Breast Cancer Awareness, Types, Symptoms, Stages, Risk Factors, Diagnosis and Treatment
What is Breast Cancer? Signs and Symptoms, Risk Factors, Diagnosis and Treatment of Breast Cancer in Women
What is Breast?
The term of the breast is normally used to refer to the embossed area of the chest in a human female that contains mammary glands. Mammary glands in mammals are sets of complex glands that produce milk for nursing the infants. A breast consists of nipple (the top part of a breast), areola (the colored area around the nipple), lactiferous/milk duct (milk-secreting cells), lobule (a group of joint deep holes called alveoli), Fatty tissues (the area, is responsible for a breast’s size, shape, and firmness), breast muscles and chest wall covered with skin.
Each breast has one complex Mammary gland that passages milk in nipple from 10-20 different lactiferous ducts located in lobules.
What is Cancer?
In the healthy human body, millions of cells create, grow and die at a balanced ratio under a naturally controlled system. Cancer is an unbalanced condition where cells do not die at a normal ratio in comparison to cell growth. As a result, there is excessive cell growth in contrast to cell death that causes cancer. The process of excessive cell growth with an invasion of existing cells or the ability to spread a tumor all over the body is called metastasis.
Definition of Breast Cancer:
Cancer of cells tissues in the area of mammary glands is called breast cancer.
1. What is Breast Cancer?
Breast Cancer is one of the major types of cancers that cause death in females. There also occurs breast cancer in males but with a low ratio than women. Usually, breast cancer does not show its signs very early. Probably the tumor has been developing for 10-15 years before showing its signs. Breast cancer occurs in milk ducts, lobules, and breast tissues, normally caused by:
- Obesity in older women
- Extreme alcohol consumption
- Abnormality in menstrual circle
- Delayed menopause
- Highly usage of steroid hormones
Initial signs of breast cancer include:
- Change in shape of breasts
- Lymph node in breasts
- Inverted nipple
- Lumpiness in breasts
- Redness or flaking of skin
- Fluid discharge other than milk from a nipple
Symptoms at an invasive stage of breast cancer include:
- Enlarged lymph nodes
- Change in skin color
- Bone pain
- Shortness of Breath
Risks of breast cancer can be lower by:
- Breastfeeding for a long period
- Having childbirth before the age of 30
- Cutting the usage of hormones to control childbirth
- Avoiding tobacco smoking and too much alcohol intake
- Avoiding underarm waxing that can lead to Lymphedema
1.1 - How does breast cancer spread?
Primary lump creates in the mammary gland and after it grows invasive, it develops outside of the breast towards the local lymph nodes or metastasizes to systems of other organs in the body and turn out to be collective. Lymph is a clear fluid rich in protein channelized via nodes, which soaks the all-over body cells and works through lymphatic towards blood circulations. A primary lymph node network is in almost all organs of a body, filtering fluid of those organs. A breast’s main lymph nodes are located under armpits. Typically, the area in which breast cancer spreads primarily is a local lymph node in the axilla. As cancer occupies its local area, it can grow into blood receptacles. Now cancer will find one more way to spread towards other body organs if the tumor gets its way into blood receptacles.
Breast tumor spreads slowly through this typical route, but sometimes this malignant tumor grows more swiftly under a few circumstances. Initially, a lump can be felt in abreast of the malignancy, which is around 1.016 centimeter – 1 centimeter in size and comprises around 1,000,000 cells. A lump of this size takes 1-5 years to grow before showing its signs. During this time, when the lump is being developed and shows its signs, the tumor may have been spreading regionally in other parts of the body or blood vessels.
Initially, breast tumor metastasizes towards its local nodes that are under the armpit. A complete metastasis can occur in other organ systems in a body if cancer travels via lymphatic or spread in blood vessels. Other organs where breast cancer inclines are soft tissues, bones, liver, lungs, and skin. At every stage of this cancer, whether it is at its initial stage or an invasive stage, lymph nodes are only signs of the presence of metastasis throughout the patient’s body. Instead of advancement in medicinal technology, still not such profound method has found to catch every little development of malignancy. Thus, armpit examination is the primary and important test to diagnose the local metastasis and start the treatment and kind of treatment for the ailment.
If breast cancer spreads to other body parts, it can affect the main functionality of those organs and may cause the death of the patient.
1.2 - Types of Breast Cancer
There are different types of breast cancer including curable to least curable cancer. At this breast cancer website, we will explain different types of breast cancer categorized by Non-invasive, Invasive, less common, and uncommon breast cancer:
- Non-invasive Breast Cancer
- Ductal Carcinoma in Situ (DCIS)
- Invasive Breast Cancer
- Invasive Ductal Carcinoma (IDC)
- Invasive Lobular Carcinoma (ILC)
- Less Common Breast Cancer
- Inflammatory Breast Cancer
- Sub-types of IDC:
- Mucinous Carcinoma
- Medullary Carcinoma
- Tubular Carcinoma
- Papillary Carcinoma
- Cribriform Carcinoma
- Adenoid Cystic Carcinoma
- Lobular Carcinoma in Situ (LCIS)
- Paget's disease of the Nipple
- Uncommon Breast Cancer
- Phyllodes Tumor of breast
- Angiosarcoma of the breast
- Breast Cancer Molecular Subtypes
- Metastatic and Recurrent Breast Cancer
- Male Breast Cancer
Read about Breast Cancer Types in Details.
1.3 - Breast Cancer Signs and Symptoms
Normally, signs and symptoms of breast cancer are not easy to detect using one method or tool. Most common tools, which are used to evaluate the existence of breast cancer in females’ body:
- Screening – it includes the assessment of females with no sign of breast disease.
- Physical Examination – it includes a detailed clinical physical examination.
- Mammography – it includes an x-ray screening of the body to detect lumps or problems in a breast.
The authentication of these tools is yet questionable. Mammogram screening has been helpful to identify 90+ percent of breast cancers. However, 10% of all breast cancers have not been measurable using mammography. The authentication score of a Physical examination is the same. This is why; it is advisable to utilize combined tools for the routine checkup to evaluate issues in a breast.
Signs and Symptoms of breast cancer leading to diagnosis include:
- A lump inside a breast or outspread around the breast is a most studied and common initial sign of a glandular tumor.
- Nipple inversion, bleeding from the nipple or skin dimpling is advanced symptoms of developed tumor and biopsy should be performed. Inverted nipples, skin lumpiness with a change in a breast size found on biopsy are a more progressive discovery of cancer.
- The symptoms involving skin i.e. red skin patches or swelling are discovered at a later stage of cancer.
Note: All kinds of lumps found in a breast are not cancerous. Changes of fibrocystic in a breast are very common. A non-cancerous lump in the breast caused by fibrocystic may also cause signs of swelling, breast pain, or nipple discharge and can be noticed as a fluid-filled / hard lump in the breast during a physical check-up. A detailed diagnostic exam of any evident breast problem is compulsory and highly advisable. Where there is a fibrocystic lump normal phenomenon of the breast, breast cancer is also a common disease. Also, signs and symptoms of the fibrocystic condition can connect to breast cancer signs and symptoms. These normal changes in a breast are also considered as an increased threat for breast cancer.
1.4 - Causes of Breast Cancer in Females
All types of cancers are considered to happen due to minor genes transformations. A gene is a DNA segment that is inherited from family. These DNA segments control the growth of body and metabolic rate. Minor transformations in arrangements of genes can result in mutations in proteins, which control metabolic functionalities. In a healthy body, genes controlled by proteins regulate cell divisions. Particular genes produce proteins, which pass information to fine cells that when to die. When cancer occurs, the regulatory genes are changed or damaged and do not make proteins required to indicate cells to break the division.
The transformation that becomes the reason for breast cancer does not have a specific cause. The factors of genetic / family history, lifestyle, and environment all are risk factors for getting breast cancer. We will look at common breast cancer risk and risk factors below:
1.5 - Breast Cancer Risk and Risk Factors
Breast cancer is a complicated syndrome instigated by various genetic and no genetic factors.
Five to ten percent females carrying these genes: BRCA2, BRCA1, including BARD1, RB1CC1, BRIP1, RAD51, BWSCR1A, TP53, BRCA3, and CHEK2 have eighty percent possibilities of growing breast cancer during a lifetime.
If there have been cases of breast cancer in a family gene, chances of developing the malignant syndrome are higher.
Chance of breast cancer in men is 100 times less than women. Breast cancer is predominantly a disease of women over the age of 40, with incidence rates increasing with age. Only 1% of breast cancer affects men, and it usually occurs when they are over the age of 60.
Mostly breast tumor is developed in aged women above the age of 50. Women of 61 years of old are all heavily in danger of invasive cancer. One percent of men of 60+ years of old can be affected by breast tumors.
Lifestyle factors that can cause glandular cancer are:
- No workout or physical activities
- Drinking alcohol for 2 times a day, 7 days a week
- Unhealthy eating like the diet that is rich in fats
- Using exogenous hormones to control childbirth
- If the menstrual cycle starts before the age of 12 and menopause after the age of 55
Menopausal Hormone Therapy (HT):
HT is an increased risk factor for glandular tumors. It is also referred to as estrogen (ET) with progestin (EPT) therapy.
Even though there are several accepted risk factors on the list, it should be noted that more than seventy percent of females who develop breast tumors have no caught identified risk factors. Exposure to several risk factors can increase the menace of getting the tumor but the relationship of prompting factors remains complicated. Family history is the most significant risk factor of all the above-mentioned risks. According to the studies full of fat diets, extreme use of alcohol and obesity are also important risk factors.
1.6 - Breast Cancer Diagnosis
However, clear evidence of breast cancer diagnosis that can lead to treatment is still complicated. Following methods and tools are used to detect breast cancer in females:
- Self-Breast Exam
- Clinical Breast Exam
- Computed tomography
- Excisional biopsies
- Incisional biopsy
- Needle aspiration biopsy
- Core needle biopsy
Read about Breast Cancer Diagnosis Methods in Details.
1.7 - Breast Cancer Staging
By the results of the above diagnostic tests, the patient’s stage of glandular cancer is defined, which helps to decide a treatment procedure and further prognosis. Formally cancer staging is established by the ‘TNM’ system. The TNM system thinks through three aspects:
(T) – Tumor size and growth rate
(N) – if cancer has involved lymph nodes
(M) – whether cancer has metastasized
Following are the stages of breast cancer:
- Stage I – The tumor is small than 2 centimeters and has not spread to lymph nodes.
- Stage II – whether the tumor is bigger than 2 centimeters but has not involved lymph nodes or is not more than 2 centimeters but has led to lymph nodes.
- Stage IIIA – The cancer is more or less than 5 centimeters and has extended towards lymph nodes.
- Stage IIIB – The tumor has spread out towards lymph nodes with the breastbone or inside the chest wall or soft tissues nearby a breast.
- Stage IV – At this stage of cancer, a tumor has metastasized towards lymph nodes and skin close to the collarbone or to systems of other organs.
Read about Breast Cancer Stages in Details.
1.8 - Breast Cancer Treatment
All kinds of evil diseases are curable or preventable if identified initially. The same is the case with breast cancer or any kind of cancer. If it is detected early or appropriately at its early stage, it can be treated and cured of further damages leading to a patient’s death.
Once the tumor is traced in the body of a patient through diagnostic tests, the physician decides from following therapies as a sequence or combination for breast cancer treatment depending on its stage:
Breast Cancer Surgical Therapy:
i. Mastectomy: Mastectomy is a favorite surgical therapy for breast cancer. In a radical mastectomy, cancerous parts of the body like affected breast, lymph nodes in the armpit with the tissues within the chest wall are eradicated to stop metastasis.
ii. Lumpectomy: Lumpectomy is a partial breast cancer. In lumpectomy, only cancerous tissues are removed from the effected area of breast.
Like radical mastectomy, radiation therapy is preferred to treat the tumor in a local area. It treats the particular malignant tissue open to radioactive rays and does not affect other parts of the body.
Chemotherapy improves the cancer resistance after successful mastectomy therapy to make sure there is no minor metastasis left in the body.
Hormone therapy is a part of postoperative care to assess the existence of uneven estrogen with progesterone carriers on cancer cells. Changing the hormonal position by hormonal drug therapy in the patient’s body slow down the growth of a tumor and maximize the survival rate.
Bio-therapeutics is a type of direct therapy that is done by monoclonal (single type) antibodies produced in a test lab, which respond with precise receptors to a tumor.
Complementary adjuvant therapy:
Complementary therapies are used to calm postoperative chemotherapy side effects on the patient’s body by using alternative medicine treatments i.e. guided imagery and acupuncture.
Read about Breast Cancer Treatments in details.
1.9 - Breast Cancer Prevention
Basic breast cancer awareness and knowledge are essential to help women be aware of primary signs of cancer so they can get appropriate early medical treatment if any symptoms are found. Also, proper education about breast cancer risk factors and preventions must be given to lower breast cancer risk among females of any age.
Lower your Breast Cancer Risk:
Glandular malignancy can be escaped by having a healthy lifestyle and routines. Like:
- Quit smoking and advice others to not smoke also, do not smoke in the presence of non-smokers. Tobacco smoking is one of the major causes of cancer.
- Drink alcohol sensibly. Two drinks a day increase the risks of cancer.
- Limit intake of full in animal / saturated fats food.
- Increase consumption of fresh fruits and vegetables.
- Eat five times a day. Starvation leads to obesity that increases cancer risk.
- Workout daily and maintain healthy body weight.
- Routine clinical health checkups will be helpful to detect the early presence of any malignancy and to refer to appropriate treatment.
2. Breast Cancer Types
In this section we will learn about types of Breast Cancer and their Symptoms, Diagnosis and Treatment Methods:
2.1 - What is Ductal Carcinoma in Situ (DCIS) non-invasive Breast Cancer, Symptoms and Diagnosis, Treatment Methods?
Ductal Carcinoma in Situ is a type of non-invasive breast cancer. DCIS is not life-threatening and mostly curable. This non-invasive breast cancer can turn into invasive if not diagnosed on time and treated properly.
What stage of Breast Cancer is DCIS?
DCIS is a zero stage cancer of the breast. It’s called ‘Ductal Carcinoma’ (abnormality of milk ducts cells) and ‘in situ’ mean (in its local place), which means In DCIScancerous cells remain limited to milk ducts and do not spread towards soft breast tissues.
2.1.1 - What is the Difference between Non–invasive & invasive breast cancer?
Non-invasive and Invasive are the most common types of breast cancer.
What is non-invasive breast cancer?
In non-invasive cancer of the breast, abnormally divided cells are limited to its local place that is lobules or milk ducts and does not spread out towards breast tissues.
What is invasive breast cancer?
In invasive cancer of the breast, cancerous cells travel out to lobules or milk ducts. These tumor cells attack nearby soft tissues in the breast and may spread towards axillary lymph nodes.
2.1.2 - What are the Symptoms of DCIS?
- Bleeding from the nipple
- Pain in breast
Are the most common symptoms of DCIS. Usually, a lump is not found in the breast in Ductal Carcinoma in Situ.
2.1.3 - What are DCIS Diagnosis Methods?
Tests to diagnose DCIS include:
Around eighty percent of DCIS tumor is diagnosed by a mammogram. A mammogram is a screening test that highlights the DCIS affected area in an X-ray.
If there are suspects of Ductal Carcinoma in Situ originate in mammogram then a physician will go to perform a biopsy to evaluate and confirm the existence of a tumor in lobules or ducts. The biopsy is done by taking samples of breast tissues with needles for analyzing DCIS breast cancer.
MRI or Ultrasound
More tests may be done to evaluate the size of cancer and the development of DCIS within the breast.
2.1.4 - What is the treatment for DCIS Breast Cancer?
However, Ductal Carcinoma in Situ is non-invasive breast cancer; there are 40-50 percent cases where DCIS can grow into invasive breast cancer with time if not treated properly.
After considering the patient’s medical history and diagnostic test results, a physician can recommend appropriate treatment methods depending on the patient’s condition.
After seeing cancer size, location, the intensity of tumor cells, family medical history and gene mutation tests results, the doctor will lead to following treatments for Ductal Carcinoma in Situ DCIS (in sequence):
Surgical therapy / Mastectomy / Lumpectomy for DCIS
First, surgical therapy is done to treat Ductal Carcinoma in Situ. There are two types of surgical therapies: Mastectomy and Lumpectomy.
If the tumor has affected a big part of the breast or spread all through the ducts within the breast, a complete mastectomy will opt. In a complete mastectomy, the whole breast with some lymph nodes (if lymph nodes are cancerous) is removed.
Lumpectomy is performed when DCIS tumor is not spread in all ducts, lobules or axillary lymph nodes. In Lumpectomy, only cancerous tissues are removed and breast or lymph nodes are left as it is. In some cases, Lumpectomy is chosen with radiation therapy for DCIS treatment.
Radiation Therapy for DCIS
Women who go through a mastectomy, they are not given radiation therapy after surgical therapy. In DCIS radiation, therapy is combined with Lumpectomy to lower your risks of developing DCIS into invasive breast cancer and to prevent reoccurrence of DCIS breast cancer.
A physician will evaluate hormone receptor status from cells removed in a biopsy. If hormone receptor status is positive that means DCIS cancer has cell receptors. In this case, Hormone therapy is done by using tamoxifen. Hormone therapy cannot be done after going under full mastectomy. In Lumpectomy hormone therapy is done with radiation therapy to prevent DCIC tumor to come back or developing into invasive breast cancer.
If hormone receptor status is negative that means DCIS tumor has not cell receptors. Then hormone therapy will not be determined.
Prognosis Factors for DCIS
Here are prognosis factors for DCIS:
Risk of DCIS turning into LCIS breast cancer after treatment
There are 30% of cases of developing LCIS invasive breast cancer in women, diagnosed with DCIS malignancy within ten years. That’s why it is essential to get complete treatment for DCIS breast tumors.
2.1.5 - Survival rate for DCIS breast cancer:
Normally, Ductal Carcinoma in Situ takes 5-10 years to be diagnosed. 98-99 percent of females diagnosed with DCIS successfully survive cancer. 80% – 85% of women diagnosed with DCIS non-invasive breast cancer lives without DCIS reoccurrence or without getting invasive breast cancer, who have taken proper treatment for DCIS breast tumors.
Still, there are minor chances of DCIS reappearance or developing invasive breast cancer in the same breast where DCIS tumor is found. Women who go for lumpectomy with radiation therapy are at higher risk than those who go for mastectomy. It is advisable to get a proper routine check-up after DCIS breast cancer treatment as invasive breast cancer is normally found early and could be cured positively.
2.1.6 - Causes of DCIS Breast Cancer
Causes of Ductal Carcinoma in Situ are still unclear. Usually, DCIS happens in the result of a genetic transformation. A genetic mutation causes abnormal cell division that creates DCIS tumors. Causes of mutation of genes are also not clear.
Other Risk Factors that may increase your risk of DCIS include:
- Women who have had DCIS in the past, are on higher of getting DCIS tumor back within 5 – 10 years
- Family medical history – if there are cases of breast cancer in the family
- Increasing age
- Getting pregnant for the first time after 30 years of age
- Getting postmenopausal hormone therapy (estrogen-progestin replacement) for three to five years
- Obesity – an unhealthy lifestyle
2.1.7 - Lower your Risk of DCIS Breast Tumor
- You can lower your risk of DCIS (Ductal Carcinoma in Situ) by
- Having low fats food
- Cutting smoking
- Moderating drinking habits
- Working out
- Avoid taking hormone replacement therapy for a long time
2.2 - What is Invasive Breast Cancer?
Invasive breast cancer starts in the breast glands or milk ducts but does not confine there; the tumor develops within the soft breast tissue. It also can grow towards local axillary lymph nodes and to other organ systems.
What Stage Invasive Breast Cancer is?
Invasive breast cancer refers to Stage II of Breast Cancer, which has spread to other lymph nodes and organ systems of the body like bones, skin, lungs, brain or liver.
There are two common types of invasive breast cancer:
Invasive Ductal Carcinoma – IDC:
There are 80% of cases account for this type (IDC) of invasive breast cancer. In IDC, tumor starts in a duct, grow through duct walls and spread into breast tissues. Mostly it develops into its local area but it can spread in the body as well.
Invasive Lobular Carcinoma – ILC:
There are 10% of cases of invasive breast cancer accounts for ILC. With ILC, tumor cells produce in the glands or lobular and then grow beyond their locality. A most common sign of ILC's existence in the breast is breast stiffness instead of lumpiness.
Some females can have a permutation of both types of invasive breast cancer.
2.2.1 - What are the Signs of Invasive Breast Cancer?
Usually, breast cancer shows visible signs after 5 – 10 years of development. However, you can notice some of the following signs during the tumor’s growth:
- Hardness or lumpiness in the breast even after menstrual periods
- A pea-size lump in the breast
- Change in the breast size or shape
- Change in the nipple size or place
- The scaly or red skin of the breast of nipple
- Blood or fluid discharge from the nipple
- A prominent area that is different from the other area of the breast
By doing monthly self-exam of the breast, you can easily notice these changes in the breast.
2.2.2 - What are Causes of Invasive Breast Cancer?
The primary cause of invasive breast cancer is undefined. There are some risk factors, which can increase the possibilities of invasive breast tumor i.e.:
Age- is the most common factor to increase the chances of developing invasive cancer of the breast. 70% of women above 55 years have an invasive type of breast cancer. Around 10% of invasive breast cancer diagnosed women are under 45 years old.
Family History – In white women, a family history of breast cancer is the second big cause of increasing invasive breast cancer risk.
Obesity – makes your breast thick and causes abnormality in cell division that causes a tumor. Having no children, late pregnancy or no breastfeeding are other reasons, cause breast thickness that can result in a tumor.
2.2.3 - Treatment of Invasive Breast Cancer
There are different things determine the treatment method for invasive breast cancer, like:
- Cancer stage, size and location
- Patient’s age and family medical history
- Genetic mutation test result
- If the patient is going through menopause
- A doctor can ask about a patient’s choice of treatment method
What is the invasive Breast Cancer Prognosis?
