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Home What is Breast Cancer Definitions ACS Breast Cancer Dictionary

ACS Breast Cancer Dictionary

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American Cancer Society Breast Cancer Dictionary

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

ablation (ab-lay-shun): elimination or removal of an organ or tissue. See also ablative

therapy.

ablative (ab-lay-tive) therapy: treatment that removes or destroys the function of an organ; for example, removing the ovaries or using some types of chemotherapy to make them stop working is called ablative therapy. See also hormone therapy.

adenocarcinoma (ad-in-o-car-suh-NO-muh): cancer that starts in glandular tissue, such as in ducts or lobules of the breast. See also duct, lobules.

adenoid (ad-in-oyd) cystic carcinoma or adenocystic carcinoma: a rare type of breast cancer that has both glandular (adenoid) and cylinder-like (cystic) features when looked at under the microscope.

adenoma (ad-in-o-ma): a growth that is not cancer that starts in the glandular tissue. See also fibroadenoma.

adhesions (ad-he-zhuns): fibrous scar tissue that tends to bind together tissues or organs that are usually not attached. This scar tissue may take the form of bands, cords, or even thin sheets of tissue. In the breast, you may be able to feel this banding or cording under the skin. See also capsule formation.

adjuvant (ad-juh-vunt) therapy: treatment used in addition to the main treatment. The term usually refers to hormone therapy, chemotherapy, or radiation therapy added after surgery to increase the chances of curing the disease or keeping it in check. See also neoadjuvant therapy.

adrenal (uh-dree-nul) glands: small glands located on the top of each kidney. Their main function is to make hormones that control metabolism, fluid balance, and blood pressure. They also make small amounts of male hormones (androgens) and female hormones (estrogens and progesterone).

advanced cancer: cancer that has spread from the primary site to other parts of the body and usually cannot be cured or controlled with treatment. When the cancer has spread only to the surrounding areas, it is called locally advanced. If it has spread to distant parts of the body, it is called metastatic cancer. See also metastasis, metastasize.

alopecia (al-o-pee-shuh): hair loss, which may include eyebrows, eyelashes, and even pubic hair. This often happens as a result of chemotherapy or from radiation therapy to the head. In most people, the hair grows back after treatment ends.

alternative therapy: use of an unproven therapy instead of standard (proven) therapy. Some alternative therapies have dangerous or even life-threatening side effects that may not be well known. With others, the main danger is that the patient may lose the chance to benefit from standard therapy. The American Cancer Society recommends that patients who are thinking about using any alternative or complementary therapy discuss this with their health care team. See also complementary therapy.

androgen (an-dro-jen): a male sex hormone. Androgens may be used to treat recurrent breast cancer. Their effect is to oppose the activity of estrogen, thereby slowing growth of the cancer. See also hormone therapy.

anemia (uh-neem-ee-uh): a condition in which there is a shortage of red blood cells in the body. It can cause a person to feel tired and short of breath.

anesthesia (an-es-thee-zhuh): the drug-induced loss of feeling or sensation. General anesthesia causes loss of consciousness (makes you go into a deep sleep). Local or regional anesthesia numbs only a certain area of the body. The drugs or gases that induce anesthesia are called anesthetics.

aneuploid (an-you-ploid): See also ploidy.

angiogenesis (an-jee-o-JEN-uh-sis): the formation of new blood vessels. Tumor angiogenesis is the formation of new blood vessels needed for tumors to grow. This is caused by the release of chemicals by the tumor. Some cancer treatments work by preventing the tumor from forming blood vessels. See also vascular endothelial growth factor.

angiosarcoma (an-jee-o-sar-KO-muh): a form of cancer that starts from cells that line blood vessels or lymph vessels; seen rarely in the breasts.

antibiotic: a drug used to kill organisms (germs) that cause disease. Antibiotics may be made naturally by living organisms or they may be man-made in the lab. Since some cancer treatments can reduce the body's ability to fight off infection, antibiotics may be used to treat or prevent these infections.

antibody: a protein made by the body's immune system cells and released into the blood. Antibodies defend against foreign agents like bacteria. These agents contain substances called antigens. Each antibody works against a specific antigen. See also antigen.

anti-emetic (an-tie-eh-MEH-tik): a drug that prevents or relieves nausea and vomiting, may also be called an anti-nausea or anti-vomiting drug.

anti-estrogen (an-tie-ess-tro-jen): a substance (for example, the drug tamoxifen) that blocks the effects of estrogen on tumors. Anti-estrogens are used to treat breast cancers that depend on estrogen for growth. See also hormone therapy, selective estrogen receptor modulator.

antigen (an-tuh-jen): a substance that causes the body's immune system to react, often resulting in the production of antibodies. For example, the immune system's response to antigens that are part of bacteria and viruses helps people resist infections. Cancer cells have certain antigens that can be found by lab tests. They are important in cancer diagnosis and in determining response to treatment. Other cancer cell antigens play a role in immune reactions that may help the body's resistance against cancer. See also antibody.

anti-metabolites (an-tie-muh-TAB-o-lites): substances that interfere with the body's chemical processes, such as making proteins, DNA, and other chemicals needed for cell growth and reproduction. In treating cancer, anti-metabolite drugs are chemotherapy drugs that disrupt DNA production, which in turn prevents cell division and growth of tumors. See also DNA.

areola (air-ee-o-la): the dark area of skin that surrounds the nipple of the breast.

aromatase inhibitors: drugs that keep the adrenal glands from making estrogens. They are used to treat hormone-sensitive breast cancer in post-menopausal women. Examples include anastrozole (Arimidex®), letrozole (Femara®), and exemestane (Aromasin®) .Aromatase inhibitors are being tested to find out if they can also be used to prevent breast cancer in post-menopausal women.

aspiration (asp-er-a-shun): the process of drawing out fluid or cells by suction. See also needle aspiration.

asymptomatic (a-simp-tuh-MAT-ik): not having any symptoms of a disease. Many cancers can develop and grow without causing symptoms, especially in the early stages. Screening tests such as mammograms help find these early cancers, when the chances of successful treatment are usually highest. See also screening.

ATM (ataxia-telangectasia mutation): an inherited mutation in a certain gene responsible for repairing damaged DNA. If this mutation is present, the carrier may have a higher risk of breast cancer. See also mutation, gene, genetic testing.

atypical (a-tip-uh-kul): not usual; abnormal. Often refers to how cancer or pre-cancer cells look under the microscope. The presence of these cells is sometimes described as atypia. See also hyperplasia.

autologous (aw-tahl-uh-gus): use of the patient's own blood or tissue in a medical procedure; for example, using a woman's own tissue to rebuild her breast is called autologous tissue construction. See also breast reconstruction.

axilla: the armpit.

axillary (ax-ill-air-ee) lymph node dissection or axillary dissection: removal of the lymph nodes in the armpit (axillary nodes). They are looked at under a microscope to see if they contain cancer. See also lymph nodes.

B

banding: See also adhesions.

basal type breast cancer: a very aggressive type of breast cancer, more commonly seen in African-American women.

benign (be-nine): not cancer; not malignant. The main types of benign breast problems are fibroadenomas and fibrocystic changes. bilateral (bi-lat-er-ul): on both sides of the body; for example, bilateral breast cancer is cancer in both breasts, either at the same time (synchronous) or at different times (metachronous). See also unilateral.

biologic response modifiers: substances that boost the body's immune system to fight cancer; interferon is one example. Also called biologic therapy. See also immunotherapy.

biopsy (by-op-see): removing a sample of tissue to see whether cancer cells are present. There are several kinds of biopsies. See also surgical biopsy, needle aspiration, stereotactic needle biopsy.

bisphosphonates: drugs that slow down the action of bone-eating cells called osteoclasts, thereby slowing the spread of cancer in the bones. Bisphosphonates are commonly used to treat breast cancer that has spread to the bones.

body image: the way a person thinks about their body and how they think it looks to others.

bone marrow: the soft tissue in the hollow center of some bones of the body that produces new blood cells. It is often affected by chemotherapy. See also platelet, red blood cells, white blood cells.

bone marrow transplant: a complex treatment that is sometimes used when breast cancer is advanced or has come back after treatment. The bone marrow transplant makes it possible to use much higher doses of chemotherapy than usual. An autologous bone marrow transplant uses the patient's own bone marrow. An allogeneic bone marrow transplant uses marrow from a donor whose tissue type closely matches the patient's. A portion of the patient or donor's bone marrow is removed, cleaned, treated, and stored. The patient is then given very high doses of chemotherapy to kill cancer cells. But the drugs also destroy the remaining bone marrow. This takes away the body's natural ability to make blood cells and fight infection. The stored marrow is then given intravenously (transplanted) to restore the patient's immune defenses and his or her ability to make blood cells. This method has been helpful in some types of cancers, but it has not been scientifically proven work better than standard treatment for breast cancer. It is risky and involves a lengthy and expensive hospital stay that may not be covered by the patient's health insurance. The best place to have a bone marrow transplant is through a clinical trial at a comprehensive cancer center or other facility that has doctors with the technical skill and experience to perform it safely.

bone scan: an imaging test that gives important information about the bones, including the location of cancer that may have spread to the bones. It can be done as an outpatient procedure and is painless, except for the needle stick when a low-dose radioactive substance is injected into a vein. Special pictures are taken to see where the radioactivity collects. These areas may contain cancer. bone (skeletal) survey: a set of x-rays of all the bones of the body; often done when looking for cancer spread (metastasis) to the bones.

brachytherapy (brake-ee-THER-uh-pee): internal radiation treatment given by placing radioactive material directly into the tumor or close to it. Also called interstitial radiation therapy or seed implantation. A newer type, called intracavitary brachytherapy, involves putting a source of radiation inside the breast for a short time after lumpectomy. brain scan: an imaging test used to find anything not normal in the brain, including brain cancer and cancer that has spread to the brain from other places in the body. This test can be done in an outpatient clinic. It is painless, except for the needle stick when a radioactive substance is injected into an arm vein. The images taken will show where radioactivity builds up, which is a sign that the area may be cancer.

BRCA1: a gene that when damaged (mutated) places a woman at much greater risk of developing breast and/or ovarian cancer, compared with women who do not have the mutation.

