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Breast Cancer

This cancer is a a malignant growth that begins in the tissues of the breast.

The main types of breast cancer are:



Ductal Carcinoma in Situ

It occurs when the cells lining the milk ducts (the channels in the breast that carry milk to the nipple) become cancerous, but stay contained within the ducts without growing through into the surrounding breast tissue. Sometimes DCIS may be described as pre-cancerous, pre-invasive, non-invasive or intraductal cancer.

Breast Anatomy

If DCIS is left untreated, it may, over a period of years, begin to spread into (invade) the breast tissue surrounding the ducts. It is then known as invasive breast cancer. It is important to remember that although DCIS should be treated to prevent it developing into an invasive breast cancer, it is not harmful at this stage. Not every woman with DCIS will go on to develop breast cancer if it is left untreated, but it is not possible to predict which women with DCIS will develop breast cancer.

There are three grades of DCIS – low, intermediate and high. The grade refers to how abnormal the cells look under the microscope and gives an idea of how quickly the cells may develop into an invasive cancer (or how likely it is that the DCIS will come back after surgery). Low-grade DCIS has the lowest risk of developing into an invasive cancer and high-grade the greatest risk.



Invasive Ductal Carcinoma

About 75% percent of all invasive breast cancers are ductal carcinomas. Under the microscope, ductal carcinoma looks like a mass with poorly defined edges that have begun to extend into the surrounding tissue. As the cancer invades the fatty tissue around a duct, it causes the formation of fibrous, scar-like tissue. Such scar formation may make ductal carcinoma appear larger than it actually is. Depending upon the location of the tumor, the symptoms of invasive ductal carcinoma may include retraction (drawing inward) of the nipple or nipple discharge and skin changes such as wrinkling or dimpling.



Lobular Carcinoma in Situ

Lobular carcinoma in situ (LCIS) is not a cancer, but its presence means that there is a small increase in the risk of developing breast cancer later in life. Even so, most women with LCIS do not develop breast cancer.

Each breast contains hundreds of tiny lobules where milk is produced before and after childbirth. With LCIS, changes are found in the cells in the lining of the lobules or lobes of the breast. It is often present in both breasts. LCIS is more common in women who have not reached their menopause (change of life).

How is LCIS diagnosed? LCIS is usually discovered as a chance finding after a woman has had a breast biopsy (removal of a small piece of tissue) or a breast lump removed.

Although LCIS itself does not show up on a mammogram (breast x-ray), it may be found incidentally after removing a suspicious area that has shown up on a mammogram.



Invasive Lobular Carcinoma

Lobular carcinomas make up approximately 5% to 10% of all invasive breast cancers. Lobular breast cancer is more difficult to detect by mammography because it may not occur as a distinct lump. Instead, lobular carcinoma may appear as an irregular thickening in the breast. A small proportion of women (~5%) may develop lobular carcinoma in both breasts.



Medullary Carcinoma

This is a less common form of breast cancer than invasive duct carcinoma. It also has a better prognosis than I.D.C. The problem with this tumor is that it can be mistaken for a begnin condition becasue on clinical exam itr is usually large, soft, deap, and moves freely.



Paget's disease of the nipple

Paget's disease of the breast is an uncommon type of cancer that occurs in 1 to 4 percent of all people with breast cancer. It is sometimes called mammary Paget's disease. Paget's disease of the breast can develop in men, but it is very rare.