To diagnose the tumor condition in breast cells, the doctor will check the cells' grades. A grade is decided on normal cells alikeness with cancer cells when observed under the microphone. There are two grade cells:
Lower-grade – tumor cells resemble normal cells of the breast.
Higher-grade – cancer cells are different from normal cells.
- A doctor will decide the type of surgical therapy depending on cell grade.
- The cancer cells will be tested for the hormone receptor. If the patient's estrogen and progesterone cause the tumor cells to develop then the doctor will also go for hormone therapies to block or stop hormones to treat the tumor.
- A genetic mutation test for HER2 gent will also be tested to diagnose invasive breast cancer. A doctor will treat HER2 gene with ‘Herceptin’ called drug if found.
More tests will be taken to examine if the tumor has spread towards other body organs from the breast.
Different Methods to Treat Invasive Breast Cancer:
There are different methods are followed to treat invasive breast cancer including:
Surgical Therapy - mastectomy or Lumpectomy
Chemotherapy – is drug therapy, which is done before surgical therapy to squeeze cancer and make it treatable. Chemotherapy is also given after surgical therapy to stop the tumor reoccurrence.
Radiation therapy – is given after surgery or chemotherapy to prevent invasive breast cancer reoccurrence.
Hormone therapy – to stop hormone receptors
Targeted Therapy – is given if the HER2 gene is found
Some invasive breast cancer females opt for clinical trials where they go under different drug treatments, which are not available for others. Often doctor also recommends a drug therapy that is good for breast cancer treatment.
The doctor will use one or a combination of these treatment methods for the betterment of the patient. You are advised to consult your physician to decide the appropriate treatment course according to your condition.
Types of Invasive Breast Cancer
In this section we will explain types of Invasive Breast Cancer:
2.3 - What is IDC – Invasive Ductal Carcinoma?
IDC - Invasive Ductal Carcinoma is the most common kind of Invasive breast cancer in which cancer has spread beyond the milk duct walls to the breast tissues. IDC has high chances of spreading to lymph nodes (axillary) and into the other parts of the body.
Overall 80% of cases are found of Invasive ductal carcinoma in all kinds of breast cancer. The chances of developing IDC are high in women of 50+ years of old. Invasive ductal carcinoma is also found in men.
2.3.1 - What are the Signs and Symptoms of IDC?
IDC does not show obvious signs or symptoms at an early stage. Often, it is detected when it has spread into lymph nodes or other parts of the body. Mostly, Invasive ductal carcinoma in the breast is diagnosed using a mammogram for the first time.
Following are possible signs of invasive ductal carcinoma:
- A lump or a hard mass in the breast or the armpit
- Swelling in the breast skin
- Pain in breast
- Nipple discharge
- Nipple inversion or pain in the nipple
- Irritation or dimpling on breast skin
- Patchy, reddened or hard skin or breast or nipple
2.3.2 - What are Diagnosis tests of Invasive Ductal Carcinoma:
More than one tests are performed to diagnose Invasive Ductal Carcinoma – IDC, including:
Physical breast exam:
Your doctor will check for swelling or lump using his/her fingers under the armpit or in the collarbone area to detect any abnormalities in the breast.
Mostly IDC is diagnosed in a screening mammogram, which is done on both of the breasts. Further tests are performed once IDC is diagnosed in mammography.
Often, Ultrasound is performed as a part of mammography.
Magnetic Resonance Imaging (MRI) of Breast:
A doctor can perform magnetic resonance imaging – MRI of the breast for a detailed examination of the abnormal area of the breast.
A doctor can perform a biopsy to diagnose the DIC if screening mammograms and imaging tests do not confirm the condition of the affected area in the breast. Following are the commonly used types of biopsy to examine the growth of cancer in cells to determine the breast cancer treatment method:
- Fine needle aspiration biopsy
It is done with a narrow needle to remove a small number of breast tissues for sampling that is examined under a microscope for cancer.
- Core needle biopsy
It is done with a big needle to remove a large number of tissues from an affected area of the breast for sampling and examination.
- Incisional biopsy
An incisional biopsy, a small piece of breast tissue is removed for analysis.
- Excisional biopsy
It’s an extreme kind of biopsy where complete lump from abnormal areas of tissue is removed.
These methods and biopsies are performed to diagnose invasive ductal carcinoma. Proper treatment procedures will be determined once the IDC is diagnosed.
2.3.3 - What are Treatment methods for Invasive Ductal Carcinoma?
These are the different therapies are used to treat the invasive ductal carcinoma step by step or as a group:
- Surgical Therapy for IDC – Mastectomy or Lumpectomy: will be done within the local area of the breast to remove complete or effected parts of breast and lymph nodes.
- Radiation Therapy for IDC – Cancer in milk ducts is also killed or reserved by radiation therapy.
- Systemic Therapies for IDC– Hormonal Therapy, Chemotherapy, and Targeted Therapies: Systemic therapies are used in addition to surgery or radiation therapy to prevent cancer recurrence and to treat metastases (it has occurred).
Follow-up care for invasive ductal carcinoma - IDC:
Follow-up physical exam and tests are recommended for IDC after treatment to prevent a recurrence, including:
- Mammogram – Mammogram X-ray must be done afterward to check any abnormality after cancer treatments.
- Physical exam – A regular physical exam done by your doctor and gynecologist to trace any abnormality in hormones level, which can trigger the tumor and cancer recurrence.
- Bone health - Your bones can be affected by chemotherapy or hormonal therapy. So, it is advised to check your bone health clinically.
2.4 - Invasive Lobular Carcinoma – ILC Signs and Symptoms, Diagnosis, Subtypes, and Treatments
In this section we will learn about Invasive Lobular Carcinoma - ILC subtypes, signs and symptoms, diagnosis and treatment methods:
What is Invasive Lobular Carcinoma (ILC)?
Invasive Lobular Carcinoma –ILC is one of the common types of invasive breast cancer where cancer cells have spread beyond the breast lobule to the breast tissues. With time, ILC can attack lymph nodes and other organs of the body.
Usually, Invasive lobular carcinoma occurs in the late 50s and early 60s in females because of hormonal therapy for menopause. Read more about subtypes of invasive lobular carcinoma, ILC symptoms, diagnosis, and treatments in the following lines:
2.4.1 - What are the Symptoms and Signs of ILC?
Normally, Invasive lobular carcinoma does not show any evident signs and symptoms. Because ILC does not form lumps in the breast, the tumor invades into breast tissues in a form of the line that is hard to see even on a mammogram.
Following are the possible signs of invasive lobular Carcinoma:
- Swelling or clotting in the breast instead of a lump
- A lump in the armpit
- Nipple inversion
- Scaly, red or irritating skin of the breast or nipples
- Skin dimpling
- Pain in the breast or the area of the nipple
- Nipple discharge
2.4.2 - How to Diagnose ILC?
Opposite to IDC, Invasive lobular carcinoma grows in different areas of the breast at a time. Research shows that invasive lobular carcinoma can also be bilateral cancer (cancer that affects both breasts). Therefore, combinations of different diagnostic tests are performed to diagnose the presence of this complex type of invasive breast cancer including:
- Breast Physical-Exam
- Mammogram screening
- Breast magnetic resonance imaging
2.4.3 - Sub-types of Invasive Lobular Carcinoma – ILC:
Invasive Lobular Carcinoma – ILC is divided into the following subtypes based on the grade of cancer cells (how big and small cancer cells look under a microscope):
Classic ILC: Classic or typical type of ILC occurs when small cancer cells spread to fatty tissues and muscles of the breast called stroma. Stroma covers lobules, ducts, blood vessels and lymph nodes in the breasts. In classic ILC, cancer cells enter layers of stroma one-by-one, which is called a single-file pattern. All cancer cells and cells’ nucleus (center of the cell where genetic data is stored) look small and similar to each other in the classic type of ILC.
Classic ILC has further sub-types:
Solid ILC: in this form of ILC, cancer does not grow in single-file pattern through the stroma. Cancer grows through big layers of breast tissues.
Alveolar ILC: The cancer cells forms in groups consist of 20+ cells.
Tubular-lobular ILC: This type of classic ILC grows in the form of the tube as well as in single-file form.
Pleomorphic ILC: In this form of invasive lobular carcinoma, cancer cells are larger than the standard size of classic ILC cells, also different in their nucleus size.
Signet-Ring Cell: Some cancer cells are filled with liquid, which causes a nucleus to be on aside. This is why this type of ILC is called signet-ring cells due to its shape.
2.4.4 - What are the Treatments of ILC?
Following are the therapies, applied to treat invasive lobular carcinoma:
- Surgical therapies: Mastectomy, Lumpectomy
- Radiation Therapy
- Chemo Therapy
- Hormonal Therapy
- Targeted Therapies
What is the Follow-Up Care for ILC?
Regular physical examination, mammography, and bone health monitoring are advised to prevent cancer re-occurrence and to improve the standard of life of the cancer patient after breast cancer treatment therapies.
2.5 - What is Inflammatory Breast Cancer?
Inflammatory breast cancer - IBC is a less common and intense breast tumor, which looks like a wound on the skin. With IBC, breast skin’s lymph vessels are blocked with lumps. Sometimes IBC (Inflammatory breast cancer) is considered as a skin infection because it is difficult to diagnose in a mammogram screening and ultrasound. Usually, it is diagnosed at a later stage when it is developed into breast skin or spread towards other body organs.
What stage Inflammatory breast Cancer is?
Inflammatory breast cancer starts as breast cancer’s stage IIIB from the time IBC develops into the skin. Once the tumor grows into chest or collarbone lymph nodes, it is cancer’s stage IIIC and if the tumor has burst out towards local lymph nodes, it is breast cancer stage IV.
What is the survival rate for Inflammatory Breast Cancer?
Now with advanced methods of treatment, the survival rate for inflammatory breast cancer is improving. According to a study eighty, two percent of IBC patient women lived three years after diagnosis.
2.5.1 - What Are the Symptoms of Inflammatory Breast Cancer?
Inflammatory breast cancer develops as a web beneath the skin and doesn’t show noticeable symptoms like a lump.
Some common signs of inflammatory breast cancer include:
- Breast pain
- Scaly skin patches often in red, pink or yellow texture
- A permanent wound on breast
- Breast skin irritation
- Inverted nipple or fluid discharge from the nipple
- Swollen Axillary or neck lymph nodes
Normally these signs happen and appear suddenly during a short time of weeks only.
2.5.2 - What are Inflammatory Breast Cancer Diagnosis Methods?
If you are observing a red swollen breast that cannot be treated with the usage of antibiotics for a week, then your physician can doubt inflammatory breast malignancy. Some screening tests and ultrasound will be taken to determine a complete diagnosis for IBC suspected breast. A doctor will ask for more tests for inflammatory breast cancer diagnosis:
Mammogram Screening - A mammogram screening will highlight the thick affected area of breast as a shadowy area.
MRI – MRI is an imaging test that makes images of breast inner structure with strong electromagnets and radiation.
CT Scan– creates a complete picture of your breast’s inner structure and shows affected areas.
PET Scan with CT Scan – help to diagnose if cancer from the breast has spread to the other organs of body and lymph nodes.
Biopsy – The doctor will take a sample of breast tissue to test for the existence of cancer. A biopsy is a sure way to diagnose breast cancer. Sample breast tissue is removed by using needles or sometimes by cutting the skin. What kind of biopsy will be appropriated for you is dependent on the results of screening tests?
If inflammatory breast cancer is diagnosed then more tests will be taken to determine the stage of cancer and how much it has developed to decide a treatment method.
2.5.3 - What is Inflammatory Breast Cancer Treatment?
As inflammatory breast cancer shows up suddenly and grows quickly, the doctor will go for a forceful course of treatment, including:
Chemotherapy – is done to shrink the tumor that can be caught for treatment.
Surgery – A complete mastectomy is done for inflammatory breast cancer after chemotherapy.
Targeted Therapy– HER2 protein will be blocked with targeted drug therapy if found in cancer cells.
Hormone therapy – Hormone receptors for cancer cells will be blocked with hormonal therapy if the hormone receptors test is positive.
Radiation – this therapy is normally given after mastectomy or chemotherapy to lower the risk for cancer reoccurrence.
You can choose a clinical trial with the consultation of your doctor. Timely diagnosis and proper treatment can increase the survival rate for inflammatory breast cancer.
2.6 - Lobular Carcinoma in Situ – LCIS Symptoms, Causes, Diagnoses and Treatments
Here we will read about Lobular Carcinoma in Situ - LCIS Casues, Symptoms, Diagnosis, Treatments:
What is Lobular Carcinoma in Situ - LCIS?
Lobular Carcinoma in Situ – LCIS is an uncommon non-cancerous breast condition in which abnormal growth of cells happens within the breast lobules or milk glands. In LCIS, abnormal cells are not spread to milk ducts yet.
Lobular Carcinoma in situ is not considered as a sign of breast cancer but it increases the risks of developing breast cancer. Overall 1% to 6% of LCIS cases are found in all benign breast diseases. Lobular Carcinoma in situ can turn out as ILC (Invasive Breast Carcinoma) that is a type of Invasive breast cancer and comprises 10% - 15% cases of breast cancers.
2.6.1 - What are the Signs and Symptoms of LCIS - Lobular Carcinoma in Situ?
Commonly LCIS does not show any evident signs and symptoms. Your doctor may find Lobular Carcinoma in situ during a physical exam conducted for another reason.
Invasive Signs of LCIS:
These can be signs of Lobular Carcinoma in situ:
- Change in breast size or shape
- Patchy or red skin
- Hardness or swelling under the breast skin
- Discharge from nipple other than milk
It is recommended to go for a complete clinical checkup if you find any of these signs in your breasts. Doctors suggest a regular clinical breast exam for females after 40 years of age.
2.6.2 - What are the Causes and risk factors of LCIS?
“What can cause LCIS?” This question does not have any approved answer.
LCIS is an abnormal glandular condition that starts when gene mutation occurs in breast lobular that causes abnormal cells growth and these abnormal cells do not invade beyond the lobular.
Risk Factors of LCIS – Lobular Carcinoma in Situ
There are 20% risks in women for developing Lobular Carcinoma in situ. Following are the some known risk factors of LCIS:
- Age factor – Risks of LCIS are increased after 40 years of old
- Family history – If there have been any cases of breast cancer or LCIS in blood relations
- HRT – Hormone Replacement Therapy to treat menopause symptoms
2.6.3 - How to diagnose Lobular Carcinoma in Situ?
LCIS breast condition can occur in one or two breasts however, it cannot be diagnosed in a mammogram screening. Lobular carcinoma in situ is often found during a biopsy, which is probably performed to examine another area of the breast to evaluate some other breast condition like calcifications (the condition when calcium is accumulated under the skin and appears as small white dots on the breast skin).
If LCIS is traced in one or two of your breasts then a doctor can recommend for further diagnostic tests to monitor closely detecting the breast cancer signs, including:
2.6.4 - Treatments for LCIS - Lobular Carcinoma in Situ
Following are the primary treatment methods for LCIS:
- Breast cancer surgery
Lumpectomy (one type of targeted breast cancer surgery to reserve cancer) is performed to treat Lobular Carcinoma in situ. In a lumpectomy, effected tissues are removed so that abnormal cells cannot spread in other areas of breast or body.
Chemotherapy is performed to kill the abnormal cells or to shrink them to stop from invading beyond the lobular.
- Hormone Therapy
With chemotherapy, estrogen-progestin hormone therapy is also used to treat LCIS with positive estrogen receptor cells. It will reduce the risks of developing invasive breast cancer.
2.6.5 - Lower your Risk of LCIS – Lobular Carcinoma in Situ
You can lower your risk of getting Lobular Carcinoma in situ – LCIS by improving your lifestyle. i.e.:
- By reducing alcohol consumption (not more than two times in a week)
- Maintaining your body weight by increasing physical activities
- Having a healthy diet, which is low in fats
It is recommended that consult with your doctor for regular cancer-preventing tips according to your body type and health condition.
2.7 - Recurrent Breast Cancer
What is Recurrent Breast Cancer?
Sometimes breast cancer returns to its local place/region or in the second breast after some time of getting successful cancer treatment, this condition is called recurrent breast cancer or breast cancer recurrence.
Causes of breast cancer recurrence:
Unfortunately, medical breast cancer diagnosis equipment is not that profound to detect insignificant tumor cells. That is why sometimes small cells are not detected during the post-surgery tests that can survive during surgery and therapies (chemotherapy/radiotherapy), which become a cause of cancer recurrence in the body.
2.7.2 - Types of Recurrent Breast Cancer:
There are three types of recurrent breast cancer depending on the areas of cancer returns:
- Local Recurrence
- Regional Recurrence
- Distant or Metastatic Recurrence
(Another name for Local and Regional recurrent breast cancer is “locoregional recurrence”, because of similar features)
In the following lines, we will learn symptoms, diagnosis, and treatments of all three recurrent breast cancers:
1. Local Recurrence:
Local recurrence of breast cancer happens when cancer returns to the same area, detected earlier.
Local Recurrence Symptoms:
Symptoms of local recurrence are:
- Swollen or redbreast skin
- Nipple’s pain, discharge, inversion or reddened skin
- The appearance of a new lump in the breast
- Unusual dimpling or firm breast skin
- Dragging or swelling at the place of breast-conserving surgery
- Hardened skin around the place of mastectomy
These signs also can appear on the breast after surgery or therapies so it is recommended to go for a complete clinical examination including imaging tests to determine the nature of symptoms.
Tests to diagnose local recurrence:
Your oncologist will perform the following diagnostic tests to confirm breast cancer local recurrence:
Mammogram: First of all a mammogram will be performed to examine the lump or swollen area in the breast.
Ultrasound / MRI / PET scan: If mammogram results do not clear the existence of lump then your doctor will go for imaging tests like ultrasound, MRI or PET scan.
Biopsy: and if mammogram and imaging tests confirm the cancer recurrence then a biopsy will be performed to take lump samples.
2. Regional Recurrence:
Regional recurrence happens when cancer returns in the same region of the breast, diagnosed earlier i.e. collarbone or axillary lymph nodes.
Regional Recurrence Symptoms:
Following are the regional recurrence symptoms:
- Frequent pain in shoulder, arm or chest
- Insensitivity in the muscles of shoulders or arm
- Difficulty in passing down the food or drink to the throat
- Swelling in the same arm where breast cancer occurred earlier
- Swelling or lump in the same axillary lymph nodes, around breastbone or above the collarbone
Tests to diagnose regional recurrence:
Following are the diagnosis tests for regional recurrence:
- Mammogram: Mostly a lump in the lymph node is detected in a mammogram.
- Imaging Test: Another imaging test like ultrasound, PET/CT scan or MRI can be performed if needed.
- Biopsy: Lymph node biopsy will be performed to confirm the recurrence of breast cancer.
Treatments for Locoregional Recurrence:
If locoregional (local+regional) recurrence has diagnosed then your doctor will determine the treatment according to its nature, like:
- Total Mastectomy: If cancer recurrence happens after breast-conserving surgery then your oncologist will choose total mastectomy to treat breast cancer’s locoregional recurrence.
- Radiotherapy: full-dose of radiations will be given to regional lymph nodes or chest wall to treat locoregional recurrence
- Systemic therapy: systemic therapy will be given to shrink or kill cancer cells.
The patient and doctor will discuss and choose his/her treatment plan according to the patient’s health condition, hormone receptor status, tumor grade, previous adjuvant therapies and the period between previous treatment and recurrence.
3. Distant or Metastatic Recurrence:
If breast cancer returns in the other breast or some other part of the body like bones, lungs, liver or brain, it will be called distant or metastatic recurrence of breast cancer.
Distant or Metastatic Recurrence Symptoms:
Symptoms of distant and metastatic recurrence will be different according to the area of recurrence:
- Weakness or insensitivity in any part of the body
- Severe headache
- Frequent pain in your bones, backbone or joints
- Not able to pass urine or experiencing difficulty with it
- Frequent pain in the chest or dry cough
- Experiencing shortness or trouble in breathing
- Experiencing problems in eye vision like lost or blurry vision)
- Absence of appetite
- Constant pain, inflammation or swelling in the stomach
- Frequent weight loss or nausea
- Loss of concentration
Diagnoses of distant or metastatic recurrence:
Following are the diagnoses tests for distant or metastatic recurrence of breast cancer:
- Bones scan
- Blood test
- Brain and Spine’s MRI
- PET/CT scan of brain, pelvis, chest or stomach
- Ultrasound/X-ray of the chest and abdomen
- Biopsy of suspected section
- Taking fluid samples from the chest/lungs or spinal area to determine the existence of cancer cells
Treatments for metastatic recurrence:
There are different methods to treat metastatic recurrence, including:
- Surgical Therapies (mastectomy/lumpectomy)
- Sentinel node biopsy
- Targeted Therapy
Every patient has a different medical history, previous treatment history and location of recurrence, so the treatment approach will be different depending on the cancer characteristics. Discuss with your doctor about your treatment preferences and state of mind for recurrent breast cancer.
2.8 - What are Paget’s disease of Nipple Causes, Symptoms, Diagnosis and Treatment Procedures
In the following section we will read about Symptoms, Causes, Diagnosis and Treatment Methods of Paget's disease of Nipple:
What is Paget’s disease of Nipple?
Paget's disease is an uncommon type of breast cancer limited to only breast’s nipple. In PDoN (Paget ’s disease of nipple) tumor cells accumulate in the nipple or the areola (the dark area under the nipple). In PDoN the skin of the nipple, areola tends to become irritated, itchy, scaly or red.
How does Paget’s disease of nipple spread?
Normally, the tumor affects the nipple’s duct first and then invades the skin of the nipple and area of the nipple. This is why it indicates that Paget’s disease is multifocal (it has primary roots in other areas of a breast).