BRCA2: a gene that when damaged (mutated) puts the carrier at a much higher risk for developing breast cancer and/or ovarian cancer than the general population.

BRCAPRO: a tool used to help health professionals estimate a woman's breast cancer risk. It estimates breast cancer risk based on certain risk factors.

breast augmentation: surgery to increase the size of the breast. See also breast implant, mammoplasty.

breast cancer: cancer that starts in the breast. The main types of breast cancer are ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, medullary carcinoma, and Paget disease of the nipple. (See definitions under these headings.) Most breast specialists believe that lobular carcinoma in situ is not a true cancer.

breast-conserving therapy or breast conservation therapy: surgery to remove a breast cancer and a small amount of normal tissue around the cancer (margin), without removing any other part of the breast. The lymph nodes under the arm may be removed and radiation therapy is often given after the surgery. This method is also called lumpectomy, segmental excision, limited breast surgery, or tylectomy. See also lymph nodes.

breast implant: a sac used to increase breast size or restore the shape of the breast after mastectomy. The sac is filled with silicone gel (a synthetic material) or sterile saltwater (saline).

breast reconstruction: surgery done to rebuild the breast after mastectomy. A breast implant or the woman's own tissue is used. If desired, the nipple and areola may also be recreated. Reconstruction can be done at the time of mastectomy (immediate reconstruction) or any time later (delayed reconstruction).

breast self-exam (BSE): a method of checking one's own breasts for lumps or suspicious changes. BSE is an option for women in their 20s and older. The goal with BSE is to know what your breast tissue feels and looks like and be able to report any breast changes to a doctor or nurse right away.

breast specialist: a health care professional who has a dedicated interest in breast health. While he or she may have specialized knowledge in this area, medical licensing boards do not certify a specialty in breast care.

C

CAT scan or CT scan: See also computed tomography.

calcifications (kal-suh-fuh-KAY-shuns): tiny calcium deposits within the breast, either alone or in clusters, usually found by mammography. They are a sign of change within the breast that may need to be followed by more mammograms or by a biopsy. Calcifications may be caused by benign breast conditions or by breast cancer. The ones most closely linked to breast cancer are called microcalcifications, while the larger macrocalcifications are more often linked to benign changes.

cancer: cancer is not just one disease but rather a group of diseases. All forms of cancer cause cells in the body to change and grow out of control. Most types of cancer cells form a lump or mass called a tumor, which can invade and destroy healthy tissue. Cells from the cancerous (another word for cancerous is malignant) tumor can break away and travel to other parts of the body. There they can continue to grow. This spreading process is called metastasis. When cancer spreads, it is still named after the part of the body where it started. For example, if breast cancer spreads to the lungs, it is still breast cancer, not lung cancer. Some cancers, such as blood cancers, do not form tumors. And not all tumors are cancer. A tumor that is not cancer is called benign. Benign tumors do not grow and spread the way cancer does. They are usually not a threat to life. cancer care team: the group of health care professionals who work together to diagnose, treat, and care for people with cancer. The breast cancer care team may include any or all of the following and others: primary care physicians and/or gynecologists, pathologists, oncology specialists (medical oncologist, radiation oncologist), surgeons, nurses, oncology nurse specialists, and oncology social workers. Whether the team is linked formally or informally, there is usually one person who takes on the job of coordinating the team. See also case manager.

cancer cell: a cell that divides and reproduces abnormally. It can spread throughout the body, crowding out normal cells and tissue. Cancer cells develop because of damage to DNA. See mutation, DNA.

cancer-related check-up: a routine health exam for cancer in people without obvious signs or symptoms of cancer. The goal of the cancer-related check-up is to find any cancer at an early stage, when chances for cure are greatest. A clinical breast exam is one of the procedures done in cancer-related check-ups. See also detection, screening. cancer-related fatigue: an unusual and persistent sense of tiredness that can occur with

cancer or cancer treatments. It can be overwhelming, last a long time, and interfere with everyday life. Rest does not always relieve it.

capsule formation: scar tissue that may form around a breast implant (or other type of implant) as the body reacts to the foreign object. Sometimes called a contracture. See also adhesions.

carcinogen (car-sin-o-jin): any substance that causes cancer or helps cancer grow. For example, tobacco smoke contains many carcinogens that greatly increase the risk of lung and many other types of cancer.

carcinoma (car-sin-o-ma): cancer that begins in the lining layer (epithelial cells) of organs. At least 80% of all cancers are carcinomas, and almost all breast cancers are carcinomas.

carcinoma in situ (car-sin-o-ma in sy-too): an early stage of cancer, in which the tumor is still only in the structures of the organ where it first started. The disease has not grown into other parts of the organ or spread to distant parts of the body. Most in situ carcinomas are highly curable.

case manager: the member of a cancer care team, usually a nurse or oncology nurse specialist, who coordinates the patient's care throughout diagnosis, treatment, and recovery. The case manager acts as a guide through the complex system of health care by helping cut through red tape, getting responses to questions, managing crises, and connecting the patient and family to needed resources.

causal (kaw-zul) association or causal link: a relationship in which one factor is thought to be responsible for or cause an outcome; for instance, smoking has a causal link to lung cancer.

CDH1: a gene that can cause hereditary diffuse gastric cancer (a rare type of stomach cancer) to develop at an early age. Women who inherit changes in this gene also have a higher risk of invasive lobular breast cancer. See also invasive lobular breast cancer.

cell: the basic unit of which all living things are made. Cells replace themselves by splitting and forming new cells (mitosis). The processes that control formation of new cells and death of old cells are disrupted in cancer. See also DNA, mutation.

cell cycle: the series of steps a cell must go through to divide. Some chemotherapy drugs interfere with the cell cycle.

centigray (cGy): a unit of radiation equal to the older unit, the rad.

centimeter or cm (sin-tuh-mee-ter): a metric measure of length. It takes about 2 ½ centimeters to equal 1 inch. Also, 1/100 of a meter.

CHEK2: a gene that can increase breast cancer risk if it is damaged or mutated. A damaged gene of this type can be inherited. See also mutation.

chemo brain: the mental cloudiness people with cancer sometimes notice before, during, and after chemotherapy. Despite the name, its exact cause is uncertain.

chemoprevention: prevention or reversal of disease by drugs, chemicals, vitamins, or minerals. Although this method is not ready for widespread use, it is a very promising area of study. Clinical trials have shown that the drugs tamoxifen and raloxifene can prevent some cases of breast cancer in women with high risk of this disease. But these drugs may have some serious side effects. Other selective estrogen receptor modulators (SERMs) are being tested for this purpose. See also selective estrogen receptor modulators.

chemotherapy: treatment with drugs to kill cancer cells, most of the time called just "chemo." Chemo is often used in addition to surgery or radiation to treat cancer when it has spread, when it has come back, or when there is a strong chance that it could come back.

chromogenic in situ hybridization (CISH) (kro-mo-jen-ick in sy-too hi-brid-ih-ZAshun): a lab test that uses small DNA probes to count the number of HER2 genes in breast cancer cells.

Claus model: a tool used to help health professionals estimate a woman's breast cancer risk. It gives an estimate of breast cancer risk based on certain risk factors.

clavicle (kla-vih-kul): the collarbone. One sits above each breast and is joined to the breastbone (sternum). Lymph nodes are above and below this bone. See also lymph nodes, infraclavicular, supraclavicular.

clinical breast exam : an examination of the breasts done by a health professional such as a doctor or nurse. Clinical breast exams (CBE) are recommended every 3 years for women in their 20s and 30s, and every year for women age 40 and older.

clinical stage: See also staging.

clinical trials: Clinical trials are carefully controlled research studies that are done with people. These studies test whether a new treatment is safe and how well it works in patients compared with current standard treatments. They may also test new ways to diagnose or prevent a disease. Clinical trials have led to many advances in cancer prevention, diagnosis, and treatment.

colloid carcinoma or mucinous carcinoma: this is a rare type of infiltrating breast cancer formed by mucus-producing cancer cells. The outlook (prognosis) for this kind of cancer is considered to be better than average.

combined modality therapy: 2 or more types of treatment used either alternately or together to get the best results. For example, surgery for cancer is often followed by chemotherapy to destroy any cancer cells that may have spread from the original site.

comedocarcinoma (kom-id-o-car-sin-NO-muh): ductal carcinoma in situ that has dead or dying cancer cells in its center. See ductal carcinoma in situ. complementary therapy: therapy used in addition to standard therapy. Some complementary therapies may help relieve certain symptoms of cancer, relieve side effects of standard cancer therapy, or improve a patient's sense of well-being. The American Cancer Society recommends that patients thinking about using any alternative or complementary therapy discuss this with their health care team. See also alternative therapy.

computed tomography (tom-ahg-ruh-fee) : an imaging test in which many x-rays of a part of the body are taken from different angles. These pictures are combined by a computer to produce cross-sectional images of internal organs. Except for injection of a dye (needed in some but not all cases), this is a painless procedure that can be done in an outpatient clinic. It is often referred to as a CT or CAT scan.

computer-aided detection (CAD): a process in which a radiologist uses a computer program to help interpret a mammogram or other imaging test.

contracture: a capsule or shell of dense scar-like tissue that may form around a breast implant. See also capsule formation.

cording: See also adhesions.

core biopsy or core needle biopsy: See also needle biopsy.

corticosteroid (kor-ti-ko-STEER-oid): any of a number of steroid substances normally made by the cortex (outer layer) of the adrenal glands. Man-made versions are sometimes used as an anti-cancer treatment or to reduce nausea.

cyst (sist): a fluid-filled mass that is usually not cancer. A needle aspiration can be done to remove the fluid for testing. See also needle aspiration.

cytology (sigh-tahl-uh-jee): the branch of science that deals with the structure and function of cells. It also refers to tests used to diagnose cancer and other diseases by looking at cells under the microscope.

cytotoxic (sy-toe-tock-sick): toxic or poisonous to cells; cell-killing.

