The words “breast cancer” instill fear and terror in anyone receiving this dreaded diagnosis. It’s important to understand the different types, stages, and grades of breast cancer, with some forms being less aggressive than others. In today’s post, I’ll be breaking down the various types of breast cancer in terms of disease risk, outcome, and treatment options. Here are 10 facts about breast cancer every woman needs to know considering the disease affects 10-12% of women, with one in eight in the United States developing the disease.
Excluding skin cancer, breast cancer is the most common type of cancer affecting women in the US, and is the second leading cause of death following lung cancer. In fact, The American Cancer Society estimates that a staggering 268,600 women will be diagnosed with invasive breast cancer in 2019, with 62,930 cases being diagnosed with the non-invasive type, resulting in over 40,000 deaths.
Men can get breast cancer as well, but the instances are rare with only one in a thousand men developing the disease.
What Is Breast Cancer?
Breast cancer is the result of epithelial cells in the breast growing uncontrollably to form a lump or tumor. These malignant cells can invade surrounding tissues, and spread via the lymphatic vessels to areas outside the breast, resulting in metastatic breast cancer of the lung, bone, or brain. Interestingly, breast cancer doesn’t cause pain until it has spread.
Most breast cancers are ductal cancers, meaning they occur in the milk-carrying ducts, but some cancers originate in the glands that produce breast milk, and are called lobular cancers. Cancer cells within the breast can form lumps, which can often be found in the early stages through mammography or self-examinations, before symptoms occur. Not all types of breast cancer cause lump formation.
It’s important to keep in mind that most lumps found in the breast are not malignant, but are abnormal benign growths contained within the breast and are not dangerous. Benign lumps may possibly increase future breast cancer risk.
Types Of Breast Cancer
Non-invasive: Non-invasive breast cancer is characterized by fast-growing cells that have not yet spread beyond the breast, and is therefore not life threatening. DCIS or Ductal Carcinoma In-Situ is a non-invasive type of breast cancer that may potentially be pre-cancerous, but may not cause any future issues.
Many practitioners, including Dr. Christiane Northrup, an OBGYN physician, now believe that DCIS is something you die with, rather than something you die of. A 1995 Lancet study noted a 328% increase in DCIS over a period of 12 years, with a 200% increase due to mammography use.
Invasive: In this type of breast cancer, cells also grow abnormally fast, spreading to other areas of the body. Invasive breast cancer develops overs years, with mutations slowly changing normal cells into malignant ones. This type of breast cancer can be life threatening.
IDC or Infiltrating Ductal Carcinoma and ILC or Infiltrating Lobular Carcinoma are the two most common invasive cancer cell types. They are treated conventionally with surgery, radiation, hormonal therapy, and in some cases chemotherapy. There are other types of invasive cancer of the breast, as well but they are less common.
Stages of Cancer
Knowing the stage of the cancer is significant for accessing how aggressive it is based on tumor size, lymph node involvement, and the degree of metastases. Cancer stage differs from cancer grade, which references the abnormality of cancer cells when viewed under a microscope.
Stage 0: The cancer is contained to one area, has not spread, and is referred to as “In situ.”
Stage 1: The earliest stage of breast cancer characterized by a tumor no bigger than two centimeters. Cancer has not spread to the lymph vessels or bloodstream.
Stage 2: In this stage, the cancer has begun to spread into nearby tissues, including the bloodstream and lymph system, with tumor side exceeding two centimeters.
Stage 3: A more advanced form of cancer, the tumor may be small or large, with cancer cells in surrounding tissues and lymph nodes, but organs have not yet been affected.
Stage 4: Cancers in this stage are malignant, invasive, and metastatic, affecting tissues and organs.
[Read my post: “The Stages of Cancer”]
The Importance Of Knowing Your Tumor Receptors
Cells contain proteins or receptors on their surface. These receptors are responsible for turning cancer growth off or on, functioning kind of like a light switch. There are three types of breast cancer receptors: estrogen receptors (ER), progesterone receptors (PR), and HER2 receptors. Receptors are not related to the stage and grade of cancer.
Knowing what type of receptors are on the surface of cancer cells helps determine the nature of the cancer, dictating treatment options. If the result of a breast biopsy is invasive, tests are run on the same tissue to access which receptors are present. This is where it gets complicated, though because the various receptors can be either positive or negative.
Breast Cancer Receptor Types
Here are the different types of receptors that will impact treatment:
Estrogen receptor positive (ER+) : This type of cancer has receptors for estrogen which promote cancer growth. It is the most common type of breast cancer, with two out of every three cancers testing positive for hormone receptors.
Estrogen receptor negative (ER-): Cancer cells do not respond to estrogen and progesterone signaling, and are typically treated with surgery. Estrogen receptor negative cancers may, however still have receptors for HER2.
Progesterone receptor positive (PR+): Receptors for progesterone are found on cancer cells.
HER2-Positive (HER2+): An oncogene that promotes the development of cancer, making it more aggressive by producing a gene that sits on the surface of breast cancer cells. In HER2 positive cancer, receptors genes are over-expressed, resulting in too many copies of the gene, which causes the cancer cells to be more aggressive.
