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21st Century Adult Cancer Sourcebook: Breast Cancer - Clinical Data for Patients, Families, and Physicians

21st Century Adult Cancer Sourcebook: Breast Cancer - Clinical Data for Patients, Families, and Physicians

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21st Century Adult Cancer Sourcebook: Breast Cancer - Clinical Data for Patients, Families, and Physicians

Longueur:
1,811 pages
18 heures
Sortie:
Sep 26, 2011
ISBN:
9781465915122
Format:
Livre

Description

Authoritative information and practical advice from the nation's cancer experts about breast cancer includes official medical data on signs, symptoms, treatment options, surgery, radiation, drugs, chemotherapy, staging, biology, prognosis, and survival, with a complete glossary of technical medical terms and current references. Starting with the basics, and advancing to detailed patient-oriented and physician-quality information, this comprehensive in-depth compilation gives empowered patients, families, caregivers, nurses, and physicians the knowledge they need to understand the diagnosis and treatment of breast cancer - covering mastectomy, hormone therapy, SERM and Tamoxifen, tissue sampling, mammograms, MRIs, thermography, biopsy, invasive ductal cancer, inflammatory cancer, Paget disease, DCIS, lobular LCIS, and much more.

Comprehensive data on clinical trials related to breast cancer is included - with information on intervention, sponsor, gender, age group, trial phase, number of enrolled patients, funding source, study type, study design, NCT identification number and other IDs, first received date, start date, completion date, primary completion date, last updated date, last verified date, associated acronym, and outcome measures.

Extensive supplements, with chapters gathered from our Cancer Toolkit series and other reports, cover a broad range of cancer topics useful to cancer patients. This edition includes our exclusive Guide to Leading Medical Websites with updated links to 81 of the best sites for medical information, which let you quickly check for updates from the government and the best commercial portals, news sites, reference/textbook/non-commercial portals, and health organizations. Supplemental coverage includes:

Levels of Evidence for Cancer Treatment Studies
Glossary of Clinical Trial Terms
Clinical Trials Background Information and In-Depth Program
Clinical Trials at NIH
How To Find A Cancer Treatment Trial: A Ten-Step Guide
Taking Part in Cancer Treatment Research Studies
Access to Investigational Drugs
Clinical Trials Conducted by the National Cancer Institute's Center for Cancer Research at the National Institutes of Health Clinical Center
Taking Time: Support for People with Cancer
Facing Forward - Life After Cancer Treatment
Chemotherapy and You

This is a privately authored news service and educational publication of Progressive Management. For over a quarter of a century, our news, educational, technical, scientific, and medical publications have made unique and valuable references accessible to all people. Our e-books put knowledge at your fingertips, and an expert in your pocket!

Sortie:
Sep 26, 2011
ISBN:
9781465915122
Format:
Livre

À propos de l'auteur

Progressive Management: For over a quarter of a century, our news, educational, technical, scientific, and medical publications have made unique and valuable references accessible to all people. Our imprints include PM Medical Health News, Advanced Professional Education and News Service, Auto Racing Analysis, and World Spaceflight News. Many of our publications synthesize official information with original material. They are designed to provide a convenient user-friendly reference work to uniformly present authoritative knowledge that can be rapidly read, reviewed or searched. Vast archives of important data that might otherwise remain inaccessible are available for instant review no matter where you are. The e-book format makes a great reference work and educational tool. There is no other reference book that is as convenient, comprehensive, thoroughly researched, and portable - everything you need to know, from renowned experts you trust. Our e-books put knowledge at your fingertips, and an expert in your pocket!

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21st Century Adult Cancer Sourcebook - Progressive Management

21st Century Adult Cancer Sourcebook: Breast Cancer - Clinical Data for Patients, Families, and Physicians

Edition 1.0 - September 2011

National Cancer Institute

Smashwords Edition

Copyright 2011 Progressive Management

Questions? Suggestions? Comments? Concerns? Please contact the publisher directly at

bookcustomerservice@gmail.com

Remember, the book retailer can't answer your questions, but we can!

* * * * * * * * * * *

Smashwords Edition, License Notes

This ebook is licensed for your personal enjoyment only. This ebook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each person you share it with. If you're reading this book and did not purchase it, or it was not purchased for your use only, then you should return to Smashwords.com and purchase your own copy. Thank you for respecting the hard work of this author.

* * * * * * * * * * * *

IMPORTANT NOTE: Information in this e-book is not a substitute for professional medical advice. If you have or suspect that you have any illness, you must consult with a physician or professional healthcare provider! Call 911 and get to the nearest emergency room if you have serious or worsening symptoms.

