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Types of Breast Cancer

The type of breast cancer you have helps your Physician determine the best way to approach the disease. The list below identifies the various types of breast cancer and how they differ.

Should your doctor suspect that you have breast cancer; in order to confirm the diagnosis, a pathologist analyzes a tissue sample (biopsy) taken from the lump or the suspect area in your breast. This will determine if it is cancerous c some other, benign condition. If the biopsy does show cancer, the results provide your doctor with information about the type of breast cancer and help determine treatment options.

The biopsy results appear on a pathology report, which provides detailed information including the type of breast cancer, if it’s invasive or noninvasive, the tumor grade — how closely the cancer cells resemble normal tissue — if the cancer is sensitive to hormonal therapies and if it has too much of a protein called HER-2.

There are many sophisticated lab tests that can also analyze breast cancer tissue for molecular and genetic features of breast cancer cells.  Each helps your doctor tailor a treatment plan.

Common types of Breast Cancer

The most common types of breast cancer begin either in your breast’s milk ducts (ductal carcinoma) or in the milk-producing glands (lobular carcinoma). The point of origin is determined by the appearance of the cancer cells under a microscope.

In situ breast cancer
In situ (noninvasive) breast cancer refers to cancer in which the cells have remained within their place of origin — they haven’t spread to breast tissue around the duct or lobule. The most common type of noninvasive breast cancer is ductal carcinoma in situ (DCIS), which is confined to the lining of the milk ducts. The abnormal cells haven’t spread through the duct walls into surrounding breast tissue. With appropriate treatment, DCIS has an excellent prognosis.

Invasive breast cancer
Invasive (infiltrating) breast cancers spread outside the membrane that lines a duct or lobule, invading the surrounding tissues. The cancer cells can then travel to other parts of your body, such as the lymph nodes.

  • Invasive ductal carcinoma (IDC). IDC accounts for about 70 percent of all breast cancers. The cancer cells form in the lining of your milk duct, then break through the ductal wall and invade nearby breast tissue. The cancer cells may remain localized — staying near the site of origin — or spread (metastasize) throughout your body, carried by your bloodstream or lymphatic system.

  • Invasive lobular carcinoma (ILC). Although less common than IDC, this type of breast cancer invades in a similar way, starting in the milk-producing lobules and then breaking into the surrounding breast tissue. ILC can also spread to more distant parts of your body. With this type of cancer, you typically won’t feel a distinct, firm lump but rather a fullness or area of thickening.

  • Inflammatory Breast Cancer (IBF) Is a very rare and very aggressive type of Breast Cancer in which the caner cells block the lymph vessels in the skin of the breast. This type of cancer is called “inflammatory” because the breast often looks swollen and red or inflamed.  It tends to be diagnosed in younger women compared to non-IBC breast cancer and occurs more frequently and at a younger age in African Americans than in Whites. Click here for more information on Inflammatory Breast Cancer.

Less common types of Breast Cancer

Not all types of breast cancer begin in a duct or lobule. Less common types of breast cancer may arise from the breast’s supporting tissue, including the fibrous connective tissue, blood vessels and lymphatic system. In addition, some tumors don’t actually begin in the breast but represent a different type of cancer that has spread (metastasized) from another part of the body, such as the lymphatic system (non-Hodgkin’s lymphoma), skin (melanoma), colon or lungs. These are not called breast cancer but are referred to as cancer from where it started, now metastatic to the breast.

Unusual types of breast cancer include inflammatory breast cancer, phyllodes tumor, angiosarcoma, osteosarcoma, metaplastic breast cancer, adenoid cystic carcinoma and Paget’s disease of the breast. There are also rare subtypes of invasive ductal carcinoma — tubular, mucinous, medullary and papillary.

Tumor grade
If the cancer is an invasive type, the pathologist assigns it a grade. The grade is based on how closely cells in the sample tissue resemble normal breast tissue under the microscope. The grading information, along with the cell type, helps your doctor determine treatment options.

Breast cancers are graded on a 1 to 3 scale:

  • Grade 1. The cells still look fairly normal (well differentiated).
  • Grade 2. The cells are somewhat abnormal (moderately differentiated).
  • Grade 3. The cells have lost their proper structure and function (poorly differentiated).

The pathologist determines the grade by looking at the size and shape of both the cell and its nucleus and counting how many cells are in the process of dividing. A higher grade suggests a faster growing cancer that’s more likely to spread.