2.8.1 - What does Cause Paget’s disease of Nipple?
There are no known causes of nipple’s Paget’s yet. Some studies say that cancer grows in the breast ducts first and then spread to the surface of the nipple. Other studies suggest that cells in the nipple become cancerous. Also, it can be a symptom of DCIS (ductal carcinoma in situ).
One should have a keen observation of abnormalities of nipple’s skin because casual changes on the nipple surface can be symptoms of PDoN. Besides, Nipple’s Paget’s disease usually can be a symptom of DCIS (ductal carcinoma in situ) or IDC (invasive ductal carcinoma).
What is the Ratio of Paget’s disease of Nipple?
It normally occurs in women in their late 50s, but Paget’s disease of nipple can also affect men. But, the cases in men are less than 1%.
2.8.2 - What are the Signs and Symptoms of PDoN?
Commonly, PDoN occurs in one breast. Initial signs of Paget’s disease include the scaly, red, swollen or flaky skin of the area of the nipple. These signs are used to appear and disappear at the time. Therefore, they are not taken seriously and often are mistaken for the signs of noncancerous skin inflammation. Sometimes, PDoN can show more intense symptoms, including:
- Pain in/around the nipple
- Burning irritation on the nipple’s skin
- Hardened or scaly skin
- Nipple becomes flat
- Nipple’s discharge other than milk
Usually, PDoN does not get diagnosed at the primary stage. It is recommended to visit your doctor if you feel any of the mentioned signs and symptoms.
2.8.3 - What are the Diagnosis procedures for Paget’s disease?
These are the procedures, applied to diagnose Paget’s disease of Nipple:
Clinical Physical-Exam: Your doctor examines the breast particularly the area of nipple for abnormalities like swollen skin or lump.
Mammogram: Mammogram screening detects the presence of cancer in a nipple and within the breast.
Breast MRI / Ultrasound: these imaging tests are done to scan the whole breast for cancer.
Biopsy: Nipple and areola’s biopsy will be done to examine cancer and its stage under the lens of a microscope. If the doctor finds discharge from the nipple then the sample of liquid will be taken to test.
2.8.4 - What is Treatment method of Paget’s disease?
Your doctor will choose a therapy depending on the stage of cancer to treat Breast’s Paget’s disease:
Mastectomy: Total Mastectomy is the first choice of doctors to treat PDoN. The whole breast including nipple and areola is removed to eradicate cancer and to reduce the risk of getting invasive or noninvasive cancer in the future.
Lumpectomy: Also known as breast-conserving therapy is done to remove cancer from the breast while conserving healthy soft tissue of the breast. In the people with Paget’s disease that is limited to a nipple and not spread to other areas of breast, Lumpectomy has been a popular choice among patients with PDoN due to its positive survival rate.
Sentinel node biopsy: Sentinel node biopsy is done to remove only lymph nodes to examine the presence of tumor after treatment to assess the success rate of a given treatment. This type of biopsy is also a favored therapy to treat PDoN limited to the nipple and has no traced of cancer within the breast.
2.8.5 - Adjuvant Therapies for Paget’s disease of the Nipple:
Radiation Therapy: Radiation therapy is given after lumpectomy to make sure there are no cancer cells left and to prevent cancer recurrence.
Chemotherapy/hormone therapy/targeted therapy: If cancer is not limited to the only nipple then other additional therapies will be applied after the radiation therapy to detect the cancer present in the body.
2.8.6 - Follow-up care for Paget’s disease of the nipple:
Follow-up physical breast checkup and mammogram is advised especially for the people who go for breast-conserving surgery to treat Paget’s disease. Please consult your doctor for further information depending on your medical condition.
3 - Breast Cancer Stages | Symptoms, Prognosis and Treatment Options
In this section, we will read about different stages of breast cancer and there sysmptoms, prognosis and treatment options:
3.1 - What is Breast Cancer Stage 0-1
Breast cancer stage 0-1 is a non-invasive or earlier stage of invasive cancer where the tumor is limited to its local area.
Types of Breast Diseases Called Stage 0:
In stage 0, cancerous cells are developing within breast milk duct but not spreading beyond duct walls. All Carcinoma ‘in Situ’ are stage 0-1 of breast cancer i.e.
- DCIS (Ductal carcinoma in situ) – the most common type of breast cancer
- LCIS (Lobular carcinoma in situ) – Now it is not considered as a type of breast cancer but this breast disease increases the risk of invasive breast cancer
- Paget disease of the nipple – is a benign breast disease but sometimes it turns out as a symptom of invasive breast cancer.
3.1.1 - Types of Breast Cancer Stage 1:
Stage 1 is an earlier stage of invasive breast cancer where cancerous cells are spreading towards nearby soft tissues of breast cancer. Invasive Ductal Carcinoma (IDC) and Invasive Lobular Carcinoma (ILC) are common stages 1 breast cancer.
Size of tumor defines the types of Stage 1 that are divided into the following categories:
Stage 1A – In stage 1A of breast cancer, cancerous cells have not reached in lymph nodes and the size of a tumor is less than 2cm.
Stage 1B – In stage 1B, the tumor has attacked breast lymph nodes and the size of the tumor is about 2.0 millimeters.
3.1.2 - Symptoms of Breast Cancer Stage 0-1:
- Learn about the symptoms of Ductal Carcinoma in Situ (DCIS)
- Learn about the symptoms of Lobular Carcinoma in Situ (LCIS)
- Learn about the symptoms of Paget Disease of Nipple (PDoN)
- Learn about the symptoms of Invasive Ductal Carcinoma (IDC)
- Learn about the symptoms of Invasive Lobular Carcinoma (ILC)
Breast Cancer Stage 0-1 Prognosis:
Earlier breast cancer stage 1 and 0 have a good ratio of prognosis with treatment. Timely diagnosis and treatment improve the survival rate of breast cancer patients. According to a study by ACS 90% of women diagnosed with breast cancer stage 1 have survived through the last two decades. The survival rate has improved until now with improved methods of treatment and diagnosis. However, the survival rate for stage 1A is higher than for breast cancer stage 1B.
3.1.3 - Treatment Options for Breast Cancer Stage 0-1:
Cancer staging is a vital factor in determining the treatment method for breast cancer. Treatment method will be determined using ‘TNM’ staging method:
TNM staging method:
- T / T1 / T2 / T3 / T3 / T4– Tumor Size
- N / N0 / N1mi – If a tumor has attacked lymph nodes
- M / M0 – if cancer has metastasized to the other body organs
Other elements those are important in determining treatment method for breast cancer:
- Speed of the growth of cancer cells
- If cancer cells have hormone receptors or HER2
- If you are having menopause
- Your health and family history for breast cancer
These are the treatment options for stage 0-1:
The most common treatment stage 1 breast cancer is surgery. Whether the whole breast will be removed using Mastectomy. Another surgical method is Lumpectomy where an only affected area will be removed including axillary lymph nodes and a margin of normal breast soft tissues.
Normally Radiation Therapy is given as additional therapy after Lumpectomy. Radiation therapy is given to the rest of the soft tissues of the breast to make sure no cancer cells have remained.
Hormone Therapy is given if breast cancer cells are Hormone Receptors positive. Normally hormone therapy is given for five years.
Normally Chemotherapy is not given in breast cancer stage 1. However, Chemotherapy can be given under some circumstance (if the tumor size is bigger than 1 centimeter)
Regular clinical breast exams and mammograms are recommended after getting treatment for breast cancer stage 0-1 to prevent the recurrence of breast cancer.
3.2 - What is Stage 2 Breast Cancer?
In stage 2 breast cancer, the tumor keeps growing inside of its local area and is not spreading outwards the breast or just spread to the local lymph nodes.
3.2.1 - Types of stage 2 breast cancer:
Stage 2 is an initial stage of breast cancer that is divided into two types, based on the tumor size and location:
Breast Cancer Stage IIA:
This Stage is defined by these factors:
- There is no tumor found in abnormal cells
- Not more than four axillary lymph nodes have tumor signs
- A tumor is smaller than 2 centimeters
- Tumor size is 2-5 cm and has not spread to axillary lymph nodes
Breast Cancer Stage IIB:
Stage IIB is defined by these factors:
- The tumor size is 2-5 cm and has entered into
- Tumor size is bigger than 5 cm but has not entered into lymph nodes
3.2.2 - Symptoms of Stage 2 Breast Cancer:
Learn about Symptoms of Invasive breast cancer stage II
3.2.3 - Breast Cancer Stage II Prognosis:
Overall, stage II patients have a good prognosis. Breast cancer Stage II is treated with invasive treatment procedures but Stage II breast cancer patients respond to treatment very well. Stage IIA has a better survival rate than Stage IIB.
3.2.4 - Stage II Breast Cancer Treatment Options:
Following are the treatment options for stage II breast cancer:
If cancer is reached to stage IIB then it will be treated with complete mastectomy followed by radiation. Lumpectomy with radiation is a better option to treat a single cancerous cell. Sentinel biopsy can also be applied to treat breast cancer spread to axillary or breast lymph nodes.
You may need breast transplantation after complete mastectomy. In this case, a breast will be implanted right after the surgery. If you need radiation after surgery then breast will be implanted after radiation.
After getting surgical treatment, you will be given radiation therapy to lower the risk of breast recurrence depending on your condition. Radiation therapy is not given to women if 60+ if:
- Tumor size is about 2 cm and has removed with breast cancer surgery
- There is no cancer found in lymph nodes
- Cancer is hormone receptors positive and hormonal therapy is being given to treat the cancer
Yet, radiation therapy can be beneficial in any case to prevent recurrent breast cancer.
Chemotherapy is recommended to treat Stage 2 Breast Cancer to reduce the chances of breast cancer recurrence and to confirm there is not cancer spread beyond the breast.
Stage II cancer that has cancerous cells with positive Estrogen receptors are treated with Hormonal Therapy.
Stage II breast cancer that contains several cells with HER2 receptors is treated using Targeted therapy that includes drug therapy and neoadjuvant therapy.
Mentioned above treatments will be given separately or systematically depending on your cancer size and grade. Other factors that will affect your treatment plan include:
- Your health condition and family history
- If you are going through menopause and using hormones to ease your menopause period
- If your cancer has positive with ER, PR or HER2 Receptors
Discuss your preferences and personal thoughts about your treatment options and plan your treatment with your doctor.
Keep visiting your doctor and go for clinical breast exams and mammograms regularly after getting treatment for Stage II breast cancer. Regular checkup after cancer treatment will lower your risk of breast recurrence and improve the survival rate.
3.3 - What is Breast Cancer Stage 3?
In Stage 3 Breast Cancer, the tumor has spread beyond its local area of the breast to adjacent lymph nodes and muscles but has not spread to other body organs. It is an advanced stage of breast cancer.
Following, we will learn about prognosis and treatment options for stage IIIA & stage IIIC.
3.3.1 - Types of Breast Cancer Stage 3:
Depending on the difference in tumor size and growth, Stage 3 breast cancer is divided into the following three types:
Breast Cancer Stage IIIA (3A):
Stage 3 breast cancer falls under the stage IIIA category if it matches any of these characteristics:
- A tumor can be of any size and has spread to 4-9 lymph nodes
- Tumor size is more than 5 cm with the breast and a small number of cancerous cells have found in local lymph nodes of about .2 – 2.0 millimeters.
- Size of the tumor is larger than 5cm and has spread to 1-3 local lymph nodes
Breast Cancer Stage IIIB (3B):
In stage IIIB (3B), a tumor can be of any size and cancer has spread to local lymph nodes. Stage IIIB is similar to Inflammatory Breast Cancer. Learn more about stage IIIB.
Breast Cancer Stage IIIC (3C):
Stage 3 breast cancer falls under the stage IIIC category if it matches any of these characteristics:
- A tumor can be of any size, cancer has spread to more than 9 axillary lymph nodes and the breast skin or chest wall
- There is no evident tumor found within breast but lymph nodes around collarbone have cancerous cells
- There is no tumor found in the breast or any size of a tumor is found in the breast and cancerous cells are found in axillary lymph nodes near the breastbone
Stage 3C breast cancer has divided further into two categories:
Operable Stage IIIC: If cancerous cells are have found in more than nine axillary lymph nodes or the lymph nodes of collarbone or breastbone, it is called ‘Operable’ stage IIIC breast cancer.
Inoperable Stage IIIC: If cancerous cells have invaded beyond the collarbone lymph nodes, it is called ‘Inoperable’ stage IIIC.
Note: ‘inoperable’ does not stand for ‘incurable’. It means more than one aggressive treatment methods will be needed to treat cancer. Patients with stage IIIC have a good response to the treatment.
3.3.2 - Prognosis of Breast Cancer Stage IIIA - IIIC:
The overall survival rate for breast cancer stage 3 is 72 out of 100. Mostly, patients with breast cancer stage 3A have a good prognosis compared to stage 3B. However, every patient has a different response rate to treatment. It is important to know that the survival rate for diagnosed stage 3 breast cancer can be multiply by having accurate support and treatment. You should discuss with your doctor about the right treatment options and care if you have diagnosed with breast cancer stage 3.
3.3.3 - Treatment Options for Breast Cancer Stage IIIA - IIIB:
Treatment options will differentiate for every patient diagnosed with breast cancer stage 3 depending on their condition. Usually, a combination of more than two treatment methods is given in stage 3 breast cancer. Following are the possible treatment options for stage 3 breast cancer:
Targeted Drug Therapy before Surgical Therapy:
A doctor will limit your cancer with targeted drug therapy before surgery, including:
Chemotherapy: Because of the growth of stage 3 breast cancer, you will need to go for chemotherapy to limit cancer before surgical therapy.
Hormonal therapy: If your cancer cells are ER-positive, PR-positive or HER2 positive, then your doctor will give you hormonal targeted therapy.
Surgical treatment of breasts and Lymph nodes:
Total mastectomy: the Whole breast will be removed to treat advanced breast cancer. Radiation therapy will be given after surgery to kill cancer completely.
Lumpectomy: If you have given successful targeted drug therapy and the tumor has shrink then your surgeon will remove the only affected area in the breast. Radiotherapy will be accompanied by chemotherapy and lumpectomy to treat stage 3 breast cancer.
Excisional Biopsy: Affected axillary lymph nodes can be removed using an excisional biopsy or can be treated by radiotherapy.
After Surgery of Breast Cancer Stage IIIA - IIIB:
You may need to go for breast implantation (after breast removal in total mastectomy) after radiotherapy. You may need hormonal therapy for cancer with positive hormone receptors or more chemotherapy to limit cancer or avoid recurrence after surgery.
3.4 - Definition of Stage IIIB (3B) Inflammatory Breast Cancer:
Stage IIIB (3B) breast cancer (is considered the same as Inflammatory breast cancer) is an invasive stage of cancer. In this stage of breast cancer:
- The breast tumor can be of any size (mostly bigger than 5cm)
- And cancer has spread into breast skin, chest wall or axillary/regional 9+ lymph nodes
- but has not invaded distant organs
3.4.1 - Stage IIIB (3B) Breast Cancer Symptoms:
Most common symptoms of Stage IIIB (3B) inflammatory breast cancer are:
- Reddened skin of the breast
- Ulcer, inflammation or swelling in the breast
- Hardened and scaly skin of the breast
- Inversion or retraction of the nipple
- The difference in the size of both breasts. One look bigger than the other one because of swelling
- Feeling like there is a heavy mass hanging in the breast
- Tenderness or continuous irritation or pain in the breast
3.4.2 - Stage IIIB Breast cancer Prognosis:
When breast cancer is diagnosed after reaching stage IIIB, it is already turned into invasive and aggressive cancer. At this stage breast cancer increases very fast that it has spread in the whole breast. That is why the prognosis of stage IIIB breast cancer is not very good that other types of breast cancer. There are higher risks of breast cancer recurrence after getting treatment.
3.4.3 - Stage IIIB Breast Cancer Survival Rate:
It is a rare stage of breast cancer. According to statistics, 72 women out of 100 diagnosed with stage IIIB breast cancer will live for 5 years after treatment. However, this is not the final number. Every patient responds differently to a treatment. Always, Discuss with your doctor about your condition and possible treatment methods.
3.4.4 - Stage IIIB (3B) Breast Cancer Treatment Options:
Because the symptoms of stage IIIB (3B) breast cancer like inflammation, tenderness, irritation, swelling are common types of conditions of breast infection during pregnancy, menopause, and breastfeeding. That is why your doctor will give you medicines to treat these infections before if you have these symptoms. If you do not respond to those medicines and it does not cure the infection in a week or 10 days then the doctor will take diagnostic tests to find breast cancer.
There are possibilities of having breast cancer stage 3B if you are having these signs and are not breastfeeding, pregnant and not going through menopause. If breast cancer stage IIIB is diagnosed then following treatment options will be considered:
Chemotherapy: Chemotherapy will be given to limit cancer in lymph nodes before surgery. Chemotherapy will also be given after surgery to lower chances of cancer recurrence.
Total Mastectomy: the Whole breast will be removed with regional lymph nodes diagnosed with cancerous cells.
Radiotherapy: Radiotherapy will be accompanied by total mastectomy.
Hormonal and targeted drug therapy: cancer that is hormone receptors positive or HER2 positive, will be treated with hormonal or targeted drug therapy followed by surgery.
3.4.5 - Risk Factors of Breast Cancer Stage 3B:
Mostly, middle-aged overweight and obese women of around 52-57 years of age get stage IIIB (3B) Stage Cancer. So you have to look for your lifestyle and cannot ignore symptoms because breast cancer increases quickly in stage 3B (IIIB).
3.5 - What is Stage 4 (metastatic) Breast Cancer?
In Stage 4 (metastatic) breast cancer, cancer has spread beyond its local place and lymph nodes towards distant lymph nodes and other organs i.e. bones, skin, brain or liver. It is the most advanced or says the last stage of cancer. Stage 4 is also referred to as metastatic breast cancer. Mostly, stage 4 breast cancer is the advanced form of cancer recurrence (initial breast cancer that was treated and returned after a year or some moths).
3.5.1 - Prognosis of Stage 4 Breast Cancer:
Stage 4 breast cancer is incurable but still treatable. Doctors give treatment to stage 4 (metastatic) breast cancer to slow down cancer growth or to limit tumors and to help patients to survive for long. Remember that stage 4 is not an indication of the end of your life. Treatment methods are improving day by day and many patients live a long productive life after stage 4 diagnoses and getting treatment.
3.5.2 - What is Survival Rate of Stage 4 Breast Cancer?
There are not authorized statistics for a survival rate of stage 4 breast cancer. Different patients response contrarily to cancer treatment. Approximately, 34% of patients survive for 5 years after an advanced breast cancer diagnosis. With improving treatment techniques, the survival rate is improving for stage 4 breast cancer patients. Many women live for 10 years after being diagnosed with advanced breast cancer.
3.5.3 - Treatment Option for Stage 4 Breast Cancer:
Whether breast cancer has metastasized to other body organs. It will be considered and treated as breast cancer. For instance, if breast cancer has spread into the skin, it will not be considered as skin cancer but breast cancer and will be treated as breast cancer. Stage 4 breast cancer treatment is decided by the following factors:
- Breast cancer symptoms
- Size and grade of cancer cells
- Where cancer has metastasized
- Previous treatments of breast cancer
Mostly, systematic (drugs) therapy is given to treat stage 4 (metastatic) breast cancer. Surgical therapy is also given to treat regional or local breast cancer sometimes. Following systematic therapies are given to treat stage 4 breast cancer depending on HR / ER / PR and HER2 status of cancerous status:
Hormone therapy: Women who have hormone receptors positive cancer are given hormone therapy first. There are different drug combinations including tamoxifen. Tamoxifen is a drug to treat stage 4 breast cancer in women who have not gone through menopause. However, hormone therapy can be slow. That is why chemotherapy is given first to treat the most aggressive breast cancer.
Chemotherapy: Women with ER / PR / HER2 negative (hormone receptors negative) cancer are given chemotherapy first as primary therapy. Patients with negative hormone receptors cancer do not respond to hormone therapy. Sometimes chemotherapy is given to treat metastasized tumors in a specific area. The chemotherapy drug is injected into a specific area.
Targeted Drug Therapy: targeted drug therapy is given to women with HER2 positive cancer. Targeted drug therapy is often combined with hormone therapy for better results.
The same drugs are given continuously to the patient until they stop responding or start reacting. Then other drugs are tried.
Surgical Therapy: Systematic drug therapy is the main approach to treat stage 4 (metastatic) breast cancer. This is the only way to control cancer that has spread in other parts of the body. Still, local and regional breast cancer is removed with surgery. It helps to avoid cancer recurrence and to avoid further complications of cancer.
Radiation Therapy: Radiation therapy followed by surgery is given in the following conditions:
- To remove a blockage in blood veins of liver
- To stop fractures in bones
- To treat metastasized tumor in a specific area like brain
- If there is a visible cancer wound in breast or chest
- When the breast tumor is causing an open wound in the breast (or chest)
- To prevent pain caused by cancer
- To prevent symptoms from appearing
Talk to your doctor to understand the purpose of a certain type of treatment for stage 4 breast cancer. If that is to treat cancer or to prevent symptoms.
4 - Breast Cancer Diagnosis Methods:
In the following section, we will read about Diagnosis Methods of Breast Cancer:
4.1 - What is Breast-Self Examination?
Breast self-examination is an inspection method of breasts using own fingers to understand the normal condition of your breasts. It helps you to get familiar with the normal form of breast and identify if it occurs any optical or physical changes within the breast tissues. Different causes can be reason changes in breasts like a lump or pain, which sometimes appears to be a reason for breast cancer.
However, breast self-examination is not a dependable method of breast cancer diagnosis and doctors do not support it anymore. Yet in some cases, women have been able to found a lump in their breasts. That lump was detected as an initial symptom of breast cancer after taking screen tests. That is why doctors recommend BSE (breast self-examination) for all human beings once in a month after 18 years of old.
