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Different types of breast cancer: What to know

May 19, 2021
Different types of breast cancer: What to know

Breast cancer can come in a variety of forms. They may appear in various areas of the breast.

Breast cancer is the most common cancer in women in the United States, apart from skin cancers. According to the American Cancer Society, this is the case (ACS).

According to the American Cancer Society, a female in the United States has a 13 percent risk of developing breast cancer. Breast cancer, on the other hand, may strike people of either gender or sex.

Learning about the anatomy of the breast will help a person better understand the different forms of breast cancer.

The different types of breast cancer, as well as their symptoms, prognoses, and treatment options, will be discussed in this article. It will also include breast cancer screening and when to seek medical help.

Ductal carcinoma in situ

DCIS (ductal carcinoma in situ) is a form of breast cancer that develops in the milk ducts.

DCIS is a noninvasive cancer, which means it stays in the tissue where it started. DCIS, on the other hand, has the potential to progress to an advanced cancer that spreads to other areas of the breast.

According to the American Cancer Society, DCIS accounts for around one out of every five new cases of breast cancer.

Signs and Symptoms

In most cases, a person with DCIS will show no signs or symptoms. DCIS, on the other hand, will sometimes cause a lump in the breast or nipple discharge.

Doctors diagnose more than 90% of DCIS cases based on mammography alone, according to the National Cancer Institute (NCI).

Treatments

DCIS can be handled using a variety of methods. These include:

  • Lumpectomy: This procedure, also known as breast-conserving surgery, entails the removal of DCIS and a small amount of surrounding tissue by a surgeon: The next step is normally radiation therapy, which lowers the risk of the cancer returning.
  • Mastectomy: A mastectomy is where a surgeon removes the whole breast from a patient.
  • Hormonal therapy following surgery: Hormone receptor-positive DCIS tumours are possible. DCIS that is hormone receptor-positive develops in the presence of oestrogen or progesterone. After surgery, a person with this type of DCIS may receive hormone therapy to reduce their cancer risk.

DCIS does not usually pose a life-threatening danger. This is due to the fact that it is non-invasive. However, it can raise a person’s chances of developing invasive breast cancer in the future.

DCIS has a 25–30% risk of returning in people who have had a lumpectomy without radiation therapy. If an individual has radiation therapy after surgery, there is a 15% risk that DCIS will return.

The majority of recurrences happen 5–10 years after the initial diagnosis.

According to a 2015 study, approximately 3.3 percent of 100,000 females with DCIS died of breast cancer over a 20-year period.

Invasive ductal carcinoma (IDC)

Invasive ductal carcinoma (IDC) begins in the milk ducts of the breast and then spreads to the surrounding tissue. IDC will spread to the lymph nodes and other parts of the body over time.

IDC is responsible for 50–70% of invasive breast cancers. Furthermore, about two-thirds of females diagnosed with IDC are 55 years or older. Males can also develop IDC.

There are less common forms of IDC, including:

Tubular carcinoma of the breast

Tubular carcinomas are IDCs that are less than one centimetre in diameter. Tubules, which are tube-shaped structures, make up tubular carcinoma.

Tubular carcinomas account for around 8%–27% of all breast cancers, though they are uncommon in men.

Tubular carcinomas are a less aggressive form of invasive breast cancer that responds well to treatment.

Breast carcinoma in the medulla

Medullary carcinoma is a less common form of IDC, accounting for just around 5% of all breast cancer cases. Medullary carcinoma tumours are soft and fleshy.

Since medullary carcinomas do not spread beyond the breast and develop slowly, they are typically easier to treat than other types of breast cancer.

Papillary carcinoma of the breast

Papillary carcinomas are a form of IDC that accounts for only 1–2% of all invasive breast cancers. Papillary carcinomas are more common in postmenopausal women.

Tiny, finger-like protrusions make up a papillary carcinoma. Papillary carcinomas develop at a moderate rate.

Cribriform carcinoma of the breast

Cribriform carcinomas grow in the breast’s stroma, or connective tissues. The gaps between the cells in cribriform carcinoma tumours give them a distinct appearance.

