Looking for C.U.R.E.

  • Increase font size
  • Default font size
  • Decrease font size
Home What is Breast Cancer Types of Breast Cancer What Are the Different Types of Breast Cancer?

What Are the Different Types of Breast Cancer?

E-mail Print
Attachments:
File
Download this file (typesofbc.pdf)PDF

 

 

Different breast cancers have different treatment options.  The type of cancer is usually determined by looking at a tissue sample from the breast (either from the biopsy or the entire tumor if you have already undergone surgery).

 

There are two main types of breast cancer:  Invasive vs. Noninvasive; and three types of tissue the breast cancer can originate from: milk ducts, milk producing lobules and connective tissue.

 

The first question is in which part of the breast did your cancer originate?

 

The tissue of origin determines how the cancer will act and which treatments are the most effective.  These types of tissue are:

 

  • Milk producing lobules: Lobular carcinoma begins in the lobules of the breast, where milk is made.
  • Milk ducts: Ductal carcinoma is the most common type of breast cancer. This cancer originates from the lining of the milk ducts within the breast.  Milk ducts carry milk from the lobules to the nipple
  • Connective tissue: In rare cases, breast cancer can start in the connective tissue which is made of muscles, fat and blood vessels. These cancers are called sarcomas, and some examples that occur in the breast include phyllodes tumors and angiosarcoma.

 

The next question is whether the cancer is invasive or not.

 

NONINVASIVE : In situ breast cancer refers to a cancer in which the cells have no spread to the breast tissue around the duct or lobule.  The most common noninvasive breast cancer is ductal carcinoma in situ (DCIS). This is confined to the lining of the mild ducts and the abnormal cells have no spread through the duct walls into the surrounding tissue. This is also often referred to as stage 0 cancer.

 

-    Lobular carcinoma in situ (LCIS): Incidental microscopic finding, often cannot be identified clinically or grossly.

  • LCIS is an important indicator for the risk of subsequent invasive breast cancer
  • Patients wich LCIS have a high risk of developing subsequent infiltrating breast cancer, including cancer in the opposite breast.
  • The risk of developing a subsequent breast cancer is approximately 1% per year.

-     Ductal carcinoma in situ (DCIS): This is a preinvasive lesion, if left untreated DCIS has a  high potential to progress to an invasive cancer

  • 90% of cases are detected  by screening  mammography (usually areas of clustered microcalcifications)
  • 10% present with palpable mass

-     Paget’s disease: DCIS of the nipple

  • You may complain of itching in the affected breast, burning sensation, and erosion of the, nipple
  • Paget's may be mistaken for an infection

 

INVASIVE: This is also known as infiltrating breast cancer and spreads outside the membrane that lines the duct or lobule and invades the surrounding tissue.  The cancer travels to other parts of the body such as the lymph nodes.  If your doctor refers to your breast cancer as stage I, II, III or IV, this is considered to be an invasive breast cancer.  Inflammatory breast cancer is one specific type of invasive cancer. it is highly aggressive and grows rapidly.

 

The next important piece of information regarding the type of breast cancer you have is if it is stimulated by hormones.

 

These breast cancer cells have receptors on the outside of their walls. These receptors are specific for hormones that circulate in the body.  Hormone status includes the following:

  • Estrogen receptor (ER) positive: These types of cancer rely on estrogen to help it grow.
  • Progesterone receptor (PR) positive: These types of cancer rely on progesterone to help it grow.
  • Hormone receptor (HR) negative: These cancer do not have hormone receptors.

 

When a breast cancer is positive for ER or PR, hormone-blocking medications (for example tamoxifen) can be an option to slow down growth. HR negative cancers do not respond to this type of treatment.

 

Finally, genetic makeup is important in determining treatment options.

 

  • HER-2 gene: Cancer cells that produce too much of HER-2 ( a protein that promotes cell growth) can be targeted by medications that shut down HER-2, and thus removes the energy source to the cancer cells.

 

Shikha Jain, MD