4.1.1 - Purpose of Breast Self-Examination
The purpose of breast self-examination is to understand your breasts for their normal condition so that one can find any abnormal change quickly it happens. This helps in detecting breast cancer or benign breast disease (that can lead to a tumor) at an initial stage and make cancer treatments more effective. These changes are often not to be worried about but BSE is considered as a prevention tool for breast cancer.
Doctors do not support screening tests as a part of breast self-exam, as severe X-rays can cause death. One should go for screening or mammography he/she feels lump or pain in the breast or the area of nipples. If you have had breast cancer and gone under the cancer treatment then breast self-examination can help detect cancer recurrence and improve survival rate. One should immediately consult with a doctor if he observes any abnormal changes and where the doctor will perform mammogram screening for confirmation. Mammography is the most practiced and reliable diagnostic tool for breast cancer.
4.1.2 - Precautions for Breast Self-Examination:
Let us learn things you should keep in mind before doing breast self-exam:
- You should inspect your breast when your menstrual periods have ended and your breasts are not swollen
- If there are irregularities in your menstrual periods or you are pregnant or having menopause after 50 then select a particular date in a month.
- Do not do your breast self-examination while you are under a shower or have applied moisturizer on your breast skin and hands.
- You do not need to worry if you feel a lump or hard mass under the breast skin. Around 80% of lumps detected in breast tissues are benign. You should visit your doctor immediately for a detailed clinical breast examination. This should not be performed in the shower or with lotion on your skin or fingers.
4.1.3 - How should one perform Breast Self-Examination?
In the following 9 points, we will learn to perform breast self-exam:
- Lie straight down on an even surface, place a cushion beneath your right shoulder and put right arm beneath the head
- Press your right breast using three left-hand fingers to feel for hard mass or lumps
- Your finger’s pressure on the breast should be firm enough. This way you will learn how does your breast feel normally.
- Press and move your hand all around the breast vertically or in circles. You should do this likewise every time. Remember to check the whole breast this way and keep in mind how it feels.
- Gently squeeze your nipple with your forefinger and thumb and check if there is any discharge
- Repeat the same on the left breast with fingers of the right hand
- Now stand in front of the mirror and check for changes in breast’s appearances like redness, swelling, dimpling of the skin and changes in the nipple
- You can check your breasts under a shower with soapy hands. Your hand will slide over the skin to feel any changes
- Examine the underarm, the area between breasts and underarm, the area between breasts and collarbone to shoulders.
When should you get a Doctor’s appointment?
Visit your doctor immediately if you find any of these symptoms in your breasts:
- Existence of a lump
- Unusual nipple discharge
- Swelling, dimpling or irritation of the breast skin
- Redness or pain in the nipple
- Patchy skin around or of nipple
- Inverted nipple
4.1.4 - Benefits of Breast Self-Examination:
Breast self-exam has its benefits if it is performed regularly including clinical breast exam and mammogram screening. There are 20% of cases where breast cancer has found using physical breast examination instead of mammography. Doctors highly recommend to everybody to perform breast self-exam regularly including screen tests like mammography and MRI to get complete benefits of BSE.
4.1.5 - Breast Self-Exam Risks and Limitations:
There have been some favors and some oppose breast self-exam from different doctors. There are mixed opinions about BSE being important in detecting breast cancer earlier or improving survival rate. Breast self-exam has some limitations, including:
- According to a survey, most women think breast self-examination caused them anxiety and harm to their health due to unnecessary exposure to radioactive rays and biopsies. After taking benign lumps serious but the tumor was not found during a biopsy, they felt they have gone under an invasive diagnosis treatment unnecessarily.
- Breast self-exam cannot be an alternative to a clinical breast exam.
There can be such risks and limitations but BSE has benefits, which is why doctors advise to include it an optional tool with screening tests. Consult your doctor about the benefits and limitations of breast self-exam to get better breast awareness.
4.2 - What is a Clinical Breast Examination?
Clinical breast examination is a detailed checkup of breasts and the area of underarms by a professional and trained physician. A clinical breast exam is performed during a routine checkup or you can ask your doctor to check for abnormal changes in breasts if you feel needed.
4.2.1 - Why is Clinical Breast Examination needed?
The main purpose of CBE is to detect changes like hard mass or lump in breasts at an earlier stage. Further diagnosis tests for breast cancer will be essential if a lump or abnormal change has found in breast tissues. Not all lumps or changes are cancer symptoms. Most of the time breasts can be hardened because of the normal hormonal cycle. People, have had breast cancer and have undergone cancer treatments, should have a clinical breast exam to prevent recurrent cancer.
4.2.2 - When Should you have Clinical Breast Exam?
Today, different advanced breast exam techniques are present including Mammogram screening and MRI. There are 22% chances that screening methods can wrong breast cancer detection. Besides, mammograms are favored to diagnose breast cancer in women of 50+. There are 30% chances that mammograms cannot detect tumors when performed on young women. A clinical breast exam is a good approach for early detection of abnormal changes in breasts in women under 25. Besides, a clinical breast exam is performed after mammogram screening to confirm the test results in women of 50+.
One should go for Clinical breast exam if:
- Found any changes in breast skin or nipple during a breast self-exam
- If you have undergone breast implantation after mastectomy
- If there is any pain or discomfort in breasts, axillary or nipple
- Annually CBE is recommended for women after 40 years of old
4.2.3 - How is the Clinical Breast Exam performed?
There are different CBE techniques, including:
Detailed Visual exam
In a detailed visual exam of breasts, a trained physician examines breasts and nipples appearance for changes. These techniques include these steps:
- A patient will sit in a form posture at a straight surface with loosening belt and cloth on breasts and arms rests downwards
- A doctor will look if there is any change in breasts and nipples shape and skin color. Whether breasts and nipples are swollen or not, breasts and nipple’s crust is scaly or abnormal in the crust or not and if nipples are inverted or not, etc…
- Then the doctor will ask the patient to raise her arms over her head and will note if there any unusual mass between breast and chest wall
- A doctor can ask the patient to bend backward with her hands on hips to observe the movement of tissues of breasts.
After visual examination, the doctor will exam for any changes in breasts’ density by palpation.
- The patient will sit upon a straight surface and the physician will use the finger pads (the area of fingers between fingertips and palm) of his/her hands to check for changes in the density of breast tissues.
- A physician will move his/her fingers from the lower part of the breasts to the upper part of the breast towards the collarbone. Palpation will be done vertically and then in circular moves without lifting fingers up or without breaking the process of palpation. During palpation, the doctor will check every portion of the tissues attentively.
- The area of nipples and areola are included in palpation. A doctor will check nipples by pinching them with his/her index finger and thumb if there is any unusual discharge.
- A doctor can ask the patient to stretch her arms behind the head and examine the lower area of breasts against the chest wall.
Palpation will be repeated in the opposite breast the same way. Deep palpation is not possible on the full breast. Thus, the accuracy of palpation is doubted.
Inspecting the axillary and lymph nodes
Also, a physician will examine breast lymph nodes and axillary area:
- While sitting up, a patient will stretch her arm over the head
- A physician will place his/her finger in the center of underarm, the patient will lower her arm while the physician’s finger is in the underarm
- A physician will move his/her finger vertically and will check for lymph nodes
- Further investigation will be recommended if a physician finds lymph nodes hard with the area of one centimeter
The physician will write down if any abnormal changes are found. Also, further screening tests will be prescribed if a physician finds any changes in breasts, axillary or breast lymph nodes.
Clinical breast examination is an affordable test for breast cancer. Many breast cancers can be diagnosed with CBE. This is why depending on mammography solely is not sufficient. Clinical breast exams can find cancer in negative mammography and can recommend ultrasound for further identification.
4.3 - What is Breast Cancer Screening?
Breast cancer screening is a set of tests to check the existence of cancer in healthy people using X-ray equipment or physical checkup.
4.3.1 - Why is Breast Cancer Screening?
Screening test for breast cancer helps to detect the tumor at an early stage when it does not show any symptoms and cannot be seen or felt. Usually, tumors are easily cured if found at an early stage rather than later.
4.3.2 - When is breast cancer screening recommended?
Normally, doctors recommend regular and advanced level breast screening to someone with a larger risk of getting breast cancer. People with gene mutation and family history of cancer are at larger risk of developing breast tumor. Overall, 8/1000 times cancer has detected through breast screening in females.
4.3.3 - Types of Breast Cancer Screening Tests:
There are different types of breast cancer screening including normal physical checkup to advanced X-ray tests. A doctor will choose a test according to the person’s medical condition. Here is a brief overview of all of breast cancer screening tests:
Physical breast exam:
The physical breast exam includes a self-breast exam and a clinical breast exam. A self-breast exam is an examination of own breasts and underarms for changes using own hands and mirror. Whereas, in clinical breast examination, a doctor inspects your breast and the axillary area for lumps and other changes that can be a reason for breast cancer.
Mammography is an advanced method of breast screening using an X-ray unit. Most oncologists for cancer detection in healthy people with no evident signs favor mammogram screening. In mammography, an X-ray machine generates breasts image that looks thorough breast skin and soft tissues. Your radiologist will read those images to find the existence of breast cancer.
Ultrasound is next to mammography. Ultrasound technique can detect cancer with images using sound waves in those areas of the breast where mammography finds it hard to reach. It also can help to check the nature and density of a lump in the breast.
MRI - Magnetic Resonance Imaging
Magnetic Resonance Imaging (MRI) is a technique of breast scanning and generating images using radio waves and magnets. MRI and mammograms are applied together to scan breasts with greater risk of breast cancer or who have already been diagnosing and treating for breast cancer. Doctors do not apply and recommend MRI to healthy women or at a lower risk of developing cancer.
4.3.4 - Pros of Breast Cancer Screening
Most health providers come to an understanding that regular breast cancer screening can multiply the survival rate of breast cancer. Breast cancer can be treated easily without applying aggressive therapies like surgery or chemotherapy if found earlier.
In women, who have undergone breast cancer therapies can prevent cancer recurrence if they follow regular breast screening.
4.3.5 - Cons of Breast Cancer Screening
Where there are enough benefits of breast screening, some risks are also there to keep in consideration:
- There are 25% chances of the false-positive test results. Some women get a positive test result but cancer is not found in further studies. This causes unnecessary pain and wastage of resources.
- Sometimes mammograms cannot detect cancer and miss the treatment. This is why depending on breast screening only is not sufficient.
- You will have to go for biopsies to avoid the confusion caused by false-positive and false-negative screening test results. Those women have not malignant tumor complaints about the harm caused by unnecessary exposure to radiation and surgical methods.
- Exposure to ultra violates radiation waves can harm you. It can even cause cancer in healthy people.
4.3.6 - Breast Cancer Screening recommendations:
Doctors strongly recommend breast cancer screening to women with assured BRCA1/2 genes mutation and family history with breast cancer every year after 30 years of old. As these women have a greater risk of growing cancer in breasts or ovaries. Doctors advise these women should go for clinical breast cancer exam every year when under 25 and every 6-12 months after 25 years of old. Breast cancer can be treated using hormonal drugs therapy if detected earlier.
Talk to your doctor about your health condition and medical history (if you have gone through breast cancer treatment before). After a complete study of your genes mutation and family history, your doctor will decide if aggressive screening tests are required.
4.4 - Mammography (Mammograms) benefits, risks, and limitations
Here we will know about breast cancer mammograms' benefits, risks and limitations:
4.4.1 - What is a Mammogram (Mammography)?
A mammogram is a more sensitive imaging test than an x-ray to detect abnormalities for cancer in muscles and tissues of the breast.
4.4.2 - How does Mammogram help to detect breast cancer?
A mammogram uses low-dose radioactive rays to enhance changes within a breast. A doctor will read and decide whether these changes are signs of breast cancer or not and determines more tests are needed or not. The changes a mammogram detects in a breast can be:
- Tumor cells
Why should I go to Mammogram?
Mammograms help diagnose the presence of breast cancer even before showing any evident signs to feel like a lump in a physical breast-exam. This ability of mammograms makes them the most favorable diagnose method for breast cancer at an early and treatable stage.
When Should I Get a Mammogram Test?
One should go for mammography when feels:
- A hard mass in one or both breasts
- Nipple discharge
- Change in breast or nipple’s shape
4.4.3 - Types of Mammograms:
There are two types of Mammograms:
1. Screening mammograms
When a mammogram is performed to look for cancer symptoms in people those have not any evident signs, it is called screening mammograms. X-ray images of both breasts from different angles are generated using screening mammograms to look for any changes or cancer signs within the breast.
2. Diagnostic mammograms
When mammogram tests are done on patients with the identified cancer symptoms or after breast cancer treatment, it’s called diagnostic mammograms. In diagnostic mammograms, more detailed images of breasts are taken that were not included in screening mammograms.
4.4.4 - Benefits of Mammograms:
Here are prime benefits of mammograms:
- Mammograms are very sensitive to detect all types of breast cancer.
- Screening mammograms are capable to detect tumors within the soft breast tissues at an initial stage. These early detected small tumors are easy to remove and curable.
- No harmful radioactivity remains within the body after mammograms.
4.4.5 - Risks of Mammograms:
Sometimes, Mammograms can be slightly harmful, but the benefits of mammography exceed in value than these risks:
- Radioactive rays produced by screening mammograms can be cancerous if left in the body.
- X-rays can harm pregnant women and their babies.
4.4.6 - Limitations of Mammograms:
Mammography is an excellent method to diagnose breast cancer at a treatable stage. There are some limitations of mammograms though:
- Not all breast cancers can be detected on mammograms.
- Mammography does not detect cancer but the abnormal area within the breast. A doctor will decide whether these abnormalities are tumors or not by reading mammogram X-rays and by determining further diagnosis results.
- There are 30% chances of False-Positive mammograms. When screening mammogram shows positive results for breast cancer but further tests like biopsy falsify the presence of cancer, it is called a False-positive mammogram. If Mammograms results show negative results but other tests confirm the presence of cancer, it is called a False-Negative mammogram.
- Application of deodorant, powder or other cosmetics can confuse the mammogram results. So it’s advised not to wear perfumes, jewelry or cosmetics while going for mammography.
- Dense breasts increase the risk of breast cancer but it is difficult for mammograms to detect cancer in dense breasts.
- Only screening mammography is not enough to detect tumors or non-cancerous diseases within breasts.
- There can be difficult for mammograms to show clear results on implanted breasts.
Mammography is an outstanding diagnosis method for breast cancer. It’s advised to go for mammograms if you feel any changes during physical breast examination as early detection can save your life.
4.5 - Magnetic Resonance Imaging - MRI for Breast Cancer
Here we will read about what is Magnetic Resonanace Imaging - MRI, why is MRI used for breast cancer, benefits and risks of MRI:
4.5.1 - What is MRI for Breast Cancer?
In Magnetic Resonance Imaging - MRI for breast cancer, the doctor takes three-dimensional images of the inner area of breasts using electromagnets and radio waves technology.
4.5.2 - Why is MRI used for Breast Cancer?
Here are different uses of Magnetic Resonance Imaging – MRI for breast cancer:
- Detailed Images: Doctors use Magnetic Resonance Imaging – MRI to get more information through detailed images about the cancerous or suspicious area within the breast.
- Detect lump: To detect a lump or hard mass in the breast that cannot be seen in mammograms or ultra-sonograms but can be felt with hands during CBE - Clinical Breast Exam.
- Test Dense Breasts: DoctorsusesMRI to detect abnormalities in young women’s breasts because young women (under 30) have dense glandular muscles. Mammograms hardly detect abnormality in dense breasts.
- To guide surgical treatment: Sometime Mammograms find cancerous cells in breast lymph nodes but there is not any lump or hard mass within the breast. Doctors use MRI during the surgical treatment of cancerous lymph nodes. By using Magnetic Resonance Imaging, technology doctor can see a cancerous area in zoom resolution that makes it easy to detect abnormal area and remove the tumor.
- To detect ILC: MRI scanning helps to detect ILC (invasive lobular carcinoma). If it is an in situ (local) breast cancer LCIS or has spread beyond to its local area.
- To check the other breast: According to the ACS recommendations, the Doctor should use MRI on the other breast for cancer symptoms after diagnosing a tumor in one breast.
- To determine additional treatment methods: After analyzing the abnormal area in cross-sectional images, a doctor can find if cancer has metastasized. It can help determine treatment methods for breast cancer whether it should be the only mastectomy or should include additional therapies including radiation therapy or lumpectomy.
- To detect the accuracy of breast implantation: after getting silicone breast implantation after mastectomy, the doctor scans breast with MRI to detect if there is any silicone gel leakage with the chest wall and normal breast tissues. MRI scanning makes it easy to differentiate the gel with normal cells during scanning.
- To detect recurrent breast cancer: Doctor scans breasts with Magnetic Resonance Imaging for surgical scars after getting cancer surgical treatment. Any abnormality around surgical scars can be a sign of cancer recurrence.
- To detect metastatic breast cancer: Doctors use MRI to scan the whole body for the possibility of breast cancer has metastasized to the other body organs like the brain, liver, or abdomen.
4.5.3 - Process of Magnetic Resonance for Breast Cancer:
Here is the process of Magnetic Resonance Imaging for breast cancer:
Preparation for breast MRI:
You will have to keep these things in mind when going for breast MRI:
- Do not wear any jewelry or metal on your body when going for breast MRI
- The MRI process can prolong for 30-40 minutes. Tell your doctor if you have a problem with lying on your stomach in one position for a long period. The doctor can give you tranquilizer or can use an open MRI unit to solve this problem.
Process of breast MRI:
Here is the
- First, you will lay with your face down and bare torso on a padded table with holes with breast spirals. These spirals are waves receivers attached to the MRI tool to generate images. Your breasts will set in holes.
- Then, the table will move into the cylinder-shaped Magnetic Resonance Imaging Machine.
- Your breasts will be scanned using electromagnets and radio waves that cannot be seen but will create an extreme sound.
- A radiologist will scan your breasts with an MRI device until it gets required images. MRI is an easy and painless process that you can go back to your daily routines right after finishing the test.
4.5.4 - Benefits of Breast MRI:
- MRI is much sensitive to detect the tumor at its earlier stage. Mostly Ductal Carcinoma in Situ (DCIS) is diagnosed using MRI that can be missed in conventional screening.
- Magnetic Resonance Imaging is more than 12% more beneficial for scanning recurrent breast cancer than mammograms.
- MRI scanning is beneficial for finding breast cancer in women who have a family history of cancer.
4.5.5 - Risks of Breast MRI:
- There are higher chances of false-positive results with breast MRI. MRI can show cancer when it does not exist. More screening and biopsies will be needed to confirm false-positive results. That is why doctors do not recommend MRI as a standard screening method.
Though MRI is sensitive to minor tumors, still it can miss most of cancer that can be seen on mammograms only. That why doctors use MRI as a complementary scanning tool (if needed) with traditional screening.
4.6 - Ultrasound Scanning for breast cancer | Breast Ultrasound
Let's read about Ultrasound scanning, process, benefits and limitations for breast cancer in the following section:
4.6.1 - What is Ultrasound Scanning for Breast Cancer?
In Ultrasound scanning for breast cancer, a doctor transmits extreme sound waves through your breasts using a machine attached with a screen to scan specious areas. These sound waves create pictures of your breasts and display them through a monitor. Ultrasound or Ultrasonography is a technique that creates images of your body using extreme sound waves, unlike Mammogram that uses radioactive rays.
4.6.2 - Purposes of Ultrasound scanning for breast cancer:
Ultrasound technique is used on breasts for the following purposes:
Breast cancer diagnoses:
The doctor uses an ultrasound-scanning method to scan the lump density within a breast identified with mammograms. With the help of ultrasound, a doctor can check if the lump is a benign fluid-filled cyst or a solid lump. If the lump is solid then the doctor recommends checking whether it is malignant or not with biopsy.
Ultrasound for breast biopsy:
Ultrasound screening is also used in stereotactic biopsies to guide the needle to reach impalpable abnormalities within the breast.
For breast screening in women fewer than 30:
Normally, Doctors use ultrasound after mammography to confirm Mammogram results but not for breast cancer screening separately. However, in women fewer than 30, ultrasound is used to screen breast lumps before mammography. It is because young women have dense breasts because of milk glands. Mammogram X-ray can show these dense areas as a tumor. Mostly, in young women, palpable lumps are just non-cancerous bumps.
4.6.3 - The Procedure of Ultrasound for Breast Scanning:
Following are the steps of ultrasound scanning for breast cancer:
- Your doctor will ask you to lie straight on your back on a firm surface and will apply a water-based ointment on the breast area that needs to examine. This water-based ointment is harmless to your skin and clothes.
- Now sound waves transmitter, which is connected to a monitor, will be placed on the breast and the doctor will move it forth and back to capture sonograms (images created with ultrasound) on the monitor.
- The test is completed after capturing all wanted sonograms. The applied ointment will be wiped and you will be allowed to go home.
4.6.4 - Ultrasound test Results:
An ultrasound test is performed to analyze the nature of identified lumps or hard masses within the breast. You can expect the following results of your ultrasound:
- Your breast sonogram provides your doctor confirmed that the lump is solid, just swelling or body fluid. Sometimes, a lump/mass happens to be a mixture of solid tumor and a fluid-filled cyst. Ultrasound test helps to identify both.
- The size of the solid lump in a breast that helps to determine further diagnosis methods like MRI or Biopsy
4.6.5 - Benefits of Ultrasound test:
Here are the benefits of an ultrasound test for breast diseases:
- Ultrasound test does not use harmful radioactive rays that is why this is safe on a body
- It is an affordable, easy, quick and painless diagnostic test in comparison to biopsy
- Ultrasound scans those tissues cannot be scan with mammography
- Ultrasound gives clear and real-time images of abnormalities
- Ultrasound helps scan abnormal areas in hard breasts which are normally difficult with mammography
4.6.6 - Limitations of Ultrasound test:
Most doctors do not use Ultrasound for breast cancer diagnosis because of these limitations:
- Ultrasound does not help in determining whether the lump is cancerous or not. A biopsy will be needed to confirm the malignancy of abnormal area
- Ultrasonography is a complementary scanning technique used with mammography. It is not a substitute for mammography
- Ultrasound scans only evident lumps/masses. Mostly small abnormalities like calcifications are scanned with mammography
This article provides information on Ultrasound scanning for breast cancer and should not be considered for medical assistance. Please consult your doctor about your health condition for advised diagnostic methods for breast cancer.
