What If A Carcinoma Is Infiltrating Or Invasive
These words are used to mean that the cancer is not a pre-cancer , but is a true cancer.
The normal breast is made of tiny tubes that end in a group of sacs . Cancer starts in the cells lining the ducts or lobules, when a normal cell becomes a carcinoma cell. As long as the carcinoma cells are still confined to the breast ducts or lobules, without breaking out and growing into surrounding tissue, it is considered in-situ carcinoma .
Once the carcinoma cells have grown and broken out of the ducts or lobules, it is called invasive or infiltrating carcinoma. In an invasive carcinoma, the tumor cells can spread to other parts of your body.
How Is Inflammatory Breast Cancer Treated
Inflammatory breast cancer is generally treated first with systemic chemotherapy to help shrink the tumor, then with surgery to remove the tumor, followed by radiation therapy. This approach to treatment is called a multimodal approach. Studies have found that women with inflammatory breast cancer who are treated with a multimodal approach have better responses to therapy and longer survival. Treatments used in a multimodal approach may include those described below.
What Does It Mean If My Report Mentions Estrogen Receptor Or Progesterone Receptor
Receptors are proteins on cells that can attach to certain substances, such as hormones, that circulate in the blood. Normal breast cells and some breast cancer cells have receptors that attach to the hormones estrogen and progesterone. These 2 hormones often fuel the growth of breast cancer cells.
An important step in evaluating a breast cancer is to test a portion of the cancer removed during the biopsy to see if they have estrogen and progesterone receptors. Cancer cells may contain neither, one, or both of these receptors. Breast cancers that contain estrogen receptors are often referred to as ER-positive cancers, while those containing progesterone receptors are called PR-positive cancers. Women with hormone receptor-positive cancers tend to have a better prognosis and are much more likely to respond to hormone therapy than women with cancers without these receptors.
All breast cancers and pre-cancers, with the exception of lobular carcinoma in situ , should be tested for these hormone receptors when they have the breast biopsy or surgery.
Results for ER and PR are reported separately and can be reported in different ways:
- Negative, weakly positive, positive
- Percent positive
- Percent positive and whether the staining is weak, moderate, or strong.
How the results of your tests will affect your therapy is best discussed with your doctor.
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Predictors For Breast Cancer Survival Rates
It has to be remembered that every single breast cancer patient has itsown , unique scenario. Thus, prognosis and breast cancer survival rates are a rough guide ONLY.
However, there are consistent predictors for breast cancer survival rates and these include:-
- The stage of breast cancer at the time of diagnosis
- The Grade of the breast cancer
- A patients age at diagnosis
Grading Breast Cancer Cells
Three cancer cell features are studied and each is assigned a score. The scores are then added to get a number between 3 and 9 that is used to get a grade of 1, 2, or 3, which is noted on your pathology report. Sometimes the terms well differentiated, moderately differentiated, and poorly differentiated are used to describe the grade instead of numbers:
- Grade 1or well differentiated . The cells are slower-growing, and look more like normal breast tissue.
- Grade 2 or moderately differentiated . The cells are growing at a speed of and look like cells somewhere between grades 1 and 3.
- Grade 3or poorly differentiated . The cancer cells look very different from normal cells and will probably grow and spread faster.
Our information about pathology reports can help you understand details about your breast cancer.
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What Is Stage 1 Breast Cancer
Stage 1 breast cancer is the earliest stage of invasive breast cancer. The breast cancer has spread from its original location to the surrounding tissue but it is still contained in a relatively small area.
If you are diagnosed with Stage 1 breast cancer, this means that the tumour is less than 2 centimetres in size. No cancer cells have been found in the lymph nodes or other parts of the body at this stage.
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Breast Cancer Survival Rates Are Affected By Tumor Grade
Breast cancer grade refers to the size and shape of the malignant breast cancer cells. If the breast cancer cells look very different than normal breast tissue cells, and somewhat random in appearance, they are called poorly differentiated and described as high grade.