Approximately 5–6% of invasive breast cancer tumours have cribriform characteristics. Low-grade cribriform carcinomas develop slowly and behave similarly to healthy cells.

Symptoms

IDC does not show any signs or symptoms. The following symptoms, on the other hand, can suggest breast cancer:

IDC may or may not trigger any. The following symptoms, on the other hand, can suggest breast cancer:

  • a new lump or mass in the breast
  • swelling in part or all of the breast
  • skin irritation or dimpling
  • breast or nipple pain
  • an inverted, or inward turning, nipple
  • skin discoloration, thickening, or scaliness on the nipple or breast
  • nipple discharge
  • a lump in the armpit or surrounding area

Treatments

Treatment for IDC can include:

  • lumpectomy
  • mastectomy
  • removal of the lymph nodes
  • chemotherapy
  • radiation therapy
  • hormonal therapy
  • targeted therapy, which are medications that target specific characteristics of cancer cells

Outlook

According to the American Cancer Society, people with invasive breast cancer have a 5-year survival rate of:

  • For cancer that is only in the breast, the survival rate is 99%.
  • If the cancer has spread to the lymph nodes, the survival rate is 86%.
  • If the cancer has spread to distant parts of the body, the survival rate is 28%.

Invasive lobular carcinoma

The second most common form of breast cancer is invasive or infiltrating lobular carcinoma (ILC). About 10% of all invasive breast cancers are ILCs.

ILCs develop in the breast lobules, which are milk-producing glands. ILCs reach out from the lobules to other breast tissues. ILCs can spread to lymph nodes and other parts of the body over time.

Females in their early 60s are more likely to develop ILC. According to some studies, postmenopausal hormone therapy can increase a person’s risk of ILC.

Symptoms

Because ILC does not cause any symptoms, doctors may have a harder time detecting it on mammograms.

ILCs, in addition to the normal breast cancer symptoms, can cause:

  • thickening or hardening of the breast
  • an area of swelling or fullness
  • a change in the skin’s texture
  • an inverted nipple

Treatments

Treatments for ILC include:

  • lumpectomy
  • mastectomy
  • lymph node removal
  • radiation therapy
  • chemotherapy
  • hormonal therapy
  • HER2-targeted therapies, if the ILC is HER2-positive due to overproduction of the protein HER2, which encourages cell growth

Outlook

According to a 2015 report, people with ILC have a long-term diagnosis that is close to or worse than people with other invasive cancers.

Inflammatory breast cancer

IBC (inflammatory breast cancer) is a rare and deadly form of cancer. According to the American Cancer Society, IBC accounts for 1–5% of all breast cancers.

IBC is more common in women under the age of 40, and it affects more Black women than white women. Obese females are more likely to develop IBC. Males are susceptible to IBC.

Symptoms

IBC can cause symptoms that appear 3–6 months after diagnosis. This may include the following:

  • swelling, thickening, or skin discoloration of the breast
  • pitting of the breast skin, making it look similar to orange peel
  • an inverted or retracted nipple
  • one breast looking larger or feeling heavier and warmer than the other
  • tender, itchy, painful breasts
  • swelling of the lymph nodes near the armpit or collarbone

Treatments

Treatment for IBC may include:

  • chemotherapy
  • targeted therapy
  • hormonal therapy
  • HER2-targeted therapy
  • radiation therapy
  • mastectomy and lymph node removal

Outlook

According to the American Cancer Society, one out of every three cases of IBC has spread to other areas of the body by the time it is diagnosed. It can be difficult to treat IBC after it has spread.

The American Cancer Society (ACS) reports the following 5-year survival rates for people with IBC based on data from 2009 to 2016: The survival rate is 56 percent if the IBC has spread beyond the breast to surrounding tissues or lymph nodes, and 19 percent if the IBC has spread to distant areas of the body, such as the bones or lungs.

Molecular subtypes of breast cancer

The molecular subtype of breast cancer is determined by the genes that the cancer expresses. A gene is a DNA unit that contains the information needed to produce specific characteristics.

