One in eight women will develop breast cancer in their lifetime. Breast cancer is the second most diagnosed cancer in women (first is skin cancer). Average five-year survival rate is more than 90% for breast cancers detected early thanks to modern screening and prevention methods as well as new improved, personalized targeted treatments.
In most cases breast cancer is diagnosed in women after 50 (about 75%) but it does occur in younger women also. Only 5-10% of all breast cancers are the result of inherited genetic factors. List of other risk factors include use of hormones, stress, obesity, low levels of vitamin D, smoking, drinking, etc.
Breast cancer types are important to clarify because all treatment strategies and future survival depend on breast cancer types.
Ductal carcinoma in situ (DCIS)
So called “Intraductal carcinoma” is considered non-invasive or pre-invasive breast cancer. DCIS is very early form of breast cancer – it means that cells that lined the ducts have changed to look like cancer cells. The difference between DCIS and invasive cancer is that the cells have not spread through the walls of the ducts into the surrounding breast tissue.
DCIS is very common – about 1 in 5 new breast cancer cases will be DCIS. Good news is that nearly all women diagnosed at this early stage of breast cancer can be cured and be healthy.
Surgery is the main treatment for DCIS – conservative surgery (lumpectomy) or removal of the whole breast (mastectomy). After surgery most women recommended to have radiation sessions – radiotherapy is to kill off any abnormal cells that may still be within the breast tissue. In cases of DCIS with hormone-sensitive cells, doctors will recommend long-term hormone therapy (tamoxifen, letrozol or other hormones) which will reduce the risk of developing an invasive breast cancer in the future.
Lobular carcinoma in situ (LCIS)
Breast cancer types
Lobular carcinoma in situ means that cells inside some of your breast lobules have started to become abnormal (lobular neoplasia) – all cells contained within the inner lining of the breast lobules. Sometimes it could happen in both breasts.
LCIS means increased risk of getting invasive breast cancer. Unfortunately LCIS cannot be discovered during mammography. It could be discovered by chance – during biopsy for something else, during laboratory test of removed breast tissues, etc.
Most women with LCIS will not get breast cancer but regular check-ups are very important – breast exams every 6-8 months and mammography every year.
Invasive (or infiltrating) ductal carcinoma (IDC)
This is the most common type of breast cancer (70- 80% of all breast cancer diagnoses) – it starts in a milk duct of the breast, breaks through the wall of the duct and grows into the fatty tissue of the breast. At this moment of development the abnormal cancer cells could be able to spread (metastasize) to other parts of the body through the lymphatic system and bloodstream. Statistics show that about 8 of 10 invasive breast cancers are infiltrating ductal carcinomas.
Statistics show that about 1 in 10 invasive breast cancers is the ILC (10%). Invasive lobular carcinoma starts in the cells that line the lobules (milk-producing glands) and it can spread into the surrounding breast tissue and to other parts of the body. ILC is most common in women between 45 and 55 years old.
Treatment for invasive lobular carcinoma is the same as for the most common types of breast cancer – surgery (mastectomy) with following radiotherapy and chemotherapy. In cases of hormone-sensitive tumors long-term hormone therapy also can be needed.
Inflammatory breast cancer (IBC)
Inflammatory breast cancer is aggressive and fast growing breast cancer in which cancer cells infiltrate the skin and lymph vessels of the breast. IBC is not common type of invasive breast cancer (about 1-3% of all breast cancer cases).
Skin changes are common for inflammatory breast cancer – skin on the breast look red and feel warm; breast skin could appear thick and pitted (similar to orange peel). Several studies confirmed that breast skin changes are not caused by inflammation or infection, but by cancer cells blocking lymph vessels in the skin. The affected breast may become larger or firmer, tender or itchy.
Early IBC symptoms could include persistent itching and the appearance of a rash or small irritation similar to an insect bite – the breast typically becomes red, swollen and warm. The skin may appear pitted like an orange peel, and nipple changes such as inversion, flattening or dimpling could occur.
Sometimes inflammatory breast cancer can be misdiagnosed because it has similar symptoms like mastitis. It is not easy to discover IBC at early stages because actually no lump can be palpated and mammography might not show it. This type of breast cancer tends to have a higher chance of spreading and a worse prognosis and survival rate.
As IBC grows fast, usually aggressive treatment is needed – urgent massive surgery (mastectomy is the best option), radiotherapy combined with chemotherapy and hormonal treatments. Sometimes chemotherapy can be recommended before surgery.
Metastatic Breast Cancer
Metastatic breast cancer is when cancer cells are spread to surrounding organs or to other parts of the body (usually lungs, liver, bones or brain). The spread of cancer cells usually happens through cell-to-cell contacts, circulatory or lymph system, bloodstream or capillaries.
Metastatic cancer has 4 stages depending how much and how far cancer cells migrated.
Diagnosis, symptoms and treatment strategies can be different depending on stage and involved organs.
Paget disease of the nipple
This type of breast cancer is rare (about 1% of all cases of breast cancer) – it starts in the breast ducts and spreads to the skin of the nipple and then to the areola, the dark circle around the nipple. Skin of the nipple and areola usually appears crusted, scaly and red (with areas of burning or itching and bleeding or oozing).
In most cases treatment include mastectomy; future treatments depend on level of cancer cells’ invasion.
So called “cystosarcoma phyllodes” is a very rare breast tumor – it develops in the stroma (connective tissue) of the breast. These tumors are usually benign but on rare occasions may be malignant.
Angiosarcoma is also very rate type of breast cancer – it starts in cells that line blood vessels or lymph vessels. It usually develops as a complication of previous radiation treatments. This is an extremely rare complication of breast radiation therapy that can develop about 5 to 10 years after radiation. It can appear also in lymphedemic arms. These cancers tend to grow and spread quickly.
Disclaimer: It is strongly recommended to consult your doctor for professional advice. Above mentioned information and recommendations are just general and should be adapted to each person according to personal health indicators and status.