Types of Breast Cancer
by Beth G. Hodges, MD

There are several different types of breast cancer and treatment depends on the type. Symptoms may vary with different types as well.

The main types of breast cancer are ductal and lobular, and each of these can be further divided into "in situ" which means very localized and invasive, which means spreading beyond the area of the cancer itself into the local tissue. Other, less common types of breast cancer include inflammatory breast cancer, cyst sarcoma phyllodes, and Paget's disease of the nipple. Very rarely, a lymphoma can present in the breast, but that is not a "breast cancer" and is treated as a lymphoma, which is a cancer of the lymph system.

Ductal Breast Cancer

As mentioned, ductal carcinoma can be broken down into in situ (DCIS) or invasive. DCIS presents as micro calcifications on mammogram and can arise in several areas simultaneously. It is treated by removing the involved area (usually a lumpectomy, where the surgeon takes out only the part of the breast that is involved, as opposed to a mastectomy, where the entire breast is removed) and possibly some treatment afterwards, such as radiation to the area and/or long term use of an estrogen antagonist, such as tamoxifen or hormonal chemotherapeutic agents such as Arimidex or Femara. These are all pills that are taken daily longterm to suppress cancer growth in the breast. If not treated, 40% of women diagnosed with DCIS will go on to develop invasive breast cancer.

Invasive ductal carcinoma , as it sounds, start in the duct of the breast. It is the most common type of breast cancer, comprising 65-85% of all breast cancers, and can present as a mass or a microcalcifications on mammography. Treatment is dependent on the extent of the disease at the time of diagnosis.

Lobular Breast Cancer

Lobular breast cancer also can be broken down into in situ (LCIS) versus invasive. LCIS can present simultaneously in multiple sites and even bilaterally. The risk of invasive breast cancer is 1% per year and can reoccur in either breast, even if the original carcinoma was only in the other breast initially. It will sometimes not resurface for 20 years, so patients with this type of cancer need longterm follow-up and surveillance.

Invasive lobular carcinoma only comprises 5-10% of all breast cancers and also can occur bilaterally or as multiple tumors in the same breast. Follow this link to learn more about lobular breast cancer

Inflammatory Breast Cancer

Inflammatory breast cancer, another type of breast cancer, is rare, comprising only 1-3% of all breast cancers. This type of cancer is aggressive and is not found on mammogram or ultrasound. Unfortunately, because of this difficulty with diagnosis, it is usually not found until it is advanced and it can easily be initially misdiagnosed as another condition, such as an infection of the skin of the breast called cellulitis. It is usually treated with a total mastectomy, chemotherapy either before or after surgery, and radiation. Click for more information about inflammatory breast cancer.

Pagets Disease of the Breast

Paget's disease of the nipple is also a rare form of breast cancer, presenting as pain, itching, or burning of the nipple, sometimes with redness or scaling. It is usually diagnosed when the patient does not respond to an initial treatment for eczema or a fungal infection of the nipple, which raises the suspicion of the physician. Diagnosis is usually made by biopsy.

Cystosarcoma phyllodes

Cystosarcoma phyllodes is another rare form of breast cancer, usually presenting as a firm, isolated tumor. It spreads through the blood as opposed to the lymph system, and is much less aggressive and easier to treat.

Types of breast cancer are several and this article hopefully demonstrates that annual mammography in a woman over forty (sometimes starting earlier if there is a strong family history of breast cancer) as well as self-breast exam monthly and reporting unusual symptoms of the breast to a medical provider are all important modalities of breast cancer surveillance ad prevention.

Published - October, 2009