Breast cancer is divided into five molecular subtypes:

Luminal A

Luminal A breast cancer is:

  • hormone receptor-positive
  • HER2-negative
  • low in the protein Ki-67, which helps control the speed of cancer cell growth

Luminal A breast cancer develops steadily and has a favourable prognosis. It accounts for approximately 50–60% of all breast cancers.

Luminal B

Luminal B breast cancer is:

  • hormone receptor-positive
  • HER2-positive or -negative
  • high in the protein Ki-67

Luminal B breast cancer grows slightly faster than luminal A breast cancer and has a worse outlook. It accounts for 15–20 percent of all breast cancer cases.

Triple-negative, or basal-like

Triple-negative breast cancer (TNBC) is:

  • hormone receptor-negative
  • HER2-negative
  • more common in younger females and Black females

TNBC spreads and grows faster than other invasive breast cancers, and treatment options are limited. TNBC has a poorer prognosis than other types of invasive breast cancer. It accounts for approximately 10%–15% of all breast cancers.

Young Black females are particularly affected by triple-negative cancers. In addition, these women are more likely to have poor health results. This is due to health inequities, which include:

  • a lack of access to oncology treatment and care
  • delays in receiving treatment
  • a lack of access to screening for breast cancer

HER2-enriched
Breast cancer that is HER2-enriched is both hormone receptor-negative and HER2-positive.

It spreads more quickly and has a poorer prognosis than luminal cancers. HER2-enriched breast cancer, on the other hand, responds well to HER2-targeted therapies. It accounts for 15–20 percent of breast cancer subtypes.

Normal-like

Normal-like breast cancer is:

  • hormone receptor-positive
  • HER2-negative
  • low in the protein Ki-67

Normal-like breast cancer has a significantly poorer prognosis than luminal A breast cancer, despite their similarity. Breast carcinomas account for around 5–10% of all cancers in the breast.

Paget’s disease is a nipple disease

Paget’s disease of the nipple is a rare form of breast cancer that affects the nipple and nearby areas. Around 1–4% of all breast cancers are caused by it.

Paget’s disease of the nipple begins in the nipple ducts and then spreads to the nipple surface and areola. The dark skin that covers the nipple is known as the areola.

Paget’s disease of the nipple occurs in about 80%–90% of cases, mostly in conjunction with DCIS or IDC.

Paget’s disease of the nipple can affect both men and women, and it typically affects people over the age of 50.

Symptoms

The following are some of the signs of Paget’s disease of the nipple:

  • itching, tingling, or burning
  • pain and sensitivity
  • scaling and thickening of the nipple
  • flattening of the nipple
  • yellowish or bloody nipple discharge

Paget’s disease of the nipple has signs that are similar to eczema or dermatitis. If any of the above symptoms persist after treatment, a person should see a doctor.

Treatments

Treatment options for Paget’s disease of the nipple include:

  • mastectomy
  • lumpectomy
  • radiation therapy
  • chemotherapy
  • targeted therapy
  • hormonal therapy

Outlook

The prognosis is generally good if there is no lump in the breast tissue and Paget’s disease of the nipple has not spread.

If Paget’s disease of the nipple has spread, the prognosis may be less favourable, and doctors may treat it like other IDCs.

Phyllodes tumors of the breast

Phyllodes tumours are very rare, accounting for less than 1% of all breast tumours. They spread easily, but very occasionally outside the breast.

The majority of phyllodes tumours are benign, or noncancerous. They can, however, be malignant, which means they are cancerous.

Tumors of the phyllodes may be both cancerous and noncancerous.

They are most common in women in their 40s, and they are extremely rare in men.

Symptoms

Symptoms of phyllodes tumors may include:

  • a painless lump
  • a visible bulge in the skin over a lump
  • an ulcer or open wound on the skin

Treatments

Treatment for phyllodes tumors can include:

  • lumpectomy
  • partial mastectomy
  • total mastectomy
  • radiation therapy
  • chemotherapy

Outlook

The Genetic and Rare Diseases Information Center reports that benign phyllodes tumours have a good prognosis.