7. Computed Tomography – CT Scan, CAT for Breast Cancer
We will read about Breast Cancer Computed Tomography - CT Scan process, benefits ad risks in the following section:
4.7.1 - What is Computed Tomography – CT (CAT) Scan for breast cancer?
In Computed Tomography (CT scan, CAT) a radiologist transfers X-rays (which is connected to a computer) from different directions through a breast. A computer generates in-depth images of the breast by combining the X-rays. These images help the doctor to evaluate if breast cancer has spread beyond its local area to the chest wall or towards other body organs.
4.7.2 - How a CT scan is used for breast cancer?
Computed Tomography is not a standard scanning tool for breast cancer. Mostly CT scan is used to evaluate metastatic breast cancer if breast cancer has metastases to other body organs or not. This helps to decide the treatment method of metastatic breast cancer. Computed Tomography (CT scan) is used in various ways for breast cancer, including:
- To diagnose the cancer existence within the breast and other body organs
- To evaluate the growth of cancerous cells in the body
- To guide biopsy needle and radioactive dose in radiation therapy
- To evaluate the breast cancer stage
- To check the treatment response of cancer
- To diagnose the recurrent breast cancer
Computed Tomography (CT scan) is performed in advanced breast cancer. Doctor scans breast cancer using CT to detect if breast cancer has metastases to the liver, chest wall, abdomen or brain. If breast cancer was detected in other parts of the body then your doctor will go for another CT scan to evaluate the stage of cancer. It will help to determine the treatment method if surgery is required or not. Moreover, you will have CT sessions during treatment to check if cancer is responding to treatment. After treatment, your body will be scanned with CT to detect if cancer has reoccurred or not. You will not require a Breast cancer CT scan if your cancer has been controlled in an earlier stage.
4.7.3 - How a CT Scan is performed?
Following are the steps of breast cancer Computed Tomography (CT scan) procedure:
- You will lie on your abdomen (face down) on a table with a hole. Your breast will be still in a hole
- A CT (computed tomography) scanner will rotate around the breast
- In some cases, the doctor will inject a coloring solution through a vein in the arm to get the clear images of your organ.
- Your doctor can ask you to hold your breath because breathing can blur images.
- The procedure of CT scan is quite similar to mammography. Also, the quantity of transmitted radiation is equal to standard mammography.
4.7.4 - Benefits of CT scan in Breast Cancer
Most doctors are trying to replace CT scan with mammograms because of this high contrast and high-resolution equipment that can:
- Help diagnose breast cancer in an earlier stage
- CT scan can detect very small calcifications (small calcium accumulations) within a breast that can be missed during mammography
- CT is a painless, non-invasive scanning procedure
4.7.5 - Risks of CT (Computed Tomography) in breast cancer:
In spite of benefits, Computed Tomography can involve risks, including:
- However, the procedure is simple and easy but sometimes it can be uncomfortable when you have to lie in one position for 30 – 60 minutes. Some patients cannot hold the breath for some time.
- The coloring solution, which is injected before CT, can be allergic to the body and harmful to kidneys. Your doctor may check your kidney health before and after injecting the solution.
- Radiations can harm the baby in the womb of pregnant women. That is why tell your doctor if you are pregnant.
- In some cases, the intense rays can cause cancer (in the non-cancerous body). That is why doctors do not recommend CT to be used as a standard diagnostic tool.
4.8 - Biopsy for Breast Cancer
In this section, we will know about types, tecniques, benfits and limitaions of breast biopsy:
4.8.1 - What is Breast Biopsy?
A biopsy for breast cancer is a method to take a sample of breast tissues to test for the existence of cancer under a microscope.
4.8.2 - Why is Biopsy done?
Tissues sampling taken through biopsy allows a pathologist to evaluate reasons for lumps or other unusual changes in breasts. A biopsy test report helps the doctor to decide if the patient needs further cancer treatment or not.
4.8.3 - When is Biopsy done?
A biopsy is done after a positive mammogram, or negative mammogram but positive clinical breast exam. A pathologist will take a sample of breast’s soft tissues to check if the identified abnormalities are cancerous or non-cancerous.
4.8.4 - Types of biopsy:
There are different types of breast biopsy technique, including:
1. Fine- Needle aspiration biopsy (FNA)
Fine-needle aspiration biopsy is the quickest and easy technique of breast biopsy. FNA biopsy is done to evaluate if the hard mass that is felt during a clinical breast exam is a benign fluid-filled lump or a hard lump. Following are the steps of Fine-Needle Aspiration biopsy:
- The patient lies down on a straight surface
- The doctor balances lump in his/her one hand and inserts a needle into the breast tissue through skin.
- The needle is attached with a syringe that extracts tissues cells or fluid in lump
- Sample cells or fluid collected with fine-needle aspiration biopsy will be examined in the lab if it is a hard mass or benign fluid-filled lump
- If the lump is hard then a complete tissue will be taken to diagnose.
(Read more about FNA Biopsy)
2. Core needle biopsy (CNB)
Core needle biopsy is done to take a sample of tissue after a lump detection in a mammogram, ultrasound or CBE. In CNB, the needle is directed through imaging tools like a mammogram, MRI or ultrasound. Which imaging tool will be used, totally depends on the location of a lump in the breast. The procedure of core needle biopsy:
- A pathologist or radiologist will insert a deep thin needle guided by an imaging tool into breast tissue
- Several tissue samples of grain size will be taken to examine in the laboratory if the lump is malignant or benign
3. Surgical Biopsy
Surgical biopsy is an invasive type of biopsy. There are two types of surgical biopsy:
- Incisional biopsy – removes a small portion of the breast including margins (the area that is not affected with a disease) to evaluate
- Excisional biopsy – removes the whole breast including margins. Only nipple and breast skin is left in an excisional biopsy. Excisional biopsy is also called lumpectomy.
Normally a surgical biopsy is done in an operation theatre. (Read the complete procedure of surgical biopsy)
4. Stereotactic biopsy
In a stereotactic biopsy, the needle is guided by a mammogram to locate the affected area of the breast. Some samples of breast tissues (about 6mm long each) are removed for diagnosis. (Read stereotactic biopsy procedure.)
4.8.5 - Benefits of Breast Biopsy
Benefits of breast biopsy are:
- Biopsies can give clearer results for breast cancer diagnosis
- Samples removed in biopsies are more precise and can avoid wrong samples
- Biopsies help to determine if cancer is invasive or non-invasive
- Breast biopsy helps pathologist to diagnose cancer with a small number of tissue samples
4.8.6 - Risks of Breast Biopsy
There are a few risks of breast biopsy, including:
- This diagnosis technique will leave breast with swelling and incision mark
- Patients can catch body infection from the place of biopsy because of sensitivity. Immediately contact your doctor if you find any signs of infection like fever, reddened, swollen or fluid discharge from the biopsy mark.
- Core needle biopsy, incisional biopsy, and stereotactic biopsy can ruin the breast shape because the removal of several samples
- Your breast can take time to heal that will cause discomfort and pain
- Further treatment depends on test results
4.8.7 - Precautions:
You have to discuss indefinite in your body (if any) with your doctor before a biopsy, like:
- If you are allergic to anything
- If you have consumed aspirin in the past seven days
- If you are consuming anticoagulants (a blood-thinning medicine)
- If you have a problem with lying down on your stomach for a long time
- If you are expecting a pregnancy
- If you have undergone cardiac surgery
- If you have implanted any electronic device within your body
- Wear lingerie when going for biopsy. Your breast may need support to hold an ice pack after a biopsy is done.
4.8.8 - Care after Breast Biopsy:
- No biopsies except surgical biopsy need special care. You can go home the same day with an ice pack on the place of biopsy (to reduce swelling) and a bandage. You will be able to resume your routine day work within a day. Your doctor can prescribe you pain reliving pills to ease your uneasiness and pain after a breast biopsy. You will be asked to keep an ice pack on the breast for a day two to lessen swelling.
- Only in the surgical biopsy, you will have some stitches on the breast. However, these stitches are not severe and you can go home the same day and can start your routines after a day. You will have to follow-up with your doctor for care recommendations for stitches.
- Once your biopsy results have arrived, a team of doctors will check if the presence of cancer is clear or not. For instance, your mammogram results are positive, biopsy results are negative, and doctors are having a different opinion about the nature of the tumor. Then doctors will agree on going for another detailed incisional biopsy to confirm the malignancy of the disease.
- If biopsy results are positive and mammogram results are, also positive that means cancer had diagnosed. The biopsy technique also helps to determine the type of cancer whether it is positive to hormone receptors etc… Now you and your doctor will plan what kind of treatment will be conducted to treat your particular type of cancer.
4.9 - Fine-Needle Aspiration Biopsy Breast (FNA)
Fine-needle aspiration biopsy of the breast is a type of breast biopsy. Let's read more about process, advantages and disadvatages of Breast FNA biopsy:
4.9.1 - What is Fine-Needle Aspiration Biopsy of the breast?
Fine-Needle Aspiration biopsy breast is a diagnostic technique that examines the nature of lumps/hard masses detected during a breast examination. A thin (20-21 gauge) needle is inserted within the skin to remove sample tissues that will be examined for the disease. The needle used in Fine-Needle Aspiration Biopsy is thinner than a standard needle that is used to pull blood. FNA biopsy is the simplest and quick type of all sampling biopsies.
4.9.2 - Why is Fine-Needle Aspiration Biopsy of the Breast performed?
FNA biopsy helps to examine the suspicious areas in the breast tissue for malignancy. A doctor cannot say what is within these suspicious areas without performing an FNA biopsy. Without confirming what is, these suspicious areas containing the doctor cannot say whether they are threatening to your health or not.
4.9.3 - When is Breast Fine-Needle Aspiration Biopsy performed?
FNA biopsy is performed after diagnosing a lump, hard mass or swollen area within the breast or axillary lymph nodes during a self-breast exam, clinical breast exam, mammography or ultrasound. Mostly FNA biopsy for the breast is performed on breast, neck / axillary lymph nodes, and thyroid gland.
4.9.4 - Precautions for Breast Fine-Needle Aspiration Biopsy:
There are no specific precautions for breast Fine-Needle Aspiration biopsy. The doctor may ask you to
- Stop taking blood-thinning medicines like aspirin
- Stop eating and drinking for some hours before going for the process
You may need to bring someone to drive you back home because the doctor can give you pain-relieving medicines after the FNA biopsy.
4.9.5 - How is Breast Fine-Needle Aspiration Biopsy performed?
Breast FNA biopsy is done on palpable (that are felt using fingers in physical examination) or impalpable (that is not felt using fingers but is shown in X-ray tests). The procedure of Fine-Needle Aspiration Biopsy for the breast is described in the following lines:
- The doctor will clean the breast’s site on which FAN biopsy is going to be done
- If the lump is palpable then the doctor will be steadying it in one hand and will insert the needle into the lump through the skin
- If the lump is not palpable then the doctor will locate it thought ultrasound and will insert the needle into the skin while monitoring the needle position on an ultrasound screen
- Then the doctor will draw the material from the lump with a needle that is attached to a syringe
- The needle can be inserted for more than once to take an adequate sampling
4.9.6 - After-effects of a Fine-Needle Aspiration Biopsy:
- This procedure is so simple that not any severe mark is left on the site of biopsy.
- Minimal bleeding can be experienced but that is not severed or something to be frightened.
- Insertion of a needle does not feel more than a normal injection
- Sometimes pain-relieving substance can be applied on skin where the needle will be inserted to ease the procedure.
- If you feel any bleeding, pain, swelling, fever or pain afterward, contact your doctor promptly.
- Do not take aspirin as a painkiller because it can be harmful in this situation.
4.9.7 - Results of FNA Biopsy:
Samples collected with FNA biopsy will be examined under a microscope in the laboratory. The results of sampling will fall under one of the following categories:
- Inadequate or insufficient: The quantity of removed sampling is not sufficient to analyze.
- Suspicious or Atypical: Findings are not clear. Some cells seem abnormal but do not seem cancerous. Surgical biopsy is needed to collect adequate sampling to confirm the nature of the abnormality.
- Benign: The lump, swelling or mass are not hard and do not contain cancerous cells. A lump or hard mass under control and has not spread beyond its local place.
- Cancerous: Cancerous cells are diagnosed. Cancerous cells have grown and have spread beyond their local place.
4.9.8 - Benefits of FNA biopsy of the breast:
- Fine-needle aspiration biopsy is the easiest and simple diagnosis method of suspicious area in the breast
- FNA biopsy is less painful than a surgical biopsy. It does not leave severe scars or infections and recovers quickly than surgical biopsy.
- Fine-needle aspiration biopsy is an effective way to diagnose and treat non-cancerous fluid-filled lumps.
4.9.9 - Disadvantages of FNA biopsy of the breast:
There are no big disadvantages of fine-needle aspiration of the breast except some of these possibilities:
- Needle insertion can tear a place around the lungs if it collapsed with lungs but it is very rare.
- Cancerous cells can be trailed into non-cancerous parts of tissues when a needle is removed. A skilled doctor to avoid such a possibility should perform an FNA biopsy.
- There is a possibility of false-negative results. FNA biopsy collects a sample of few cells into that lump or cyst so there is a possibility to miss abnormal cells and collect normal cells. To avoid falls-negative results doctor will need to collect a sample of a larger number of cells by core needle biopsy.
4.10 - Surgical Breast Biopsy
In this section, we will read about surgical breast biopsy, its types, procedure, benefits and risks:
4.10.1 - What is Surgical Breast Biopsy?
When breast biopsy is done by surgical procedure, it is called Surgical Breast Biopsy. In Surgical breast biopsy, a complete lump or a part of effected tissue is removed to diagnose breast cancer.
4.10.2 - Types of Surgical Breast Biopsy:
We can divide Surgical breast biopsy into two types:
I. Incisional Biopsy
This type ‘Incisional biopsy’ of surgical biopsy only removes the tumorous part within the soft tissue of the breast. Now a day, most people prefer this type of surgical biopsy as a diagnostic technique for breast cancer.
II. Excisional Biopsy
The second type of surgical biopsy, which is called Excisional biopsy, removes complete tumorous part including margin. A margin is a normal area around the abnormal areas. A doctor removes normal cells along to make sure if all cancerous cells are removed or not.
Excisional biopsy is also called Lumpectomy when it is used to treat non-invasive breast cancer. Now a day, most people prefer lumpectomy to treat non-invasive breast cancer.
4.10.3 - Purposes of Surgical Breast Biopsy:
A doctor will perform surgical breast biopsy:
- Your pathologist need larger samples of abnormal tissues to find tumor
- After getting positive screening test reports, the doctor will perform a surgical biopsy to know tumor grade. It helps to determine the further cancer treatment method
- Excisional biopsy is also performed to treat non-invasive breast cancer, DCIS
4.10.4 - Preparation for Surgical Breast Biopsy:
You will have to these things in mind before going for surgical breast biopsy:
- Wear a sports bra when going for a surgical biopsy. Your breasts will need support after surgery
- Your doctor can ask you to stop drinking/dining before a few hours of process
- Your doctor can prohibit you from having blood thinners (if you are taking any like aspirin) or insulin before ten days of the process
4.10.5 - Process of Surgical Breast Biopsy:
The process of surgical breast biopsy goes as following:
- Surgical biopsy is performed by a professional surgeon in operation theatre
- The area that needs to be biopsied will be frozen using anesthesia. A patient will also be given sedation medicine through a vein line. You will remain awake but will not be able to speak or feel the pain. Unlike regular anesthesia, you will recover soon after the surgical process.
- For an impalpable lump, a doctor will take the help of a wire that will be guided by mammograms or ultrasound. This procedure is called needle/wire localization.
- Complete suspicious area or a part of the abnormal area will be removed through a cut.
- If the removed area matches the area that shows on X-rays then the process is done. If removed tissue does not match with X-rays then the doctor will repeat the process to remove the right breast tissue.
- In Excisional biopsy, the doctor will be able to eliminate complete cancerous area with lymph nodes. Then you will not require another cancer treatment.
Follow-up care of Surgical Breast Biopsy:
- You will be able to go home the same day after surgery.
- Normal bleeding and bruising can cause swelling at the surgery site and on the breast. However, it is normal and recovers with time. Your health provider’s team will instruct you on how to take care of your surgery afterward.
4.10.6 - Results of Surgical Breast Biopsy:
A pathologist will analyze removed breast parts in a lab. You can expect the following results of your surgical biopsy:
- No cancer found: Your doctor will recommend you further mammography if cancerous cells are not found in the abnormal area
- Cancer is found: your doctor will recommend you further therapies for cancer treatment
Your biopsy results determine further treatments for your breast disease. You can take the opinions of different doctors about further treatment.
4.10.7 - Benefits of Surgical Breast Biopsy:
- Surgical breast biopsy avoids false-negative results as it removes larger samples of abnormal tissues.
- An excisional biopsy can be your final cancer treatment as it removes a complete cancerous area from the breast.
- A doctor can analyze tumor grade, size and hormone receptors status from larger sampling. This helps to determine further treatment methods. If cancer cells hormone receptors status is positive then cancer will be treated by using hormone drugs.
4.10.8 - Risks related to Surgical Breast Biopsy:
- A surgical breast biopsy is an invasive sampling technique. If a biopsy shows a negative cancer result then the patient may have undergone unrequired surgery.
- Surgical breast biopsy cause bleeding and bruising that takes longer recovery time in comparison to core needle biopsy or VAB
- A surgical biopsy removes larger tissue sampling. This can change your breast shape. Also, a surgical biopsy leaves a scar on your breast.
4.11 - Stereotactic Breast Biopsy | X-ray, Mammogram Guided Breast Biopsy
In the following section, we will know about method, benefits and risks of Stereotactic breast biopsy.
4.11.1 - What is Stereotactic Breast Biopsy?
Stereotactic breast biopsy or X-ray, Mammogram guided breast biopsy is a non-invasive type of breast biopsy. This method utilizes two images of the same site taken from two different angles, that why it is called stereotactic.
In this type of breast, biopsy doctor sees breast tissue’s mammograms to locate the place, need to be biopsied. A mammogram is an X-ray imaging method, used to diagnose breast cancer at an earlier stage. A stereotactic biopsy helps to identify the abnormal area that cannot be felt with the hand within the breast and makes sure that insertion is on point.
4.11.2 - Why is Stereotactic Breast Biopsy Performed?
These are the main purposes of performing stereotactic breast biopsy:
- Calcification (accumulation of calcium within the breast is a form of small dots): If calcification is identified on mammograms but not on ultrasound
- An impalpable lump or hard mass within the breast tissues
- Abnormal changes on the site of surgical therapy of breast
- Abnormal changes in breast shape
4.11.3 - Preparation for Stereotactic Breast Biopsy:
- You have to lie face down during stereotactic biopsy, talk to your doctor if you have a problem lying on your stomach for a longer period (for about 30-60 minutes).
- Tell your doctor if you are on any kind of medication especially aspirin.
- Tell your doctor if you have any kind of allergies particularly if you have experienced an allergy to anesthesia
- Tell your doctor if you are pregnant. Your doctor may recommend your other type of biopsy if you are pregnant because x-rays can harm your baby in the womb. Do not apply or wear perfume, moisturizer or jewelry before going to stereotactic biopsy
- Wear a bra when going for stereotactic biopsy because your doctor can give you an ice pack to place on the site of biopsy to reduce pain and inflammation
4.11.4 - Method of Stereotactic Breast Biopsy:
Here is the method of stereotactic breast biopsy:
- You will be lying face down or sitting upon a biopsy table with bare torso
- One of your breasts will be set in a table hole. The table will be elevated high for some feet
- A mammogram will be fitting behind the table
- Your breast will be compressing between to plates where your radiologist will take images to locate the exact location of the biopsy
- Once the location is marked through mammograms, your doctor will cut (approx. 6mm long) in the skin of the breast where the needle will be inserted
- Now your doctor will insert needle within the breast tissue and removes several tissue samples. There are two types of needles to collect sampling:
- CN- Core needle, a deep big needle takes one sample with one insertion
- VAD- the vacuum-assisted device can take multiple samples with one insertion
- Then collected samples will be sent to a lab where your pathologist will analyze samples and sort the result report for your doctor.
- Lab testing will diagnose whether abnormal tissue contains cancerous cells or non-cancerous cells
- You will be able to go home the same day. Your health care team will instruct you how to take off your bruise caused by a small biopsy cut.
- There does not happen to sever bruising or bleeding during a stereotactic biopsy. You are advised to immediately visit your doctor if you feel fever, infection or continuous pain after coming home.
4.11.5 - Advantages of Stereotactic breast biopsy:
A stereotactic breast biopsy is a highly recommended technique of biopsy by doctors. Main reasons for its being highly recommended are:
- Doctors think that with mammogram x-ray it is easy to locate the exact location of abnormality with breast tissues. There are fewer chances of missing abnormal cells in stereotactic breast biopsy, which helps to avoid false-negative results.
- Stereotactic is a much effective, non-invasive and affordable biopsy method than surgical biopsy.
4.11.6 - Risks of Stereotactic Breast Biopsy:
Stereotactic breast biopsy has not severe risks except:
- Swelling, soreness or bruising at the site of biopsy
- Infection caught from the place where a biopsy was done
- Radiations can harm pregnant women and their children in the womb.
However, these risks can be prevented by following the post-biopsy care instructions given by your health care team.