D

DES: diethylstilbestrol, a man-made form of estrogen. Women who took this drug while pregnant may be at a slightly higher risk of breast cancer. detection: finding disease. Early detection means that the disease is found at an early stage, before it has grown large or spread to other sites. Many forms of cancer can reach an advanced stage without causing symptoms. For breast cancer, the chances of early detection improve when women have mammograms and clinical breast exams on the schedule recommended by the American Cancer Society, and when they get medical attention for any lumps or changes they find themselves through breast self-exam. Mammograms are the principal way to detect breast cancer early. A mammogram can show a developing breast tumor before it can be felt by the woman herself or even by ahighly skilled health care professional.

diagnosis: identification of a disease by its signs or symptoms and through the use of imaging tests and lab findings. The earlier a diagnosis of cancer is made, the better the chance for long-term survival.

diagnostic: relating to a diagnosis; methods used to make a diagnosis. See also diagnosis, mammogram.

diaphanography (die-af-un-OG-ruh-fee): a method of examining the breast. It is used mostly in women age 40 or younger. The technique uses bright light to illuminate inner structures, in much the same way that children observe the blood and bones in their hands with flashlights. It has limitations and by itself is not an adequate method of examination. Also called transillumination.

dietary supplement: a product, such as a vitamin, mineral, or herb, intended to improve health but not to diagnose, treat, cure, or prevent disease. Dietary supplements are not considered drugs, so their manufacturers do not have to prove they are effective, or even safe.

diethylstilbestrol (die-ETH-ul-still-bes-trahl): See also DES.

differentiation (dif-uh-ren-she-A-shun): the normal process through which cells mature so they can carry out the jobs they were meant to do. Cancer cells are less differentiated than normal cells. Doctors use grading to evaluate and report the degree of a cancer's differentiation. See also grade.

digital mammography: a method of storing an x-ray image of the breast as a computer image rather than on the usual x-ray film. Digital mammography can be combined with computer-aided detection (CAD), a process in which the radiologist uses a computer program to help interpret the mammogram. See also mammogram.

dimpling: a pucker or indentation of the skin. On the breast, it may be a sign of cancer.

discharge: See also nipple discharge.

disease-free survival rate: the percentage of people with a certain cancer who still have no evidence of disease (cancer) a certain period of time (usually 5 years) after treatment. This rate does not measure actual "survival," which is expressed by the 5-year survival rate.

dissection: surgery to divide, separate, or remove tissues. See also axillary lymph node dissection.

DNA (deoxyribonucleic acid): the genetic "blueprint" found in the nucleus (center) of each cell. DNA is in every cell of the body, and directs all the cells’ activities. It contains genetic information on cell growth, division, and function. See also mutation.

dose-dense chemotherapy: giving the usual doses of chemo closer together (every 2 weeks) rather than the every-3-week schedule. This aggressive schedule requires drugs called growth factors to be given to prevent low blood counts. Clinical trials are in progress to better define the best way to use dose-dense chemotherapy.

doubling time: the time it takes for a cell or a cancer to divide and double itself. The doubling time of breast cancer cells depends on many things, such as the type of tumor, the resistance of the individual's body, and the location in which it tries to grow. A single cell needs 30 doublings to reach a noticeable size of 1 centimeter (a little less than a half inch). Cancers vary in doubling time from 8 to 600 days, averaging 100 to 120 days. Thus, a cancer may grow for many years before it can be felt.

drug resistance: the ability of cancer cells to resist the effects of chemo drugs used to treat cancer.

duct: a hollow passage for gland secretions. In the breast, milk passes from the lobule (which makes the milk) through the ducts to the nipple.

duct ectasia (ek-tay-zhuh): widening of the ducts of the breast, often related to breast inflammation called periductal mastitis. Duct ectasia is not cancer. Symptoms of duct ectasia are nipple discharge, swelling, retraction of the nipple, or a lump that can be felt.

ductal carcinoma in situ (ductal car-sin-o-muh in sy-too) (DCIS): cancer that starts in cells in the milk passages (ducts) and does not break through the duct walls into the nearby tissue. This is a highly curable form of breast cancer that is treated with surgery or surgery plus radiation therapy. Also called intraductal carcinoma.

ductogram: a test in which a fine plastic tube goes into the nipple and injects a contrast dye that outlines the shape of the duct. X-rays are then taken to see if there is a mass. Also called a galactogram.

E

edema (uh-deem-uh): build-up of fluid in the tissues, causing swelling, which is often short-term. Edema of the arm or leg can occur after radiation or surgery, such as radical mastectomy or axillary dissection of lymph nodes. See also lymphedema.

emesis (em-ih-sis): vomiting.

endocrine (en-duh-krin) glands: glands that release hormones into the bloodstream. The ovaries are one type of endocrine gland.

endocrine therapy: management of hormones to treat a disease or condition. See also hormone therapy.

endometrium (en-doe-mee-tree-um): the lining of the womb (uterus). This tissue is affected by some of the estrogen blockers used in breast cancer treatment, which may cause a higher risk of endometrial cancer.

epidemiology (ep-ih-deem-ee-AHL-uh-jee): the study of diseases in populations (large groups of people) by collecting and analyzing statistical data. In the field of cancer, epidemiologists look at how many people have cancer, who gets specific types of cancer, and what factors (such as environment, job hazards, family patterns, and personal habits like smoking and diet) are linked to cancer risk.

estrogen: a female sex hormone produced mainly by the ovaries, and in smaller amounts by the adrenal glands. In women, levels of estrogen and other hormones work together to regulate the development of secondary sex characteristics, including breasts; regulate the monthly cycle of menstruation; and prepare the body for fertilization and reproduction. In breast cancer, estrogen may promote the growth of cancer cells. See also estrogen receptor assay, estrogen replacement therapy, hormone therapy.

estrogen receptor assay: a lab test done on a sample of the cancer to see if estrogen receptors are present. Growth of normal breast cells and some breast cancers are stimulated by estrogen. Estrogen receptors are molecules that function as a cell's "welcome mat" for estrogen circulating in the blood. Breast cancer cells without these receptors (called estrogen-receptor negative or ER-negative) are unlikely to respond to hormonal therapy such as tamoxifen. Cancers with estrogen receptors (ER-positive) are more likely to respond to hormonal therapy. See also progesterone receptor assay.

estrogen replacement therapy or ERT: the use of estrogen from sources other than the body. Estrogen may be given after a woman's body no longer makes its own supply. This type of hormone therapy is often used to relieve symptoms of menopause in women who no longer have a uterus. It has also been shown to help protect against bone thinning (osteoporosis). Since estrogen nourishes some types of breast cancer, scientists are working on the question of whether estrogen replacement therapy increases breast cancer risk. ERT probably will be shown to not increase the risk of breast cancer very much, if at all, especially if used for a relatively short period of time. But some studies have shown that it may increase the risk of stroke.

etiology (ee-tee-ahl-uh-jee): the cause of a disease. There are probably many causes of cancer, and research is showing that both genetics and lifestyle are major factors in many cancers.

excisional biopsy: See also surgical biopsy.

extended radical mastectomy: See mastectomy.

external beam radiation therapy (EBRT): radiation that is focused from a source outside the body on the area affected by the cancer. It is much like getting a diagnostic xray, but for a longer time and at a higher dose. Compare with internal radiation. Radiation to the breast can be delivered from outside the body in different ways

accelerated breast irradiation: use of a slightly larger than usual dose of radiation each day, so that the course of radiation can be completed in a shorter time. This is also called hypofractionated radiation.

intraoperative radiation: a single large dose of radiation given in the operating room right after lumpectomy, while the breast cancer site is still exposed. This is a type of accelerated partial breast radiation, in that it does not treat the whole breast but only the affected area.

F

false negative: test result implying a condition does not exist when in fact it does.

false positive: test result implying a condition exists when in fact it does not.

fascia (fash-uh): a sheet or thin band of fibrous tissue that covers muscles and some organs of the body.

fat necrosis (nuh-crow-sis): the death of fat cells, usually following injury. Fat necrosis is not cancer, but it can cause a breast lump, pulling of the skin, or skin changes that can be confused with breast cancer. fatigue: See also cancer-related fatigue.

fibroadenoma (fi-bro-ad-un-O-muh): a breast tumor made of fibrous and glandular tissue that is not cancer. On a clinical breast exam or breast self-exam, it usually feels like a firm, round, smooth lump. These usually occur in young women.

fibrocystic (fi-bro-sis-tick) changes (fibrocystic disease): a term that describes certain changes in the breast that are not caused by cancer. Symptoms are breast swelling or pain. The breasts often feel lumpy or nodular. Because these signs sometimes look a lot like breast cancer, more tests may be needed to show that there is no cancer.

fibrosis: formation of fibrous (scar-like) tissue. This can occur anywhere in the body.

fine needle aspiration (FNA) biopsy: See also needle aspiration.

first-degree relative: a parent, sibling (brother or sister), or child.

FISH: See also fluorescent in situ hybridization.

five-year survival rate: the percentage of patients who live at least 5 years after their cancer is diagnosed. Five-year survival rates are used to produce a standard way of discussing prognosis (outlook). Five-year relative survival rates do not count the patients who died of other diseases in the calculations. They are considered to be a more accurate way to describe the prognosis for patients with a certain type and stage of cancer. Of course, 5-year survival rates are based on patients diagnosed and treated more than 5 years ago. Improvements in treatment often result in a better outlook for recently diagnosed patients.

flow cytometry (flow sy-tahm-uh-tree): a test of tumor tissue to see how fast the tumor cells are growing based on whether they contain a normal or abnormal amount of DNA. This test is used to help predict how aggressive a cancer is likely to be. See also DNA, ploidy, S-phase fraction.

fluorescent in situ hybridization (FISH): a test used to detect HER2/neu protein in breast cancer biopsy samples. This protein is a marker of a more aggressive cancer that may benefit from new drugs. See also HER2 gene, chromogenic in situ hybridization. fracture: a partial or complete break, usually in bone.

frozen section: a very thin slice of tissue that has been quick-frozen and then looked at under a microscope. This method is sometimes done during an operation because it gives a quick diagnosis and can help a surgeon decide whether to go on with the surgery. The diagnosis is confirmed within a few days by a more detailed study called a permanent section. See also permanent section.

