Methodist Healthcare - December 07, 2020

Following a mammogram, it is common for your healthcare provider to call with the results. Understanding the results can help determine the treatment option(s) best for you.

Types of breast cancer

There are two main types of breast cancer, which differ in their points of origin in the breast.

  • Ductal carcinoma ‐ begins in the cells that line the milk ducts in the breast, also called the lining of the breast ducts.
  • Lobular carcinoma ‐ begins in the lobes, or lobules (the glands that make milk) of the breast.

Breast cancer grades

Breast cancer grades refer to how close the biopsy sample looks to normal breast tissue and how rapidly the cancer cells are dividing. The lower the number, the slower the cancer is growing, making it less likely to spread.

Staging identifies if the cancer has spread within the breast or to other parts of the body.

  • Stage 0 (ductal carcinoma in situ or DCIS) ‐ has not spread beyond the actual tumor.
  • Stage I, II & III ‐ Stage I is smaller in size, is less likely to have lymph node involvement, and has lower risk molecular features. Stage III is larger and is more likely to have lymph node involvement or other high risk molecular features.
  • Stage IV ‐ cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.

Breast cancer is also classified by whether the cancer has estrogen receptors (ER), progesterone receptors (PR), and/or a growth-promoting protein called HER2/neu.

Breast cancer patients can receive up to three different classifications for their breast cancer: type, grade, and stage. It is important to know your specific diagnosis so you can better understand your treatment plan.

Treatment options

Advancements in medicine have provided a wide range of treatments for breast cancer, including both surgical and therapeutic. Depending on your age, type of breast cancer and grade will determine the type of treatment or combination of treatments appropriate for you.

There are two primary types of surgical options for breast cancer – one that preserves the breast (lumpectomy) and one that removes the breast (mastectomy).

  • A lumpectomy is considered a breast-conserving surgery, and the goal of the procedure is to remove the cancer and some of the surrounding normal tissue, while leaving the remainder of the breast intact.
  • A mastectomy removes all breast tissue from the entire breast

Preventative mastectomy surgery is the removal of all breast tissue to prevent breast cancer. Surgical Oncologist Alfredo Santillan, MD notes that 10-15% of all breast cancer is related to genetics. If you or a loved one have a strong family history of breast cancer, we encourage you to speak with your healthcare provider about getting tested to determine if you are a genetic carrier.

Treatment of breast cancer can be a multi-disciplinary approach. Surgery is traditionally the first treatment, but alone does not always cure breast cancer.

Additional treatments may include:

  • Chemotherapy is administered prior to surgery to shrink cancer cells (preoperative therapy or neoadjuvant therapy) or after surgery (postoperative therapy or adjuvant therapy) to prevent cancer cells from returning.
  • Hormonal therapy blocks hormones (estrogen and progesterone) in certain types of tumors that are driven off the female hormones.
  • Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
  • Radiation therapy uses high-energy X-rays through either external radiation (sending radiation from outside the body to the cancer) or internal radiation (placing a radioactive substance sealed in needles, seeds, or wires directly into or near the cancer).
For more information on the breast cancer services available, call askSARAH at (210) 507-0941 or visit our breast cancer page.

Sources: Sarah Cannon, Centers for Disease Control and Prevention and National Cancer Institute