5 - Breast Cancer Treatment
In this section, we will know about breast cancer treatment methods i.e. Chemotherapy, Breast Surgery, mastectomy, Lumpectomy and Radiotherapy.
5.1 - Chemotherapy for Breast Cancer Treatment
In the following lines, we will read about Chemotherapy for breast cancer, types of chemotherapy, the process, drugs and side effects of breast cancer chemotherapy.
5.1.1 - What is Chemotherapy for Breast Cancer?
Chemotherapy refers to a technique of breast cancer treatment where cancerous cells are killed or shrunken using medicines. It is also called systemic therapy that means chemotherapy drugs treat cancer in the local site also if the cancer cells have metastasized in other parts of the body.
5.1.2 - Types of Chemotherapy:
There are two types of Chemotherapy:
Before Surgery Chemotherapy (Neoadjuvant therapy):
The doctor will give recommend chemotherapy before going for breast cancer surgical treatment if:
- You are diagnosed with Inflammatory breast cancer
- You have a larger tumor in the breast
- If cancer cells have invaded tissues around the breast
- To shrink the tumor at one place so that it can be removed with minor surgery (Lumpectomy) and mastectomy can be avoid
- To lower the risks of recurrent breast cancer
After Surgery Chemotherapy (Adjuvant therapy):
The doctor uses chemotherapy after surgical breast cancer treatment if:
- There are higher risks of cancer cells to metastasize in other body organs
- There are higher risks of cancer recurrence
5.1.3 - Chemotherapy is recommended to:
Your doctor will recommend chemotherapy for treatment plan of breast cancer in such cases:
- If cancer cells are found in axillary lymph nodes
- If you have invasive breast cancer
- If you are diagnosed with early-stage of hormone receptors negative cancer
- If your breast cancer is HER2 positive
- If there are higher chances of recurrent breast cancer
Normally Chemotherapy is not recommended to those diagnosed with non-invasive (DCIS) cancer. As non-invasive cancer, have lesser chances of metastasizing.
Chemotherapy is given at these stages of Breast Cancer Treatment:
Chemotherapy is used to treat almost all invasive stages of breast cancers, including:
- Stage I
- Stage II (Advanced Breast Cancer)
- Stage IIIA, Stage IIIC
- Stage IV (Metastatic Breast Cancer)
- Recurrent Breast Cancer
The treatment plan of Chemotherapy varies from person to person depending on their health condition.
5.1.4 - These Chemotherapy Drugs are used for Breast Cancer:
There is a range of Chemotherapy drugs to be used to treat breast cancer, including:
- 5-fluorouracil (5-FU)
- pegylated liposomal doxorubicin
- Paclitaxel (Albumin-bound)
- Platinum agents (carboplatin, cisplatin)
Factors determine chemotherapy drugs:
Usually, the doctor chooses a combination of 2 – 3 chemotherapy drugs depending on the following factors:
- Breast Cancer Stage
- Tumor’s hormone receptor / HER2 status
- If you are going through menopause or not
- On-going breast cancer treatment plan
- Risk of cancer recurrence
- Over-all health condition (if you have diabetes, heart disease or any other disease)
5.1.5 - The Process of Chemotherapy:
There are two methods of chemotherapy drugs consumption:
A patient takes doctors prescribed Chemotherapy drugs by mouth in the form of tablets or capsules. Oral chemotherapy is usually done at home. The patient’s health care team instructs how to take medicines with an appropriate diet plan.
If you experience any physical issues while taking drugs like vomit, skin allergy or stomach problem, then consult your doctor immediately.
A doctor injects chemotherapy drugs into your arm or chest vein through a drip. the treatment can continue for a few months. The plastic tube, through which drugs are injected, may remain into your vein during the treatment.
Usually, the doctor gives you chemotherapy drugs for 1-5 days a week and then takes a break for 2 – 4 weeks. 3-4 weeks of chemotherapy is called a cycle. Normally, a patient has 8 chemotherapy cycles.
5.1.6 - Side Effects of Breast Cancer Chemotherapy:
These are the most common side effects of breast cancer chemotherapy:
- Mouth infections
- Vomiting or nausea
- Weight loss
- Loss of appetite
- Nail changes
- Blood deficiency
Usually, side effects caused by chemotherapy drugs disappear after treatment completion. If you experience any side effects, consult your doctor to recommend you tips or medicines to reduce or prevent chemotherapy side effects.
5.1.7 - Things to remember during Breast Cancer Chemotherapy:
Though chemotherapy drugs of breast cancer do not affect your ovary fluids, yet you have to be careful in your sexual life. Doctors recommend preventing any fluid exchange during the treatment as oral sex or intercourse. Most doctors advise not to conceive for few times after chemotherapy and use precautionary steps during direct intercourse.
5.2 - Breast Cancer Surgery
In this section, we will read about Breast Cancer surgery. Goals, Type, process, benefits and side effects of breast surgery.
5.2.1 - What is Breast Cancer Surgery?
Breast Cancer Surgery (BCS) is the primary method of treating initial breast cancer by removing breast tumors using surgical medical tools. If breast cancer has, metastasized or large then chemotherapy and systematic drug therapy will be given to treat cancer before breast cancer surgery.
Goals of Breast Cancer Surgery:
The goal of breast cancer surgery is to remove a tumor found in breast and lymph nodes including margins (margin is a non-cancerous layer of cells around cancerous cells). Margins and lymph nodes that are removed in surgery will be examined under a microscope for cancer growth.
5.2.2 - Types of Breast Cancer Surgery:
There are two types of surgical treatment for breast cancer:
- Mastectomy – whole breast is removed in a mastectomy.
- Lumpectomy (Breast-Conserving Surgery) – an only malignant area of the breast with margins are removed in Lumpectomy.
5.2.3 - Which Surgical Treatment is best for your Breast Cancer?
Different factors will be considered to determine the best surgical treatment for your breast cancer, including:
Type of Breast Cancer: If the breast cancer is Invasive (IDC, ILC, Metastatic breast cancer) or Non-Invasive (i.e. DCID, LCIS).
Breast Tumor Size: Aggressive treatment is required for larger tumors.
Location of tumor: Tumors involving nipples or skin or in the central area of the breast will be treated using mastectomy or according to the requirements.
Node-Positive or Node-Negative: If breast cancer has spread to lymph nodes or not. Breast cancer that has spread to lymph nodes is called Node-Positive.
You should have a detailed discussion with your doctor about these factors and the treatment method suitable for you.
5.2.4 - Benefits of Breast Cancer Surgery:
Immediate and proper treatment of breast cancer is inevitable as soon as it is diagnosed. As breast cancer metastasizes to other organs if not treated on time. Therefore, breast cancer surgery is an effective and primary treatment method to cure breast cancer and to examine cancer growth in lymph nodes. Lymph nodes are the first place where breast cancer metastasizes. Breast cancer spreads to other organs after lymph nodes. Besides, the goal of breast cancer surgery is to take lymph node samples as well as removing the tumorous areas.
5.2.5 - Side Effects of Breast Cancer Surgery:
You may have these side effects of breast cancer surgical treatment:
- Recurrence of local breast cancer
- Chronic pain
- Lymph nodes removal
- Infection in cancer wound
5.2.6 - Breast Cancer Surgery Recovery Time:
Recovery time of breast cancer surgery depends on the type of surgery you have:
Mastectomy: It will take 7-21 days to recover from a mastectomy. You will remain in the hospital for 2-3 days after Mastectomy. Surgery sanitations will remain on for 1-3 weeks. Your doctor will remove these sanitations during surveillance visits. If you do not experience any side effects after surgery then incisions will take about a month to recover totally. If lymph nodes are removed during surgery then it can take a little longer to recover.
Normally, breast transplantation is done right after the mastectomy. But if your cancer type requires radiotherapy following by surgery then breast transplantation will be done after radiotherapy. Complete rest is recommended after mastectomy.
Lumpectomy: Lumpectomy is an outpatient procedure and takes 1-2 weeks to recover. Normally, you do not stay in the hospital overnight after surgery. But you may have surgical sanitation so don not resumes your daily tasks and have complete rest. If lymph nodes have removed during lumpectomy then it can take a little longer to recover.
The risk for breast cancer recurrence is higher after surgical treatment. It is recommended to visit your physician every six months after having breast cancer surgery. Your physician can ask you to visit every three months after surgery depending on your condition. Self-breast exam and chest-wall exam is advised every month after surgery. Mammogram every six months is advised for patients to have gone for Lumpectomy (Brest conserving surgery) Your doctor will advise you according to a proper follow-up plan for you.
5.3 - Breast Cancer Mastectomy
in this section, we will read about what is breast cancer mastectomy, who gets breast cancer matectomy, process, recovery time after mastectomy and side effects of breast cancer mastectomy.
5.3.1 - What is Breast Cancer Mastectomy?
In breast cancer mastectomy, complete breast cancer with tissues and lymph nodes are removed to treat cancer. Mastectomy surgical treatment is given if cancer has grown large in one or more areas of the breast. In such a case, breast cancer cannot be treated by Lumpectomy.
5.3.2 - Who does get Breast Cancer Mastectomy?
Breast cancer mastectomy is recommended in following breast conditions:
- First 3 breast cancer stages (I, II, III)
- Paget disease of the nipple
- Recurrent breast cancer (In this case, mastectomy will be given with radiotherapy and lumpectomy (breast-conserving therapy).
5.3.3 - Types of Mastectomy:
Following are the common types of Mastectomy:
In a skin-sparing mastectomy, the doctor removes whole breast tissues, nipple, and areola with nearby lymph nodes except the skin of the breast. This type of surgery is a beast for those women; tend to go for breast reconstruction after treatment. If radiotherapy is needed after mastectomy then breast reconstruction will be done after radiation.
Nipple-sparing mastectomy involves whole breast tissue removal with lymph nodes except breast nipple.
In a partial mastectomy, the doctor removes a quarter of breast tissues including a margin to treat breast cancer. A partial mastectomy is an aggressive form of lumpectomy (breast-conserving surgery). Comparatively, in partial mastectomy, a larger portion of breast tissue is removed than lumpectomy.
Simple / Total Mastectomy:
Simple or total mastectomy involves the removal of the whole breast including all breast tissues, areas of nipple and areola, and breast skin. Only the muscles of the chest wall and axillary lymph nosed that are not connected to the breast are left. Mostly, Simple or Total mastectomy is given to treat DCIS, or to avoid recurrence of breast cancer. In this case, the breast is not removed during one mastectomy but during several mastectomy sessions. This procedure is called prophylactic mastectomies.
Modified Radical Mastectomy:
In Modified Radical Mastectomy, the doctor removes the whole breast including an area of the nipple, areola and axillary lymph nodes except the muscles of the chest wall. Modified radical mastectomy is given to treat invasive breast cancer and to examine lymph nodes for breast cancer growth.
Radical mastectomy was a common type of breast cancer mastectomy. It is the most aggressive type of mastectomy where the whole breast with axillary and nearby lymph nodes, nipple, areola and chest wall muscles are removed to get rid of cancer. Now, radical mastectomy is done if cancer has invaded chest wall muscles.
Bilateral / Double Mastectomy:
When mastectomy is done on both breasts, it is called bilateral or double mastectomy. Bilateral/double mastectomy is only performed to reduce the risks of recurrent breast cancer in women with breast cancer family history. Mostly, total breasts are removed in double mastectomy or sometimes nipples are left.
Factors determining the type of mastectomy you should have:
A doctor will look through the following factors, which determine the type of mastectomy you should go for:
- Breast shape/size
- Type and stage of cancer
- Location of cancer
- If cancer has invaded into lymph nodes or not
5.3.4 - Breast Cancer Mastectomy Recovery:
Mastectomy is an inpatient treatment method. Generally, the patient has to stay for 1-2 nights after the surgery. Period of Breast cancer mastectomy recovery depends on the type of mastectomy you have. Mostly, a patient can resume regular activities after 3-4 weeks of surgery. If axillary lymph nodes have also removed during mastectomy then recovery time will be longer. Your physician and health care team will guide you through follow-up care after mastectomy.
5.3.5 - Breast Reconstruction after Mastectomy:
Breast reconstruction can be done right after mastectomy or of you need radiotherapy with surgery then it will be done after radiotherapy. Some women do not choose to have breast reconstruction. You need to decide and discuss to your doctor whether you want to go for breast reconstruction or not before going for surgery. Sometimes the choice of having or not breast reconstruction also determines the type of mastectomy.
Methods of breast reconstruction:
There are different methods of breast reconstruction, including:
Silicon Implantation: Saline or Silicone implants will be placed under chest muscles to form a breast shape.
Flap Implantation: Breasts will be formed with flaps of tissues and skin taken from other body parts.
5.3.6 - Side-effects of Breast Cancer Mastectomy:
Mastectomy is a verified surgical method to treat early breast cancer. There are also side effects of this type of surgery, including:
Tenderness and numbness: There are chances that some nerves may cut down during mastectomy. That can result in tenderness and dumbness of the site and nearby the area of surgery.
Seroma: Fluid accumulation under the surgery scar.
Hematoma: Blood accumulation under the surgery scar.
Delayed healing: Due to the cut of blood vessels, surgery wounds may not heal on time.
Infection in the site of surgery: infection could be caught from the place where surgery was performed.
Lump in the wound: After mastectomy or breast reconstruction, a lump can be formed in the wound of surgery.
Remember these problems are not serious or something to be frightened. Visit your doctor immediately if you experience any problem after surgery. Your doctor will treat it accordingly and advise you how to care properly.
5.4 - Lumpectomy (Breast Conserving) Surgery for Breast Cancer
In this section, we will read about breast cancer Lumpectomy also known as breast conserving surgery. Types, process, recovery time and side effects of Breast Lumpectomy.
5.4.1 - What is Lumpectomy? (Breast Conserving) Surgery for Breast Cancer?
Lumpectomy is a surgical method of removing cancerous area including margins in the breast to treat breast cancer.
5.4.2 - Types of Lumpectomy:
Technically Lumpectomy surgery can be divided into the following types:
Simple Lumpectomy: In Simple Lumpectomy, a breast tumor (a lump) including a rim of normal tissue around the malignant part (margin) is removed. A normal part of tissue will be tested for the growth of cancer cells. Unlike Mastectomy, Lumpectomy does not affect the shape of the natural breast. Therefore, you do not need to have breast reconstruction after Lumpectomy surgery.
Breast-Conserving Surgery: If cancer cells are found in normal tissues removed with tumor during surgery then Radiotherapy will be given for 5-7 weeks right after Lumpectomy. Lumpectomy with Radiation is called Breast-Conserving Therapy. If chemotherapy is also needed then radiation will be given after chemotherapy.
Excisional Biopsy / Sentinel Lymph nodes Biopsy: In some cases, axillary lymph nodes are also removed to examine if the cancer is limited to its origin or have grown to the other parts. This is called Excisional Biopsy.
Quadrantectomy / Partial Mastectomy: Sometimes, a quarter of abnormal area (roughly) with normal tissues is removed. This is called Partial Mastectomy / Quadrantectomy. You should discuss with your doctor about the size of breast tissues that will be removed. As sometimes you may need breast reconstruction after this type of breast Lumpectomy.
5.4.3 - Purpose of Lumpectomy:
The primary goal of Lumpectomy is to remove a sufficient amount of abnormal and normal breast tissues while not damaging the breast’s normal structure. Lumpectomy surgery is used to treat Invasive breast cancer i.e. IDC and ILC and DCIS too.
Lumpectomy is also used to diagnose the growth of cancer cells. The normal tissues rim (marginal tissues) and axillary lymph nodes removed in Lumpectomy or Excisional Biopsy are tested in the laboratory for cancer cells. If cancer cells are found in these areas then the doctor will determine further treatment for breast cancer.
5.4.4 - Determining Factors of Lumpectomy:
The women who have diagnosed with invasive breast cancer, that is confined to its local area and has not invaded chest wall or skin, are most likely to get Lumpectomy surgery. These factors determine if the patient needs lumpectomy:
- Size of the tumor and breast
- Location of the Tumor
- Type and stage of the Tumor
Lumpectomy is preferred in an earlier stage of cancer.
5.4.5 - The procedure of Lumpectomy:
Following is the procedure of breast lumpectomy:
- First, targeted breast with arm and chest area will be cleaned
- Now your surgeon will make an opening cut on the targeted area of the breast leaving the areola.
- Then, it cuts out the tumorous area with a small number of normal tissues.
- If surgery includes the removal of axillary lymph nodes, then another opening cut will be made around the underarm. Lymph nodes will be removed for testing.
- After removing the targeted tissues in breast and lymph nodes, the doctor will stop bleeding. If your doctor inserts a drainage tube to stop bleeding then it will be removed now. The wound will be dampened, stitched and bandaged. These stitches dissolve with time.
The surgical procedure takes 1-3 hours in total. The doctor may recommend an ice bag to place on the surgery site for 24 hours to release the inflammation.
5.4.6 - Lumpectomy Recovery Time:
Lumpectomy surgery’s recovery time depends on a patient’s health condition, type of lumpectomy and doctor/patient’s preferences. Most women are discharged from the hospital the same way after Lumpectomy surgery. In some cases, a patient may need to stay for 1-2 days in the hospital after surgery.
Most women are ready to resume their routine work after 1-2 days. If you have gone for Quadrantectomy in which a quarter of the breast has removed then it will recover slowly. If you have removed axillary lymph nodes then it can take 1-2-weeks to recover. Your doctor will prescribe you medicines that will help you to heal and relieve the pain.
5.4.7 - Follow-up Care and Results:
Your doctor and health care team will guide the caring process of the surgery at home. You will have to go for follow-up visits for 10-14 days after surgery. As your doctor can check for any complications and development in recovery.
In the follow-up period, you will get your Lumpectomy results. Usually, the test results describe breast cancer characteristics i.e. tumor size, if the cancer is local or has spread beyond the local area and if the cancer is ER/PR positive. This will determine the further treatment plan that you and your doctor will discuss.
5.4.8 - Side Effects of Lumpectomy
Today, Lumpectomy is the preferred surgical method by doctors and women to treat breast cancer. As Lumpectomy, surgery is less damaging for breast than Mastectomy. However, Lumpectomy has some side effects, including:
Numbness: The patient can feel numbness or lack of sensitivity on the site of Lumpectomy surgery. However, the sensitivity will retain over time.
Change in breast size: The major reason for choosing Lumpectomy over Mastectomy is to reserve the natural breast size and shape. However, Breast size can decrease after Lumpectomy because of the removal of breast tissues. This change may not be noticed right after surgery because of swelling. Is such a case, women can go for breast reconstruction surgery after some time of Lumpectomy to regain the size of the breast.
Pain or infection: These are less common issues of Lumpectomy. You should contact them immediately if you experience any of them. Swelling is a normal thing after surgery that will diminish after 2-3 days of surgery.
5.5 - Radiation Therapy (Radiotherapy) for Breast Cancer Treatment
In the following section, we will read about Radiation Therapy also called "Radiotherapy" for breast cancer. Types, determining facts, side effects and tips to treat side effects of breast cancer radiotherapy.
5.5.1 - What is Radiation Therapy (Radiotherapy) for Breast Cancer?
Radiation therapy (Radiotherapy) is a method of shrinking tumors and killing breast cancer cells using high-energy X-rays. Radiation affects cells in the part of the breast that is being treated only.
5.5.2 - How Does Radiation Therapy Works for Breast Cancer?
Usually, radiation therapy for breast cancer starts after 3-4 weeks of breast cancer surgery. It kills remaining cancer cells in the breast or axillary area and lowers the risks of breast cancer recurrence. Radiotherapy is also given to women who have developed metastatic breast cancer in their bones. In such cases, radiotherapy is given as a part of adjuvant therapy to prevent breast cancer from recurring.
Radiation oncologist (the health professional gives radiotherapy), will discuss cancer treatment with you before going for radiotherapy. Before radiotherapy, a CT scan of your breast will be performed to check and mark the area that needs to be treated.
5.5.3 - Who does Get Radiation therapy?
Radiation therapy is not recommended for all breast cancer patients. It is given under special circumstances. Normally, oncologists recommend radiotherapy:
- To treat cancer cells left in the chest or underarm area after a mastectomy
- After Lumpectomy (Breast-conserving surgery) to treat breast cancer stage 0-1
- After Chemotherapy to treat invasive breast cancer
- In cancerous lymph nodes, chest wall area or collarbone
- If a patient has a higher risk of breast cancer recurrence especially in breast cancer stage 3 and stages 4
You should discuss your on-going breast cancer treatment plan with your radiation oncologist. This will help your oncologist to be ensured if it is effective in your situation.
5.5.4 - Determining Factors of Radiation Therapy:
Radiation Oncologist analyzes the following factors to decide what kind of radiotherapy is appropriate for the patient:
- Size of tumor
- Grade of tumor
- How many lymph nodes have cancerous cells
- If cancer cells are detected in margins removed during Lumpectomy/excisional biopsy
- Age of the patient
5.5.5 - Types of Breast Cancer Radiation Therapy:
Following are the two main types of breast cancer radiotherapy:
External Beam Radiation for Breast Cancer:
External beam radiation is also called whole breast or traditional radiation therapy. It uses radiation beam (rays) externally like a traditional X-ray machine. In External beam radiation, targeted areas of breast or underarms are exposed to high-energy X-rays for 2-3 minutes. If a patient has gotten breast cancer reconstruction, then the targeted area will include reconstructed breast as well.
External beam radiation includes multiple sessions. It is given for five days a week and continues for 5-6 weeks regularly. In some cases, accelerated radiation is considered for invasive breast cancer treatment. During accelerated radiation, a high dose of radiation is given over the short course (usually for 3-4 weeks).
A high dose of radiation can be damaging for the lungs and heart. Therefore the machine of external beam radiation is designed to minimize the radiation exposure to the chest and normal tissues from getting rays. However, in some, it is not possible to avoid the heart and lungs with whole breast radiation. In such cases, the breast hold technique is used. The patient is asked to hold her/his breath during the radiation session. Another technique is to use proton rays, instead of a photon (x-rays). Proton rays transfer in cancerous areas only and do not penetrate in the lungs or heart.
