type of Stage III locally advanced breast cancer.
- Recurrent breast cancer - a recurrence of a previous breast cancer; can be a " local recurrence" in the breast or a "distant recurrence" (metastatic).
Types discussion: A "tumor" is an abnormal growth that can be "benign" or "malignant." Benign breast tumors do not threaten life and do not spread to other parts of the body. Malignant breast tumors are cancers that may threaten life and may spread to other parts of the body. A malignant tumor that grows into surrounding tissues is called "invasive." Invasive tumors are more likely to spread to other parts of the body than non-invasive tumors. 1
Invasive breast cancer is categorized as Stage I, II, III, or IV. Stages I and II are considered "early stage" invasive breast cancer and generally refer to smaller tumors that have not yet spread to distant parts of the body. 1
Tumors can be benign or malignant.
Benign tumors are not cancer. They can usually be removed, and in most cases, they do not come back. Cells from benign tumors do not spread to other parts of the body. Most important, benign breast tumors are not a threat to life.
Malignant tumors are cancer. Cells in these tumors are abnormal. They divide without control or order, and they can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or the lymphatic system. That is how cancer spreads from the original (primary) cancer site to form new tumors in other organs. The spread of cancer is called metastasis.
When cancer arises in breast tissue and spreads (metastasizes) outside the breast, cancer cells are often found in the lymph nodes under the arm (axillary lymph nodes). If the cancer has reached these nodes, it means that cancer cells may have spread to other parts of the body -- other lymph nodes and other organs, such as the bones, liver, or lungs. When cancer spreads from its original location to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if breast cancer spreads to the brain, the cancer cells in the brain are actually breast cancer cells. The disease is called metastatic breast cancer. (It is not brain cancer.) Doctors sometimes call this "distant" disease.2
The most common type of breast cancer is ductal carcinoma. It begins in the lining of the ducts. Another type, called lobular carcinoma, arises in the lobules. When cancer is found, the pathologist can tell what kind of cancer it is (whether it began in a duct or a lobule) and whether it is invasive (has invaded nearby tissues in the breast).2
In most cases, the most important factor is the stage of the disease. The stage is based on the size of the tumor and whether the cancer has spread. The following are brief descriptions of the stages of breast cancer and the treatments most often used for each stage. (Other treatments may sometimes be appropriate.)
Stage 0 is sometimes called noninvasive carcinoma or carcinoma in situ.
Lobular carcinoma in situ (LCIS) refers to abnormal cells in the lining of a lobule. These abnormal cells seldom become invasive cancer. However, their presence is a sign that a woman has an increased risk of developing breast cancer. This risk of cancer is increased for both breasts. Some women with LCIS may take a drug called tamoxifen, which can reduce the risk of developing breast cancer. Others may take part in studies of other promising new preventive treatments. Some women may choose not to have treatment, but to return to the doctor regularly for checkups. And, occasionally, women with LCIS may decide to have surgery to remove both breasts to try to prevent cancer from developing. (In most cases, removal of underarm lymph nodes is not necessary.)
Ductal carcinoma in situ (DCIS) refers to abnormal cells in the lining of a duct. DCIS is also called intraductal carcinoma. The abnormal cells have not spread beyond the duct to invade the surrounding breast tissue. However, women with DCIS are at an increased risk of getting invasive breast cancer. Some women with DCIS have breast-sparing surgery followed by radiation therapy. Or they may choose to have a mastectomy, with or without breast reconstruction (plastic surgery) to rebuild the breast. Underarm lymph nodes are not usually removed. Also, women with DCIS may want to talk with their doctor about tamoxifen to reduce the risk of developing invasive breast cancer.
Stage I and stage II are early stages of breast cancer in which the cancer has spread beyond the lobe or duct and invaded nearby tissue. Stage I means that the tumor is no more than about an inch across and cancer cells have not spread beyond the breast. Stage II means one of the following: the tumor in the breast is less than 1 inch across and the cancer has spread to the lymph nodes under the arm; or the tumor is between 1 and 2 inches (with or without spread to the lymph nodes under the arm); or the tumor is larger than 2 inches but has not spread to the lymph nodes under the arm.
Women with early stage breast cancer may have breast-sparing surgery followed by radiation therapy to the breast, or they may have a mastectomy, with or without breast reconstruction to rebuild the breast. These approaches are equally effective in treating early stage breast cancer. (Sometimes radiation therapy is also given after mastectomy.)
The choice of breast-sparing surgery or mastectomy depends mostly on the size and location of the tumor, the size of the woman's breast, certain features of the cancer, and how the woman feels about preserving her breast. With either approach, lymph nodes under the arm usually are removed.
Many women with stage I and most with stage II breast cancer have chemotherapy and/or hormonal therapy after primary treatment with surgery or surgery and radiation therapy. This added treatment is called adjuvant therapy. If the systemic therapy is given to shrink the tumor before surgery, this is called neoadjuvant therapy. Systemic treatment is given to try to destroy any remaining cancer cells and prevent the cancer from recurring, or coming back, in the breast or elsewhere.
Stage III is also called locally advanced cancer. In this stage, the tumor in the breast is large (more than 2 inches across) and the cancer has spread to the underarm lymph nodes; or the cancer is extensive in the underarm lymph nodes; or the cancer has spread to lymph nodes near the breastbone or to other tissues near the breast.
Inflammatory breast cancer is a type of locally advanced breast cancer. In this type of cancer the breast looks red and swollen (or inflamed) because cancer cells block the lymph vessels in the skin of the breast.
Patients with stage III breast cancer usually have both local treatment to remove or destroy the cancer in the breast and systemic treatment to stop the disease from spreading. The local treatment may be surgery and/or radiation therapy to the breast and underarm. The systemic treatment may be chemotherapy, hormonal therapy, or both. Systemic therapy may be given before local therapy to shrink the tumor or afterward to prevent the disease from recurring in the breast or elsewhere.
Stage IV is metastatic cancer. The cancer has spread beyond the breast and underarm lymph nodes to other parts of the body.
Women who have stage IV breast cancer receive chemotherapy and/or hormonal therapy to destroy cancer cells and control the disease. They may have surgery or radiation therapy to control the cancer in the breast. Radiation may also be useful to control tumors in other parts of the body.
Recurrent cancer means the disease has come back in spite of the initial treatment. Even when a tumor in the breast seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained somewhere in the body after treatment.
Most recurrences appear within the first 2 or 3 years after treatment, but breast cancer can recur many years later.
Cancer that returns only in the area of the surgery is called a local recurrence. If the disease returns in another part of the body, the distant recurrence is called metastatic breast cancer. The patient may have one type of treatment or a combination of treatments for recurrent cancer.
1. excerpt from Early Stage Breast Cancer: NWHIC
2. excerpt from What You Need To Know About Breast Cancer: NCI
Last revision: April 9, 2003
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