An individual with malignant phyllodes tumours has a 60–80 percent 5-year survival rate.

Angiosarcoma

Angiosarcoma is a rare cancer that starts in the cells that line the blood vessels or lymph vessels. Radiation therapy may cause it to grow.

Angiosarcoma makes up about 1–2% of all sarcomas, according to the National Cancer Institute. It is most prevalent in people over the age of 70.

Symptoms

Symptoms of angiosarcoma can include:

  • purple nodules on the skin that bleed easily
  • a lump
  • swelling
  • pain around the lump

Treatments

Treatment may include:

  • mastectomy
  • radiation therapy
  • chemotherapy

Outlook

Low-grade breast angiosarcoma has a higher survival rate than other forms of angiosarcoma, according to the National Cancer Institute.

Many patients, however, do not obtain a diagnosis until the cancer has spread, resulting in a worse prognosis.

Metastatic breast cancer

Stage 4 breast cancer is also known as metastatic breast cancer. Stage 4 breast cancer has spread from the breast to other areas of the body.

Around 30% of women with early-stage breast cancer will progress to metastatic disease.

Symptoms

The symptoms of metastatic breast cancer vary depending on where the cancer has spread across the body. They may contain the following:

Bone metastasis

The following are some of the signs and symptoms of bone metastasis:

  • sudden new pain
  • pain that gradually gets worse over time
  • pain that feels the same or worse during rest
  • sudden severe pain
  • an inability to move
  • pain in the back or neck
  • numbness or weakness
  • difficulty urinating or having bowel movements
  • fatigue
  • weakness
  • nausea
  • loss of appetite
  • dehydration

Lung metastasis

Symptoms of lung metastasis include:

  • pain or discomfort in the lung
  • shortness of breath
  • wheezing
  • persistent cough
  • coughing up blood or mucus

Brain metastasis

Symptoms of brain metastasis include:

  • headache
  • slurred speech
  • blurred vision
  • dizziness
  • balance problems
  • memory problems
  • personality or mood changes
  • seizures
  • stroke

Liver metastasis

Symptoms of liver metastasis include:

  • pain or discomfort in the mid-section
  • fatigue or weakness
  • weight loss
  • poor appetite
  • fever
  • bloating
  • swollen legs
  • a yellow tint to the skin or eyes

Treatments

Treatment options for metastatic breast cancer include:

  • radiation therapy
  • lumpectomy
  • cryoablation, which freezes cancer cells to destroy them
  • chemotherapy
  • hormonal therapy
  • targeted therapy
  • local treatments applied to areas where the cancer has spread
  • immunotherapy, which helps the body’s immune system fight the cancer

Outlook

According to the American Cancer Society, the 5-year survival rate for late-stage cancer is 28%. A person’s survival rate, on the other hand, can vary depending on their age, general health, and how well the cancer responds to treatment.

Recurrent breast cancer

Breast cancer that has returned is known as recurrent breast cancer. When a single cancer cell that has escaped treatment expands and multiplies, this may happen.

Breast cancer can come back in three different areas:

  • Local recurrence: This refers to when the cancer returns to the breast area where the doctor originally diagnosed it.
  • Regional recurrence: This refers to when the cancer returns in the lymph nodes near the collarbone or armpit.
  • Distance recurrence: This refers to when the cancer comes back in the lungs, brain, or bones. Rarely, it can come back in the other breast.

Symptoms

Some symptoms to look out for in the chest and breast area include:

  • swelling in the chest, armpit, and collarbone
  • a change in the size and shape
  • puckering or dimpling of the skin
  • a rash around the nipple
  • nipple discharge
  • a lump
  • an inverted nipple
  • swelling in the hand or arm

Some other symptoms may include:

  • severe and ongoing headaches
  • dry cough
  • shortness of breath
  • unexplained weight loss
  • appetite loss
  • bone pain
  • fatigue

Treatment

Depending on where the cancer has returned, different treatment options are available.

Local

Hormone therapy, targeted therapy, and chemotherapy can be recommended by a doctor.

