Learn

Understanding your diagnosis

It is normal to have a range of emotions from shock, fear, stress, anger, or numbness after having a breast cancer diagnosis. It may be overwhelming to understand all of the terms, the next steps, financial aspects of treatment, the welfare of your family, your career, and your physical, mental, and emotional well-being.

Here you will find some information about diagnosis and treatment options that can give you a foundation to learn more about your breast cancer and be able to make key decisions for you. Remember, this is only general information and what you and your provider decide will be unique to you.

Types of Breast Cancer

Source: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/breast

DCIS

DCIS or ductal carcinoma in situ, occurs when there are abnormal cells found in the lining of the milk ducts that carry milk to the nipple. This type of cancer has not broken though the walls of the duct into healthy breast tissue. This type of cancer is also known as stage 0 breast cancer.

Diagnosis usually occurs via mammography and then biopsy.

Treatment involves local treatment via surgery +/- radiation and systemic treatment with an estrogen-blocking pill if your cancer responds to estrogen (ER+).

Invasive Cancer

There are different types of invasive cancer. The most common type is invasive ductal cancer, followed by invasive lobular cancer. There are other types such as mammary carcinoma and metaplastic to name a few. Each cancer is tested for three receptors: estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (her2). The status of your receptors will impact which systemic treatments you will receive.

Inflammatory Breast Cancer

Inflammatory breast cancer is an aggressive type of invasive cancer that bring about symptoms rather quickly. Symptoms include: breast swelling, skin color changes, breast pain, thickening of the skin, dimpling of the skin. It may look like an infection and thus it is important to diagnose and treat quickly. If antibiotics do not improve symptoms then it is important to see a breast surgeon.

Treatment involves chemotherapy before surgery followed by mastectomy, and then radiation.

Treatment

There are two parts to breast cancer: local treatment and systemic treatment. Local treatment aims at controlling the disease in the breast and lymph nodes. Systemic treatments treats the disease throughout your body system and aims to get rid of small tiny cancer cells that may have traveled way from the breast. Sometimes surgery is performed first followed by systemic treatment and at other times systemic treatment (neoadjuvant treatment) is given before surgery.

Local therapy includes surgery with or without radiation. Types of surgery are lumpectomy (aka partial mastectomy or breast conservation) and mastectomy. A sentinel lymph nodes biopsy is performed at the time of either surgery to have an appropriate pathologic stage and to ensure cancer has not spread to the lymph nodes. There are different types of mastectomies and this will be individualized to you and your cancer. Radiation is usually given after lumpectomy surgery as this has shown to decrease recurrence rates. Radiation is only sometimes given after mastectomy if the tumor is very large, involves, the lymph nodes, skin, or chest wall.

Systemic therapy involves chemotherapy, hormonal therapy, and targeted therapy. Chemotherapy is not given to every patient and it depends on the type of breast cancer and your oncotype (genomic testing on estrogen receptor positive/ her2 negative tumors). Hormonal therapy is given to patients who have estrogen receptor positive tumors.