This material represents a snapshot in time, with authoritative information formatted for ebook reading that was up-to-date at the moment of publication. For the latest cancer updates, please be sure to visit the NCI website:

http://www.cancer.gov/

From our Guide to Leading Medical Websites, here are three valuable sites with authoritative cancer information:

OncoLink * http://www.oncolink.upenn.edu/

eMedicine.com * http://www.emedicine.com/

American Cancer Society (ACS) * http://www.cancer.org/

* * * * * * * * * * * *

This is a privately authored news service and educational publication of Progressive Management. Our publications synthesize official government information with original material - they are not produced by the federal government. They are designed to provide a convenient user-friendly reference work to uniformly present authoritative knowledge that can be rapidly read, reviewed or searched. Vast archives of important data that might otherwise remain inaccessible are available for instant review no matter where you are. This e-book format makes a great reference work and educational tool. There is no other reference book that is as convenient, comprehensive, thoroughly researched, and portable - everything you need to know, from renowned experts you trust. For over a quarter of a century, our news, educational, technical, scientific, and medical publications have made unique and valuable references accessible to all people. Our e-books put knowledge at your fingertips, and an expert in your pocket!

CONTENTS

PART ONE

Chapter 1A: Breast Cancer Patient Information

Chapter 2A: Breast Cancer Health Professional Information

Chapter 3A: Breast Cancer NCI Drugs

Chapter 4A: Breast Cancer Background Information

Chapter 5A: Breast Cancer Clinical Trials

PART TWO

Chapter 1B: Levels of Evidence for Adult and Pediatric Cancer Treatment Studies (NCI)

Chapter 2B: Glossary of Clinical Trial Terms

Chapter 3B: Clinical Trials Background Information

Chapter 4B: Cancer Clinical Trials -The Basic Workbook

Chapter 5B: Cancer Clinical Trials - The In-Depth Program

Chapter 6B: Clinical Trials at NIH

Chapter 7B: How To Find A Cancer Treatment Trial: A Ten Step Guide

Chapter 8B: Taking Part in Cancer Treatment Research Studies

Chapter 9B: Cancer Clinical Trials

Chapter 10B: Access to Investigational Drugs

Chapter 11B: Clinical Trials Conducted by the National Cancer Institute's Center for Cancer Research at the National Institutes of Health Clinical Center

Chapter 12B: Taking Time: Support for People with Cancer

Chapter 13B: Facing Forward - Life After Cancer Treatment

Chapter 14B: Chemotherapy and You

Chapter 15B: Guide To Leading Medical Websites, Internet Resources For Medical And Health Information

* * * * * * * * * * * *

PART ONE

* * * * * * * * * * * *

Chapter 1A: Breast Cancer Patient Information

Breast Cancer Treatment

Last Modified: 08/18/2011

Patient Version

General Information About Breast Cancer

Key Points for This Section

* Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

* Age and health history can affect the risk of developing breast cancer.

* Breast cancer is sometimes caused by inherited gene mutations (changes).

* Possible signs of breast cancer include a lump or change in the breast.

* Tests that examine the breasts are used to detect (find) and diagnose breast cancer.

* If cancer is found, tests are done to study the cancer cells.

* Certain factors affect prognosis (chance of recovery) and treatment options.

Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.

The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes, which have many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can produce milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.

Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.

Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless fluid called lymph. Lymph vessels lead to organs called lymph nodes. Lymph nodes are small bean-shaped structures that are found throughout the body. They filter substances in a fluid called lymph and help fight infection and disease. Clusters of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Cancer that begins in the lobes or lobules is called lobular carcinoma and is more often found in both breasts than are other types of breast cancer. Inflammatory breast cancer is an uncommon type of breast cancer in which the breast is warm, red, and swollen.

Age and health history can affect the risk of developing breast cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for breast cancer include the following:

* Older age.

* Menstruating at an early age.

* Older age at first birth or never having given birth.

* A personal history of breast cancer or benign (noncancer) breast disease.

* A mother or sister with breast cancer.

* Treatment with radiation therapy to the breast/chest.

* Breast tissue that is dense on a mammogram.

* Taking hormones such as estrogen and progesterone.

* Drinking alcoholic beverages.

* Being white.

NCI's Breast Cancer Risk Assessment Tool 2 uses a woman's risk factors to estimate her risk for breast cancer during the next five years and up to age 90. This online tool is meant to be used by a health care provider. For more information on breast cancer risk, call 1-800-4-CANCER.

Breast cancer is sometimes caused by inherited gene mutations (changes).

The genes in cells carry the hereditary information that is received from a person’s parents. Hereditary breast cancer makes up approximately 5% to 10% of all breast cancer. Some altered genes related to breast cancer are more common in certain ethnic groups.

Women who have an altered gene related to breast cancer and who have had breast cancer in one breast have an increased risk of developing breast cancer in the other breast. These women also have an increased risk of developing ovarian cancer, and may have an increased risk of developing other cancers. Men who have an altered gene related to breast cancer also have an increased risk of developing this disease.

Tests have been developed that can detect altered genes. These genetic tests are sometimes done for members of families with a high risk of cancer.

Possible signs of breast cancer include a lump or change in the breast.

