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breast cancer

Breast cancer

Breast cancer

Breast cancer is a cancers type that develops in the breast tissue of women and sometimes men. This case is about breast cancer in women. Separate information is available for men with breast cancer .

Breast cancer can develop in all areas of the chest. Another word for breast cancer is mammary carcinoma. 
Breast cancer can be subdivided into the place where it develops: 
  • Ductal: The cancer has developed in a milking parlor
  • Lobular: the cancer has developed in the mammary gland

In addition, there are also rare forms of breast cancer .

If your doctor is only a prerequisite for breast cancer, it is called in situ carcinoma. There are 2 forms of in situ carcinoma: ductal and lobular. Not all breast cancer has to be of the same kind. There may be several types of cancer in one breast at a time, for example a ductal and lobular carcinoma. 
Breast cancer is further subdivided into: 
  • Hormone-sensitive or hormone-sensitive breast cancer
  • HER2 positive breast cancer and HER2 negative breast cancer
  • Triple negative breast cancer

Ductal carcinoma in situ

Are there turbulent abnormal cells in the milk tubes, which have not yet grown through the walls of the milk tubes? Then this is a precursor of breast cancer. This is a "non-invasive" tumor. Usually this is a ductal carcinoma in situ (DCIS). For example, DCIS can be detected early in the population survey. 

Each year 1,800 patients have DCIS. 
Normally, milking passages feel smooth, sometimes the dairy gangs may feel hard and dizzy at a DCIS. However, in 80-85% of all DCIS cases is nothing to feel. Mammal patches are often visible on mammography. Another word for this is microcalcifications. These occur when the cancer cells in the tubes choke each other, die and then calcify. Kalkspats do not always indicate a DCIS. They may also have a benign cause. To investigate whether these lime pats are good or malignant, you get a biopsy. 

In DCIS, you usually get an operation. That's no different from invasive breast cancer. You will have a chest-lung operation with irradiation or chest irradiation without irradiation. 

DCIS does not grow through the wall of the milk tubes and, for that reason, does not cause any sowing. Sometimes there is also an invasive tumor between the DCIS. That's why you sometimes get a shield gland procedure . This applies especially to high grade DCIS (grade 3) and if the area with a DCIS is large.

Treating a DCIS reduces the risk of developing an invasive form of breast cancer. After treatment of a DCIS, the risk of cure is almost 100%. 
A DCIS that is not treated can develop into an invasive tumor. It is impossible to tell which women this happens and which women do not.

Lobular Carcinoma In situ (LCIS)

This form of breast cancer develops in a mammary gland and has not yet grown outside the wall of the mammary gland. LCIS is a precursor of breast cancer. LCIS increases the risk of developing lobular carcinoma. This stage of breast cancer is hard to find. Usually it is found by chance. 

Invasive ductal carcinoma

This cancer develops in the milking passages and can grow beyond. The invasive ductal carcinoma is the most common form of breast cancer and can feel like a hard bump. 

Invasive lobular carcinoma

This cancer occurs in the milk glands. The tumor is often only felt like a swelling of the breast. On a mammography or at an MRI, the lobular tumor is not always good to see. Under a microscope, small tumor cells can be seen, which are in strands. Lobular tumors occur less often than ductal tumors: in 5 to 15% of breast cancer. The prognosis of hormone-sensitive ductal carcinoma is the same as of a lobular carcinoma. These forms are therefore often treated in the same way. 

Another additional classification of breast cancer is based on the presence of receptors or the HER2 protein.

Hormone-sensitive or hormone-sensitive

Breast cancer can be hormone-sensitive or hormone-sensitive. That's important to know before treatment because hormonal therapy only works with hormone-sensitive breast cancer. 

Hormone-sensitive means that hormones can stimulate the tumor to grow and share. The hormones, for example estrogens, bind to receptors in the tumor cell. This is also called hormone receptor-positive breast cancer. 

If there are no receptors, you have hormone receptor-negative or hormone-sensitive breast cancer. This is also called an ER negative and / or PR negative tumor. The tumor does not grow under the influence of hormones. 

If more than 10% of the cancer cells have estrogen receptors, the cancer is called ER-positive in the Netherlands. Estrogen then stimulates tumor growth. A tumor less than 10% ER-positive is called ER negative. In progesterone sensitivity, the tumor is called PR-positive. 80% of breast cancer is ER-positive. About 65% of this ER positive breast tumor is also PR positive. 
Aromatase inhibitors reduce estrogen production, which causes the tumor to grow less or no longer. The tumor cells then die over time.

HER2-positive or HER2-negative

Breast cancer is also subdivided into HER2-positive or HER2-negative. That's important to know for treatment. HER2 positive breast cancer can be treated with targeted therapy. HER2 is a protein and stands for: Human Epidermal Growth Factor Receptor 2. 

A HER2-positive tumor means that excess HER2 protein is present on the tumor. HER2 protein stimulates tumor growth. To know if you are eligible for targeted therapy, the doctor must first investigate whether the tumor has too much HER2 protein.

Triple negative breast cancer 

In triple negative breast cancer, the protein HER2 is missing. In addition, the receptors for estrogen and progesterone (ER and PR) are also absent. Because it lacks all three, one speaks of triple negative breast cancer. Either: 3 times negative. 

Hormonal therapy correctly uses these receptors. The drug trastuzumab needs the HER2 protein. Therefore, hormonal therapy or treatment with trastuzumab in triple negative breast cancer is not useful.

Tumorin filtering lymphocytes 

The presence of tumor-infiltrating lymphocytes (TIL's) says something about their own defense against the tumor cells. If the defects in the cells are no longer cleared by the own immune system, cancer can develop. It is known that tumor-infiltrating lymphocytes have a predictive value in triple-negative breast cancer. When there are many tumor-infiltrating lymphocytes, patients have a better prognosis.

Benign diseases

A change in or chest does not necessarily indicate cancer. Usually it is a benign condition, such as a cyst. A cyst is a cavity filled with moisture. 

Benign cells cause swelling but do not grow through other tissues and do not spread through the rest of the body. There are more benign breast complaints. They are known as mastopathy.

Does the physician not know enough about the type of abnormality? Then he always advises further research.