G

galactocele (guh-lack-tuh-seal): a clogged milk duct; a cyst filled with milk. It may occur in the breast during breast-feeding.

galactogram (guh-lack-tuh-gram): See also ductogram.

gene: a piece of DNA that contains information on hereditary characteristics such as hair color, eye color, or height, as well as tendency to have certain diseases. Women who have BRCA1 or BRCA2 gene mutations (defects) have an inherited (genetic) tendency to develop breast cancer. See also BRCA1, BRCA2, mutation, genetic testing. genetic counseling: the process of counseling people who may have inherited a gene that makes them more likely to develop cancer. The purpose of the counseling is to explore what the genetic test results might mean, help them decide whether they wish to be tested, and support them before and after the test.

genetic counselor: a specially trained health professional who helps people as they consider genetic testing, as they adjust to the test results, and as they consider whatever screening and preventive measures are best for them.

genetic testing: tests done to see if a person has inherited certain gene changes known to increase cancer risk. Such testing is not recommended for everyone, but rather for those with specific types of family history. Genetic counseling should be part of the process as well. See also mutation.

glands: organs that produce and release substances used nearby or in other parts of the body.

glandular: related to the glands or cells of the glands.

glandular tissue: tissue that makes and secretes a substance. The ducts and lobules of the breast are glandular tissue because they make breast milk.

grade: the grade of a cancer reflects how different its cells look compared with normal cells under the microscope. There are several grading systems for breast cancer, but all divide cancers into those with the greatest abnormality (grade 3 or poorly differentiated), the least abnormality (grade 1 or well-differentiated) and those with intermediate features (grade 2 or moderately differentiated). Grading is done by the pathologist who looks at the tumor tissue under a microscope. Grading is important because higher-grade cancers tend to grow and spread more quickly, and have a worse prognosis (outlook). Along with the cancer’s stage, the grade is used to help determine the best treatment options. A cancer's nuclear grade is based on features of the central part of its cells, the nucleus. The histologic grade is based on features of individual cells as well as how the cells are arranged together. See also stage, staging, pathologist.

graphic stress telethermometry (GST): a method of measuring surface heat from a distance. Some have attempted to use this method, plus computer analysis of heat patterns in the breast, to measure breast cancer risk. This is not a reliable method and is not in standard practice.

H

Halsted radical mastectomy: See also mastectomy.

hematologist (he-muh-TAHL-uh-jist): a doctor who specializes in diseases of the blood and blood-forming tissues.

hematoma (he-muh-TOE-muh): a collection of blood outside a blood vessel caused by a leak or injury. A hematoma that occurs in the breast after injury or after surgery may feel like a lump.

HER2 gene: a gene that produces a type of receptor that helps cells grow, also called HER2/neu. This receptor is present in very small amounts on the outer surface of normal breast cells. About 25% to 30% of breast cancers have too many of these receptors. These cancers tend to be more aggressive. They may respond to treatment with trastuzumab (Herceptin®), a monoclonal antibody that attaches to the HER2 receptor. See also oncogenes, immunocytochemistry, chromogenic in situ hybridization, fluorescent in situ hybridization.

hereditary cancer syndrome: a condition in which cancers occur in multiple family members because of an inherited, mutated gene. See also mutation, genetic testing.

high risk: when the chance of developing cancer is greater than that normally seen in the general population. People may be at high risk because of many factors, including heredity (such as a family history of breast cancer), personal habits (such as smoking), or the environment (such as too much exposure to sunlight).

histology (hiss-tah-luh-jee): how cells or tissues look when studied under a microscope. The histologic examination is done by a pathologist. See also pathologist

hormone: a chemical substance released into the body by the endocrine glands, such as the thyroid, adrenals, or ovaries. Hormones travel through the bloodstream and set in motion various body functions. For example, prolactin, which is made in the pituitary gland, begins and continues milk production in the breast after childbirth. See also estrogen, progesterone. hormone receptor: a protein located in or on a cell that binds a hormone. Tumors can be tested for hormone receptors to see if they can be treated with hormones or hormone-like substances. See also hormone receptor assay.

hormone receptor assay: a test to see if a breast tumor is likely to be affected by hormones and if it can be treated with hormones. See also estrogen receptor assay, progesterone receptor assay, hormone therapy.

hormone replacement therapy or HRT: the use of estrogen and progesterone from an outside source after the body has stopped making its own supply because of natural or induced menopause. This type of hormone therapy is often given to relieve symptoms of menopause in women who still have a uterus and has been shown to offer protection against thinning of the bones (osteoporosis). Studies have found that combined HRT(estrogen plus progesterone) slightly increases breast cancer risk, as well as the risk of heart disease and blood clots. See also estrogen replacement therapy.

hormone therapy: treatment with hormones, with drugs that interfere with hormone production or hormone action, or the surgical removal of hormone-producing glands to kill cancer cells or slow their growth. The most commonly used hormone therapy for breast cancer is the drug tamoxifen. Other hormonal therapies include megestrol, aminoglutethimide, androgens, and surgical removal of the ovaries (oophorectomy). See also tamoxifen, aromatase inhibitors.

hospice: a special kind of care for people near the end of life that includes their families and caregivers. The care most often takes place in the patient's home, but may be given in a nursing home-like facility. See also palliative treatment.

hyperplasia (hy-per-PLAY-zhuh): an abnormal increase in the number of cells in an area, such as the lining of the breast ducts or the lobules. By itself, hyperplasia is not cancerous, but when the increase is large and/or the cells are not like normal cells, the risk of cancer developing is greater.

hysterectomy (hiss-ter-EK-tuh-me): an operation to remove the uterus. There are presently 3 ways to perform a hysterectomy:

• through a large incision (cut) in the abdomen (belly) (abdominal hysterectomy)

• through the vagina (vaginal hysterectomy)

• through a few very small incisions in the lower abdomen (laparoscopic hysterectomy)

Removal of the ovaries (oophorectomy) may be done at the same time.

I

image cytometry: a method that uses computers to analyze digital images of the cells from a microscope slide to check ploidy. imaging studies: methods used to make pictures of internal body structures. Some imaging methods used to help diagnose or stage cancer are x-rays (a breast x-ray is called a mammogram), bone scans, CT scans, MRI, and ultrasound.

immune system: the complex system by which the body resists infection by germs (such as bacteria or viruses) and rejects transplanted tissues or organs. The immune system may also help the body fight some cancers. See also lymphatic system.

immunocytochemistry or immunohistochemistry (IM-yuh-no-sy-toe-KEM-iss-tree or IM-yuh-no-hiss-toe-KEM-iss-tree): a lab test that uses antibodies to look for certain antigens in biopsy samples. This procedure can be used to help detect and classify cancer cells. It is also one of the methods used for estrogen receptor assays and progesterone receptor assays. See also monoclonal antibodies, estrogen receptor assay, progesterone receptor assay.

immunology (im-yuh-nahl-uh-jee): the study of the immune system, which includes how the body resists infection and certain other diseases. Knowledge gained in this field is important in cancer treatments.

immunosuppression (im-yuh-no-suh-PREH-shun): a state in which the immune system is less able to fight germs. This condition may be present at birth, or it may be caused by certain infections (such as HIV), or by certain cancer treatments, like chemotherapy, radiation, and bone marrow transplantation.

immunotherapy (im-yuh-no-THER-uh-pee): treatments that strengthen or support the body's immune system response to a disease such as cancer.

implant: anything surgically put into the body. In cancer treatment, a small amount of radioactive material placed in or near a cancer, as in radiation implant. Also, an artificial form used to restore the shape of an organ after surgery, for example, a breast implant.

in situ (in-sight-oo): in place; localized and confined to one area. A very early stage of cancer. See also carcinoma in situ.

incidence: the number of new cases of a disease that occur in a population (large group of people) each year. See also prevalence.

inconclusive: uncertain finding; a result that cannot say for certain whether a disease or condition is present; neither positive nor negative.

infiltrating ductal carcinoma: See also invasive ductal carcinoma.

inflammatory breast cancer: a type of invasive breast cancer with spread to lymphatic vessels in the skin covering the breast. The skin of the affected breast is red, feels warm, and may thicken to look and feel like an orange peel. About 1% of invasive breast cancers are inflammatory breast cancers. Also called inflammatory carcinoma. See also invasive cancer, lymphatic system.

informed consent: the process by which patients agree to treatment, after getting an explanation of the course of treatment and the risks, benefits, and other possible options. Patients usually sign a legal document, called a consent form, which shows they have given informed consent.

infraclavicular (in-fruh-kluh-VICK-yuh-ler) nodes: lymph nodes located beneath the clavicle (collar bone). See also lymph nodes, supraclavicular.

interferon (in-ter-fear-on): a protein made by cells that helps regulate the body's immune system, boosting activity when a threat, such as a virus, is found. Scientists have learned that interferon helps fight against cancer, so it is used for immunotherapy of some types of cancer. See also biologic response modifiers, immunotherapy.

internal mammary nodes: See also mammary lymph nodes.

internal radiation: treatment involving placement of a radioactive substance into the body. See also brachytherapy, radiation therapy. external beam radiation therapy.

intraductal carcinoma: See also ductal carcinoma in situ.

intraductal papillomas: small, finger-like, non-cancerous growths in the breast ducts that may cause a clear or bloody nipple discharge. These are most often found in women 45 to 50 years of age. A woman who has had papillomas has a slightly increased risk of breast cancer.

intramuscular (IM): injected into a muscle.

intravenous (IV): a method of giving fluids or medicines using a needle inserted in a vein.

invasive cancer: cancer that has spread beyond the layer of cells where it started and into nearby tissues. For example, invasive breast cancers develop in milk glands (lobules) or milk passages (ducts) and spread to the nearby fatty breast tissue. Some invasive cancers spread to distant areas of the body, but others do not. Also called infiltrating cancer. See also carcinoma in situ.

invasive ductal carcinoma: a cancer that starts in the milk passages (ducts) of the breast and then breaks through the duct wall and spreads into the fatty tissue of the breast. When it reaches this point, it can spread elsewhere in the breast, as well as to other parts of the body through the bloodstream and lymphatic system. Invasive ductal carcinoma is the most common type of breast cancer, accounting for about 80% of breast malignancies. Also known as infiltrating ductal carcinoma. See also lymphatic system.

invasive lobular carcinoma: a cancer that starts in the milk-producing glands (lobules) of the breast and then breaks through the lobule walls to spread into nearby fatty tissue. It may then spread elsewhere in the breast. About 10% of invasive breast cancers are invasive lobular carcinomas. It is often difficult to detect by physical examination or even by mammography. Also called infiltrating lobular carcinoma.

