How many types of breast cancer do you really know? Do you know that breast cancer appears as different types? This article looks into the various types of breast cancer. This should go a long way in adding to the body of knowledge you already have about breast cancer. But before going into that, let’s do a quick review of what breast cancer is and some statistics.
Breast cancer is a form of cancer that develops when cells within the breast begins to grow out of control. These cells form a tumour within the breast and these present as lumps that can be felt within the breast or seen on an x-ray. According to a Vanguard Newspaper report, In Nigeria alone, the federal government estimates a breast cancer rate of 102,000 cases annually and an annual death rate of about 72,000 individuals. The report estimates that in combination with cervical cancer, breast cancer makes up for over 50% of reported cases in Nigeria.
Reports from World Health Organization say that breast cancer is the most frequent cancer among women, impacting 2.1 million women each year, and also causes the greatest number of cancer-related deaths among women. In 2018, it is estimated that 627,000 women died from breast cancer – that is approximately 15% of all cancer deaths among women. These cases are more prevalent in women with a projected estimated rate of about 100 times more. However, men can also develop breast cancer.
7 Types of Breast Cancers
Early detection of breast cancer is very important because it affects the treatment outcomes. Some of the ways you can screen for breast cancer is through mammography, clinical breast examination (CBE) and self breast examination (SBE). You should regularly examine your breast for any of the following signs and symptoms :
- swelling of all or part of the breast.
- skin irritation or dimpling.
- breast pain.
- nipple pain or the nipple turning inward.
- redness, scaliness, or thickening of the nipple or breast skin.
- a nipple discharge other than breast milk.
- a lump in the underarm area.
There are a number of variations in breast cancer and medical scientist have typified them distinctly into 7. Breast cancer types have been differentiated based on a number of factors including where it begins, how it begins, its severity and whom it affects, among other variations. This article briefly describes the different types of breast cancer recognized.
Breast Angiosarcoma (BAS)
Angiosarcoma is an uncommon malignant neoplasm and it is a type of cancer that affects the cells that lines the walls of blood vessels or lymphatic vessels. It is rarely reported as a form of breast cancer but because of its metastatic capability. Statistically, less than 10% of all angiosarcoma cases originates from the breast. When talking about breast cancer alone, angiosarcoma account for a very small percentage of cases; less than 005% or approximately, 1 in every 2500 breast cancer cases.
Breast Angiosarcoma may be graded as low grade, intermediate grade, and high grade, for staging purposes, based on the histological evaluation of tumour cells and upon the degree to which malignant cells exhibiting vascular differentiation have infiltrated the breast parenchyma.
Ductal Carcinoma in situ (DCIS)
Also known as intraductal carcinoma, this is the most common type of pre-cancerous non-invasive breast cancer. This type of cancer occurs within the milk duct, hence the name. While carcinoma is a generic name that describes every form of cancer that begins or occurs in the skin or other tissue that covers or lines the internal organs, in situ is an English word that means “in its original place or location”.
Though DCIS is not life threatening and invasive, it can increase the risk of developing other forms of invasive breast cancer with time. In breast cancer staging, DCIS is classified as stage 0. It is rare for DCIS to produce symptoms or lumps and can only be detected through mammographic scans and when it does cause any symptoms, it is most usually characterized by a bloody nipple discharge.
Inflammatory Breast Cancer (IBC)
Inflammatory breast cancer is a rare and very aggressive form of breast cancer. It develops rapidly and occurs when cancer cells block the lymphatic vessels in skin covering the breast, causing a characteristic red and swollen appearance of the breast. IBC is one of the most aggressive forms of breast cancer and can occur in women of any age and rarely in men.
Because of its presentation as an inflammation, IBC can easily be confused with a breast infection. It is considered a locally advanced cancer because it can spread from its point of origin to nearby tissue and possibly, nearby lymph nodes. Compared with other forms of breast cancer, inflammatory breast cancer tends to be diagnosed at younger ages. It is more common in blacks and African Americans and is more common in obese women than in women with normal weight.
Invasive Lobular Carcinoma (ILC)
From its name, invasive lobular carcinoma is a type of cancer that begins in the lobules (each breast contains 15 to 20 lobes of glandular tissue, arranged like the petals of a daisy. The lobes are further divided into smaller lobules that produce milk for breastfeeding) of the breast. This form of cancer is the second most common type of breast cancer after ductal carcinoma. In a nutshell, ILC refers to a form of cancer that has broken through the wall of the lobule of the breast and begun to invade other tissue of the breast. If left undetected and untreated, overtime, ILC can invade and spread to the lymph nodes and possibly other parts of the body.
Invasive lobular carcinoma does not form a lump, which is common in most breast cancer types. Instead, there is a change in the breast that feels like a thickening or fullness in the affected area of the breast and is different from the surrounding tissue. It accounts for 5-10% of all cases of invasive breast cancer. Unlike inflammatory breast cancer that is diagnosed earlier in women, invasive lobular carcinoma is reported by the American Cancer Society as diagnosed in older women. It is reported that about two-thirds of the cases of women reported with invasive lobular carcinoma are 55 and above.
Male Breast Cancer
Men do not have a pronounced breast like women. Even at this, they still have a small amount of breast tissue. The size of breast of an adult man is similar to the size of the breast of a little girl before puberty. Men do get all the forms of breast cancer as women do but cases of ductal carcinoma and invasive lobular carcinoma are rare.
Male cancer occurs more in older men but can still occur at a younger age. Men that are diagnosed of breast cancer in the early stages have good chances of a cure. It is however not unseen that men do not turn up to see the doctor when signs and symptoms begin to appear either because of lack of education on breast cancer in men or because they can’t just conceive the possibility of a breast cancer in men.
Breast cancer in men just like it is in women spreads via lymphatics and blood stream. Lesions are easier to find in males rather than females because of the size of the breasts. The presence of gynecomastia (an endocrine system disorder in which there is a non-cancerous increase in the size of male breast tissue) may mask the condition. In men, lesions are less contained in males as they do not have to travel far to infiltrate skin, nipple or muscular tissue.
Paget’s Disease of the Breast
First described by Sir James Paget in 1874, it is a rare type of breast cancer that starts on the nipple and extends to the areola (dark circle of skin around the nipple). It has an outward appearance of eczema with skin changes around the nipple. Accounting for between 1-4.3% of reported cases, Paget’s disease of the breast often appears harmless and limited to the surface; thereby causing misdiagnosis.
Paget’s disease of the breast is characterized by Paget cells. Paget cells are relatively large, neoplastic epithelial cells (carcinoma cells) with a hyperchromatic nucleus and abundant palely staining cytoplasm. In Paget’s disease of the breast, such cells occur in neoplastic epithelium in the ducts and in the epidermis of the nipple, areola and adjacent skin.
Paget’s disease of the breast mostly affects women above the age of 50. Most women with this disease have underlying ductal breast cancer which can be in situ or less commonly invasive breast cancer.
Recurrent Breast Cancer
Recurrent breast cancer as the name indicates is one that recurs after it has been treated. This recurrence could be within months or years of initial treatment. When it recurs, it could be at the initial point of occurrence (local recurrence) or within other parts of the body (distant recurrence). However, recurrence is known to occur within the first five years of initial treatment.