The breast cancer staging system is based on three main factors: invasiveness spread to lymph nodes and spread to other parts of the body. The staging system uses number 0-4 to better identify feature and prognosis of particular cancer. Stages of Breast Cancer: Stage 0: This classification is used to describe non-invasive breast cancers, like DCIS. Stage 1a: This classification describes invasive breast cancer where the tumor is at least 2 centimeters long and remains contained in the breast, with no evidence of spread to the lymph nodes or other tissues Stage 1b: This classification describes invasive breast cancer where there are small 0.2-2 millimeter groups of cancer cells found within the lymph nodes. This stage can present with or without a tumor in the breast. Stage 2a: This classification describes invasive breast cancer where there are medium (>2 millimeters) sized tumors found within axillary lymph nodes. This stage can be present with or without a tumor in the breast. However, if there is a tumor in the breast that is larger than 2 centimeters, but smaller than 5 centimeters and no spread to the axillary lymph nodes, this that tumor could also be described as stage 2a. Stage 2b:

Breast Cancer Treatments The treatment of breast cancer will be individualized and based on genetic factors, grade, and stage identified in the diagnosis. There are five main categories of treatment; surgery, chemotherapy, radiation therapy, hormone therapy, and targeted therapies. Any combination of these can be chosen by the patient and the doctor for the best potential outcome. Surgery Surgery to remove the mass is the most common form of treatment for breast cancer. This procedure involves removing the mass as well as the nearby healthy tissue called the margins. The margin is removed in hopes of eradicating the entire tumor and preventing further spread of the cancer. The pathology report will identify if the surgery resulted in “clear margins”, which means that the tumor has not begun to spread outside of the main mass. Occasionally, in more advanced stages of cancer, chemotherapy will be used before surgery to shrink the tumor before its removal. There are three potential surgical options available and range from removing portions of the tumor to removing the entire breast. A lumpectomy, otherwise known as a partial mastectomy, is the least aggressive surgery option available. It only removes the main lump along with the healthy marginal tissue surrounding the tumor.

As with all treatments for disease, the side effects of breast cancer therapy depends on the plan of care. Most breast cancer therapies have similar main side effects. These include pain, nausea, fatigue, hair loss, and osteoporosis (weakening of the bones). However each of the treatment options comes with their own specific set of particular side effects as well. Chemotherapy treatments: can increase the risk of infection, cause anemia, dry skin, brittle nails and an increase in mouth ulcers. More seriously, chemotherapy can affect fertility in both men and women. It can also result in menopausal-like symptoms due to the interference of normal hormonal cycles. The length of time these side effects are experienced by patients depends on the specific drugs used and the total length of treatment. Radiation therapy: side effects are generally divided into two categories: short-term and long-term effects. Short-term effects are caused by the radiation treatment itself and results in severe skin irritations and reddening, breast swelling, breast pain, and change in breast size, shape, or color. Long-term side effects begin weeks to months after the radiation therapy ends and cause hardened breast tissue, breast tenderness, and inflamed lungs resulting in a reoccurring dry cough. Hormonal therapy: as it blocks the normal uptake of specific, crucial hormones for a woman’s monthly cycle, many menopausal-like symptoms including hot flashes, night sweats, vaginal dryness, and mood changes can occur.

Pathology of Breast Cancer Breast cancer is a disease caused by unregulated cell growth in the tissues of the breast. Unlike normal cells, which have specific functions and grow at a controlled rate, cancer cells are mutated and grow rapidly. As growth continues over time the cancer cells will often form a mass of tissue that will develop into a lump or tumor. While it should be noted that not all unusual lumps or abnormalities are cancer, it is important to have every breast lump examined by a medical professional. Once a cancerous tumor or lump has been identified there are two potential classifications for the tissue: noninvasive and invasive cancers. Non-Invasive Breast Cancer Breast cancer that remains inside the breast tissue, the milk lobules, or duct. Does not extend into other normal tissues within or outside of the breast. These will sometimes be called pre-cancers. Invasive Breast Cancer Breast cancers that become invasive are not contained in breast tissue. Grow into the normal surrounding tissue and can spread to other distant parts of the body. This spread is called metastatic breast cancer. Cancer that is found in the breast, but spreads to the bones is an example of metastasizing Survival Rates of Breast Cancer The prognosis or future outlook of each breast cancer patient varies depending on the stage, grade, and course of treatment for each specific tumor.

Breast Lumps Can Be Cancerous or Non Cancerous Benign breast tumors are noncancerous masses of cells that can be removed and will not lead to further harm. Malignant tumors refer to tumors that are composed of cancer cells. Malignant tumors have the ability to spread to other tissues, in a process known as metastasis. What separates benign from malignant tumors is the ability of the cells to spread outside of their structure. Breast Cancer Identified by Type The “type” refers to the area in which the cancer cells originate. While most breast cancer arises from the superficial epithelial cells, some originate in the deeper connective tissue in the breast. The four most common types of breast cancer are carcinomas (originating the epithelial cells) DSIC, or Ductal Carcinoma In Situ  Breast cancer that remains inside the milk ducts. LCIS, or Lobular Carcinoma In Situ A large growth of cells that remain inside the milk lobules.  IDC, or Invasive Ductal Carcinoma Invasive cancer that has spread from the milk ducts to the surround normal breast tissue and is the most common form of breast cancer. ILC, or Invasive Lobular Carcinoma Invasive cancer that begins in the milk lobules but grows into the surrounding normal breast tissue.