Breast cancer may cause any of the following signs and symptoms. Check with your doctor if any of the following problems occur:

* A lump or thickening in or near the breast or in the underarm area.

* A change in the size or shape of the breast.

* A dimple or puckering in the skin of the breast.

* A nipple turned inward into the breast.

* Fluid, other than breast milk, from the nipple, especially if it's bloody.

* Scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin that is around the nipple).

* Dimples in the breast that look like the skin of an orange, called peau d’orange.

Other conditions that are not breast cancer may cause these same symptoms.

Tests that examine the breasts are used to detect (find) and diagnose breast cancer.

A doctor should be seen if changes in the breast are noticed. The following tests and procedures may be used:

* Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.

* Mammogram: An x-ray of the breast.

* Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.

* MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

* Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.

* Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a lump in the breast is found, the doctor may need to remove a small piece of the lump. Four types of biopsies are as follows:

* Excisional biopsy: The removal of an entire lump of tissue.

* Incisional biopsy: The removal of part of a lump or a sample of tissue.

* Core biopsy: The removal of tissue using a wide needle.

* Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid, using a thin needle.

If cancer is found, tests are done to study the cancer cells.

Decisions about the best treatment are based on the results of these tests. The tests give information about:

* how quickly the cancer may grow.

* how likely it is that the cancer will spread through the body.

* how well certain treatments might work.

* how likely the cancer is to recur (come back).

Tests include the following:

* Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.

* Human epidermal growth factor type 2 receptor (HER2/neu) test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab (Herceptin) and lapatinib (Tykerb).

* Multigene tests: Tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back).

* Oncotype DX: This test helps predict whether stage I or stage II breast cancer that is estrogen receptor positive and node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.

* MammaPrint: This test helps predict whether stage I or stage II breast cancer that is node-negative will spread to other parts of the body. If the risk of the cancer spreading is high, chemotherapy may be given to lower the risk.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

* The stage of the cancer (the size of the tumor and whether it is in the breast only or has spread to lymph nodes or other places in the body).

* The type of breast cancer.

* Estrogen receptor and progesterone receptor levels in the tumor tissue.

* Human epidermal growth factor type 2 receptor (HER2/neu) levels in the tumor tissue.

* Whether the tumor tissue is triple-negative (cells that do not have estrogen receptors, progesterone receptors, or high levels of HER2/neu).

* How fast the tumor is growing.

* How likely the tumor is to recur (come back).

* A woman’s age, general health, and menopausal status (whether a woman is still having menstrual periods).

* Whether the cancer has just been diagnosed or has recurred (come back).

Glossary Terms

areola (ayr-EE-oh-luh)

* The area of dark-colored skin on the breast that surrounds the nipple.

axilla (ak-SIH-luh)

* The underarm or armpit.

benign (beh-NINE)

* Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body. Also called nonmalignant.

biopsy (BY-op-see)

* The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

blood chemistry study (blud KEH-mih-stree STUH-dee)

* A procedure in which a sample of blood is examined to measure the amounts of certain substances made in the body. An abnormal amount of a substance can be a sign of disease in the organ or tissue that produces it.

blood vessel (blud VEH-sel)

* A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.

breast (brest)

* Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.

breast cancer (brest KAN-ser)

* Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

cancer (KAN-ser)

* A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

cell (sel)

* The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

chemotherapy (KEE-moh-THAYR-uh-pee)

* Treatment with drugs that kill cancer cells.

condition (kun-DIH-shun)

* In medicine, a health problem with certain characteristics or symptoms.

core biopsy (... BY-op-see)

* The removal of a tissue sample with a wide needle for examination under a microscope. Also called core needle biopsy.

diagnosis (DY-ug-NOH-sis)

* The process of identifying a disease, such as cancer, from its signs and symptoms.

drug (drug)

* Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

duct (dukt)

* In medicine, a tube or vessel of the body through which fluids pass.

ductal carcinoma (DUK-tul KAR-sih-NOH-muh)

* The most common type of breast cancer. It begins in the cells that line the milk ducts in the breast.

estrogen (ES-truh-jin)

* A type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of long bones. Estrogens can also be made in the laboratory. They may be used as a type of birth control and to treat symptoms of menopause, menstrual disorders, osteoporosis, and other conditions.

estrogen receptor positive (ES-truh-jin reh-SEP-ter PAH-zih-tiv)

* Describes cells that have a receptor protein that binds the hormone estrogen. Cancer cells that are estrogen receptor positive may need estrogen to grow, and may stop growing or die when treated with substances that block the binding and actions of estrogen. Also called ER+.

estrogen receptor test (ES-truh-jin reh-SEP-ter test)

* A lab test to find out if cancer cells have estrogen receptors (proteins to which estrogen will bind). If the cells have estrogen receptors, they may need estrogen to grow, and this may affect how the cancer is treated.

excisional biopsy (ek-SIH-zhuh-nul BY-op-see)

* A surgical procedure in which an entire lump or suspicious area is removed for diagnosis. The tissue is then examined under a microscope.

fine-needle aspiration biopsy (... NEE-dul AS-pih-RAY-shun BY-op-see)

* The removal of tissue or fluid with a thin needle for examination under a microscope. Also called FNA biopsy.

fluid (FLOO-id)

* A substance that flows smoothly and takes the shape of its container. Liquids and gases are fluids.

gene (jeen)

* The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein.

genetic testing (jeh-NEH-tik TES-ting)

* Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder.