There are three main breast cancer grades and these are as follows:-
- Grade 1: The cancer cells are well differentiated and look the most like normal cells. These type of cancers tend to be slow-growing.
- Grade 2: These cancer cells are moderately differentiated. This means that the cells look less like normal cells and tend to grow faster.
- Grade 3: Poorly differentiated cells do not appear like normal cells at all and tend to be very fast growing. Hence, the affect on prognosis.
Microscopic Images of Ductal cell carcinoma in Situ Grades 1, 2 and 3
Higher grade breast cancers tend to have a poorer prognosis.
You will be able to find the Grade of your tumor on your pathology report.
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Invasive Ductal Cancer With Central Necrosis
Necrosis refers to the debris left behind when cells die. In the context of a suspected breast cancer tumor doctors usually consider necrosis as an indicator of a more aggressive breast carcinoma.
It is quite common to see cell necrosis in mature invasive breast cancers. However, in the case of central necrosis, when the necrosis collects in a central location doctors commonly associate this with comedo DCIS or comedo carcinoma and notinfiltrative breast cancer.
Additional And Relevant Useful Information For Invasive Micropapillary Carcinoma Of Breast:
- Current studies have shown that aromatase inhibitors, medications that block estrogen hormonal effects in the body, reduce the risk of recurrence of breast cancer. Recent studies have shown that treatment using aromatase inhibitors can be given up to 10 years without affecting the quality of life of women
- Tumors that are negative for estrogen receptor, progesterone receptor, and HER2/neu have worse prognosis. Such tumors are called âtriple-negativeâ tumors
The following DoveMed website links are useful resources for additional information:
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What Does Stage 3 Mean
Because stage 3 breast cancer has spread outside the breast, it can be harder to treat than earlier stage breast cancer, though that depends on a few factors.
With aggressive treatment, stage 3 breast cancer is curable however, the risk that the cancer will grow back after treatment is high.
Doctors further divide stage 3 cancer into the following stages:
What If My Report Mentions Sentinel Lymph Node
In a sentinel lymph node biopsy, the surgeon finds and removes the first lymph node to which a tumor drains. This lymph node, known as the sentinel node, is the one most likely to contain cancer cells if they have started to spread. This procedure may be done during surgery to remove a breast cancer. It is a way to check for the spread of cancer to underarm lymph nodes without removing as many of them.
The sentinel lymph node is then checked to see if it contains cancer cells. If there is no cancer in the sentinel node, it’s very unlikely that the cancer has spread to other lymph nodes, so no further lymph node surgery is needed.
If a sentinel lymph node does contain cancer, your report will say that cancer was present in the lymph node. It may also say how large the deposit of cancer cells is. In some cases, if cancer is found in a sentinel lymph node, you may then also need additional treatment such as surgery to remove more underarm lymph nodes or radiation therapy to the underarm region. You should discuss this with your doctor.
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Mucinous Tumor In Breast
Mucinous breast carcinoma, sometimes called colloid carcinoma, is a rare condition of invasive ductal carcinoma . Mucinous carcinoma is an invasive cancer that could also spread to the rest of the body. Nonetheless, it is less destructive than many other invasive cancers and usually reacts well to medication . The rate of survival for mucinous breast carcinoma is greater than that of most other forms of invasive breast cancer with a 5-year survival rate of 87%. Mucinous tumors are a component of the epithelial-stromal ovary neoplasm cancer community, which accounts for nearly 36% of all ovary tumors. Total mucinous carcinomas have a lower level of genetic uncertainty. Genome patterns of the cancer constituents of mixed mucinous tumors are strikingly identical to those of total mucinous carcinomas.
Russell Vang, Brigitte M Ronnett, in, 2009
What Are The Causes Of Invasive Ductal Carcinoma Of Breast
The exact cause of development of Invasive Ductal Carcinoma of Breast is currently not clearly known.
