Know the Signs, Know the Breast Cancer Types

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Most breast cancers are carcinomas, a type of cancer that starts in the cells (epithelial cells) that line organs and tissues like the breast. In fact, breast cancers are often a type of carcinoma called adenocarcinoma, which is carcinoma that starts in glandular tissue. In some cases, a single breast tumor can be a combination of different types or be a mixture of invasive and in situ cancer. In rarer types of breast cancer, the cancer cells may not form a tumor at all. Breast cancer can also be classified based on proteins on or in the cancer cells, into groups like hormone receptor-positive or triple-negative.

Ductal Carcinoma in Situ: Ductal carcinoma in situ (DCIS; also known as intraductal carcinoma) is considered non-invasive or pre-invasive breast cancer. DCIS 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 (invaded) through the walls of the ducts into the diagnosed at this early stage of breast cancer can be cured.

Invasive Ductal Carcinoma: This is the most common type of breast cancer. Invasive (or infiltrating) ductal carcinoma (IDC) 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 point, it may be able to spread (metastasize) to other parts of the body through the lymphatic system and bloodstream. About 8 of 10 invasive breast cancers are infiltrating ductal carcinomas.

Invasive Lobular Carcinoma: Invasive lobular carcinoma (ILC) starts in the milk-producing glands (lobules). Like IDC, it can spread (metastasize) to other parts of the body. About 1 in 10 invasive breast cancers is an ILC. Invasive lobular carcinoma may be harder to detect by a mammogram than invasive ductal carcinoma.

Less common types of breast cancer: Inflammatory Breast Cancer

This type of invasive breast cancer accounts for about 1% to 3% of all breast cancers. Usually there is no single lump or tumor. Inflammatory breast cancer (IBC) makes the skin on the breast look red and feel warm. It also may give the breast skin a thick, pitted appearance that looks a lot like an orange peel. Doctors now know that these changes are not caused by inflammation or infection, but by cancer cells blocking lymph vessels in the skin. The breast may become larger or firmer, tender, or itchy.

In its early stages, inflammatory breast cancer is often mistaken for an infection in the breast (called mastitis) and treated as an infection with antibiotics. If symptoms are caused by cancer, they will not improve, and a biopsy will find cancer cells. Because there is no actual lump, it might not show up on a mammogram, which can make it even harder to find it early. This breast cancer tends to have a higher chance of spreading and a worse outlook (prognosis) than typical invasive ductal or lobular cancer.

Paget Disease of the Nipple: This type of breast cancer starts in the breast ducts and spreads to the skin of the nipple and then to the areola (the dark circle around the nipple). It is rare, accounting for about 1% of all cases of breast cancer. The skin of the nipple and areola often appears crusted, scaly, and red, with areas of bleeding or oozing. A woman may notice burning or itching. Paget is almost always associated with ductal carcinoma in situ (DCIS) or infiltrating ductal carcinoma.

Treatment often requires mastectomy. If no lump can be felt in the breast tissue, and the biopsy shows DCIS but no invasive cancer, the outlook (prognosis) is excellent. If invasive cancer is present, the prognosis is not as good, and the cancer will need to be staged and treated like any other invasive cancer.

Last Revised: 02/26/2015, Source: ACS

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