L

lactation: production of milk in the breast. latissimus dorsi flap procedure: a method of breast reconstruction in which a long flat muscle of the back and attached skin are moved into the breast area. This method almost always uses a breast implant. See also breast reconstruction, implant.

lesion (lee-zhun): area of abnormal tissue, such as a lump, tumor, or spot.

limited breast surgery: surgery that removes the breast cancer and a small amount of tissue around the cancer but saves most of the breast. It is almost always combined with axillary lymph node removal and is usually followed by radiation therapy. Also called lumpectomy, segmental excision, and tylectomy. See also axillary lymph node dissection, breast-conserving therapy, lumpectomy, mastectomy, radiation therapy.

linear accelerator: a machine used in radiation therapy to treat cancer. It gives off gamma rays and electron beams. This treatment is called external beam radiation therapy. See also external beam radiation therapy.

lipoma: a tumor made of fatty tissue . It is not cancer.

lobular carcinoma in situ (LCIS): although not a true cancer, LCIS is classified as a type of non-invasive cancer. It develops within the milk-producing glands (lobules) of the breast and does not break through the wall of the lobules. Researchers think that LCIS cells almost never progress to invasive lobular cancer. But having LCIS puts a woman at a higher risk of developing an invasive breast cancer later. For this reason, it's important for women with LCIS to have an annual mammogram and clinical breast exam. Also called lobular neoplasia. See also clinical breast exam, invasive lobular carcinoma, mammogram.

lobules: the glands in a woman's breasts that make milk.

local therapy: treatment of cancer at its site, so that the rest of the body is not affected. Surgery and radiation are examples of local therapy. See also systemic therapy.

localized breast cancer: cancer that starts in the breast and is confined to the breast.

luminal breast cancer: type of breast cancer that is estrogen-receptor positive, usually low grade, which tends to grow slowly. This type of cancer is divided into 2 subtypes, luminal A and luminal B. Luminal B cancers tend to grow a bit more quickly than luminal A. See also estrogen receptor assay, grade.

lump: any kind of mass in the breast or elsewhere in the body that may or may not be cancer. See also mass, tumor.

lumpectomy (lum-peck-tuh-me): surgery to remove the breast tumor and a small amount of the normal tissue around it. See also breast-conserving therapy, two-step procedure.

lymph (limf): clear fluid that flows through the lymphatic vessels and contains cells called lymphocytes. See lymphatic system, lymphocyte.

lymphatic (limf-at-ick) system: the tissues and organs (including lymph nodes, spleen, thymus, and bone marrow) that produce and store lymphocytes (cells that fight infection) and the channels that carry the lymph fluid. The entire lymphatic system is an important part of the body's immune system. Invasive cancer cells sometimes are carried through the lymphatic vessels (channels) and spread to other parts of the body. See also bone marrow, invasive cancer, lymph nodes.

lymph nodes: small bean-shaped collections of immune system tissue, such as lymphocytes, found along lymphatic vessels. They remove cell waste, germs, and other harmful substances from lymph. They help fight infections and also have a role in fighting cancer. Also called lymph glands. Cancer can spread to the lymph nodes near where it starts. See also lymphocyte, lymphatic system, sentinel lymph node biopsy, axillary lymph node dissection, mammary lymph nodes, infraclavicular, and supraclavicular.

lymphocyte (limf-oh-site): a type of white blood cell that helps the body fight infection and may also have a role in fighting cancer.

lymphedema (limf-uh-dee-muh): swelling due to a collection of excess fluid in the breast, chest, or arms after breast cancer treatment. It may happen after the lymph nodes and vessels are removed or are injured by radiation. It can happen at any time, even many years after treatment. It may also happen when a tumor disrupts normal fluid drainage. Lymphedema can persist and interfere with activities of daily living. See also lymphatic system, lymph nodes.

M

macrocalcifications: See also calcifications.

magnetic resonance imaging (MRI): a method of taking pictures of the inside of the body. Instead of using x-rays, MRI uses a powerful magnet to send radio waves through the body; the images appear on a computer screen as well as on film. Like x-rays, the procedure is physically painless, but some people may feel confined inside the MRI machine.

malignant (muh-lig-nunt): cancerous. See also cancer.

malignant tumor: a mass of cancer cells that may invade nearby tissues or spread to distant areas of the body. See also cancer, cancer cell, invasive cancer.

mammary lymph nodes: lymph nodes that are near the sternum or breastbone, inside the chest. See also lymph nodes.

mammogram, mammography: an x-ray of the breast; a way to find breast cancers that cannot be felt. Mammograms are done with a special type of x-ray machine that is used only for this purpose. A mammogram can show a developing breast tumor before it is large enough to be felt by a woman or even by a highly skilled health care professional. A screening mammogram is used to help find breast cancer early in women without any lumps or symptoms. A diagnostic mammogram helps the doctor learn more about breast masses that have been found by clinical breast exam, or the cause of other breast symptoms. See also digital mammography. mammoplasty: any plastic surgery to reconstruct the breast or to change the shape, size, or position of the breast. Reduction mammoplasty reduces the size of the breast. Augmentation mammoplasty enlarges a woman's breast, usually with implants. See also breast reconstruction.

margin: the edge of the cancerous tissue or lump removed during surgery. A negative surgical margin is a sign that no cancer was left behind. A positive surgical margin means that cancer cells are found at the outer edge of the removed sample, and is usually a sign that some cancer is still in the body.

mass: lump or tumor, which may or may not be cancer. See also lump, tumor.

mastectomy: surgery to remove all or part of the breast and sometimes other tissue. There are different types of mastectomy:

Extended radical mastectomy removes the breast, skin, nipple, areola, chest muscles (pectoral major and minor), and all axillary and internal mammary lymph nodes on the same side.

Halsted radical mastectomy removes the breast, skin, nipple, areola, both pectoral muscles, and all axillary lymph nodes on the same side.

Modified radical mastectomy removes the breast, skin, nipple, areola, and most of the axillary lymph nodes on the same side, leaving the chest muscles intact.

Partial mastectomy removes less than the whole breast, taking only the part of the breast in which the cancer occurs and a margin of healthy breast tissue surrounding the tumor.

Prophylactic mastectomy is a mastectomy done before any evidence of cancer can be found, to prevent cancer. This procedure is sometimes recommended for women at very high risk of breast cancer.

Quadrantectomy is a partial mastectomy in which the quarter of the breast that contains a tumor is removed.

Segmental mastectomy is a partial mastectomy.

Simple mastectomy or total mastectomy removes only the breast and areola.

Skin-sparing mastectomy leaves as much of the breast skin as possible to improve the way the reconstructed breast looks.

Subcutaneous mastectomy is surgery to remove internal breast tissue. The nipple and skin are left intact. This may be used for some preventive mastectomies but it leaves behind more breast tissue than other mastectomies, so there is a higher risk of cancer later on.

mastitis (mass-tie-tiss): inflammation or infection of the breast. mastopexy: surgery to lift a breast that sags.

medical oncologist: a doctor who is specially trained to diagnose and treat cancer with chemotherapy and other drugs.

medullary (med-you-lair-ee) carcinoma: a special type of invasive ductal carcinoma with especially sharp boundaries between tumor tissue and normal tissue. About 5% of breast cancers are medullary carcinomas. The outlook (prognosis) for this kind of cancer is considered to be better than average. See invasive ductal carcinoma.

menarche (men-ar-key): a woman's first menstrual period. Early menarche (before age 12) is a risk factor for breast cancer, possibly because the earlier a woman's periods begin, the longer her exposure to estrogen. See also menopause.

menopause (men-uh-paws): the time in a woman's life when monthly cycles of menstruation stop forever and the level of hormones made by the ovaries decreases. Menopause usually occurs naturally when a woman is in her late 40s or early 50s, but it can also be caused by surgical removal of both ovaries or by some chemotherapy drugs that destroy ovarian function. Women who are past menopause are called menopausal or post-menopausal. Women who are still menstruating are called pre-menopausal. Those who have begun to have signs of menopause, but have not completely stopped menstruating are said to be perimenopausal.

metachronous: happening at different times. See also bilateral.

metaplastic carcinoma: a very rare type of invasive ductal cancer. These tumors include cells that are normally not found in the breast, such as cells that look like skin cells or cells that make bone. These tumors are also called carcinoma with metaplasia, and are treated like invasive ductal cancer. See also invasive ductal carcinoma.

metastasis (meh-tas-tuh-sis): the spread of cancer cells from the primary site to distant areas of the body by way of the lymph system or bloodstream. See also lymphatic system, primary site, cancer.

metastasize (meh-tas-tuh-size): to spread from one part of the body to another.

microcalcifications: See calcifications.

micrometastases (mike-row-muh-TAS-tuh-sis): the spread of cancer cells in groups that are so small they can only be seen under a microscope.

microvascular surgery: an operation that uses a microscope to see and attach very tiny blood vessels to each other.

modified radical mastectomy: See also mastectomy.

monoclonal antibodies: antibodies made in the lab and designed to lock onto specific substances called antigens. Monoclonal antibodies may be used to treat cancer by themselves, or they may be attached to chemotherapy drugs or radioactive substances to deliver these treatments directly to the cancer, thus killing the cancer cell and not harming healthy tissue. Monoclonal antibodies are also often used in immunocytochemistry to help detect and classify cancer cells. Studies are being done to see if radioactive atoms attached to monoclonal antibodies can be used in imaging tests to detect and locate small groups of cancer cells. See also antibody, antigen, immunocytochemistry.

mucinous carcinoma (mew-sin-us car-sin-o-ma): a type of carcinoma that is formed by mucus-producing cancer cells. See also colloid carcinoma.

mucositis (mew-ko-site-us): inflammation of a mucous membrane such as the lining of the mouth. Chemotherapy can cause this.

multicentric breast cancer: breast cancer occurring in several areas of a breast.

multidrug resistance (MDR): resistance of tumor cells to several unrelated drugs after exposure to a single chemotherapy drug. See also drug resistance.

mutation: a change in the DNA of a cell. Most mutations do not produce cancer, and some may even be helpful. But all types of cancer are thought to be caused by mutations that damage a cell's DNA. A few cancer-related mutations can be inherited, which means that the person is born with the mutated DNA in all the body’s cells. But most mutations happen after the person is born and are called sporadic mutations or acquired mutations. This type of mutation happens in one cell at a time, and only affects cells that come from the single mutated cell.

