You are here

More about breast cancer

It is likely that you had a core biopsy or fine needle aspiration (FNA) before you were referred to Dr Lancashire.

A core biopsy gives a surgeon some of the important information regarding what type of breast cancer you may have. It is important to remember that a biopsy is only a small sample of tissue, so will not give you all of the detailed information you would get after an operation.

The following information is a broad overview of the breast cancers types, and the information you will get about a breast cancer from the pathologist.

Types of Breast Cancer

There are a number of different types of breast cancer.

1. Ductal carcinoma in situ (DCIS)

  • This is a non-invasive breast cancer. That means that it has not spread outside of the ducts into the surrounding breast tissues
  • If left untreated it is likely to develop into invasive breast cancer

2. Lobular carcinoma in situ (LCIS)

  • Despite its name, LCIS is not a true breast cancer
  • It means there are abnormal cells contained within the breast lobules.  It is not able to spread to other parts of the breast or body
  • LCIS does not require treatment on its own but is a risk factor for developing a breast cancer in the future
  • There is a subtype of LCIS called pleomorphic LCIS. Its significance is still the subject of great debate and controversy amongst medical specialists

3. Invasive breast cancer

  • There are many types of these. Invasive ductal carcinoma and invasive lobular carcinoma are the two most common
  • There are a number of different sub-types of invasive cancer

4. Paget’s Disease of the nipple

  • A rarer form of breast cancer (<5%)
  • Cancerous cells are in and around the nipple, and may spread onto the areola

5. Inflammatory breast cancer

  • A very rare (<2%) and aggressive form of breast cancer
  • It causes the lymphatic vessels in the skin to become blocked which makes the breast look red and swollen

This list is not meant to be exhaustive. There are a number of special ‘sub-types’ of breast cancers which Dr Lancashire can explain if it is pertinent to your management.

Other Information about breast cancer

In addition to the type of breast cancer, a pathologist will report on a number of other important pieces of information about a breast cancer:

1. Location

  • Where in the breast the cancer is and its relationship to the chest wall and skin

2. Size

  • How big the breast cancer is

3. Grade

  • This is how the cancer cells appear when compared to normal breast cells and how fast they are growing
  • Breast cancers are graded from 1 to 3
  • Grade 1 (Low grade / well differentiated) – slow growing and less aggressive
  • Grade 2 (Intermediate grade / moderately differentiated) – grow faster than low grade cancer cells
  • Grade 3 (High grade / poorly differentiated) – grow quickly and more likely to be aggressive

4. Margins

  • This gives information on whether the tumour has been removed completely and if there is a rim of healthy tissue around it
  • If margins are ‘involved’ or deemed to be ‘too close’, a surgeon may recommend subsequent surgery

5. Lymph node involvement

  • This tells you if there are cancerous cells in the lymph nodes in the armpit.
  • It may determine if you need more surgery or other treatment (chemotherapy, for example)

6. Hormone receptors

  • Some breast cancers have hormone receptors on their surface
  • When these are stimulated, it can cause the cancer cells to grow
  • The two types of receptors that are tested for are oestrogen receptors (ER) and progesterone receptors (PR)
  • People that are ER positive may be recommended endocrine therapy as part of their treatment

7. HER2 status

  • Some breast cancers have a certain type of protein on their surface (a receptor called HER2) that allows chemicals to bind causing the cancer to divide (and grow)
  • People with breast cancers that are HER2 positive may be recommended chemotherapy and a medication called Herceptin®.

Dr Lancashire will take you through your pathology report in detail as soon as it returns from the pathologist. He will explain what it means for your treatment and what you can expect in the future.

 Follow the links below for more on breast cancer management:

Breast conserving surgery

Mastectomy

Axillary surgery

Oncoplastic breast surgery

Prophylactic mastectomy

Breast Reconstruction

Endocrine Therapy

Radiotherapy

Using the internet