At Stony Brook Cancer Center, our team of experts specialize in breast cancer care. Breast cancer is not a single disease. There are many different forms of breast cancer, and each type may have multiple variations. We provide comprehensive diagnostics and multidisciplinary treatment for the following cancers:
Noninvasive Breast Cancer
Invasive Breast Cancer
Metastatic Breast Cancer
Recurrent Breast Cancer
Additional Types of Breast Cancer
NONINVASIVE BREAST CANCER
If you are diagnosed with a noninvasive breast cancer, it means that your disease is confined to the milk ducts, where it started. A noninvasive cancer has not spread to anywhere else in the breast or to other parts of the body.
- Ductal Carcinoma in Situ (DCIS)
This is the most common form of noninvasive breast cancer. “Ductal” refers to the milk ducts in the breast, and “in situ” means “in its original place.” DCIS is a stage 0 cancer, which is the earliest and generally the most treatable form of breast cancer. Although DCIS is noninvasive when it’s diagnosed, over time it can become invasive. This means that, for some women, the cancer may spread from its original site. That’s why treatment for DCIS is usually recommended. Treatment could include a lumpectomy, which is surgery that removes the cancer tumor while sparing the breast. Radiation may follow surgery, or hormone therapy may be recommended depending on your individual circumstances.
INVASIVE BREAST CANCER
If you’re told you have an invasive breast cancer, it means that your cancer has spread beyond its original location to invade other parts of the breast and possibly the lymph nodes. Over time, invasive breast cancer may also spread to other, sometimes remote, parts of the body.
- Invasive Ductal Carcinoma (IDC)
About 75 percent of women diagnosed with invasive breast cancer each year have IDC, making this the most common form of breast cancer. The disease is “ductal” which means it starts in the milk ducts, but then grows and invades the surrounding tissue in the breast. As it progresses, it can spread into the lymph nodes. IDC is measured in stages, with Stage I being the earliest and Stage III being the most advanced. Surgery is almost always the standard of treatment, whether in the form of a lumpectomy or more extensive procedures. Depending on the size and extent of the cancer, radiation and/or systemic treatments — which can be chemotherapy, hormonal therapy and targeted therapies — may also be used to fight the cancer.
There are six specific types of Invasive Ductal Carcinoma (IDC), which all begin in the milk ducts and then spread into healthy breast tissue:
- Tubular Carcinoma of the Breast consists of small tube-shaped tumors called “tubules”. Accounting for up to 27 percent of breast cancers, this is a less aggressive, slow-growing disease that is diagnosed most often in women in their 50s. It usually does not spread beyond the breast, and responds well to treatment.
- Medullary Carcinoma of the Breast is a rare form of IDC characterized by soft, fleshy tumors. It is a slow-growing form of breast cancer that doesn’t usually spread outside of the breast. It can occur at any age though it’s more common in women in their late 40s and early 50s. This type of breast cancer responds well to treatment.
- Mucinous Carcinoma of the Breast is characterized by a tumor with cancer cells that “float” in pools of mucin, which is an ingredient in mucus. It accounts for only about two to three percent of IDC, and tends to affect post-menopausal women in their 60s and 70s. This less aggressive cancer is less likely to spread to the lymph nodes than other types of breast cancer, and responds well to treatment.
- Papillary Carcinoma of the Breast, which accounts for less than two percent of IDC cases, is more often seen in older, post-menopausal women. These tumors have small, finger-like projections called papules. This type of cancer is frequently found in a breast that also has ductal carcinoma in situ (DCIS), a breast cancer that is confined to the milk ducts. Papillary carcinoma responds well to treatment.
- Cribriform Carcinoma of the Breast has cancer cells that invade the connective tissues of the breast. Cribriform carcinoma is present in about five to six percent of invasive breast cancers. This type of breast cancer responds well to treatment.
- Metaplastic Carcinoma is a another very rare form of invasive ductal carcinoma, accounting for fewer than one percent of all breast cancers. The word “metaplasia” means the transformation of one cell type to another. With metaplastic carcinoma, the cancer tumor contains two or more types of cancer cells — often both carcinoma and sarcoma. These are very different cancers that usually respond to different treatments. This makes treating this cancer extremely difficult.
- Invasive Lobular Carcinoma (ILC)
Accounting for 10 to 15 percent of breast cancers, invasive lobular carcinoma is the second most common type of invasive breast cancer after invasive ductal carcinoma (IDC). Invasive lobular carcinoma starts in the breast’s lobules. As it progresses, the cancer breaks through the lobule wall to spread into healthy breast tissue. ILC can spread to the lymph nodes and other parts of the body. While it’s found in women of all ages, ILC more commonly affects those in their early 60s. Treatment options depend on your cancer’s stage and aggressiveness, but most often include surgery, possibly with chemotherapy, radiation and hormone surgery.