HER2/neu

* A protein involved in normal cell growth. It is found on some types of cancer cells, including breast and ovarian. Cancer cells removed from the body may be tested for the presence of HER2/neu to help decide the best type of treatment. HER2/neu is a type of receptor tyrosine kinase. Also called c-erbB-2, human EGF receptor 2, and human epidermal growth factor receptor 2.

hereditary (huh-REH-dih-tayr-ee)

* Transmitted from parent to child by information contained in the genes.

hormone (HOR-mone)

* One of many chemicals made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs. Some hormones can also be made in the laboratory.

incisional biopsy (in-SIH-zhuh-nul BY-op-see)

* A surgical procedure in which a portion of a lump or suspicious area is removed for diagnosis. The tissue is then examined under a microscope to check for signs of disease.

infection (in-FEK-shun)

* Invasion and multiplication of germs in the body. Infections can occur in any part of the body and can spread throughout the body. The germs may be bacteria, viruses, yeast, or fungi. They can cause a fever and other problems, depending on where the infection occurs. When the body’s natural defense system is strong, it can often fight the germs and prevent infection. Some cancer treatments can weaken the natural defense system.

inflammatory breast cancer (in-FLA-muh-TOR-ee brest KAN-ser)

* A type of breast cancer in which the breast looks red and swollen and feels warm. The skin of the breast may also show the pitted appearance called peau d'orange (like the skin of an orange). The redness and warmth occur because the cancer cells block the lymph vessels in the skin.

lapatinib (luh-PA-tih-nib)

* A drug used with another anticancer drug to treat breast cancer that is HER2 positive and has advanced or metastasized (spread to other parts of the body) after treatment with other drugs. Lapatinib is also being studied in the treatment of other types of cancer. It is a type of ErbB-2 and EGFR dual tyrosine kinase inhibitor. Also called GW572016, lapatinib ditosylate, and Tykerb.

lobe

* A portion of an organ, such as the liver, lung, breast, thyroid, or brain.

lobular carcinoma (LAH-byuh-ler KAR-sih-NOH-muh)

* Cancer that begins in the lobules (the glands that make milk) of the breast. Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found only in the lobules. When cancer has spread from the lobules to surrounding tissues, it is invasive lobular carcinoma. LCIS does not become invasive lobular carcinoma very often, but having LCIS in one breast increases the risk of developing invasive cancer in either breast.

lobule (LOB-yule)

* A small lobe or a subdivision of a lobe.

lymph (limf)

* The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.

lymph node (limf node)

* A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

lymph vessel (limf ...)

* A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.

mammogram (MA-muh-gram)

* An x-ray of the breast.

menopause (MEH-nuh-pawz)

* The time of life when a woman’s ovaries stop producing hormones and menstrual periods stop. Natural menopause usually occurs around age 50. A woman is said to be in menopause when she hasn’t had a period for 12 months in a row. Symptoms of menopause include hot flashes, mood swings, night sweats, vaginal dryness, trouble concentrating, and infertility.

menstrual cycle (MEN-stroo-ul SY-kul)

* The monthly cycle of hormonal changes from the beginning of one menstrual period to the beginning of the next.

menstruation (MEN-stroo-WAY-shun)

* Periodic discharge of blood and tissue from the uterus. From puberty until menopause, menstruation occurs about every 28 days when a woman is not pregnant.

microscope (MY-kroh-SKOPE)

* An instrument that is used to look at cells and other small objects that cannot be seen with the eye alone.

MRI

* A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or x-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints, and the inside of bones. Also called magnetic resonance imaging, NMRI, and nuclear magnetic resonance imaging.

NCI

* NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. It conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://www.cancer.gov. Also called National Cancer Institute.

node-negative (node-NEH-guh-tiv)

* Cancer that has not spread to the lymph nodes.

organ (OR-gun)

* A part of the body that performs a specific function. For example, the heart is an organ.

ovarian (oh-VAYR-ee-un)

* Having to do with the ovaries, the female reproductive glands in which the ova (eggs) are formed. The ovaries are located in the pelvis, one on each side of the uterus.

pathologist (puh-THAH-loh-jist)

* A doctor who identifies diseases by studying cells and tissues under a microscope.

peau d'orange (poh duh RAHNJ)

* A dimpled condition of the skin of the breast, resembling the skin of an orange, sometimes found in inflammatory breast cancer.

personal medical history (PER-suh-nul MEH-dih-kul HIH-stuh-ree)