If a lumpectomy was performed, the doctor could recommend a mastectomy. The doctor would remove the tumour and perform radiation therapy if they had a mastectomy.

Regional

Radiation treatment should be used after the lymph nodes have been removed by a doctor.

Chemotherapy, targeted therapy, or hormone therapy can be used following surgery.

Distant

Cancer that has spread to other areas of the body needs treatment similar to stage 4 breast cancer. The previous treatment may have an effect on the treatment choices available now.

Outlook

The prognosis for recurrent breast cancer is difficult to predict in general.

Local recurrent breast cancer is also successfully treated by doctors. Regional recurrence, on the other hand, is more difficult to predict. There’s a chance that the cancer will spread to other areas of the body.

According to recent studies, only about 5% of people live for ten years or longer after suffering a distant recurrence.

Male breast cancer

Breast tissue is used in both men and women. This means that breast cancer can strike anyone at any time.

Male breast cancer accounts for around 1% of all breast cancers, according to the Centers for Disease Control and Prevention (CDC).

Males are most often affected by the following forms of breast cancer:

  • IDC
  • ILC
  • DCIS

A male is more likely to develop breast cancer if they:

  • are aged around 68 years old
  • have high levels of estrogen
  • have Klinefelter syndrome, which causes low androgen levels and high estrogen levels
  • have a family history of breast cancer or genetic mutations
  • have had exposure to radiation

Symptoms

Symptoms of male breast cancer can include:

  • a lump in the breast
  • nipple pain
  • an inverted nipple
  • nipple discharge
  • sores on the nipple
  • enlarged lymph nodes under the arm

Treatments

A doctor may suggest the following treatments for male breast cancer:

  • mastectomy
  • lymph node removal
  • radiation therapy
  • hormonal therapy
  • chemotherapy
  • targeted therapy

Outlook

The 5-year survival rates for male breast cancer are as follows:

  • 97% if it is localized
  • 83% if it is regional
  • 22% if it is distant

Diagnosis

A doctor can diagnose breast cancer in a variety of ways. They can, for example, use:

  • a breast ultrasound scan, wherein they use sound waves to take detailed photos inside the breast
  • a mammogram, which is a detailed X-ray of the breast
  • an MRI scan, which is a body scan that can take detailed pictures inside the breast
  • a biopsy, wherein they take a sample of tissue or fluid from the breast for testing
  • a clinical breast exam, wherein they manually feel the breast for lumps

Screening

A woman between the ages of 50 and 74 who has an average risk of breast cancer should get a mammogram every two years, according to the CDC.

Females aged 40–49 should also consult their doctor on how often they should get a mammogram.

The sooner a person is diagnosed with breast cancer, the greater their chances of recovery.

According to the American Cancer Society, screening males in the general population is not effective due to the rarity of male breast cancer. However, if a man notices any breast cancer signs, he should see a doctor.

Low cost screening

Breast cancer screening will be provided by the National Breast and Cervical Cancer Early Detection Program to those who:

  • have no health insurance
  • have insurance that does not cover screening exams
  • have a yearly income of below 250% of the federal poverty level
  • are aged 40–64 years

The CDC has a tool that can assist an individual in determining who to contact.

Support

A breast cancer diagnosis can be terrifying and upsetting.

If a person is having trouble dealing with their breast cancer diagnosis, they may turn to the following resources for help:

  • doctors and other healthcare professionals
  • therapists
  • friends and family members
  • breast cancer support helplines or charities
  • breast cancer support groups

When to consult a doctor

If you find any odd lumps, pains, or chamge in your breast, you should see a doctor right away.

A person’s breasts should be familiarised with their normal form, structure, and feel. Self-checking for lumps and changes on a regular basis may aid in early detection.

Breast cancer can manifest itself in a variety of ways. Breast cancer can also be diagnosed in a variety of ways by a doctor.

An individual should check their breasts for any signs of breast cancer on a regular basis. Mammograms for older women should be done on a daily basis.

Anyone who feels any odd lumps, pains, or change in their breast should see a doctor right away.

Sources

Last updated on May 20, 2021