N

National Comprehensive Cancer Network (NCCN): a group of many cancer centers in the United States. The NCCN develops cancer treatment guidelines for health professionals.

necrosis (nuh-crow-sis): the death of living tissues. Necrotic refers to tissue that has died.

needle aspiration: a type of needle biopsy done to remove fluid from a cyst or cells from a tumor. In this procedure, a needle is used to reach the cyst or tumor and, with suction, draw up samples to be looked at under a microscope. See also biopsy, needle biopsy.

needle biopsy (by-op-see): removal of fluid, cells, or tissue with a needle to be looked at under a microscope. There are 2 types: fine needle aspiration (also called FNA or needle aspiration) and core biopsy. FNA uses a thin needle and syringe (like those used to give injections) to pierce the skin and draw up (aspirate) fluid or small tissue fragments from a cyst or tumor. A core needle biopsy uses a thicker needle to remove a piece of tissue from a tumor.

needle localization: a procedure used to guide a surgical breast biopsy when the lump is hard to find or when there are areas that look suspicious on the mammogram but there is not a distinct lump. A thin needle is placed into the breast. X-rays are then used to guide the needle to the suspicious area. The surgeon then uses the path of the needle as a guide to find the abnormal area to be removed. See also wire localization. negative: a result from lab tests or pathology findings in which the abnormality being looked for was not found. In breast cancer, when lymph nodes or tissues are found to be negative for cancer it means that no cancer was found there.

neoadjuvant (nee-o-AD-juh-vunt) therapy: systemic therapy, such as chemotherapy or hormone therapy, given before surgery. This can shrink some breast cancers, so that surgical removal can be done with a less extensive operation than would otherwise be needed. See also adjuvant therapy.

neoplasm (nee-o-plaz-um): an abnormal growth (tumor) that starts from a single altered cell; a neoplasm may or may not be cancer. If it is cancer, it is called a malignant neoplasm.

neuropathy (nur-ah-puth-ee): nerve abnormality or damage which causes numbness, tingling, pain, muscle weakness, or even swelling. It may be caused by injury, infection, disease (cancer, diabetes, kidney failure, or poor nutrition, for example), or by drugs.Peripheral neuropathy is a type of neuropathy that starts in nerves farthest away from the brain, such as the hands and feet.

nipple: the tip of the breast; the pigmented projection in the middle of the areola. The nipple contains the opening of milk ducts from the breast.

nipple discharge: any fluid coming from the nipple. It may be clear, milky, bloody, tan, gray, or green. A nipple discharge examination is done by collecting the fluid and looking at it under the microscope to see if any cancer cells are found.

nipple retraction: an inward turning of the nipple of the breast.

nipple-sparing mastectomy: mastectomy in which the nipple and areola are cut away, scraped clean of breast tissue, and looked at under a microscope by a pathologist. As long as there are no breast cancer cells found close to the nipple and areola, they are reattached. See also areola, mastectomy, pathologist.

nodal status: whether a breast cancer has spread (node-positive) or has not spread (nodenegative) to lymph nodes in the armpit (axillary nodes). The number and site of positive axillary nodes can help predict the risk of cancer recurrence. See also stage, staging.

node: a lymph node. See also lymph nodes, lymphatic system.

nodule: a small, solid lump that can be found by touch.

Nolvadex®: trade name for tamoxifen. See also tamoxifen.

normal hormonal changes: changes in breast and other tissues that are caused by changes in the levels of female hormones during the menstrual cycle. See hormone.

nuclear grade: See also grading.

nuclear medicine scan: a method for looking at diseases of internal organs such as the brain, liver, or bone. Small amounts of a radioactive substance (called an isotope) are injected into the bloodstream. The isotope collects in certain organs, and a special camera called a scintillation camera is then used to make an image of the organ and detect areas of disease.

nucleus (new-klee-us): the center of a cell where the DNA is found and where it reproduces. Studying the size and shape of a cell's nucleus under the microscope can help pathologists tell breast cancer cells from normal breast cells.

nulliparous: never having given birth to a child.

nurse practitioner (NP): a registered nurse with a master's or doctoral degree. Licensed nurse practitioners diagnose and manage illness and disease, usually working closely with doctors. In nearly every state, NPs can prescribe medicines.

O

oncogenes (on-kuh-genes): genes that promote cell growth and multiplication. These genes are normally found in all cells. But oncogenes may undergo changes that turn them on, causing cells to grow too quickly and form tumors. See also mutation.

oncologist (on-call-uh-jist): a doctor with special training in the diagnosis and treatment of cancer.

oncology clinical nurse specialist: a registered nurse with a master's degree in oncology nursing who specializes in the care of cancer patients. Oncology clinical nurse specialists may prepare and administer treatments, monitor patients, prescribe and give supportive care, and teach and counsel patients and their families.

oncology social worker: a person with a master's degree in social work who is an expert in coordinating and providing non-medical care to cancer patients. The oncology social worker provides counseling and assistance to people with cancer and their families, especially in dealing with the non-medical issues that can result from cancer, such as financial problems, housing (when treatment must be taken at a facility away from home), and child care.

oncoplastic surgery: newer techniques that combine oncology (cancer care) with plastic surgery.

one-step procedure: surgery in which treatment (such as mastectomy) is done right after the procedure to diagnose the presence of breast cancer (see biopsy). The patient is given general anesthesia and does not know until she wakes up if the diagnosis was cancer or if a mastectomy was done. Once the only option in breast cancer, the one-step procedure is now rarely used, having been replaced by a two-step approach. See also two-step procedure.

oophorectomy (oof-uh-rek-tuh-me): surgery to remove the ovaries.

oral contraceptives: birth control pills, which contain estrogen and/or a progesteronelike substance, known as progestin. See also estrogen, progesterone. osteoporosis: thinning of bone tissue, resulting in less bone mass and weaker bones. Osteoporosis can cause pain, deformity (especially of the spine), and broken bones. This condition is common among post-menopausal women. See also estrogen replacement therapy, hormone replacement therapy, menopause.

ovarian ablation: See also hormone therapy.

ovary: reproductive organ in the female pelvis. Normally a woman has 2 ovaries. They contain the eggs that, when joined with sperm, result in pregnancy. Ovaries are also the primary source of estrogen. See also estrogen.

P

p53: an important tumor suppressor gene that is not working properly in many cancers. The protein that this gene makes (also called p53) normally causes damaged cells to die. Mutations, or changes, in this gene can be inherited or they can occur during a person's life. When they do occur, they can increase risk of getting many types of cancer. See also mutation, tumor suppressor genes.

Paget (pa-jet) disease of the nipple (formerly called Paget’s disease): a rare form of breast cancer that begins in the milk ducts and spreads to the skin of the nipple and areola, which may look crusted, scaly, red, or oozing. The outlook is usually better if these nipple changes are the only sign of breast disease and no lump can be felt. See also duct, nipple.

palliative (pal-ee-uh-tiv) treatment: therapy that relieves symptoms, such as pain, but is not expected to cure the disease. Its main purpose is to improve the patient's quality of life. See also hospice.

palpation (pal-pay-shun): using the hands to examine. In a clinical exam, the doctor palpates the breast. A palpable mass in the breast is one that can be felt.

papillary carcinoma: breast tumors which can be non-invasive or invasive. Intraductal papillary carcinoma or papillary carcinoma in situ is non-invasive, and is often thought to be a type of ductal carcinoma in situ (DCIS). In rare cases the tumor is invasive and is treated like invasive ductal carcinoma. See also ductal carcinoma in situ and invasive ductal carcinoma.

papilloma (pap-uh-low-muh): non-cancerous growth in the breast. Also called papillary tumor.

partial mastectomy: See also mastectomy.

pathologic staging: See also staging.

pathologist (path-all-o-jist): a doctor who specializes in the diagnosis and classification of diseases by lab tests, such as looking at tissue and cells under a microscope. The pathologist determines if a tumor is cancer and, if it is, the exact cell type and grade. pectoral muscles: muscles attached to the front of the chest wall and upper arms. The larger one is called pectoralis major, and the smaller one is called pectoralis minor. Because these muscles are next to the breast, breast cancer may spread to them, although this rarely happens.

peripheral stem cell transplant: a procedure that allows cancer to be treated using very high doses of chemotherapy and radiation. Drugs are given to move blood-forming cells (hematopoietic stem cells) from the bone marrow into the bloodstream, where they can be harvested. These cells are carefully preserved while the cancer is treated, because the cancer treatment kills all the stem cells in the patient's body. Soon after the cancer treatment, the blood-forming cells are given to the patient into a vein, much like a blood transfusion. Over time they settle in the patient's bone marrow and begin to grow and make blood cells again.

permanent section: a way to prepare tissue to be looked at under a microscope. The tissue is soaked in formaldehyde, processed in various chemicals, surrounded by a block of wax, sliced very thin, attached to a microscope slide, and stained. This may take 1 to 2 days. It gives a clear view of the specimen so that the presence or absence of cancer can be determined. See also frozen section.