* A collection of information about a person’s health. It may include information about allergies, illnesses and surgeries, and dates and results of physical exams, tests, screenings, and immunizations. It may also include information about medicines taken and about diet and exercise. Also called personal health record and personal history.

physical examination (FIH-zih-kul eg-ZA-mih-NAY-shun)

* An exam of the body to check for general signs of disease.

progesterone (proh-JES-teh-RONE)

* A type of hormone made by the body that plays a role in the menstrual cycle and pregnancy. Progesterone can also be made in the laboratory. It may be used as a type of birth control and to treat menstrual disorders, infertility, symptoms of menopause, and other conditions.

progesterone receptor test (proh-JES-teh-rone reh-SEP-ter test)

* A lab test to find out if cancer cells have progesterone receptors (proteins to which the hormone progesterone will bind). If the cells have progesterone receptors, they may need progesterone to grow, and this can affect how the cancer is treated.

prognosis (prog-NO-sis)

* The likely outcome or course of a disease; the chance of recovery or recurrence.

protein (PROH-teen)

* A molecule made up of amino acids that are needed for the body to function properly. Proteins are the basis of body structures such as skin and hair and of substances such as enzymes, cytokines, and antibodies.

radiation therapy (RAY-dee-AY-shun THAYR-uh-pee)

* The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

radio wave (RAY-dee-oh…)

* A type of wave made when an electric field and a magnetic field are combined. Radio waves are being studied in the treatment of several types of cancer and other conditions. The radio waves are sent through needles inserted into tumor tissue and may kill cancer cells. Radio waves are also used in MRI to create detailed images of areas inside the body.

receptor (reh-SEP-ter)

* A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell.

recur

* To come back or to return.

risk factor (... FAK-ter)

* Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.

sonogram (SAH-noh-gram)

* A computer picture of areas inside the body created by bouncing high-energy sound waves (ultrasound) off internal tissues or organs. Also called ultrasonogram.

stage

* The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

stage I breast cancer (... brest KAN-ser)

* Stage I breast cancer is divided into stages IA and IB. In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast. In stage IB, (1) no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or (2) the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.

stage II breast cancer (... brest KAN-ser)

* Stage II breast cancer is divided into stages IIA and IIB. In stage IIA, (1) no tumor is found in the breast, but cancer is found in the axillary (under the arm) lymph nodes; or (2) the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes. In stage IIB, the tumor is (1) larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or (2) larger than 5 centimeters but has not spread to the axillary lymph nodes.

symptom (SIMP-tum)

* An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

tissue (TIH-shoo)

* A group or layer of cells that work together to perform a specific function.

trastuzumab (tras-TOO-zuh-mab)

* A monoclonal antibody that binds to HER2 (human epidermal growth factor receptor 2), and can kill HER2-positive cancer cells. Monoclonal antibodies are made in the laboratory and can locate and bind to substances in the body, including cancer cells. Trastuzumab is used to treat breast cancer that is HER2-positive and has spread after treatment with other drugs. It is also used with other anticancer drugs to treat HER2-positive breast cancer after surgery. Trastuzumab is also being studied in the treatment of other types of cancer. Also called Herceptin.

triple-negative breast cancer (TRIH-pul-NEH-guh-tiv brest KAN-ser)

* Describes breast cancer cells that do not have estrogen receptors, progesterone receptors, or large amounts of HER2/neu protein. Also called ER-negative PR-negative HER2/neu-negative and ER-PR-HER2/neu-.

ultrasound (UL-truh-SOWND)

* A procedure in which high-energy sound waves are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.

x-ray (EX-ray)

* A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.

Table of Links

1 http://www.cancer.gov/cancertopics/pdq/treatment/unusual-cancers-childhood/Pati

ent/Page4#Section 100

2 http://www.cancer.gov/bcrisktool

3 http://www.cancer.gov/cancertopics/pdq/treatment/malebreast/Patient

4 http://www.cancer.gov/cancertopics/pdq/screening/breast/Patient

5 http://www.cancer.gov/cancertopics/pdq/prevention/breast/Patient

6 http://www.cancer.gov/cancertopics/pdq/genetics/breast-and-ovarian/HealthProfessional

* * * * * * * * * * * *

Stages of Breast Cancer

Key Points for This Section

* After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.

* There are three ways that cancer spreads in the body.

* The following stages are used for breast cancer:

* Stage 0 (carcinoma in situ)

* Stage I

* Stage II

* Stage IIIA

* Stage IIIB

* Stage IIIC

* Stage IV

After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.

The process used to find out whether the cancer has spread within the breast or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

* Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

* CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

* Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.

* PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

* Through tissue. Cancer invades the surrounding normal tissue.

* Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.

* Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

The following stages are used for breast cancer:

Stage 0 (carcinoma in situ)

There are 2 types of breast carcinoma in situ:

* Ductal carcinoma in situ (DCIS) is a noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive.

* Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the lobules of the breast. This condition seldom becomes invasive cancer; however, having lobular carcinoma in situ in one breast increases the risk of developing breast cancer in either breast.

Enlarge

Tumor size compared to everyday objects; shows various measurements of a tumor compared to a pea, peanut, walnut, and lime

Pea, peanut, walnut, and lime show tumor sizes.

Stage I

In stage I, cancer has formed. Stage I is divided into stages IA and IB.

* In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast.

* In stage IB, either:

* no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or

* the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.

Stage II

Stage II is divided into stages IIA and IIB.

* In stage IIA:

* no tumor is found in the breast, but cancer is found in the axillary lymph nodes (lymph nodes under the arm); or

* the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or

* the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.

* In stage IIB, the tumor is either:

* larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or

* larger than 5 centimeters but has not spread to the axillary lymph nodes.

Stage IIIA

In stage IIIA:

* no tumor is found in the breast. Cancer is found in axillary lymph nodes that are attached to each other or to other structures, or cancer may be found in lymph nodes near the breastbone; or

* the tumor is 2 centimeters or smaller. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone; or

* the tumor is larger than 2 centimeters but not larger than 5 centimeters. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone; or

* the tumor is larger than 5 centimeters. Cancer has spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.

Stage IIIB

In stage IIIB, the tumor may be any size and cancer:

* has spread to the chest wall and/or the skin of the breast; and

* may have spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.

Cancer that has spread to the skin of the breast is inflammatory breast cancer.

Stage IIIC

In stage IIIC, there may be no sign of cancer in the breast or the tumor may be any size and may have spread to the chest wall and/or the skin of the breast. Also, cancer:

* has spread to lymph nodes above or below the collarbone; and

* may have spread to axillary lymph nodes or to lymph nodes near the breastbone.

Cancer that has spread to the skin of the breast is inflammatory breast cancer. See the section on Inflammatory Breast Cancer 1 for more information.

Stage IIIC breast cancer is divided into operable and inoperable stage IIIC.

In operable stage IIIC, the cancer:

* is found in ten or more axillary lymph nodes; or

* is found in lymph nodes below the collarbone; or

* is found in axillary lymph nodes and in lymph nodes near the breastbone.

In inoperable stage IIIC breast cancer, the cancer has spread to the lymph nodes above the collarbone.

Stage IV

In stage IV, the cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.

Glossary Terms

abnormal (ab-NOR-mul)

* Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).

axillary lymph node (AK-sih-LAYR-ee limf node)

* A lymph node in the armpit region that drains lymph from the breast and nearby areas.

blood (blud)

* A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

bone cancer (bone KAN-ser)

* Primary bone cancer is cancer that forms in cells of the bone. Some types of primary bone cancer are osteosarcoma, Ewing sarcoma, malignant fibrous histiocytoma, and chondrosarcoma. Secondary bone cancer is cancer that spreads to the bone from another part of the body (such as the prostate, breast, or lung).

bone scan (bone skan)

* A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner.

breast (brest)

* Glandular organ located on the chest. The breast is made up of connective tissue, fat, and breast tissue that contains the glands that can make milk. Also called mammary gland.

breast cancer (brest KAN-ser)

* Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare.

breast carcinoma in situ (brest KAR-sih-NOH-muh in SY-too)

* There are 2 types of breast carcinoma in situ: ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). DCIS is a noninvasive condition in which abnormal cells are found in the lining of a breast duct (a tube that carries milk to the nipple). The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known how to predict which lesions will become invasive cancer. LCIS is a condition in which abnormal cells are found in the lobules (small sections of tissue involved with making milk) of the breast. This condition seldom becomes invasive cancer; however, having LCIS in one breast increases the risk of developing breast cancer in either breast. Also called stage 0 breast carcinoma in situ.

breastbone (brest...)

* The long flat bone that forms the center front of the chest wall. The breastbone is attached to the collarbone and the first seven ribs. Also called sternum.

cancer (KAN-ser)

* A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

capillary (KA-pih-layr-ee)

* The smallest type of blood vessel. A capillary connects an arteriole (small artery) to a venule (small vein) to form a network of blood vessels in almost all parts of the body. The wall of a capillary is thin and leaky, and capillaries are involved in the exchange of fluids and gases between tissues and the blood.

cell (sel)

* The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

centimeter (SEN-tih-MEE-ter)

* A measure of length in the metric system. There are 100 centimeters in a meter and 2½ centimeters in an inch.

chest wall (chest wawl)

* The muscles, bones, and joints that make up the area of the body between the neck and the abdomen.

chest x-ray (chest EX-ray)

* An x-ray of the structures inside the chest. An x-ray is a type of high-energy radiation that can go through the body and onto film, making pictures of areas inside the chest, which can be used to diagnose disease.

collarbone (KAH-lur …)

* One of a pair of bones at the base of the front of the neck. The clavicles connect the breastbone to the shoulder blades. Also called clavicle.

contrast material (KON-trast muh-TEER-ee-ul)

* A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.