External breast cancer radiation used to be the most common type used for breast cancer. However, in more recent years, internal radiation clinical trials have enabled more women to opt for this method if their cancer was caught early enough. Internal radiation typically offers fewer noticeable side effects.
Internal Radiation for Breast Cancer:
External beam radiation is the most common type of radiotherapy to treat breast cancer. But it also causes damages to normal tissues. That is why Internal Radiation for breast cancer is being practiced for a few years.
Internal radiation is also called Partial radiation. In this type of radiotherapy, radiation, in a form of fluid is injected using wire, tube or needle in the cancerous areas of the breast. It is equally effective and less damaging on other body parts. Most women are choosing Internal radiation for treatment.
The oncologist will choose the appropriate type of radiotherapy according to your health condition. Sometimes, breast cancer is treated using both types of radiation therapy.
5.5.6 - Breast Cancer Radiation Therapy Side Effects:
Radiation therapy is a painless method of breast cancer treatment. However, it has some side effects including skin burning. The patients who get radiation after mastectomy, experience severe kind of skin burning after some days of radiation therapy. While after lumpectomy, skin burning is not that severe as radiation targets tissues of the breast and not the skin.
However, the side effects of radiotherapy person-to-person vary. These are the most common side effects of breast cancer radiation therapy:
- Breast Swelling
- The color of your skin may grow dark during radiation
- Thicker or hardened breast skin
- Breast or chest skin may grow tender
- You may feel tired during weeks of radiation sessions
- You may feel less appetite
5.5.7 - Tips to Treat Breast Cancer Radiation Therapy Side Effects:
You should consult with your doctor if you are facing the side effects of breast cancer radiation therapy. Your doctor will recommend a cream/moisturizer and mild soap for skin related problems like burning or soreness.
Here are some tips that you can use to treat the most common side effects of breast cancer radiotherapy:
- Don’t use any deodorant right after radiation therapy or ask your doctor before using it.
- Wear loose cotton shirts and bras after radiotherapy. Tight bras can cause swelling, itching, and inflammation
- Aggressive breast cancer treatments can cause tiredness. Keep your diet full of nutrition and take proper rest during the treatment
- However, giving your body a proper rest is beneficial. Yet doctors recommend mild exercises to keep your body stress free after radiotherapy.
- Sometimes you can feel the change in your breast size or your lungs or heart can be effected after radiation therapy. If you feel these kinds of side effects, visit your doctor immediately and talk about your condition. Your doctor will check you and recommend the treatment.
6 - Male Breast Cancer Causes, Symptoms, diagnosis & treatments
Male and female both are born with breast tissues and cells. The male breast does not develop for lactation still male breast tissues and cells can grow cancer. However, breast cancer in men is very rare in comparison to female breast cancer. There are less than one-in-hundreds of breast cancer case is male breast cancer and only one-in-thousand males will be diagnosed with breast cancer.
Commonly observed sign of breast cancer in men is a hard lump under areola and nipple. Because breast cancer is not so common in males, the lump is not considered as cancer and not diagnosed and treated on time, which increases the ratio of death with breast cancer in men.
6.1 - Types of Male Breast Cancer:
- Infiltrating Ductal Carcinoma - a Most common type of breast cancer in men is Infiltrating Ductal Carcinoma – IDC. With IDC in males’ cells around or in breast ducts, start spreading to breast tissues.
- Papillary Carcinoma is the second most detected type of breast cancer in males.
- Lobular Carcinoma - is an uncommon male breast tumor.
- Chances of getting Inflammatory breast cancer or benign breast disease i.e. Paget disease is less than 0-1 in men.
6.2 - Causes of Breast Cancer in Males:
Genetic and environmental causes have been known for male breast cancer. These are the studied risk factors linked to male breast cancer; most of them are similar to female breast cancer:
- If there is a history of benign breast disease
- Cancer-related to BRCA2 gene is caused by a genetic mutation
- If there is a history of testicular disease
- Family breast cancer history
- If you have been exposed to radiation
- Positive estrogen hormone – may cause by obesity, thyroid dysfunction or liver diseases.
- Men with the syndrome of ‘Klinefelter’ are at higher risk, equal to women, of developing breast cancer
Moreover, studies suggest that men have breast cancer, produce estriol at a high level that is linked to hormones and genes cause breast cancer.
6.3 - What Are the Symptoms and Signs of Male Breast Cancer:
Breast cancer in males can be identified with the same signs and symptoms as female breast cancer i.e.
- Breast Pain
- Swelling in breast tissues
- Red or scaly patches on the skin
- Fluid discharge from the nipple
If a man or woman observes any abnormality in his/her breast, they shouldn’t ignore and must go for complete checkup and diagnosis. Therefore, proper treatment could be taken. The mortality rate of breast cancer is equal in males and females. Detection of breast cancer at early stage multiplies cure possibilities and lowers the death risk caused by breast cancer.
6.4 - How to Diagnose Male Breast Cancer?
There is not sufficient awareness and education about male breast cancer, which is the biggest reason for late breast cancer diagnosis in males. About 40% of patients have already stage iii or iv of cancer when detected. Usually, a painless lump or permanent swelling under areola is found in male breast cancer. These are the diagnosis methods for male breast cancer:
Mammography: A mammography screening also is helpful in male breast cancer diagnosis.
Biopsy: If mammography results could not confirm the presence of a breast tumor, a fine-needle-aspiration-biopsy will approve the analysis.
Hormone Receptors: Doctor will check estrogen with progesterone receptors for cell tumor. Studies suggest about 80% of breast tumors in men have positive hormone receptors.
Genetic mutation Testing: According to studies if a male carries defective genes BRCA1 or BRCA2, about 7% are possibilities to develop breast cancer.
Also, a man can transfer cancerous genes to his offsprings. A female child of a male with breast cancer is at risk of developing breast cancer with 40% to 80%. Moreover, Male with these genes BRCA2 and BRCA 1 have chances of getting prostate cancer at an early age. Genetic mutation testing is necessary to diagnose male breast cancer.
6.5 - Treatment methods of Male Breast Cancer:
There are the same treatment methods for male and female breast cancer including:
- Surgical Therapy (Mastectomy followed by Chemotherapy)
- Clinical Trial
Follow up Care:
Men who were diagnosed with initial breast tumor before the age of 50 are at the highest risk of developing inflammatory breast cancer. That is why males have had cancer are advised to go for regular checkups and screening. They are at a higher level of developing inflammatory breast cancer.
Informed is healthy! In this article, I have shared primary information about breast cancer for breast cancer awareness. Please contact your doctor in any serious case and to better understand your individual condition.
7. Breast Cancer Facts
- Breast cancer is the most common cancer among women and second foremost death cause in women around the world.
- In the U.S: 1 in 8 women is diagnosed with breast cancer and over 3.3 million women have survived breast cancer.
- Approximately, one woman is diagnosed with breast cancer in every 2 minutes and 1 woman is died with breast cancer every 13 minutes.
- Though breast cancer in men is not common, approximately 2,470 males are diagnosed with breast cancer and 460 die every year.
- After a reduction in hormone replacement therapy after menopause, there is observed a gradual decline in breast cancer ration in 50+ women.
- Due to improved breast cancer treatment options, early detection and advanced screening / diagnosing methods, a significant decline in death rate has been observed for 1990.
7.1 - Breast Cancer Awareness Month
Breast Cancer Awareness Month is a yearly breast cancer awareness campaign starts on October 1 – October 31 every year. This breast cancer awareness campaign is held by breast cancer charitable organizations all around the world to collects funds and to raise breast cancer awareness among women and men. The funds raised from breast cancer campaign are used for further breast cancer research, breast cancer diagnosis, breast cancer treatment, breast cancer prevention and breast cancer support.
8 - Glossary of Breast Cancer Terms
95% CI (Confidence Interval) – A mathematical term to measure the survival rate in percentage.
Ablation – disabling a body part by different therapies like radiation, hormonal therapy or surgery.
Abraxane – A name of a drug used in breast cancer chemotherapy.
Absolute Risk – A human being’s risk of growing disease in a particular course of time.
AC chemotherapy – A mixture of drugs of chemotherapy Cyclophosphamide and Doxorubicin.
Acupuncture- A type of alternative medicine therapy that helps to heal after breast cancer treatment by inserting thin needles in the skin.
Adjuvant Therapy (Treatment) – Additional therapies are given after primary therapies (like chemotherapy, surgery or radiotherapy) to treat breast cancer have spread in other organs.
Advanced Breast Cancer – Stage IV of breast cancer also known as metastatic or secondary breast cancer in which cancer has advanced outside of the breast and local lymph nodes (in underarms) to other body parts.
Adverse Effect – Treatment’s side effect.
Alopecia – Baldness
Alternative Medicine Therapy – A different kind of therapy used to lessen pain or side effects on the body caused by primary treatment therapy (surgery, radiotherapy or chemotherapy) for cancer.
Amenorrhea –Missing menstruation continuously for three months
Anemia – Shortage of hemoglobin or red blood cells in the body.
Anastrozole – a kind of hormone therapy also known as Arimidex.
Anesthesia – Artificial pain insensitivity by using drugs or injections before surgical therapy.
Aneuploidy – The existence of an irregular number of chromosomes in body cells.
Angiogenesis – The development of new blood vessels that increase the growth of new body cells.
Anthracyclines – Chemotherapy drugs to treat breast cancer.
Antibody – A medicine to increase the body's immune system.
Anti-carcinogen – A drug to fight elements that cause cancer in the body.
Anti-emetic – A drug to stop nausea/vomiting.
Antigen – A drug to strengthen the immune system in a body.
Antioxidant – A drug to protect the body from harm caused by oxidizing agents in the body.
Apoptosis – A process of normal cells that cause cell division and cell death. In cancer, apoptosis may block.
Areola – The dark circled area beneath a nipple on the breast skin.
Aromatase Inhibitors – A drug used to treat women breast cancer with positive hormone receptors- This drug cut down the body’s estrogen level.
Ascites - Fluid accumulation in the middle of peritoneum layers.
Aspirate – Removing fluid by suction from body vessels.
Atypical Hyperplasia – A noncancerous breast disease in which the growth of breast cells increases. This condition of the breast can increase breast cancer risk.
Autologous – Using tissue and skin grafts from a patient’s own body to reconstruct a breast.
Axilla – The area under the arm, commonly called armpit.
Axillary Clearance – Removing all axillary lymph nodes with surgery.
Axillary Lymph Nodes – The lymph glands in the area of underarm.
Axillary Sampling – Removing some of the axillary lymph nodes as a sample to diagnose the breast cancer presence.
Benign – non-malignant, not cancerous.
Benign Breast Disease - Noncancerous breast disease or abnormal condition of a breast, which may appear as lumps or swellings.
Breast-Conserving Surgery – A kind of surgical therapy (also called Lumpectomy) in which cancer cells and tissues are removed from a particular area of the breast only.
Benign Phyllodes Tumor – A less common noncancerous breast disease in which painless lump or swelling appears in the breast.
Bevacizumab – Blocking the blood supply in tumor cells and stopping them from developing. This targeted therapy is also called Avastin.
Bilateral – Involving or affecting the right and left both sides of the body.
Bilateral Mastectomy Surgery – In bilateral mastectomy surgery, both breasts are removed. Bioimpedance – Bioelectrical Impedance Analysis that measures the quantity of fluid in tissues.Biological Therapy – A type of targeted therapy (also known as immunotherapy) that fights cancer cells by developing the immune system in the body.
Biomarker – A method to measure body response to a certain treatment.
Biopsy – A diagnosis method for breast cancer that involves removing some of the body tissues to test for tumor cells.
BI-RADS (Breast Imaging Reporting and Data System) - A standard system to define the mammogram findings.
Bisphosphonates – A drug group used to prevent secondary breast cancer effects in the bone. Also, used to prevent risks of re-occurrence of primary breast cancer.
Blood cells- All types of cells flowing in the blood.
Blood count – A method to measure the number of blood cells in the given blood sample.
Body Mass Index, BM – A method to calculate body fat.
Bone Marrow – A substance in bones that is responsible for producing the blood cells.
Bone Metastases – Secondary breast cancer that has spread to the bones.
Bone Scan – A method to analyze the cancer signs or any abnormality in the bones.
Boost – Extra dose of radiotherapy to treat breast cancer.
Brachytherapy – A targeted treatment of cancer in which radiation is inserted directly into the tumorous tissues.
Brain Metastases – A state of secondary breast cancer in which the tumor has spread to the brain.
BRCA1, BRCA2 – Types of genes that may increase the risk of growing breast cancer.
Breast Calcification– Areas of the breast with calcium deposits normally appear in a mammogram.
Breast Cancer Advocacy – Promotion for breast cancer issues support.
Breast Cancer – An abnormal growth of cells in the breast.
Breast Care Nurse – An individual provides help and info to the patients of breast cancer.
Breast Density – A method to measure the amount of fat and tissues in the breast.
Breast Reconstruction Surgery – Reconstructing the physical look of a breast after surgery.
Breast Self-Examination, BSE – Checking the breast by own self for normal and abnormal feels and looks.
Breast Tomosynthesis– Digital tool that takes 3D X-ray mammogram images of a breast.
Breasts – A glandular part of the body having lobules and ducts bordered with fatty tissues.
Cancer – A disease with 100+ types caused by abnormal cells growth
Capecitabine – A chemotherapy medicine
Carboplatin – A chemotherapy medicine for breast cancer
Carcinoma – A medical term to define cancer
Carcinoma in situ – Primary phase of breast cancer where the tumor is limited to its local place. “In situ” means in place and has not spread beyond milk ducts or lobules.
Cardiotoxicity – Cardiac damage caused by chemotherapy or targeted therapy medications.
Catheter – The tube used to remove or provide fluid to the body.
Cell Proliferation – Cells’ abnormal growth
Cells – Small functional units of all living beings’ bodies that consist of a nucleus, cytoplasm and surrounded with a membrane.
Cellulitis – An under the skin disease of skin and tissues.
Centigray – A unit (RAD = Radiation absorbed dose) to describe the radiation amount taken by a body
Chemoprevention – A treatment to prevent the risk of developing breast cancer
Chemotherapy – A treatment to reduce or kill the cancer cells
Chest – The upper part of the body describes the area between the neck and the bell.
Chronic – A long-lasting illness
CISH, Chromogenic in situ Hybridization – A measurement of HER2 level in cancerous cells.
Cisplatin – A chemotherapy medicine for breast cancer treatment.
Clear margin – The area of noncancerous tissues around cancer tissues
Clinical Breast Examination, CBE – A clinical checkup to examine any abnormalities in the breast
Clinical Trial – Study to test the advantages of potential new treatment methods for a certain disease.
CMF – A mixture of 3 chemotherapy medicines (5FU, methotrexate, and cyclophosphamide).
Cognitive – A function that makes the mind capable of understanding and comprehending the problems
Cognitive Impairment – Also mentioned as chemo fog or chemo brain, is a mental side effect of cancer treatment that causes trouble in concentration and short memory loss.
Cohort Study – A study involves a great number of people at a time
Colony-stimulating factors – A medicine used to increase the production of blood cells in a body after chemotherapy
Complementary Therapies – Alternative medicine therapies given to release the side effects of primary treatments on a patient’s body.
Computed axial tomography, CAT scan – 3D X-ray images of the body
Computer-assisted detection, CAD - A computerized program to enhance the affected areas on a mammogram.
Contralateral – Opposite / other side
Cording – Underarm web syndrome, stretching of the tight muscles of tissue
Core Needle Biopsy – Biopsy is done by taking tissue sampling with deep needle for cancer
Co-Survivor – Breast cancer supporter
CT Scan - Computerized tomography, complete internal body scan with computer X-ray images
Cumulative Risk – Ratio of breast cancer risk during a lifetime
Cyclophosphamide – Name of a drug used in breast cancer
Cyst – Swelled skin filled with fluid
Cytopathologist – An individual, specialized in body cells analysis
Cytotoxic – Method of the killing of cells, an alternative term used for chemotherapy
DCIS, Ductal Carcinoma in Situ – Also known as 0 stages/ non-invasive / intraductal in which tumor is developed in its local place but has not spread to other parts of the body.
Definitive Surgery – Complete removal of cancer from the body where no subsequent surgeries are required
Denosumab – A targeted treatment for advanced breast cancer in bones.
DEXA Scan - Dual-Energy x-ray Absorptiometry scan to analyze bone’s damage or fracture due to cancer treatments
Diabetic Mastopathy – A less common breast disease (benign) that is observed in diabetic women dependent on insulin. Small lumps in breasts are found in this disease.
Diagnosis – Disease detection by its symptoms and signs
Diagnostic Mammogram - A clinical checkup of the breast for cancer symptoms using mammogram screening (X-ray)
Radiologic Technologists – Also known as, diagnostic radiographers or radiographers are medical professionals, specialized in X-ray and scans to diagnose a disease
DIEP Flap, Deep Inferior Epigastria Perforator – A method of breast reconstruction by taking the fat and skin flaps from an area between abdomen and legs
Differentiation – A scale to evaluate cancerous and normal cells
Diploid – A normal number of chromosomes in a cell, which is 2 (1 from each parent)
Disease-Free Survival Rate – An average living period of people without cancer after getting treatment
Distant Recurrence – An alternative name for metastatic, stage 4, advanced or secondary breast cancer that has spread beyond its local tissues towards another body
DNA, Deoxyribonucleic Acid – Gene’s data
Docetaxel – A drugs group used in chemotherapy for breast
Dose-Dense Therapy – A way of chemotherapy where therapy sessions are shortened and frequent than standard chemotherapy sessions
Down-Staging – A method of lowering the cancer stage by limiting or shortening tumor cells through Neoadjuvant therapies (like hormone therapy or chemotherapy)
Doxorubicin – A name of chemotherapy medicine
Drug resistance – The ability of cancer cells to resist the drug's effect
Duct – Milk tube that passes milk to the nipple through lobules in the breast
Early Breast Cancer – Stage I, II breast cancer where cancer has spread to axillary lymph nodes or is in the breast only
Edema – Extra body fluid that becomes a cause for swelling
EGFR, Epidermal growth factor receptor – Proteins level on the cells
Embolism – a blockage in blood flow
Encapsulated – Wrapped, for example, implanted breast that is wrapped with fibrous tissue.
Endometrial Cancer – Cancer of the inside layer of the uterus
Enzyme – Protein in the body that boost up biological reactions
Epidemiology – A study of preventions and causes of specific disease
Epirubicin – A medicine name of chemotherapy for breast cancer
ER status – Status of estrogen receptors. ER status is determined as ER+ (if breast cancer has positive estrogen receptors); ER- (if breast cancer does not has estrogen receptors). ER status decides treatment methods for breast cancer.
Eribulin – A drug used for Breast cancer chemotherapy
Erythrocytes – Blood cells that carry lungs oxygen through the body and transfer carbon dioxide to the lungs from the body cells
Estradiol – Organic estrogen in females
Estrogen – Primary hormone in females responsible for reproduction
Estrogen receptor test – A test done to analyze ER status for breast cancer. If estrogen receptors are positive that means cancer cells need estrogen to grow.
Estrogen Receptors – Particular cells proteins linked to estrogen hormone
Etiology – Causes of specific disease
Everolimus – Secondary breast cancer’s targeted treatment
Excision Biopsy Surgical – Complete removal of the cancerous part of the breast
Exemestane – A drug used of hormone therapy for breast cancer
Expander implant – A method of breast implantation using saltwater
False Negative – Incorrectdisease test report in which result shows that the person is not suffering from that specific disease but actually, the person has that disease
False Positive - Incorrectdisease test report in which result shows that the person is suffering from that specific disease but actually, the person has not that disease
Family Medical History – A record of blood relations health history that helps to analyze disease genetic factor
Fat Necrosis – A non-cancerous breast condition where the breast has an uneven shape. This change in the breast does not develop breast cancer risk
FEC-T – A group of chemotherapy drugs used to treat breast cancer
Fibroadenoma – A benign fibrous cancer that normally occurs in young females
Fibrocystic Changes – A noncancerous (benign) condition that causes painful lumps and swelling in the breast
FNA, Fine Needle Aspiration – an alternative term used for Biopsy
First-Degree Relative – Direct blood relation like father, mother, brother, sister, and child
First-Line Therapy – Initial cancer treatment given to a patient
FISH, Fluorescence in situ Hybridization – A scale to measure the level of HER2 in tumor cells. FISH+ indicates excessive HER2 level, FISH- indicates normal HER2 levels
Flow Cytometry – A cancer tissue test to determine the growth rate of the tumor and to assess cell’s DNA rate
Fluorouracil – 5FU, A breast cancer drug used in chemotherapy
Fraction – Every radiotherapy session is called ‘fraction’. Multiple fractions are given to treat breast cancer
Frozen Section – A part of a surgical biopsy where tissues are frozen of a body section to take a sample for cancer diagnosis.
