Breast Disease

Types of Breast Cancer

Breast Cancer is one of the most common forms of cancer today. It is frightening…but treatable. It is critical to seek early diagnosis and treatment for any type of cancer and then be prepared for great outcomes with todays’ amazing treatments. Dr. Rudderman is an expert in matters of the breast and as a specially trained reconstructive surgeon, he has been able to guide many, many women through the process and procedures with wonderful, positive results.

The following information gives an overview of the types of breast cancer, diagnostics, treatments and surgical options:

Lobular Carcinoma in Situ (LCIS)

This non-invasive breast cancer starts in the milk ducts. It does not grow through the lobular walls and rarely becomes and an invasive form of cancer. It can be a risk factor for developing invasive cancer in the same or the opposite breast.

Ductal Carcinoma in SITU (DCIS)

Also called intraductal carcinoma this is the most common type of non-invasive breast cancer. With DCIS the cancers cells are inside the ducts but have not spread through the duct walls into adjacent tissue.

DCIS Overview:

• 1 in 5 new breast cancer cases is diagnosed as DCIS
• DCIS can be cured, in nearly all cases in the early stage
• Pathology looks for tumor necrosis in the tissue sample
• If necrosis is present the tumor may be more aggressive
• DCIS with necrosis is called – comedocarcinoma

Invasive Ductal Carcinoma (IDC)

Also called Infiltrating Ductal Carcinoma, it starts in the milk duct, is the most common type of breast cancer and is invasive. It grows in the fatty breast tissue and can metastasize, after breaking through the duct wall.

Invasive Lobular Carcinoma (Infiltrating Lobular Carcinoma)

It starts in the milk-producing glands and can metastasize to other parts of the body. Invasive lobular carcinoma is often more difficult to detect by mammograms than IDC. About 1 in 10 breast cancers are ILC’s

Breast Cancer Staging

Staging is a process of determining your prognosis and treatment options based upon the type and extent of the cancer. It may involve blood tests and other tests:

1. Blood tests & Biopsies
2. Mammogram of the opposite breast
3. Chest X-Ray
4. Breast MRI
5. Bone Scan
6. CT Scan (Computerized Tomography)
7. PET Scan (Positron Emissions Tomography)

Testing is based on each individual. One or a combination of tests may be needed to determine this. Your Oncologist makes this decision.

Stages of Breast Cancer

STAGE O

Non-invasive, abnormal cells as in DCIS.

STAGE I

An early stage of invasive breast cancer in which Cancer cells are contained in the breast but have spread through the breast tissue.

STAGE II

Involves one of the following:

• The cancer has spread to the lymph nodes under the arm but the tumor is no more than 2 centimeters across.
• The tumor is between 2 to 5 centimeters but the cancer has not spread to the underarm nodes.
• The tumor is between 2 and 5 centimeters and the cancer has spread to the underarm nodes.
• The tumor is larger than 5 centimeters.
• The cancer has not spread to the underarm nodes.

STAGE III

Is locally advanced cancer that is broken into 3 sub-stages:

• 111A – Tumor 5+ centimeters has spread and attached to each other or to other structures.
• 111B – tumor of any size has grown into the chest wall or skin of the breast, the lymph nodes, attached to each other and/or advanced into Inflammatory breast cancer.
• 111C – Tumor of any size that has spread as follows: into the lymph nodes behind the breast bone and under the arm. Has spread into the lymph nodes above or below the collarbone.

STAGE IV

Cancer that appears after previous treatment and a period of remission. It usually shows up in some other part of the body such as the bones, liver, lungs or brain.

Risk Factors & BRCA

There are certain things we know about cancer today such as certain risk factors that increase the chance of getting a disease. Aging, previous history of breast cancer, family with other females who have had cancers, certain chromosomes are being studied for linkage to breast cancer and others. BRCA involves genetic testing to determine if a woman (man) is predisposed to breast cancer. It looks like this:

• BRCA tests determine the risk factor level for developing cancer
• BRCA testing is based upon gene mutations
• BRCA1 & BRCA2 gene changes are linked to between 5% & 10% of all ovarian & breast cancers
• Testing positive for one of these changes say lifetime risk can be as high as 85% for developing breast cancer & up to 60% for Ovarian cancer
• Personal & family history is factored in heavily as these numbers show a wide range
• Breast cancer (rare in men) does occur & is related to BRCA e gene changes along with a possibility for prostate cancer
• Risk of colon & pancreatic cancers (e.g.) may also be higher
• Genes can be inherited from either the mother’s or father’s side of the family

Contact us at 678.566.7200 to meet with Dr. Rudderman in our Alpharetta or Midtown Atlanta offices.

Written and reviewed by:

This article was written by Dr. Randy Rudderman, who is board certified by the American Board of Plastic and Reconstructive Surgery (1994). He practices medicine at his offices in Alpharetta and Atlanta.
Learn more about Dr. Rudderman, his medical training, and credentials.