Cancer isn’t black and white, especially when it comes to breast cancer. There are several different types that have different categories and it can be confusing. The following is a general guideline to help you sort through it all.
Non Invasive Carcinoma Category: Non invasive carcinoma means that the cancer is in the ducts or lobules and has not spread to another part of the breast or body. This is also called “in situ”, which is the Latin phrase for “in the place”. This type of cancer is typically caught in the early stage and is also not normally found during a self breast exam or a clinical breast exam. The best detection for this kind of cancer is a digital mammogram, so be sure to keep up on your annual screenings if you are over the age of 40 and have a baseline mammogram starting around the age of 35. If you have a family history of breast cancer, you may need to have a baseline mammogram earlier than age 35, but talk to your doctor.
Ductal Carcinoma In Situ (DCIS)-occurs in the milk duct due to abnormally multiplying cells. DCIS is the earliest form of breast cancer and is not considered to be life threatening. That said, DCIS is considered to be preinvasive, as the cells are capable of becoming invasive, which means that they could spread into the breast or other parts of the body. DCIS does need to be treated with a lumpectomy or a total mastectomy to prevent it from becoming an invasive cancer. A DCIS lesion can feel like a lump or a thickening of the duct, but this type of cancer is best detected by a digital mammogram.
Lobular Carcinoma In Situ (LCIS)-perhaps LCIS is the most confusing of all, because it’s not actually cancer. LCIS, according to www.mayoclinic.com, means that there is an area of abnormal tissue growth that occurs within — and stays within — the lobules or milk glands located at the end of the breast ducts. LCIS has the potential to be in both breasts, as well as turn into an invasive cancer more than other type of breast cancer. Those diagnosed with LCIS typically are pre-menopausal. LCIS is almost next to impossible to detect on a mammogram and is generally found via a breast biopsy that was done for another reason. For the most part, the recommended treatment for LCIS is to have both breasts removed and/or with the drug tamoxifen. LCIS has the potential to be in both breasts, as well as turn into an invasive cancer more than other type of breast cancer. Symptoms of LCIS can be thickening of the breast from the nipple to the underarm, skin puckering and nipple discharge. Diagnosis for LCIS is by a digital mammogram and breast biopsy.
Paget’s disease-occurs in the nipple, is slow growing and does not involve the surrounding skin. Normally, only one breast is involved and rises from the ducts underneath the nipple and grows to the nipple itself. The typical Paget’s patient is a middle-aged woman and can occur in association with an underlying in situ or invasive ductal carcinoma of the breast. Signs and symptoms of Paget’s disease are pain/sensitivity of the nipple, flattened nipple, crustiness, oozing, itching of the areola and nipple. These signs/symptoms can be incorrectly diagnosed as eczema or other type of skin condition. Diagnosis of Paget’s disease can include a clinical breast exam, a digital mammogram, breast ultrasound, breast MRI and biopsy.
Invasive Carcinoma Category: Invasive carcinoma means that the cancer has spread from the point of origin-from the duct or lobule and can grow into other areas of the breast or metastasize to other parts of the body. As with a non invasive carcinoma, the the best detection is to have a digital screening mammogram, so make sure to keep up on your yearly screenings if that applies to you, or to have a baseline mammogram at around age 35, possibly earlier if you have a family history, but talk with your doctor first. Treatments for these types of cancers are generally tumor removal by lumpectomy or mastectomy and/or with chemotherapy and radiation treatment after surgery.
Invasive Ductal Carcinoma (IDC): the most common form breast cancer starts out in the milk duct and spreads into the surrounding breast tissue. IDC is also called infiltrating ductal carcinoma. This type of cancer can affect women of any age (like all cancers can), but generally those diagnosed with IDC are over age 55. Signs/Symptoms of IDC are inverted nipple, swelling, skin irritation or dimpling, pain, nipple discharge, redness, thickening of the nipple or breast skin, or scaliness, underarm lump. Diagnosis of IDC can include a clinical breast exam, a digital mammogram, breast ultrasound, breast MRI and biopsy.
Invasive Lobular Carcinoma (ILC): starts in the lobules, and spreads to the surrounding breast tissue. ILC is the second most common breast cancer type (right behind invasive ductal cancer (IDC)) and like IDC is generally diagnosed in women over the age of 55. Signs/symptoms of ILC are like IDC, swelling, skin irritation or dimpling, pain, nipple discharge, redness, thickening of the nipple or breast skin, or scaliness, underarm lump. Diagnosis of ILC can include a clinical breast exam, a digital mammogram, breast ultrasound, breast MRI and biopsy.
Tubular Carcinoma: is tube shaped cancer that is slow growing. According to breastcancer.org, Tubular cancer is a rare subtype of invasive ductal cancer (cancer that begins inside the milk duct and spreads beyond it). Tubular cancer is easy to treat and is less likely to metastasize. Most people who are diagnosed with this type of cancer are aged around mid 40’s to late 60’s. Signs/symptoms may not be obvious because the area is generally 1 centimeter or less in diameter and feels firm to the touch. Diagnosis of tubular cancer can include a digital mammogram, clinical breast exam, breast MRI or breast biopsy.
Medullary Carcinoma: like tubular cancer, medullary cancer is a rare subtype of invasive ductal cancer (cancer that begins inside the milk duct and spreads beyond it). This is a slow growing cancer that generally doesn’t spread from the breast to the lymph nodes, which can make it easy to treat. It’s been noted that those with a BRCA1 mutation and those who live in Japan are more likely to be diagnosed with this kind of cancer. Medullary cancer gets its name because it looks like the medulla, or gray matter of the brain. Most people who are diagnosed with this type of cancer are aged around late 40’s to early 50’s. Signs/symptoms and diagnosis are like those of tubular cancer, which may not be obvious as the area is generally 2 centimeters or less in diameter and can be firm to the touch or soft and fleshy. Other potential signs are redness, pain, tenderness and swelling. Diagnosis of tubular cancer can include a digital mammogram, clinical breast exam, breast ultrasound or breast biopsy.
Mucinous Carcinoma : is a cancer that contains a mucous protein and like medullary cancer and tubular cancer, is a rare subtype of invasive ductal carcinoma (cancer that begins inside the milk duct and spreads beyond it). Mucinous cancer is also called colloid cancer. What happens with this type of cancer is that the cancer cells float in a pool of mucin, which is in what we all know as mucus. Most women who are diagnosed with this type of cancer are over age 60. Signs/symptoms may not appear at all, however a lump may grow large enough over time to be felt. Diagnosis of mucinous cancer can include a digital mammogram, clinical breast exam, breast ultrasound or breast biopsy or breast MRI.
Inflammatory Carcinoma (IBC): is a type of cancer that is hard to diagnose and has signs/symptoms of breast and lymph node swelling, warmth of the breast, aching or burning of the breast, redness (the #1 sign of IBC), orange peel like appearance, welts, hives or ridges of the breast and inverted or flattening of the nipple. IBC is hard to diagnose because it’s very similar to an infection in women who breast feed called mastitis and a bacterial infection of the breast skin called cellulitis. If you have been diagnosed with mastitis or cellulitis and are not responding to treatment, demand that you be tested for IBC. IBC is an aggressive, fast growing cancer and diagnosis can include a clinical breast exam, digital mammogram and breast biopsy.
Information for this article was found from www.mayoclinic.com, www.ehealthmd.com, www.breastcancer.org and the book Straight Talk about Breast Cancer from Diagnosis to Recovery. Photo credit for this article is courtesy of the National Cancer Institute and was created by artist Susan Spangler.
This article is intended to convey general educational information and should not be relied upon as a substitute for professional healthcare advice.