October 5: What Is Breast Cancer?

Breast Cancer is a huge umbrella that covers so many different types and variations, all of which can impact treatment and prognosis.

Ductal Carcinoma accounts for 80% of the breast cancers out there. It can be Invasive, or "in situ", when it hasn't left its area or origin to invade the surrounding tissue. This is the type that forms the classic lump, although depending on the density of the breast tissue, it's not always easy to find.

Inflammatory Breast Cancer

Lobular Carcinoma is the second most common type of breast cancer. Like Ductal, it can be either invasive or in situ. It does not always form a firm lump, and it can be elusive in mammogram screenings.

Inflammatory Breast Cancer does not form a lump at all, but has thickening and painful redness of the breast tissue. It can frequently be misdiagnosed as mastitis. It is usually advanced to stage III or IV by the time it's properly diagnosed. It is one of the more aggressive forms of breast cancer.

Paget's Disease of the Nipple is a rare form of breast cancer, accounting for just 1% of all breast cancer cases. It begins in the ducts and spreads to the skin of the nipple and areola. It presents with symptoms which can include crusted, scaly, red, or oozing skin of the affected area, as well burning or itching. 

This is just a short list, there's several more forms of breast cancer out there, although they are rare, accounting for 1-2% of the diagnosed cases.

On top of the different types of breast cancer, they can have different characterizations as well. They can be hormone receptor positive, growth factor receptor positive, hormone receptor negative, and so forth. A woman can be Triple Positive (ER/PR+ Her2+), Triple Negative (ER/PR- Her2-) or a mixture (ER/PR+ Her2-) These impact the various treatments available and how effective they might be. Triple Negative is one of the harder forms of breast cancer to treat because it has the least amount of available treatments which are successful.

There's also staging, which is another variable to account for in each unique case of breast cancer. Factors which impact on the staging include: the size of the tumor within the breast, the number of lymph nodes affected, and signs indicating whether or not the breast cancer cancer has invaded other organs within the body.

Stage 0 - There's slight differences between DCIS and LCIS in this stage. Ductal carcinoma in situ (DCIS) is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. In Stage 0 breast cancer, the atypical cells have not spread outside of the ducts or lobules into the surrounding breast tissue.  Lobular carcinoma in situ (LCIS) at Stage 0 generally is not considered cancer. Although it has carcinoma in the name, it really describes a growth of abnormal but non-invasive cells forming in the lobules.

Stage 1 - In this stage, cancer is evident, but it is contained to only the area where the first abnormal cells began to develop. The breast cancer has been detected in the early stages and can be very effectively treated. It is divided up into Stage 1A and Stage 1B. With 1B, there is cancer evidence in the lymph nodes.

Stage 2 - Like Stage 1, it's divided up between 2A and 2B. With 2A, no actual tumor is associated with the cancerous cells, or the tumor is less than 2 centimeters and less than four auxillary lymph nodes have cancer cells present, or the tumor is between 2 and 5 centimeters and has not yet spread to the lymph nodes. With 2B, the tumor is between the 2 and 5 centimeters and has spread to less than four axillary lymph nodes, or the tumor is larger than five centimeters, but has not spread to any axillary lymph nodes.

Stage 3 - The cancer has spread beyond the point of origin and into surrounding tissue and lymph nodes, but has not yet appeared anywhere else in the body. Sometimes the term 'advanced breast cancer' is used to include Stage 3. It is divided into three groups: Stage 3A, 3B, and 3C. The difference is determined by the size of the tumor and whether cancer has spread to the lymph nodes and surrounding tissue.

Stage 4 - This means that the breast cancer cells have spread to other areas of the body, such as the brain, bones, lung and liver. It is at this point considered incurable, and the goal of treatment is to extend life as long as possible. You can have Stage 4 Breast Cancer and not be actively dying, living with it more like a chronic condition, although it's considered a terminal progression.