- Studies have shown that such tumors may be caused by hormonal influence
- Certain gene mutations have also been reported in the tumors. Research is being performed to determine how these mutations contribute to the formation of the tumors
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Less Common Invasive Breast Cancers
- Inflammatory breast cancer is an aggressive form of locally advanced breast cancer. Its called inflammatory breast cancer because the main warning signs are swelling and redness in the breast.
With inflammatory breast cancer, warning signs tend to arise within weeks or months. With other breast cancers, warning signs may not occur for years.
- Paget disease of the breast is a cancer in the skin of the nipple or in the skin closely surrounding the nipple. Its usually found with an underlying breast cancer.
- Metaplastic breast cancers tend to be larger and have a higher tumor grade than more common breast cancers. Metaplastic breast cancers can be hard to diagnose because the tumor cells can look very different from the tumor cells of more common breast cancers.
How Is Invasive Micropapillary Carcinoma Of Breast Treated
Treatment options available for individuals with Invasive Micropapillary Carcinoma of Breast are dependent upon the following:
- Type of cancer
- The staging of the cancer
- Whether the cancer cells are sensitive to certain particular hormones, and
- Personal preferences
In general, breast cancer stages range from 0 to IV. 0 may indicate a small and non-invasive cancer, while IV indicates that the cancer has spread to other areas of the body. Briefly, as per National Cancer Institute , breast cancer is staged as follows:
- Stage 0 : The abnormal cancer cells are confined to their site of origin
- Stage I: The tumor is 2 centimeters in diameter or less, and has not spread outside the breast
- Stage II: The tumor may be up to 5 centimeters in diameter and may have spread to lymph nodes. Another criteria is that the tumor may be larger than 5 centimeters in diameter, but has not spread to surrounding lymph nodes
- Stage III: The tumor may be more than 5 centimeters in diameter and may have spread to several axillary lymph nodes, or to the lymph nodes near the breastbone. The cancer may also have spread to the breast skin/chest wall, causing ulcer-like sores, or a swelling
- Stage IV: The tumor has spread outside the breast and to other organs, such as the bones, liver, lungs, or brain, regardless of its size
If breast cancer is diagnosed, staging helps determine whether it has spread and which treatment options are best for the patient.
Hormone therapy:
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Stage 1 Or 2 Early Breast Cancer
Stage 1 and 2 breast cancer refers to invasive breast cancer that is contained within the breast, and may or may not have spread to the lymph nodes in the armpit. These stages are also known as early stage breast cancer.
At Stage 1 and 2, some cancer cells may have spread outside the breast and armpit area, but at this stage these cannot be detected.
How Is Invasive Ductal Carcinoma Of Breast Treated
Treatment options available for individuals with Invasive Ductal Carcinoma of Breast are dependent upon the following:
- Type of cancer
- The staging of the cancer
- Whether the cancer cells are sensitive to certain particular hormones, and
- Personal preferences
In general, breast cancer stages range from 0 to IV. 0 may indicate a small and non-invasive cancer, while IV indicates that the cancer has spread to other areas of the body. Briefly, as per US National Cancer Institute , breast cancer is staged as follows:
- Stage 0 : The abnormal cancer cells are confined to their site of origin
- Stage I: The tumor is 2 centimeters in diameter or less, and has not spread outside the breast
- Stage II: The tumor may be up to 5 centimeters in diameter and may have spread to lymph nodes. Another criteria is that the tumor may be larger than 5 centimeters in diameter, but has not spread to surrounding lymph nodes
- Stage III: The tumor may be more than 5 centimeters in diameter and may have spread to several axillary lymph nodes, or to the lymph nodes near the breastbone. The cancer may also have spread to the breast skin/chest wall, causing ulcer-like sores, or a swelling
- Stage IV: The tumor has spread outside the breast and to other organs, such as the bones, liver, lungs, or brain, regardless of its size
If breast cancer is diagnosed, staging helps determine whether it has spread and which treatment options are best for the patient.
