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The most common forms of breast cancers begin in the milk ducts, lobules or glands and are named accordingly. There are many types of breast cancer but a pathologist can identify the differences by observing sections of the tumor through a microscope. It is important to speak with your healthcare team as each breast cancer case is unique.
Ductal Carcinoma In-Situ (DCIS)
The term “in situ” or "in place" refers to a very early form of cancer that has not spread. DCIS is a type of pre-cancer inside of the ductal system that has not attacked the nearby tissue. Currently, there is no way to determine if this type of breast cancer will go on to become invasive. This is a very common type of non invasive cancer with 1 in 5 diagnosed as DCIS. Nearly all patients diagnosed with this type of pre-cancer can be cured.
Lobular Carcinoma in Situ (LCIS)
This is a very rare non-invasive tumor that most doctors believe will not develop into invasive cancer. LCIS is more of a “marker” or signal that breast cancer may develop. Described as an abnormal growth in the number of cells, LCIS has recently been renamed lobular neoplasia. Women who have these “markers” are at greater risk of developing breast cancer later in life.
Infiltrating Ductal Carcinoma (IDC)
IDC is the most common type of breast cancer. It starts in the milk ducts of your breast and spreads to surrounding tissues. IDC could spread through the lymph system or bloodstream to other parts of your body. Approximately 8 out of 10 invasive breast cancers are IDC.
Medullary carcinoma accounts for 15% of all breast cancer types. It most frequently occurs in women in their late 40s and 50s, presenting with cells that resemble the medulla (gray matter) of the brain.
Infiltrating Lobular Carcinoma (ILC)
ILC is the second most common type of breast cancer after infiltrating ductual carcinoma. It usually appears as a subtle thickening in the upper-outer section of the breast. ILC starts in the lobules or lobes and has an greater chance of spreading to other parts of the body. Usually positive for estrogen and progesterone receptors, these tumors respond well to hormone therapy. About 1 out of 10 invasive breast cancers is ILC.
Tubular carcinoma cells have a distinctive tubular structure when viewed under a microscope. This type of breast cancer is typically found in women aged 50 and above. It has an excellent 10-year survival rate of 95%.
Mucinous Carcinoma (Colloid)
Mucinous (colloid) carcinoma is a rare type of invasive breast cancer that rarely spreads to your lymph nodes. It is formed when cancer cells inside your breast produce mucous. This mucous contains cancer cells that are very distinct from normal cells under a microscope. The mucous and cancer cells combine to form jelly-like tumors.
Paget’s disease of the breast is an eczema-like change in the skin of the nipple. The nipple becomes itchy and scaly and does not get better. Studies have shown that 9 out of 10 women who experience these symptoms have an underlying breast cancer. Paget’s Disease can occur at any age but will more likely occur in women who are in their 50s.
Inflammatory Breast Cancer (IBC)
Inflammatory breast cancer is a rare and very aggressive type of cancer that accounts for 1-3% of all breast cancers. It causes the lymph vessels in the skin of the breast to become blocked. IBC usually grows in nests or sheets, rather than as a confined, solid tumor or palpable mass. This type of breast cancer is called "inflammatory" because the breast often looks swollen and red, or "inflamed". It is often mistaken for an infection called "mastitis" and treated with antibiotics. If the patient shows no signs of improvement, further testing will be required to determine if cancer is present.
IBC requires quick and aggressive treatment. Here are important symptoms to watch for:
- Increase in breast size over a relatively short period of time (sometimes a cup size in a few days)
- Itching that is unrelenting and unrelieved by oral drugs or topical agents
- Pink, red, or dark-colored areas sometimes with peau d'orange (texture similar to the skin of an orange)
- Ridges and thickened areas of the skin
- What appears to be a bruise that does not go away
- Nipple flattening or retraction
- Nipple discharge
- Breast is excessively warm to the touch
- Breast is harder or firmer than usual
- Breast pain which is not cyclic in nature (may be constant or stabbing)
- Change in color and/or texture of the areola (area surrounding the nipple)
- Swollen lymph nodes in the underarm or above the collarbone
Triple Negative Breast Cancer
This breast cancer is Estrogen receptor negative, Progesterone receptor negative and HER2neu negative. This type of breast cancer accounts for approximately 15% of all invasive breast cancers. It is most commonly found in younger patients, African American (up to 60% premenopausal women in Africa) and BRAC1 carriers (up to 80%).
ER, PR and HER2 are known to fuel most breast cancers and the most successful treatments target these receptors. Medicines like Tamoxifen and Herceptin are not helpful in treating TNBC however this type of breast cancer does respond well to chemotherapy. For more information about TNBC and teatments read Dr Maureen Trudeau MD FRCP (C) from Sunnybrook's Odette Cancer Center presentation " New Treatment Options for Metastatic Breast Cancer A Focus on HER2 & Triple Negative Disease" . For more comprehensive information read "Guide to Understanding Triple Negative Breast Cancer".