Fulvestrant - A type of hormone therapy used to treat secondary breast cancer in postmenopausal females
Gail Model – A tool to assess the risk of developing invasive breast cancer by family medical history
Galactocele – Breast swelling filled with milk
GCSF, granulocyte-colony stimulating factor – A medicine to increase white blood cells in the body that has decreased in chemotherapy
Gene – Primary body element carries the inheritance
Gene Mutation – changes or transformation in genes
Genetic – Inherited
Genetic counseling – A method to educate and pass information to people with the risks of genetic disorders, which may help them to reduce disease risks
Genome –Complete genetic data of a living being
Genomics – Genes’ study
Glandular Tissue - Breast tissue including lobules and milk ducts
Grade – A method to categorize noncancerous and cancerous cells and cells ability to grow cancer
HER2, human epidermal growth factor receptor 2 – The protein linked to cells growth
HER2neu receptor – HER2 receptor found on cancerous cells of the breast
Hereditary Characteristics – Diseases or abnormality that can be transferred to children from their parents
Hickman line – A thin silicon tube to give Chemotherapy drugs
Hormonal therapy – A method to treat breast cancer with ER+ breast cancer
Hormones – Substances produced in a body by tissues and glands and are responsible to regulate cells and organs growth and reproduction system
HRT, Hormone Replacement Therapy – A treatment to normalize and control hormone level in menopausal signs of breast cancer
Hypercalcemia – Increased calcium level in the blood caused in bones affected by secondary breast cancer
Hyperplasia – A benign breast condition where cells growth is increased
IBC, Inflammatory Breast Cancer – An aggressive and rare type of invasive breast cancer with the symptoms of swelling and redness on the breast skin. See Inflammatory Breast Cancer
HIS, Immunohistochemistry – A test to check HER2 level on the sells surface
Immune response - Body’s ability to resist infections
Immune system – Natural system of the body to resist diseases and infections
Immunosuppression – Body’s decreased ability to fight against infections and diseases. Normally Chemotherapy can weaken Immunosuppression.
Immunotherapy - A method to fight cancer by increasing the immune system.
Breast Implantation: A silicon pouch attached with breast to enhance breast shape after mastectomy surgery
In situ: In place, breast cancer that has not spread to the other parts of the body
Incisional Biopsy – Targeted biopsy in which only affected cancerous part is removed
Invasive Breast Cancer – Developed breast cancer that has spread to the other parts of the body from lobules and milk ducts
Kadcyla /TrastuzumabEmtansine - The targeted method to treat breast cancer with HER2 positive
Ki-67 – Proteins that are responsible for cells growth and division
Ki-67 Rate – A method to check the Ki-67 level in cells. The higher the level the more cells grow swiftly
Lactation – Milk producing and feeding on breast
LCIS, Lobular Carcinoma in Situ – An initial type of breast cancer in which malignant cells develop in breast lobules
LD, LatissimusDorsi flap – reconstructing breast by using fat and skin grafts from the shoulder
Lesion - A Tissue’s abnormal area
Liquid Biopsy – A method to test advanced breast cancer by measuring cancer cells that are floating in the body
Lobe – Breast tissue responsible for milk-producing
Lobule / Lobules – Small round shaped bags inside breast lobes
Local Recurrence – Cancer’s reappearance to the same breast area where appeared earlier
Local therapy – Targeted therapy to kill tumor cells in the local area where cancer occurs
Localized Breast Cancer – Alternative term used for non-invasive, DCIS
Locally Advanced Breast Cancer- Stage III of breast cancer where the tumor is spread beyond its local area to chest wall or skin but has not approached other organs like liver and lungs
Lump – Accumulated hard mass in the body
Lumpectomy – Targeted breast surgery where only cancerous part of the breast is removed
Lymph – Body fluid that flows through arteries and keeps tissues firm and clean
Lymph Node Status – A test to check if the tumor has spread to lymph nodes or not
Lymph Nodes – Swelling of glands in the lymphatic system
Lymph Node Negative(Node-Negative) – Tumor that has not developed in lymph nodes Cancer that has not spread to the lymph nodes. See Lymph Node Status.
Lymph Node-Positive (Node-Positive) – Cancer, is grown to lymph nodes
Lymphatic System – Lymph and vessels network where lymph nodes are filtered through the body
Lymphedema – Swollen part of the body due to bad lymph nodes filtering after surgery or radiation therapy
Lymph – Tumor attack to the breast lymph and blood vessels
Malignant – Deadly infection that can spread through the body parts
Malignant Cancer – Invasive cancer cells that have developed and spread to other organs
Mammary Duct – Milk duct
Mammary Duct Ectasia – A benign breast disease with swollen ducts under the nipple that can cause pain or irritation around the nipple
Mammary Glands – Milk producing glands in the breast
Mammogram – A diagnosis tool that detects affected areas in the breast using X-ray
Margins – Noncancerous/normal area surrounding the abnormal/cancerous cells
Mastectomy – Surgical treatment of cancer where a complete cancerous area of the breast is removed
Mastitis – breast irritation and swelling occurs during breastfeeding that can cause pain, redness, lumpiness, fever and nipple discharge
Medical Oncologist – A doctor specialized in cancer treatment using hormone therapy, chemotherapy, and targeted therapy
Menarche – The first menstruation period
Menopausal Hormone Therapy – As known as Hormone Replacement Therapy in which hormonal drug with estrogen-progestin are given to women during menopause to ease the menopausal period
Menopause – End of the menstruation in females normally in the late forties and early fifties
Metastases (short ‘Mets’)– Plural of Metastasis. An alternative term used for Secondary Breast cancer
Metastasis– The process of cancerous cells travel through the body via the lymphatic system
Metastasize – The process of metastasis
Metastatic Breast Cancer – Advanced breast cancer where cancer has spread to other organs of the body like liver, lungs
Microcalcifications – Calcium small deposits in the breast that appear as small white dots on the breast skin and can occur in DCIS
Microvascular Surgery – Surgery that involves small vessels of blood
Modified Radical Mastectomy – Early treatment of advanced breast cancer where cancer is stopped by removing complete cancerous breast
MRI, Magnetic Resonance Imaging – A complete body scan using magnetism linked to a computer that generates images of the inner body. MRI is the most strong tool if body scan also, the body is not exposed to radioactive rays during imaging
MultiCentric (Multifocal) – Cancer is divided into small portions into different parts of the same breast
Multifocal / MulticentricTumors – The tumor developed from regional breast tumor
Multimodality Therapy – When two therapies like chemotherapy, radiotherapy or surgery are applied as a group or step-by-step to get better results of treatment
Neo-adjuvant Cancer Treatment – When hormone therapy or chemotherapy is given before the primary surgical treatment to shrink the tumor in tissues
Neoplasia - Abnormal cell growth
Nipple-Sparing Mastectomy – A breast surgical therapy where cancerous tissues with margins are removed but nipple and areola are left intact.
Non-Invasive – cancer that has not developed beyond lobules or ducts. Known as 0 stages or Carcinoma in situ
No palpable – Abnormalities that normally cannot be felt but can be detected on a mammogram screening
Normal Tissue – Healthy cells, noncancerous cells
Nuclear Medicine Imaging of the Breast – Also known as Molecular Breast Imaging that is an understudied technique for primary detection of breast cancer. There are given radioactive agents through iv contrast that is absorbed by cells and imaged with a camera. Thus, cancer can be detected early. Breast specific gamma imaging is a type of Nuclear Medicine Imaging.
Occult Breast Cancer – Breast cancer, which is usually diagnosed during the treatment of some other parts of the body but can’t be detected on mammogram screening or doesn’t show signs of breast cancer.
Oestrogen Receptors(ER, Estrogen) – Cells proteins linked to female reproductive hormones and can grow cancer
Oligo-metastatic Disease - Oligo for ‘few’, ‘little’. An even and minor secondary breast cancer that is present in a small area of the breast and not developing further.
Oophorectomy – Removing ovaries with surgery
OSNA, One Step Nucleic acid Amplification – A test done during surgical therapy to check if the tumor has spread to axillary lymph nodes
Osteopenia – A method to measure bones strength that cannot be detected during osteoporosis
Osteoporosis – A bone disease in which bones are weakened mostly in a result of chemotherapy or radiation therapy
Ovarian Suppression / Ablation – A method to stop ovaries from producing estrogen with medication or surgery.
Over-Diagnosis – Non-invasive or initial invasive breast cancer that is not shown or found through symptoms unless mammogram is performed.
Over-Treatment – The treatment given to DCIS or early invasive breast cancer that would have never detected if not diagnosed or treated. Such small breast cancer is not malignant or become a cause of death.
Paget Disease of the Nipple / Breast - An uncommon type of cancer on the nipple skin or around the nipple that can be a symptom of developing DCIS or invasive breast cancer under the skin.
Palliative Care Consultant – A team comprises doctors, nurses, social workers, and psychotherapists who work in palliative care.
Palliative Care/Palliative Therapy/Palliation – A Soothing and relaxing method of healthcare for patients with incurable cancer. It focuses on controlling the cancer symptoms and progress, pain-relieving therapies rather than disease curing treatments.
Palliative Care Nurse: A nurse who takes care of patients suffering from incurable cancer.
Palpable – Abnormalities in breast like a lump, which can be felt with hands during a clinical breast exam.
Palpation – Examining the body using fingers and hand to detect the disease
Partial Mastectomy – Alternative term used for Lumpectomy
Pathologic Response – A method to measure the neoadjuvant therapy response on cancer and lymph nodes
Pathologist – The doctor examines lymph nodes and breast tissues samples removed during a biopsy for cancer cells
Pathology – The medical branch deals with the disease effects on body tissues and cells
Peri-Menopause – The time before menopause when menopausal signs appear and menstruation circles disturb
Permanent Section – A diagnosis method used in biopsy where processed body tissues are examined under the microscope by a pathologist
Personalized Medicine/Precision medicine – using targeted therapies to treat cancer which includes analyzing family medical history, risk factors, and diagnosis test
Pertuzumab/Perjeta – A targeted treatment for breast cancer with HER2 positive
Phyllodes Tumor – An uncommon tumor of soft breast tissues
PICC, Peripherally Inserted Central Catheter – The tube inserted into the arm’s vein to give chemotherapy drugs
Predictive Factors – The factors that help to decide the treatment method for a particular disease like ER status
Premenopausal Women – 40+ women having regular menstruation
Preoperative Chemotherapy / Primary Chemotherapy – Alternative terms used for Neoadjuvant Chemotherapy
Prevention – Actions performed to stop the disease from occurring
Primary breast cancer – DCIS or non-invasive breast cancer that is not developed and spread beyond the axillary lymph nodes or breast
Primary Tumor – main tumor from which the cancer is developed
Progesterone – Reproductive system’s hormone in women
Progesterone receptors / PR – Progesterone hormone’s proteins found on the surface of tumor cells
Progestin – Lab processed or organic element with the effects of progesterone hormone in the body
Prognosis – Prediction of effects of the disease and treatment on patient’s health
Prognostic Factors – The factors that determine disease prognoses like cancer size, stage, and type
Progression – Development of cancer before or after treatment
Progression-Free Survival, PFS – The time a patient lives with and after cancer treatment when cancer doesn’t grow anymore.
Proliferative – Rapid growth of cancer cells
Prophylactic Mastectomy – Removing complete breast to stop cancer from growing and spreading to other parts of the body. The surgery is called ‘bilateral prophylactic mastectomy’ it is performed on both breasts.
Prosthesis / Breast Prosthetic – A breast made of silicone, saline or any artificial substance to wear under clothes to enhance breast shape after a mastectomy.
Protocol – A plan of using an experimental drug in cancer diagnosis or therapy.
Punch Biopsy – Taking tissue sampling in biopsy using a tool called trephine or punch.
Quadrantectomy – A type of Lumpectomy where 25% of the breast is removed in surgery.
Quality of Care – A standard to measure given treatment to the patient of particular disease and care before and after treatment.
Quality of Life – Standard of life of a person that includes a person’s health/well-being and how has he/she led and his/her life overall.
RAD, Dose of Radiation – The total amount of radiation absorbed by the body’s tissues. One unit of RAD is calledCentigray
Radial Scars – Also known as Complex Sclerosing Lesions. A benign breast disease where lobules and ducts start growing outside of their center
Radiation Oncologist – A cancer specialist doctor who treats cancer with high-energy targeted radioactive rays
Radiotherapy (Radiation therapy) – A method of cancer treatment in which radioactive rays are used to kill, shrink or control the cancer cells
Radical Mastectomy – Also known as Halsted Radical, removal of complete breast with axillary armpits and chest muscles to treat invasive breast cancer
Radiologist – A specialist doctor who uses mammograms, X-rays and other screening tests to diagnose or treat a particular disease
Radio-opaque (Radiopaque) – A substance that resists X-rays and other radiation to pass through
Raloxifene – A hormonal drug to treat osteoporosis and prevent breast cancer risks in postmenstrual women.
Reconstruction – Breast reconstruction after surgery
Recurrence(Relapse) – Return of definite disease or infection. Local recurrence happens in the same area of the breast. Distant recurrence happens in other body parts where invasive breast cancer has spread.
Regional Lymph Nodes – Local lymph nodes. Breast cancer’s regional lymph nodes are in core mammary nodes, underarm (axillary lymph nodes), under the collarbone (infraclavicular lymph nodes) and above collarbones (supraclavicular lymph nodes).
Regression – Limiting cancer using lumpectomy or targeted radiotherapy
Relative Risk – the risk factor, is directly related to a certain disease
Relative Survival Rate (Relative Survival) – Standard statistics to measure the survival rate of people with certain diseases after treatment.
Remission – Absence of symptoms and signs of the chronic disease temporarily or permanently
Risk – A possibility of disease to grow during a person’s lifetime.
Risk factor – A factor that can increase the possibility of getting a certain disease
Risk-Benefit Ratio – A link between the potential benefits and side effects of a particular treatment method
RNA(Ribonucleic Acid) – A substance produced in a lab similar to a person’s DNA. RNA is used to make proteins in a person’s body
Saline – A substance made of saltwater that is used to fill breast implantation
Saline implant – A kind of breast implantation graft that is filled with Saline
Scalp Cooling – A chilled cap that is under study to be used in chemotherapy to reduce the hair loss
Schedules – Time table of taking drugs and chemotherapy
Scintimammography – Alternative term used for Nuclear Medicine Imaging of the Breast
SclerosingAdenosis – Small lumps in the breast (benign) caused by inflamed lobules, which can be painful sometimes
Screening – A diagnosis test for benign disease or cancer that does not have visible symptoms or problems
Screening Mammogram – A diagnostic test for breast cancer that does not show definite symptoms
Second Primary Tumor – A type of secondary breast cancer that grows in a distant location from its primary location.
Secondary breast cancer – Another term used for Stage 4 breast cancer, Advanced Breast Cancer, Secondaries and metastases. A type of invasive breast cancer that has spread to the other parts of the body and lymph nodes.
SIRT, Selective Internal Radiation Therapy – A kind of radiotherapy in which radioactive drips are used to insert radiation to the cancer cells
Sentinel lymph node – The main lymph node where cancer cells spread at first. Axillary breast cancer is breast cancer’s Sentinel lymph node
SNB, Sentinel Node Biopsy– Taking Sentinel Lymph node samples to analyze the presence of cancer in cells
SERM, Selective Estrogen Receptor Modulator – A drug that can be used as an alternative of estrogen or to control estrogen depending on its usage method. Types of SERMs are Raloxifene and Tamoxifen
Seroma – A fluid occasionally accumulated beneath a wound after surgery. It can be uncomfortable but is harmless.
SGAP, IGAP - Super gluteal artery perforator or inferior gluteal artery perforator are fat and skin grafts are taken from lower or upper buttocks to be used in breast reconstructions.
Side effect – Bad or cross effects of a medicine or treatment
Silicone Gel – A solid substance made of silicon (a synthetic compound) to be used in medical breast implantation
Silicone Implant – A kind of breast implant used in breast instruction that is filled with silicone gel
Simple Mastectomy – Complete Mastectomy surgery
Skin-Sparing Mastectomy – A method of breast mastectomy that removes breast tissues but leaves the skin as much as can be. This skin is used afterward in breast reconstruction
SNB, Sentinel Node Biopsy– Taking Sentinel Lymph node samples to analyze the presence of cancer in cells
Sonogram – Alternative term used for Ultrasound
Spinal cord compression – Stress on the nerves and spinal cord caused by cancer and can damage the spinal cord permanently
Stable Disease – The tumor that remains the same size and does not grow further or grows very little
Stage (Stage of Cancer,) – The status of cancer development, size and how much it is spread
Staging, Staging Cancer – Determining the stage of cancer by development and size of the tumor. Staging cancer helps to decide the treatment method of cancer. Breast cancer is divided into 0 – IV stages.
Standard Treatment (Standard of Care) – The scientifically approved treatment method of a certain disease that is used globally.
Statistical Significance – the possible link between a risk factor and breast cancer.
Stereotactic core biopsy (Stereotactic Needle Biopsy) – Biopsy is done using a 3D needle connected to a mammogram machine, which guides the needle to detect the precise location of the part to be analyzed.
Stereotactic Mammography – 3D mammogram machine used in Stereotactic Needle Biopsy to guide the biopsy needle
Stereotactic Radiotherapy(Radiosurgery, CyberKnife, Gamma Knife) – A type of Radiotherapy is used to treat Secondary Breast Cancer
Steroids – A group of drugs that can be used to prevent the side effects of breast cancer’s treatments. For instance, Steroids can be used to control vomiting or nausea caused by chemotherapy
Subcutaneous injection – Injection under the skin of fatty tissues
Supraclavicular Lymph Nodes – Lymph nodes under and above the collarbone
Surgeon – A doctor who performs surgical therapies like mastectomy or biopsy in breast cancer
Surgical Margin – Distance between cancer cells and tissues that are removed during surgical treatment for breast cancer
Surgical Oncologist – Surgeon specialized in cancer treatment by using surgical therapies
Survival (Relative Survival) – A person’s lifetime after cancer treatment
Survivors(Breast Cancer Survivors) – People who have diagnosed with breast cancer and have gone under cancer treatment
Survivorship – Lifetime physical and psychological care of a breast cancer patient
Systemic Treatment (Adjuvant Treatment) – Type of breast cancer treatment given with primary treatment and treats cancer cells, which are spread in other parts of the body like hormone therapy, targeted therapy, and chemotherapy.
Tamoxifen – Also known as Nolvadex, a drug used in hormonal therapy to treat estrogen-positive breast cancer and to avoid breast cancer in females with increased breast cancer risks.
Targeted Therapy (Biological Therapies) – A group of drug therapies that target cancer cells spread all over the body to kill or control cancer to grow. A type of targeted therapy used for breast cancer is called Herceptin (Trastuzumab).
TENS machine – A portable massage pain with glue skin mats to relieve pain caused by cancer or cancer treatments.
Terminal – Last few weeks or days of someone’s life
Thermography – A screening method of breast cancer where infrared light is crossed through breast tissues and abnormal tissues are detected. Abnormal tissues are heated more than normal tissues. However, this screening method of diagnosis is not still proven.
Tissue – A layer of cells in a living being
Total Mastectomy, Simple Mastectomy – Removing the cancerous breast but not axillary lymph nodes or other tissues. This Surgical therapy is used to treat DCIS, cancer recurrence or prophylactic mastectomy.
TP53gene – A type of gene that works as an indicator for producing p53 type of protein. Sometimes TP53 is inherited in an altered form that can increase the risk of developing Li-Fraumeni, an uncommon breast cancer syndrome. This leads to increased risks for breast cancer.
Transverse Rectus AbdominisAuscle flap, TRAM – A kind of breast reconstruction that uses skin and fat grafts with fat muscle from the area of pelvic bone and ribs.
Transverse Upper Gracilis flap, TUG / Transverse MyocutaneusGracilis flap, TMG – Breast reconstruction methods, which use skin / fat grafts and muscles from the outer upper or inner side of the thigh.
Trastuzumab, Herceptin – A drug therapy used to treat HER2 positive breast cancer.
Triple-Negative Breast Cancer – A type of breast cancer, which is HER2- (HER2 negative), ER- (Estrogen Receptor-Negative) and PR- (Progesterone Receptor-Negative). These types of breast cancer usually turn out to be aggressive and have limited treatment options. Tipple Negative breast cancer is mostly found in African American females.
A tumor (Tumour) – Growth and division of cells producing a lump, hard mass or swelling that can be cancerous or noncancerous (benign).
Tumor Grade – A method to define how much cancer cells looks like normal cells. There are three grades of the tumor. Grade 1 tumor has slow developed and looks almost similar to normal cells. Grade 3 tumor is fast growing and cells look very abnormal. A grade 2 tumor is between grades 1 and 3.
Tumor Marker – It is a broad term used to describe the abnormality in body tissues or blood vessels caused by a tumor, to spot the cancer treatment response on cancer cells or to define the characteristics of tumors like HR (hormone receptors).
Tumor Profiling – Also known as Gene Expression Profiling is a method to test thousands of genes in cancer cells. Useful information can be gathered from particular genes that can help make decisions regarding the treatment methods for breast cancer.
Two-Step Procedure – When biopsy and surgical therapies afterward are done in two different steps.
Ultrasonography (Ultrasound, Sonogram, Ultrasound Scan) – A type of internal body’s imaging done by sound waves, which are high-frequency and are inaudible to the man ear. These sound waves are transferred through the tissues of body and resonances are recorded and converted into images or video. The structures of soft tissues are created using ultrasound. Besides, blockings in blood vessels can be detected with ultrasound technology. Ultrasound scan is a powerful method that can help diagnose absolute diseases and abnormalities. Through a sonogram, lump condition can be determined, if it is in solid or swollen form. A solid lump can be a sign of malignancy or the appearance of the noncancerous disease.
Usual Hyperplasia (Proliferating) – A benign breast disease where cell number increases swiftly that can increase the risk of cancer.
Vacuum-Assisted Excision Biopsy – A type of biopsy in which more than one tissue samples are analyzed under a microscope to diagnose cancer. The vacuum-assisted biopsy can be performed as an alternative of mastectomy where the whole part of breast tissues is removed.
Vaginal Atrophy – Dryness of vagina also known as Atrophic Vaginitis
WLE, Wide Local Excision – Alternative term used for lumpectomy / breast-conserving surgery where breast cancer tissues are removed including normal cells attached to cancer tissues.
Wire Localization – Also known as Needle Localization is a type of biopsy or lumpectomy done with a wire where a fine wire is inserted into the tissues of the breast to detect the abnormal area.
X-ray – Powerful radioactive rays used in low-frequency rays to create images to diagnose the disease and used in high frequency to treat the tumor.