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About this Condition: Breast Cancer
Types of Breast Cancer
The breast comprises several types of tissue:
- A network of lobes containing glands called lobules that produce milk
- Thin tubes called ducts that carry milk from the lobes to the nipple
- Fat
- Connective tissue
- Blood vessels
- Lymph nodes and vessels
- Nerves
The more common types of breast cancer are named for where they start in the breast. Breast cancer has two major categories, as well as subtypes within those categories:
Invasive breast cancer:
- Invasive (or infiltrating) ductal carcinoma (IDC) is the most common type of breast cancer, making up about 80 percent of all breast cancers. IDC begins in the ducts, invades across the architecture of the duct and has the ability to spread locally and distantly in the body.
- Invasive (or infiltrating) lobular carcinoma (ILC) accounts for about 10 percent of invasive breast cancers. ILC begins in the lobes and invades across the architecture of the lobe and has the ability to spread locally and distantly in the body.
Noninvasive breast cancers or precancerous conditions:
- Ductal carcinoma in situ (DCIS) is the development of cancer cells that grow only within the milk ducts and do not have the ability to spread to surrounding breast tissue. DCIS is considered a high risk lesion (area of abnormal tissue) and, left untreated, has the likelihood of evolving into invasive ductal cancer. It is typically treated by surgery with or without radiation and sometimes hormone-blocking therapy.
- Lobular carcinoma in situ (LCIS) is the development of cancer cells that begin growing in the lobes. LCIS is much less common than DCIS and is not considered a precursor lesion, but is a risk factor for the development of other breast cancers. LCIS may be surgically removed. People with a diagnosis of LCIS may benefit from a high-risk screening program.
Inflammatory breast cancer: Rarely, breast cancer will first present as redness, dimpling and swelling of the breast skin. This is because of a particularly aggressive form of invasive breast cancer that spreads in the breast and in the lymph vessels of the skin, causing blockage that results in fluid buildup. Because it can resemble inflammation from an infection, it was called “inflammatory” breast cancer, but it has little to do with inflammation. This breast cancer presentation is treated with drug therapy before surgery.
Metastatic breast cancer: Invasive breast cancer that has spread to distant sites and is considered metastatic. This advanced form of breast cancer is treatable but most often is not curable. It is often consider a chronic illness.
Biological factors to consider
Invasive breast cancer is characterized based on additional pathology findings. Some of these pathology findings include:
- Cell type (histologic type): This feature is based on the growth pattern of the cancer under the microscope. The vast majority (approximately 80%) of breast cancers are a ductal histologic subtype. About 5-10% of breast cancers are lobular. Lobular cancers are less likely to form a distinct mass and their extent may be harder to identify on mammography. There are other less common special histologic types, like mucinous and tubular carcinomas, that have a particularly slow growth and good prognosis.
- Grade: This feature describes how like or unlike normal tissue the cancer is. A higher grade means it is more aggressive and fast growing, and less like normal tissue. A lower grade usually goes along with slower growth. Grading is performed using the Nottingham system, with a range of grades from 1 (low), to 2 (intermediate) to 3 (high).
- Hormone receptor status: Breast cancers that produce estrogen receptors (ER) and/or progesterone receptors (PR) are considered hormone receptor positive. Approximately 80% of breast cancers are hormone receptor positive. These cancers may require estrogen and/or progesterone to grow so anti-hormone treatments can be very effective treatments for these cancers.
- HER2 status (human epidermal growth factor 2): Between 10-20% of breast cancers have too many copies of the HER2 gene, which results in increased production of the HER2 protein on the cancer cell. This high level of HER2, which is a growth factor receptor, allows the cancer cells to grow very quickly. There are special antibody treatments targeted to the HER2 protein that can be given with chemotherapy to treat this particularly aggressive form of breast cancer.
- Oncotype DX: Special genetic testing performed on early stage tumors, which predicts a breast cancer recurrence score. This helps your provider to evaluate whether chemotherapy may benefit you.
Learning that you may have cancer plunges you into uncertainty. The more you understand about your condition, the greater your sense of control. This overview explains diagnosis and treatment planning, to help you understand what to expect as you go through the early steps of your care.
Breast Care at Stanford Health Care
Learn more about how breast cancer is diagnosed and the options for treatment.
Learn more about surgical treatment options that preserve the breast.
Learn more about various approaches to mastectomy.
Learn more about breast cancer may be treated with medications like chemotherapy, targeted therapy, and hormone therapy.
Learn more about how lymph nodes are removed and examined to help stage and treat breast cancer.
Learn more about what it is like to receive radiation treatments for breast cancer.
To make an appointment with a breast cancer specialist, call 650-498-6004.
Learn More About Breast Cancer
What We Offer
Our providers use leading edge techniques to diagnose and treat breast cancer.
About this Condition
Learn about the symptoms, risk factors, types, diagnosis, stages and prevention of breast cancer.
Patient Care Resources
Learn what to expect as you go through the early steps of your care.
Clinical Trials
We offer one of the nation’s most robust clinical trial programs for breast cancer. These research studies evaluate new medical approaches, devices, drugs, and other treatments.
As a Stanford Health Care patient, you may be eligible to participate in open clinical trials. Open trials refer to studies currently recruiting participants or that may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
To learn more about the clinical trials we offer, contact Pei-Jen Chang at 650-725-0866.
Our Clinics
You can access Stanford’s expertise and compassionate care for any stage or type of breast cancer at a location that is convenient for you. We always accept new patients, and we take many insurance plans, including Medicare and Medi-Cal.