CT scan (… skan)

* A series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography scan, computerized axial tomography scan, and computerized tomography.

duct (dukt)

* In medicine, a tube or vessel of the body through which fluids pass.

ductal carcinoma in situ (DUK-tul KAR-sih-NOH-muh in SY-too)

* A noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, ductal carcinoma in situ may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Also called DCIS and intraductal carcinoma.

glucose (GLOO-kose)

* A type of sugar; the chief source of energy for living organisms.

inflammatory breast cancer (in-FLA-muh-TOR-ee brest KAN-ser)

* A type of breast cancer in which the breast looks red and swollen and feels warm. The skin of the breast may also show the pitted appearance called peau d'orange (like the skin of an orange). The redness and warmth occur because the cancer cells block the lymph vessels in the skin.

injection (in-JEK-shun)

* Use of a syringe and needle to push fluids or drugs into the body; often called a shot.

inoperable (in-AH-peh-ruh-bul)

* Describes a condition that cannot be treated by surgery.

invasive cancer (in-VAY-siv KAN-ser)

* Cancer that has spread beyond the layer of tissue in which it developed and is growing into surrounding, healthy tissues. Also called infiltrating cancer.

lesion (LEE-zhun)

* An area of abnormal tissue. A lesion may be benign (not cancer) or malignant (cancer).

liver (LIH-ver)

* A large organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile.

lobular carcinoma in situ (LAH-byuh-ler KAR-sih-NOH-muh in SY-too)

* A condition in which abnormal cells are found in the lobules of the breast. Lobular carcinoma in situ seldom becomes invasive cancer; however, having it in one breast increases the risk of developing breast cancer in either breast. Also called LCIS.

lobule (LOB-yule)

* A small lobe or a subdivision of a lobe.

lung

* One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.

lymph (limf)

* The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.

lymph node (limf node)

* A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

lymph vessel (limf ...)

* A thin tube that carries lymph (lymphatic fluid) and white blood cells through the lymphatic system. Also called lymphatic vessel.

lymphatic system (lim-FA-tik SIS-tem)

* The tissues and organs that produce, store, and carry white blood cells that fight infections and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes, and lymphatic vessels (a network of thin tubes that carry lymph and white blood cells). Lymphatic vessels branch, like blood vessels, into all the tissues of the body.

malignant (muh-LIG-nunt)

* Cancerous. Malignant cells can invade and destroy nearby tissue and spread to other parts of the body.

metastasis (meh-TAS-tuh-sis)

* The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a metastatic tumor or a metastasis. The metastatic tumor contains cells that are like those in the original (primary) tumor. The plural form of metastasis is metastases (meh-TAS-tuh-SEEZ).

millimeter (MIH-luh-MEE-ter)

* A measure of length in the metric system. A millimeter is one thousandth of a meter. There are 25 millimeters in an inch.

noninvasive (NON-in-VAY-siv)

* In medicine, it describes a procedure that does not require inserting an instrument through the skin or into a body opening. In cancer, it describes disease that has not spread outside the tissue in which it began.

operable (AH-peh-ruh-bul)

* Describes a condition that can be treated by surgery.

organ (OR-gun)

* A part of the body that performs a specific function. For example, the heart is an organ.

PET scan (… skan)

* A procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body. Also called positron emission tomography scan.

primary tumor (PRY-mayr-ee TOO-mer)

* The original tumor.

radioactive (RAY-dee-oh-AK-tiv)

* Giving off radiation.

scanner (SKA-ner)

* In medicine, an instrument that takes pictures of the inside of the body.

stage

* The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

stage I breast cancer (... brest KAN-ser)

* Stage I breast cancer is divided into stages IA and IB. In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast. In stage IB, (1) no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or (2) the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.

stage IA breast cancer (... brest KAN-ser)

* Stage I breast cancer is divided into stages IA and IB. In stage IA, the tumor is 2 centimeters or smaller and has not spread outside the breast.

stage IB breast cancer (... brest KAN-ser)

* Stage I breast cancer is divided into stages IA and IB. In stage IB, (1) no tumor is found in the breast, but small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes; or (2) the tumor is 2 centimeters or smaller and small clusters of cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes.

stage II breast cancer (... brest KAN-ser)

* Stage II breast cancer is divided into stages IIA and IIB. In stage IIA, (1) no tumor is found in the breast, but cancer is found in the axillary (under the arm) lymph nodes; or (2) the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes. In stage IIB, the tumor is (1) larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or (2) larger than 5 centimeters but has not spread to the axillary lymph nodes.

stage IIA breast cancer (... brest KAN-ser)

* Stage II breast cancer is divided into stages IIA and IIB. In stage IIA, (1) no tumor is found in the breast, but cancer is found in the axillary (under the arm) lymph nodes; or (2) the tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has not spread to the axillary lymph nodes.

stage IIB breast cancer (... brest KAN-ser)