Hormone therapy:
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How Is Inflammatory Breast Cancer Diagnosed
Inflammatory breast cancer can be difficult to diagnose. Often, there is no lump that can be felt during a physical exam or seen in a screening mammogram. In addition, most women diagnosed with inflammatory breast cancer have dense breast tissue, which makes cancer detection in a screening mammogram more difficult. Also, because inflammatory breast cancer is so aggressive, it can arise between scheduled screening mammograms and progress quickly. The symptoms of inflammatory breast cancer may be mistaken for those of mastitis, which is an infection of the breast, or another form of locally advanced breast cancer.
To help prevent delays in diagnosis and in choosing the best course of treatment, an international panel of experts published guidelines on how doctors can diagnose and stage inflammatory breast cancer correctly. Their recommendations are summarized below.
Minimum criteria for a diagnosis of inflammatory breast cancer include the following:
- A rapid onset of erythema , edema , and a peau d’orange appearance and/or abnormal breast warmth, with or without a lump that can be felt.
- The above-mentioned symptoms have been present for less than 6 months.
- The erythema covers at least a third of the breast.
- Initial biopsy samples from the affected breast show invasive carcinoma.
Imaging and staging tests include the following:
What Is Inflammatory Breast Cancer
Inflammatory breast cancer is a rare and very aggressive disease in which cancer cells block lymph vessels in the skin of the breast. This type of breast cancer is called inflammatory because the breast often looks swollen and red, or inflamed.
Inflammatory breast cancer is rare, accounting for 1 to 5 percent of all breast cancers diagnosed in the United States. Most inflammatory breast cancers are invasive ductal carcinomas, which means they developed from cells that line the milk ducts of the breast and then spread beyond the ducts.
Inflammatory breast cancer progresses rapidly, often in a matter of weeks or months. At diagnosis, inflammatory breast cancer is either stage III or IV disease, depending on whether cancer cells have spread only to nearby lymph nodes or to other tissues as well.
Additional features of inflammatory breast cancer include the following:
- Compared with other types of breast cancer, inflammatory breast cancer tends to be diagnosed at younger ages.
- Inflammatory breast cancer is more common and diagnosed at younger ages in African American women than in white women.
- Inflammatory breast tumors are frequently hormone receptor negative, which means they cannot be treated with hormone therapies, such as tamoxifen, that interfere with the growth of cancer cells fueled by estrogen.
- Inflammatory breast cancer is more common in obese women than in women of normal weight.
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Hormone Receptor Status Influences Breast Cancer Survival Rates
The hormone receptor status of a breast tumour is not usually included in formal discussions of prognosis.
Each breast tumour will potentially have a different hormone receptor status. When a breast cancer tumour tests positive for the hormones estrogen and progesterone, it implies two things:-
Therefore, due to improvements in treatments, overall survival rates will be higher for hormone receptor positive breast tumors than for those that are hormone negative.
How Can Invasive Ductal Carcinoma Of Breast Be Prevented
The following measures may help in reducing the risk for Invasive Ductal Carcinoma of Breast :
General lifestyle changes:
- Maintain a healthy weight and exercise regularly physical activity can reduce risk, especially in post-menopausal women
- Implement and follow a well-balanced diet a high intake of fiber via fresh fruits and vegetables can reduce the risk
- Drink alcohol in moderation limit to one or two drinks a day
- Limit combination hormone therapy used to treat symptoms of menopause. It is advised that individuals be aware of the potential benefits and risks of hormone therapy
- Cancer screenings can help detect any breast cancer, at its earliest stages
- Learn to do âbreast self-examsâ, in order to help identify any unusual lumps, signs in the breasts
In women with a high risk for developing Invasive Ductal Carcinoma of Breast , the physician may suggest the following:
- Preventative medications: The medications tamoxifen and raloxifene are estrogen-blocking drugs that can help prevent the onset of breast cancer in women at high risk. Both drugs have potential side effects including being at a higher risk for blood clots
- Preventative mastectomy: Prophylactic mastectomy, a procedure to surgically remove healthy breasts, is another possible preventative option for women, at a high risk for breast cancer
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