METASTATIC BREAST CANCER
If your doctors says your cancer is “metastatic”, your breast cancer has spread from the original site in your breast to another part of the body. Breast cancer most often spreads to the liver, brain, bones or lungs. When breast cancer cells spread (metastasize), the cancer cells found in other parts of the body — for example the liver or the lungs — look like breast cancer cells, not liver or lung cancer cells. Metastatic breast cancer is classified as a Stage IV cancer, the most advanced stage.
RECURRENT BREAST CANCER
When a doctor tells you your breast cancer has recurred, it means the cancer has returned. This can sometimes happen even many years after the initial treatment was successful. The cancer may recur in the breast or in other parts of the body.
ADDITIONAL TYPES OF BREAST CANCER
- Breast Sarcoma
This is a very rare form of breast cancer, accounting for only one percent of all breast cancers. With most breast cancers, the cancer forms inside the lobes or the milk ducts. With this disease, the tumor forms in the connective or fibrous tissue that surrounds the lobes or ducts. Surgery followed by radiation is often recommended. - Inflammatory Breast Cancer (IBC)
IBC is an aggressive form of cancer that has spread to the skin of the breast. The skin becomes inflamed — red, swollen, warm to the touch and very sore. The disease is caused by invasive cancer cells that spread from the milk ducts into the skin of the breast, where they block the lymph vessels. This causes a painful build-up of lymphatic fluid in the breast. IBC progresses rapidly and is often at an advanced stage when it is diagnosed. Treatment may be chemotherapy followed by surgery and radiation. - Lobular Carcinoma in Situ (LCIS)
LCIS is technically not cancer, but it may increase your risk of getting breast cancer. The disease is caused by an overgrowth of the cells that line the milk ducts or the lobules. Because of the increased risk, women with LCIS should be screened frequently for breast cancer. - Paget’s Disease of the Nipple
This is a rare form of cancer in which cancer cells are found in or around the nipple. The nipple and the areola (the darker circle of skin around the nipple) may itch or burn, and may also ooze or bleed. Surgery followed by radiation is the standard treatment. - Phyllodes Tumor of the Breast
This is a large, bulky tumor in the breast that may be benign (not cancer) or malignant (cancer). It tends to grow quickly and may spread to other parts of the body. These tumors are most common in women in their 40s. Surgery to remove the tumor is the usual treatment.
MOLECULAR SUBTYPES OF BREAST CANCER
Molecular subtyping is a system for grouping breast cancer tumors that have similar genetic makeup into categories of cancers that behave in similar manners. This can lead to better treatments and outcomes for patients with breast cancer.
Some subtypes are based on whether or not a breast cancer cell has a receptor — a protein that attaches to estrogen and/or progesterone. Estrogen and progesterone are the hormones that fuel cancer growth. Breast cancer can contain receptors for one of these hormones, both of them, or neither of them.
These subtypes are:
- Estrogen Receptive Positive — Breast cancer with receptors for estrogen is called ER positive.
- Estrogen Receptive Negative — Breast cancer with no receptors for estrogen is called ER negative.
- Progesterone Receptive Positive — Breast cancer with receptors for progesterone is called PR positive.
- Progesterone Receptive Negative — Breast cancer with no receptors for progesterone is called PR negative.
- HER2-positive breast cancer
HER2 is an abbreviation for a protein called “human epidermal growth factor receptor 2.” HER2 promotes the uncontrolled growth of cancer cells. If a patient has HER2-positive breast cancer, it means the cancer cells are making an excess of the HER2 protein. HER2-positive breast cancer is an aggressive disease.
- Triple-negative breast cancer Some breast cancers lack receptors for estrogen, progesterone and HER2. These are called triple negative breast cancer, and affect about 10 to 15 percent of breast cancers. Women with triple-negative breast cancers tend to have genetic mutations more often than other women, which makes them more likely to have the BRCA1 and BRCA2 genes and other genetic mutations. The mutations make treating the breast cancer more challenging.
MALE BREAST CANCER
Breast cancer in men makes up less than one percent of all cases of breast cancer. More than 90 percent of the cancers in men are invasive ductal carcinoma (IDC), though men can also get ductal carcinoma in situ (DCIS), inflammatory breast cancer and Paget’s disease of the nipple. Breast cancer in men is usually treated the same way as in women, and survival rates in both genders are similar.