* Stage II breast cancer is divided into stages IIA and IIB. In stage IIB, (1) the tumor is larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary (under the arm) lymph nodes; or (2) the tumor is larger than 5 centimeters but has not spread to the axillary lymph nodes.

stage IIIA breast cancer (... brest KAN-ser)

* Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIA, (1) no tumor is found in the breast, but cancer is found in axillary (under the arm) lymph nodes that are attached to each other or to other structures, or cancer may be found in lymph nodes near the breastbone; or (2) the tumor is 2 centimeters or smaller and cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or the cancer may have spread to lymph nodes near the breastbone; or (3) the tumor is larger than 2 centimeters but not larger than 5 centimeters and cancer has spread to axillary lymph nodes that are attached to each other or to other structures

stage IIIB breast cancer (... brest KAN-ser)

* Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIB, the tumor may be any size and cancer (1) has spread to the chest wall and/or the skin of the breast; and (2) may have spread to axillary (under the arm) lymph nodes that may be attached to each other or to other structures, or the cancer may have spread to lymph nodes near the breastbone.

stage IIIC breast cancer (... brest KAN-ser)

* Stage III breast cancer is divided into stages IIIA, IIIB, and IIIC. In stage IIIC, there may be no sign of cancer in the breast or the tumor may be any size and may have spread to the chest wall and/or the skin of the breast. Also, cancer (1) has spread to lymph nodes above or below the collarbone and (2) may have spread to axillary (under the arm) lymph nodes or to lymph nodes near the breastbone. In operable stage IIIC, the cancer is found (1) in ten or more axillary lymph nodes; or (2) in the lymph nodes below the collarbone; or (3) in axillary lymph nodes and in lymph nodes near the breastbone. In inoperable stage IIIC, the cancer has spread to the lymph nodes above the collarbone.

stage IV breast cancer (... brest KAN-ser)

* Cancer has spread to other organs of the body, most often the bones, lungs, liver, or brain.

staging (STAY-jing)

* Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

tissue (TIH-shoo)

* A group or layer of cells that work together to perform a specific function.

tumor (TOO-mer)

* An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.

vein (vayn)

* A blood vessel that carries blood to the heart from tissues and organs in the body.

x-ray (EX-ray)

* A type of high-energy radiation. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer.

Table of Links

1 http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/Page3#Section 181

* * * * * * * * * * * *

Inflammatory Breast Cancer

In inflammatory breast cancer, cancer has spread to the skin of the breast and the breast looks red and swollen and feels warm. The redness and warmth occur because the cancer cells block the lymph vessels in the skin. The skin of the breast may also show the dimpled appearance called peau d’orange (like the skin of an orange). There may not be any lumps in the breast that can be felt. Inflammatory breast cancer may be stage IIIB, stage IIIC, or stage IV.

Recurrent Breast Cancer

Recurrent breast cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the breast, in the chest wall, or in other parts of the body.

Treatment Option Overview

Key Points for This Section

* There are different types of treatment for patients with breast cancer.

* Six types of standard treatment are used:

* Surgery

* Sentinel lymph node biopsy followed by surgery

* Radiation therapy

* Chemotherapy

* Hormone therapy

* Targeted therapy

* New types of treatment are being tested in clinical trials.

* High-dose chemotherapy with stem cell transplant

* Patients may want to think about taking part in a clinical trial.

* Patients can enter clinical trials before, during, or after starting their cancer treatment.

* Follow-up tests may be needed.

There are different types of treatment for patients with breast cancer.

Different types of treatment are available for patients with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Six types of standard treatment are used:

Surgery

Most patients with breast cancer have surgery to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells.

Breast-conserving surgery, an operation to remove the cancer but not the breast itself, includes the following:

* Lumpectomy: Surgery to remove a tumor (lump) and a small amount of normal tissue around it.

* Partial mastectomy: Surgery to remove the part of the breast that has cancer and some normal tissue around it. The lining over the chest muscles below the cancer may also be removed. This procedure is also called a segmental mastectomy.

Breast-conserving surgery. Dotted lines show the area containing the tumor that is removed and some of the lymph nodes that may be removed.

Patients who are treated with breast-conserving surgery may also have some of the lymph nodes under the arm removed for biopsy. This procedure is called lymph node dissection. It may be done at the same time as the breast-conserving surgery or after. Lymph node dissection is done through a separate incision.

Other types of surgery include the following:

* Total mastectomy: Surgery to remove the whole breast that has cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgery or after. This is done through a separate incision.

* Total (simple) mastectomy. The dotted line shows where the entire breast is removed. Some lymph nodes under the arm may also be removed.

* Modified radical mastectomy: Surgery to remove the whole breast that has cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.

* Modified radical mastectomy. The dotted line shows where the entire breast and some lymph nodes are removed. Part of the chest wall muscle may also be removed.

* Radical mastectomy: Surgery to remove the breast that has cancer, chest wall muscles

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