PET scan: See positron emission tomography.

phyllodes tumor: rare breast tumor, usually not cancer, which grows quickly and can become quite large. Also called phylloides tumor or cystosarcoma phyllodes.

placebo (pluh-see-bo): an inert, inactive substance that may be used in studies (clinical trials) to compare the effects of a given treatment with no treatment. In common speech, a "sugar pill."

platelet: a type of blood cell that helps plug up holes in blood vessels after an injury by forming clots. These cells are made in the bone marrow. Chemotherapy can cause a drop in the platelet count, a condition called thrombocytopenia that carries the risk of excessive bleeding or easy bruising. See also bone marrow.

ploidy (ploy-dee): a measure of the amount of DNA within a cell. Ploidy is a marker that helps predict how quickly a cancer is likely to spread. Cancers with the same amount of DNA as normal cells are called diploid, and those with either more or less than that amount are aneuploid. Patients with diploid cancers have longer disease-free intervals and better outlooks, but about 2 out of 3 breast cancers are aneuploid. This test is done using lasers and computers, a process called flow cytometry. See also flow cytometry.

positron emission tomography (PET): a type of imaging test that uses a form of sugar linked to a slightly radioactive substance. The small amount of this liquid is put into avein, and cancer cells take in large amounts of sugar. A special camera then makes detailed pictures of the places where the radioactive sugar collects.

post-menopausal: See also menopause.

post-mastectomy pain syndrome (PMPS): chronic neuropathic (nerve-related) pain after lumpectomy or mastectomy. The classic signs of PMPS are chest wall pain and tingling down the arm. Pain may also be felt in the shoulder, scar, arm, or armpit. Other common complaints include numbness, shooting or pricking pain, or unbearable itching. PMPS is thought to be linked to damage done to the nerves in the armpit and chest during surgery. But the causes are not known.

pre-cancerous: See also pre-malignant.

predisposition: susceptibility to, or an increased risk for a disease that can be triggered under certain conditions. For example, some women have a family history of breast cancer and are more likely (but not necessarily destined) to develop breast cancer.

pre-malignant: changes in cells that may, but do not always, become cancer. Also called pre-cancerous.

pre-menopausal: See also menopause.

prevalence: a measure of the proportion of persons in a population (large group of people) with a certain disease at a given time. See also incidence.

primary site: the place where cancer begins. Cancer is usually named after the organ in which it starts. For example, cancer that starts in the breast is always breast cancer even if it spreads to other organs such as the bones or lungs. See also metastasis.

progesterone (pro-jes-ter-own): a female sex hormone released by the ovaries during every menstrual cycle to prepare the uterus for pregnancy and the breasts for milk production. See also hormone, ovary, estrogen.

progesterone receptor assay: a lab test done on a breast cancer specimen that shows whether the cancer depends on progesterone for growth. Progesterone and estrogen receptor tests provide more complete information to help in deciding the best cancer treatment for the patient. See also progesterone, estrogen.

prognosis (prog-no-sis): a prediction of the course of a disease; the outlook for the chances of survival. For example, women with breast cancer that was detected early and who get treatment right away have a good prognosis.

progression: spreading or growing disease, with or without treatment.

prolactin: a hormone released from the pituitary gland that prompts milk production. See hormone.

proliferative (pro-lih-fer-uh-tiv): excessive growth of cells in the ducts or lobules of the breast tissue. See duct, lobules.

prophylactic mastectomy: See also mastectomy.

prosthesis (pros-thee-sis): an artificial part used to replace or improve the function of a body part. For example, a breast prosthesis or breast form can be worn under the clothing after a mastectomy. See also mastectomy.

protocol (pro-tuh-call): a formal outline or plan, such as a description of what treatments a patient will get and exactly when each should be given. See also regimen. PTEN: a gene that normally helps control cell growth. Inherited changes in this gene cause Cowden syndrome, a rare disorder in which people are at higher risk for both noncancerous and cancerous breast tumors. It is also linked to growths in the digestive tract, thyroid, uterus, and ovaries.

Q

quadrantectomy: See also mastectomy.


R

rad: stands for "radiation absorbed dose," a measurement of the amount of radiation absorbed by tissues. The term rad is being replaced by cGy (centigray).

radiation: high energy particles that are used for x-rays, and in higher doses for cancer treatment. Natural radiation comes from radon gas and into the air from sources in outer space, such as the sun.

radiation oncologist (on-call-uh-jist): a doctor who specializes in using radiation to treat cancer.

radiation therapist: a person with special training to operate the equipment that delivers radiation therapy.

radiation therapy: treatment with high-energy rays (such as x-rays) to kill cancer cells. The radiation may come from outside of the body (see external beam radiation therapy), and may be given in different ways. Radiation may also come from radioactive materials placed directly in the tumor (see brachytherapy or internal radiation). Radiation therapy may be used to reduce the size of a cancer before surgery, to destroy any remaining cancer cells after surgery, or in some cases, as the main treatment. In advanced cancer cases, it may also be used as palliative treatment. See also palliative treatment.

radical (Halsted or standard) mastectomy: See also mastectomy.

radioisotope (ray-dee-oh-EYE-suh-tope): a type of atom that is unstable and prone to break up (decay). Decay releases small fragments of atoms and radiation. Exposure to certain radioisotopes can cause cancer. But radioisotopes are also used to find and treat cancer. In certain imaging procedures called nuclear scans, for example, radioisotopes are injected into the body where they then collect in areas where the disease is active, showing up as highlighted areas on the pictures. In breast cancer, radioisotopes are used to check for cancer spread to the bones. See also bone scan. radiologic technologist: a health professional (not a doctor) trained to properly position patients for x-rays, take the pictures, and then develop and check the images for quality. Since mammograms are done on a machine that is used only for mammograms, the technologist must have special training in mammography. The films taken by the technologist are sent to a radiologist to be read. See also mammogram, radiologist. radiologist: a doctor with special training to diagnose diseases by interpreting x-rays and other types of diagnostic imaging studies, such as CT and MRI scans.

radiotherapy: See radiation therapy.

raloxifene: a drug that blocks effects of estrogen on breast tissue. The brand name is Evista® ,It is used to reduce breast cancer in women at very high risk. See also estrogen .hormone therapy, selective strogen receptor modulator.

Reach to Recovery®: a visitation program of the American Cancer Society for people who have a personal concern about breast cancer. Carefully selected and trained volunteers who have successfully adjusted to breast cancer and its treatment give information and support to people who are also dealing with the disease.

reconstructive mammoplasty: plastic surgery that is done after mastectomy to rebuild the breast. See breast reconstruction, mammoplasty, mastectomy, latissimus dorsi flap procedure, transverse rectus abdominus muscle flap procedure. rectus abdominus flap procedure: See transverse rectus abdominus muscle flap procedure.

recurrence: cancer that has come back after treatment. Local recurrence means that the cancer has come back at the same place as the original cancer. Regional recurrence means that the cancer has come back in the lymph nodes near the first site. Distant recurrence is when cancer spreads after treatment to distant organs or tissues (such as the lungs, liver, bone marrow, or brain). See also primary site, metastasis, metastasize.

red blood cells: blood cells that contain hemoglobin, the substance that carries oxygen to the tissues of the body. These cells are made in the bone marrow. Low red blood cell counts, a condition called anemia, are a common side effect of chemotherapy. See alsoanemia, bone marrow.

reduction mammoplasty: See also mammoplasty.

re-excision: a second surgery to remove remaining cancer. This may be done if cancer cells were found at the edge of surgically removed tissue. See also margin.

refractory: no longer responds to a certain therapy. See also drug resistance.

regimen (reh-juh-men): a strict, regulated plan (such as diet, exercise, or other activity) designed to reach certain goals. In cancer treatment, a treatment plan which may include different medicines given on a certain schedule, as well as other methods such as radiation treatments. See protocol.

regional involvement: the spread of cancer from its original (primary) site to nearby areas (such as the lymph nodes in the armpit), but not to distant sites such as other organs. See also lymph nodes.

regression: decrease in the size of the tumor or the extent of the cancer.rehabilitation: activities and/or counseling designed to help a person adjust, heal, and return to as full and productive a life as possible after injury or illness. This may involve physical restoration (such as the use of prostheses, exercises, and physical therapy), counseling, and emotional support. See prosthesis.

relapse: reappearance of cancer after a disease-free period. See also recurrence.

remission: complete or partial disappearance of the signs and symptoms of cancer in response to treatment; the period during which a disease is under control. A remission may not be a cure.

replicate: reproduce.

risk factor: anything linked to an increase in a person's chance of getting a disease such as cancer. Some known risk factors for breast cancer include: family history of the disease especially in one's mother or sister; starting menstrual periods at a young age (called early menarche) and ending periods at an older age (late menopause); and obesity. Risk factors often do not cause a disease, but may go along with the illness. For example, older age is linked to higher risk of many types of cancers, but the actual cause appears to be gene mutation, which is more likely with age. See also mutation.

S

saline (say-lean): saltwater solution.

saline breast implant: See also breast implant.

sarcoma (sar-ko-muh): a cancer starting in connective tissues, such as cartilage, fat, muscle, or bone. Several types of sarcoma (such as angiosarcoma, liposarcoma, and malignant phyllodes tumor) can develop in the breast, but this is rare.

scan: a study using either x-rays or radioisotopes and special cameras to make images of internal body organs. See also bone scan, brain scan, computed tomography (CT) scan, magnetic resonance imaging (MRI), nuclear medicine scan, radioisotope.

scintillation (sin-till-AY-shun) camera: device used in nuclear medicine scans to detect radioactivity and produce pictures that help stage cancer and other diseases.

scintimammography (sin-ti-mam-AHG-gruh-fee): an imaging technique in which a radioactive tracer is put into the vein to detect breast cancer cells. It is a new technique that seems to help evaluate women with abnormal mammograms. The tracer attaches to breast cancers.

sclerosing adenosis (skluh-ro-sing ad-in-o-sis): non-cancerous condition in which extra tissue grows in the breast lobules. It may cause tenderness, pain, or breast lumps, and is linked to fibrocystic changes in the breast. See also fibrocystic changes, lobules.

screening: the search for disease, such as cancer, in people without symptoms. Screening may refer to coordinated programs in large populations. The principal screening measure for breast cancer is mammography. See also mammogram. screening mammogram: See mammogram, screening.

secondary tumor: a tumor that forms as a result of spread (metastasis) of cancer from the place where it started.

segmental mastectomy: See also mastectomy.

segmental resection: See also mastectomy.

selective estrogen receptor modulator (SERM): a man-made estrogen-like substance that possesses some, but not all, of the actions of estrogen. For example, raloxifene is classified as a SERM because it prevents bone loss (like estrogen) and lowers serum cholesterol (like estrogen), but (unlike estrogen) does not stimulate the endometrial lining of the uterus. Tamoxifen and aromatase inhibitors are also SERMs. See also estrogen, endometrium, tamoxifen, raloxifene, aromatase inhibitors.

sentinel lymph node biopsy (SLNB): a newer procedure that might replace standard axillary lymph node dissection. Blue dye and/or a radioactive tracer is injected into the tumor site at the time of surgery, and the first (sentinel) node that picks up the dye is removed and biopsied. If the node is cancer-free, fewer nodes are removed. Also known as sentinel node biopsy. Compare with axillary lymph node dissection. See also lymph node.

seroma: a lump or swelling that is caused by a build-up of clear fluid. A seroma may form in the breast after injury or after surgery.

side effects: unwanted effects of treatment, such as hair loss caused by chemotherapy and fatigue caused by radiation therapy.

sign: a visible physical change caused by an illness. See also symptom.

silicone gel: man-made material used in breast implants. Because of its flexibility, strength, and texture, it is much like the natural breast. Silicone gel breast implants are available for women who have had breast cancer surgery. See also breast implant.

simple mastectomy: See also mastectomy.

skin-sparing mastectomy: See also mastectomy.

