Breast cancer usually begins with the formation of a small, confined tumor (lump), or as calcium deposits (microcalcifications) and then spreads through channels within the breast to the lymph nodes or through the blood stream to other organs. The tumor may grow and invade tissue around the breast, such as the skin or chest wall. Different types of breast cancer grow and spread at different rates — some take years to spread beyond the breast while others grow and spread quickly.
Symptoms of Breast Cancer
Breast Cancer usually has no symptoms. As a tumor develops, you may note the following signs.
• A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle
• A mass or lump, which may feel as small as a pea
• A change in the size, shape, or contour of the breast
• A blood-stained or clear fluid discharge from the nipple
• A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed)
• Redness of the skin on the breast or nipple
• An area that is distinctly different from any other area on either breast
• A marble-like hardened area under the skin
• An area that is distinctly different from any other area on either breast.
Types of Breast Cnacer
Breasts are made up of lobules (milk-producing glands) and ducts (tubes that carry milk to the nipple), which are surrounded by glandular, fibrous and fatty tissue. Breast cancer starts when the cells in the breast begin to divide and grow in an abnormal way.
Invasive breast cancer
Invasive primary breast cancer is breast cancer that has the potential to spread from the breast to other parts of the body. The most common type of invasive breast cancer is invasive breast cancer of no special type (sometimes called invasive ductal cancer). This accounts for most breast cancer diagnoses, but there are many other less common special types. Special type means when the cells are looked at under a microscope they have features that class them as a particular type of cancer. Some types of invasive breast cancer are outlined below.
Invasive ductal breast cancer/Invasive breast cancer of no special type
You may see no special type invasive breast cancer – written as NST or NOS (not otherwise specified). It’s also referred to as invasive ductal breast cancer. Invasive breast cancer of no special type is the most common breast cancer in both women and men and accounts for about 75% of all breast cancers.
Invasive lobular breast cancer
Invasive lobular breast cancer is the second most common invasive breast cancer accounting for about 10-15% of all breast cancers. It occurs when the cancer cells spread outside the lobules and into the breast tissue around them.
Cribriform breast cancer
About 4% of invasive breast cancers have a cribriform part. It’s often mixed with tubular breast cancer. Under the microscope there are distinct holes between the cancer cells, making it look a bit like a sieve.
Inflammatory breast cancer
The symptoms of inflammatory breast cancer are also common symptoms of breast infections.Inflammatory breast cancer gets its name because the skin of the breast develops a red inflamed appearance and may feel warm and tender to the touch. The skin may also appear pitted like the skin of an orange. The redness and swelling (oedema) is caused by cancer cells blocking tiny channels called lymph channels in the breast tissue.
Malignant phyllodes tumour
Malignant phyllodes tumours account for less than 1% of all breast cancers. There are two other types of phyllodes tumour called benign (not cancer) and borderline malignant.
Medullary breast cancer
This type of breast cancer usually has a clear, well defined border between the cancer and the surrounding breast tissue – a feature which pathologists use to help distinguish it from other types of breast cancer. It’s more common in women who inherit a faulty copy of the BRCA1 gene.
Metaplastic breast cancer
In this type of breast cancer the cells have changed (transformed) from one cell type into another.Metaplastic breast cancer is treated in the same way as other types of invasive breast cancer although is more likely to be triple negative.
Mucinous breast cancer
Mucinous (also known as colloid) breast cancer is so called because when it is looked at under a microscope, the cells look like they are surrounded by mucous. It’s common to see mucinous cancer mixed with other types of breast cancer, such as invasive breast cancer of no special type.
Paget’s disease of the breast
Paget’s disease of the breast is an uncommon condition which is often noticed by changes to the nipple such as a red, scaly rash which can feel itchy or painful. The nipple may also become inverted. It occurs in less than 5% of all people with breast cancer.
Papillary breast cancer
This type of breast cancer accounts for less than 2% of all breast cancers. Under the microscope the breast cancer cells are in a pattern that looks a bit like the shape of a fern. It is common to see DCIS alongside papillary breast cancer.
Tubular breast cancer
Tubular breast cancer accounts for around 2% of all breast cancers. It is called tubular breast cancer because the cells look tube-like when they are examined under a microscope.
Triple negative breast cancer
This means the breast cancer is oestrogen receptor negative, progesterone receptor negative and HER2 receptor negative which is why it’s called ‘triple negative’ breast cancer. Around 15-20% of people with breast cancer test negative for all three of these receptors. Special and non-special types of breast cancer can be triple negative.
Types of Breast Cancer Treatment
Local treatments are used to remove or destroy the disease within the breast and surrounding regions, such as lymph nodes. These include:
1.Surgery, either mastectomy or lumpectomy — also called breast-conserving therapy. There are different types of mastectomies and lumpectomies.
2. Radiation Therapy
Systemic treatments are used to destroy or control cancer cells all over the body and include:
• Chemotherapy uses drugs to kill cancer cells. Side effects can include nausea, hair loss, early menopause, hot flashes, fatigue, and temporarily lowered blood counts.
• Hormone therapy (endocrine therapy) such as tamoxifen in premenopausal and postmenopausal women and the aromatase inhibitors Arimidex, Aromasin, and Femara in postmenopausal women. Hormone therapy uses drugs to prevent hormones, especially estrogen, from promoting the growth of breast cancer cells. Side effects can include hot flashes and vaginal dryness.
• Biological therapy such as Herceptin, Perjeta, or Tykerb, which work by using the body’s immune system to destroy cancer cells. These drugs target breast cancer cells that have high levels of a protein called HER2.