Triple negative (ER-) (PR-) (HER2-): A highly aggressive form of cancer that is more likely to be metastatic, triple negative cancers test negative for estrogen, progesterone and the HER2 protein. This type of cancer does not respond to hormonal therapy.
It’s possible that hormone receptor positive cancers may lose some of their receptors over time, with the converse also being true, with hormone receptor negative cancers gaining receptors. Hormonal therapy is used to interrupt the effect of hormones on cancer cell functioning and growth.
Signs To Look For
It’s critical to be aware of potential signs of breast cancer, including changes in breast size or shape, nipple discharge or inversion, skin dimpling or puckering, persistent pain in one area, discoloration, scaly patches of skin, redness or swelling, areas of warmth, or darkening of the breast. Don’t be unduly alarmed if you notice any of these signs as most don’t turn out to be breast cancer, but do get promptly checked to cover your bases.
Diagnosis is usually confirmed through a biopsy to determine if a mass is malignant or benign. If malignant, further testing is required to determine if metastasis has occurred, and which treatment options will be the most effective. Outcomes depend on the age you are at the time of diagnosis, the type of breast cancer you have, receptor type, and the degree of metastasis.
Your risk of developing breast cancer increases if you are:
- Have never breastfed a child
- Drink alcohol frequently or smoke
- Have been around ionizing radiation
- Began menstruating before age 12
- Bore children at an older age or never became pregnant
- Have a family history of breast cancer
- Have a care-taking personality, always putting yourself last
Under 10% percent of breast cancers have a genetic link, including the BRCA1 and BRCA2 genes. While you can’t control your genetics or family history of cancer, it is possible to reduce your risk by how you live.
Treatment Options And Approaches
Breast cancer is very complex, with various treatment options and approaches available. Treatment will depend on the type, stage, and grade of the cancer, along with receptor type. It’s critical to remember that you do not need to make rash decisions regarding treatment or let anyone persuade you in doing any treatment you’re not comfortable with. Take your time and weigh all your options before deciding.
Conventional treatments include:
4. Neoadjuvant chemotherapy (chemo given before surgery)
5. Hormonal therapy
6. Targeted immunotherapy
Some patients choose to be treated solely using alternative cancer therapies or used in conjunction with conventional therapies.
Biopsies, ultrasounds, mammograms, genetic testing, genomic assays, MRIs, CT scans, PET scans, Chest X-rays, and bone scans are used diagnostically.
10 Facts About Breast Cancer Your Doctor May Not Tell You
1. Chemotherapy does not kill cancer stem cells, only tumor cells.
2. Only 5% of cancers are genetic.
3. Unhealthy lifestyle habits can turn on cancer genes. What you eat, how you move, how much sleep you get, how you think, your emotional wounds, and even the health of your mouth are vitally important in determining cancer risk.
4. Negative gene expression can be altered by engaging in healthy lifestyle strategies as had been seen in the study of Epigenetics. For instance, Nutrigenomics is the science of how food impacts gene expression.
5. Sugar feeds cancer. Since cancer cells have more insulin receptors on their cell membranes, eating sugar fuels their growth.
6. Cancer is a preventable disease if major lifestyle changes are implemented.
7. 10 million people will be affected by cancer worldwide.
8. Alternative cancer therapies help and can be used in conjunction with conventional therapies to build the immune system.
9. Chemotherapy and radiation increase stem cells and circulating tumor cells. A long-term cure is not possible unless stem cells, or tumor-initiating cancer cells are eradicated. Chemotherapy actually increases stem cell resistance, making them more aggressive later on, requiring even more chemotherapy and radiation. This is significant because stems cells are responsible for metastasis.
10. Alternative cancer treatments have a positive effect on stem cells. For instance, sulphorophane or broccoli sprouts have been shown to kill stem cells. Curcumin is a powerful remedy for reducing inflammation and firing protective genes. Halen, a non-GMO fermented soy product originating in China, also inhibits stem cell production. There are many more alternative and complementary cancer therapies that have been used successfully to treat cancer.
Although, up to 10% of women will be diagnosed with breast cancer in their lifetime, 90% will be cured with treatment. It’s vitally important to look for possible signs that could indicate cancer, and reduce your risk of developing the disease by adhering to a healthy lifestyle, such as eating well, exercising, aiming for a healthy body weight, not smoking, limiting alcohol consumption, learning coping strategies for dealing with stress, evaluating your relationships, and decreasing your exposure to environmental and household toxicity.
Cancer is frightening but you can reduce your chances of developing it by being your own advocate. If you have cancer, I wish you well on your healing journey.
Do you or someone you love have breast cancer? Let me know in the comments:)
BreastCancerCourse.org: What Is Breast Cancer
American Cancer Society: About Breast Cancer
BreastCancer.org: Hormone Receptor Status
Susan G Komen: The Who, What, Where, When And Sometimes, Why
Pink Ribbons And Promises: Category Archives: Dr. Christiane Northrup
Disclaimer: This article is strictly for informational purposes only and is not intended to be medical advice.