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BREAST CANCER

 

Breast cancer, also known as carcinoma of the breast, starts when a single cell in the tissue of that breast starts to divide and grow in an abnormal way.  There are different types of breast cancer and it is important that an accurate diagnosis is made so that the most appropriate treatment can be planned.

This is an early form of breast cancer where the malignant cells are only found within the milk ducts and have not developed the ability to spread into either the breast tissue or other parts of the body.  As it does not spread it is sometimes described as pre-cancerous, intraductal or non- invasive carcinoma. It does not usually present any visible or palpable symptoms and is most commonly diagnosed during routine mammography.

Most breast cancers fall within this category. The cancer cells are no longer contained within the ducts but have spread to the surrounding breast tissue. They also have the ability to spread to other parts of the body. The most common sign of an Invasive Ductal Carcinoma is an abnormal lump, or sometimes an area of nodularity (glandular breast tissue) without a definite lump. There may also be nipple changes or a nipple discharge - however these symptoms are not usually due to cancer if there is no lump. Sometimes a swelling occurs under the arm.

This is a pre invasive carcinoma, where there are abnormal changes to the cells lining the lobules within the breast. The presence of LCIS may indicate that there is a small increased risk of developing breast cancer but often no treatment is required other than careful monitoring of the condition.

This cancer occurs when malignant cells in the lobules at the end of the breast ducts have begun to spread out into the breast tissue.  It is usually no more serious than other types of cancer but it does behave differently in that, when it occurs, the entire breast tends to be genetically, or genomically unstable.  It can also occur in both breasts at the same time and has a slightly higher risk, at a later date, of occurring in the opposite breast.  These carcinomas tend to be less receptive to hormone treatment.   Lobular cancers may not show up on a mammogram as they have the same density as normal breast tissue. Fortunately they are often palpable so it is important that everyone has a clinical examination. 

Although ductal and lobular cancers make up 95% of breast cancers, there are other types. The full diagnosis will be made by the pathologist and treatment will be planned accordingly.  We will always ensure that we pass on to you all the relevant information about your cancer.

Following diagnosis of Breast Cancer, your cancer specialist will usually want to carry out further tests and investigations. This will include tests to find out the stage and the grade of the cancer, which helps determine the best treatment plan for you.

The stage of a cancer defines its size and whether it has spread beyond its original site. Staging may involve further scans and tests.

The grade of a cancer gives an idea of how quickly the disease may develop. To find the grade of your cancer, your doctors will examine the cancer cells under a microscope.

Two of the most commonly used staging systems are a numbered staging system and the TNM staging system.

TNM stands for Tumour, Node and Metastases.

  • T describes the size of the tumour
  • N describes whether the cancer has spread to the lymph nodes.
  • M describes whether the cancer has spread to another part of the body (metastatic or secondary cancer).

Each cancer has its own staging system. Not every cancer uses a number or TNM system.

Grading is about how the cancer cells look under the microscope when compared with normal cells. Many cancers use the following grading system:

  • Grade 1 or low-grade or well differentiated - The cancer cells look similar to normal cells and usually grow slowly and are less likely to spread.
  • Grade 2 or moderate-or intermediate-grade - The cancer cells look more abnormal and are slightly faster growing.
  • Grade 3 or high-grade or poorly differentiated - The cancer cells look very different from normal cells and may grow more quickly.

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