S-phase fraction: a lab test that shows the percentage of cells that are replicating or reproducing their DNA. DNA replication is usually a sign that a cell is getting ready to split into 2 new cells. A low S-phase fraction is a sign that a tumor is slow-growing; a high S-phase fraction shows that the cells are dividing rapidly and the tumor is growing quickly. See also DNA.

spiral CT: a special scanner that takes cross-sectional pictures from all around the body, also called helical tomography. See also computed tomography.

stage: a certain time or phase in the course of an illness. Used in cancer treatment to describe how advanced the cancer is. This helps to determine what type of treatment will be used. See also staging. staging: the process of finding out whether cancer has spread and if so, how far. Staging of breast cancer is based on the size of the tumor, whether nearby lymph nodes in the armpit are involved, and whether there is distant spread. Knowing the stage at diagnosis is important in selecting the best treatment and predicting a patient's outlook for survival. The staging system of the American Joint Committee on Cancer is sometimes also known as the TNM system. This system gives 3 key pieces of information, as follows:

The letter T followed by a number from 0 to 4 describes the tumor's size and whether it has spread to the skin or chest wall under the breast. Higher T numbers indicate a larger tumor and/or more extensive spread to tissues near the breast.

The letter N followed by a number from 0 to 3 indicates whether the cancer has spread to lymph nodes near the breast and, if so, whether the affected nodes are fixed (stuck) to other structures under the arm.

The letter M followed by a 0 or 1 indicates whether or not the cancer has spread to distant organs (for example, the lungs or bones) or to lymph nodes that are not next to the breast, such as those above the collarbone.

The types of staging are:

clinical staging: an estimate of the extent of cancer based on physical exam, biopsy results (see biopsy), and imaging tests.

pathologic staging: an estimate of the extent of cancer by direct study of tissue removed during surgery.

Once a patient's T, N, and M categories have been determined, this information is combined in a process called stage grouping to determine a woman's disease stage. This is expressed in Roman numerals from Stage 0 (the least serious or earliest stage) to Stage IV (the most serious or advanced stage). See also lymph nodes, metastasis.

standard therapy, standard treatment: the most commonly used and widely accepted form of therapy in a given situation.

stereotactic needle biopsy (steer-ee-o-TACK-tik by-op-see): a method of needle biopsy that is useful in some cases where there are calcifications or a mass that can be seen on mammogram but cannot be felt. A computer maps the location of the mass to guide the placement of the needle. When this type of biopsy is done with a larger needle it may be called a stereotactic core needle biopsy. See also needle aspiration, needle biopsy.

sternum: breastbone, the flat bone where the ribs meet in the center of the front of the chest.

stomatitis (sto-muh-TIE-tus): inflammation or ulcers of the mouth. This condition can be a side effect of some chemotherapy drugs.

stroma: connective tissue. subcutaneous mastectomy: See also mastectomy.

supraclavicular (sue-pruh-cluh-VIK-you-lar) nodes: lymph nodes just above the collarbone (clavicle). See also infraclavicular, lymph nodes.

surgical biopsy: a method of biopsy in which all or part of a lump is removed by a surgeon for examination. See also biopsy, wire localization.

survival rate: See five-year survival rate.

survivor: any living person who has been diagnosed with cancer, at any stage of illness or treatment.

symptom: a change in the body caused by an illness, as described by the person experiencing it. See also sign.

synchronous (sin-kruh-nus): happening at the same time; for example, cancer in both breasts at the same time is synchronous. See also bilateral, metachronous.

systemic (sis-tem-ick) disease: in breast cancer, a tumor that started in the breast has spread to distant organs or structures.

systemic therapy: treatment that reaches and affects cells throughout the body; for example, chemotherapy and hormone therapy. See also local therapy.

T

TRAM flap: See transverse rectus abdominus muscle flap procedure.

tamoxifen: a drug that blocks the effects of estrogen on many organs, such as the breast. Tamoxifen can be used to treat or reduce the risk of breast cancer coming back after treatment. Recent research suggests that tamoxifen may also lower the risk of developing breast cancer in women with certain risk factors. See also estrogen, hormone therapy, selective estrogen receptor modulator.

targeted therapy: treatment that attacks some part of cancer cells that make them different from normal cells. Targeted therapies tend to have fewer side effects than other chemotherapy drugs.

therapy: any of the measures taken to treat a disease.

thermography (thur-mog-ruh-fee): a method in which heat from the breast is measured and mapped. This method is not a reliable way to detect breast cancer. Also called a thermogram.

tissue: a collection of cells that perform a certain function.

total mastectomy: See also mastectomy.

transverse rectus abdominus muscle (TRAM) flap procedure: a method of breast reconstruction in which tissue from the lower abdominal wall (belly), which gets its blood supply from the rectus abdominus muscle, is used. The tissue from this area is moved up to the chest to create a breast mound and usually does not require an implant. Moving muscle and tissue from the lower abdomen to the chest results in flattening of the lower abdomen (a "tummy tuck"). Also called a TRAM flap or rectus abdominus flap procedure. See also breast reconstruction, mammoplasty.

triple-negative breast cancer: breast cancer that does not have estrogen receptors, progesterone receptors, or human epidermal growth factor receptor 2 (HER2). This limits the effective treatment options for patients. See also estrogen receptor assay, HER2 gene, progesterone receptor assay, basal type breast cancer.

tubular carcinoma: a rare type of low-grade infiltrating breast cancer that accounts for about 2% of invasive breast cancers. The outlook for this kind of cancer is considered to be better than average. See also invasive cancer.

tumor: an abnormal lump or mass of tissue. Tumors can be benign (not cancer) or malignant (cancer).

tumor suppressor genes: genes that slow down cell division or cause cells to die at the right time. Changes that turn off these genes can lead to too much cell growth and development of cancer. BRCA1 and BRCA2 are examples of tumor suppressor genes.

two-step procedure: a method in which the procedure to diagnose the presence of breast cancer (see biopsy) and breast surgery for cancer treatment (such as lumpectomy or mastectomy) are done as 2 separate procedures, days or even weeks apart. This method is strongly preferred by women and their health care teams because it gives them time to consider all options. See also lumpectomy, mastectomy, one-step procedure.

tylectomy: See also lumpectomy.

U

ultrasound (ultrasonography or sonography): an imaging method in which highfrequency sound waves are used to outline a part of the body. The sound wave echoes are picked up and shown on a monitor (much like a television screen). This painless method is sometimes used to figure out whether a lump is a fluid-filled cyst or a solid tumor. It can also be used to guide a needle biopsy of breast abnormalities too small to feel. See also cyst, needle aspiration.

unilateral: affecting one side of the body. For example, unilateral breast cancer occurs in one breast only. See also bilateral.

unproven therapy: any therapy that has not been scientifically tested and approved.

uterus: small, pear-shaped organ in a woman’s pelvis in which a fetus can grow. Also called the womb.

V

vaccine: a modified version of a germ or other substance related to a disease, usually given by injection. It is used to stimulate the immune system to bring about resistance to that disease for a period of time, or even permanently. Development of a cancer vaccine is the subject of intense research.

vaginitis: any inflammation of the vagina. Atrophic vaginitis is an inflammation of the vagina in which vaginal tissue becomes thin and dry. This condition occurs after menopause and is caused by lack of estrogen. An estrogen cream may be prescribed to relieve this problem. Vaginitis can also be a side effect of chemotherapy. See also estrogen, menopause.

vascular endothelial growth factor (VEGF): a protein that helps tumors form new blood vessels. See also angiogenesis.

W

white blood cells or WBCs: cells that help defend the body against infections, which work as part of the immune system. This is one of many types of blood cells made in the bone marrow. Certain cancer treatments (especially chemotherapy) can reduce the number of these cells (a condition called neutropenia) and make a person more likely to get infections. See also bone marrow, immune system.

wire localization: a procedure used to guide a surgical breast biopsy when the lump is hard to find or when there is an area that looks suspicious on a mammogram. A thin hollow needle is placed into the breast and x-rays are taken to guide the needle to the area in question. A fine thin wire is inserted through the center of the needle. A small hook at the end of the wire keeps it in place. The hollow needle is then removed, and the surgeon uses the path of the wire as a guide to find the abnormal area to be removed. See alsobiopsy, mammogram, x-ray.

X

xeroradiography (xeromammography): an outdated form of mammography that records the image of the breast on paper rather than on film. This method is rarely used now.

x-ray: a form of radiation that can be used at low levels to produce an image of the body on film. It can also be used at high levels to destroy cancer cells. See also imaging studies, radiation therapy.

 

 

Last Medical Review: 7/22/2010

Last Revised: 7/22/2010

2010 Copyright American Cancer Society