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A Woman's Guide to Breast Cancer Diagnosis and Treatment
About Breast Cancer
- Staging of Breast Cancer
Breast cancer is a complex disease. There is no right treatment for all women. Your breast cancer will be placed into one of 5 stages. How your cancer is staged and your treatment choices will depend on:
- How small or large your tumor is and where it is found in your breast.
- If cancer is found in the lymph nodes in your armpit.
- If cancer is found in other parts of your body.
The following words and information also can help you understand how your cancer is "staged".
- Benign means that your lump or other problem was NOT cancer.
- Malignant means that your tissue DOES contain cancer cells.
- In Situ or noninvansive cancer is a very early cancer or a precancer that has NOT SPREAD beyond the breast, to the lymph nodes in the armpit, or to other parts of the body. This type of cell is still totally contained in the milk ducts or lobules of the breast.
- Invasive cancer HAS SPREAD to surrounding tissue in the breast and MAY HAVE SPREAD to the lymph nodes in the armpit or to other parts of the body. All breast cancers, except in situ, are invasive.
- Metastasized cancer HAS SPREAD to other parts of the body, such as the bones, lungs, liver, or brain.
| STAGING OF BREAST CANCER |
| Stage 0 |
- Very early breast cancer or preinvasive cancer. This type of cancer has NOT spread within or outside of your breast (also called in situ or noninvasive cancer).
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| Stage I |
- Tumor smaller than 2 cm. (1 inch). No cancer is found in lymph nodes in the armpit, or outside the breast.
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| Stage II |
- Tumor smaller than 2 cm. (1 inch). Cancer is found in the lymph nodes in the armpit,
- Tumor between 2 and 5 cm. (1 and 2 inches). Cancer may or may not be found in the lymph nodes in the armpit.,
- Tumor larger than 5 cm. (2 inches). Cancer is not found in the armpit.
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| Stage III |
- Tumor smaller than 5 cm. (2 inches) with cancer also in the lymph nodes that are stuck together,
- Tumor larger than 5 cm. (2 inches), OR cancer is attached to other parts of the breast area including the chest wall, ribs, and muscles,
- Inflammatory breast cancer. In this rare type of cancer, the skin of the breast is red and swollen.
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| Stage IV |
- Tumor has spread to other parts of the body, such as the bones, lungs, liver, or brain.
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- Risk Factors for Recurrence
Some women are at higher risk for the spread and return of breast cancer. Remember, the risk factors for recurrence are complex. They ARE NOT absolute forecasts of what your future will be. The factors are:
- Tumor size. The larger your tumor, the higher your risk.
- Lymph nodes. The more lymph nodes in your armpit that have cancer, the higher your risk.
- Cell studies. New tests can measure the growth rate and aggressiveness of the tumor cells. The cancer cells that show the most rapid growth are linked to higher risk for the return of cancer.
- In Situ "Cancers"
Because of the success of x-ray mammography, tiny growths are being discovered that raise concerns about a woman's risk of developing breast cancer. These growths are called carcinoma in situ or noninvasive cancer. Today fifteen to twenty percent of breast "cancers" fall into this category. Two types exist:
- Ductal carcinoma in situ (DCIS) is noninvasive, which means it is limited to the milk ducts of the breast. It has NOT spread beyond the breast, to the lymph nodes in the armpit, or to other parts of the body. However, there are several types of DCIS. If it is not removed, some types may in time change and develop into an invasive cancer. Some may never progress to an invasive cancer.
- Lobular carcinoma situ (LCIS) is a noninvasive growth limited to the milk lobules of the breast. It is NOT cancer, only a warning sign of increased risk of developing cancer, according to the National Cancer Institute. Women with LCIS have about a 1% risk of developing invasive breast cancer equally in either breast per year. At 20 years, this risk is about 18%.
- Your Treatment Team
If your lump does contain cancer cells, you will need a team of medical experts. No one doctor is able to provide all the services you may need. Here are some of the experts you may need.
- Anesthesiologist: a doctor who gives medications that keep you comfortable during surgery.
- Oncologist: a doctor who uses chemotherapy or hormone therapy to treat cancer.
- Pathologist: a doctor who examines tissue and cells under a microscope to decide if they are normal or cancer.
- Physical Therapist: a medical professional who teaches exercises that help restore arm and shoulder movements after surgery.
- Radiation Oncologist: a doctor who uses radiation therapy to treat cancer.
- Radiologist: a doctor who reads mammograms and performs other tests, such as x-rays or ultrasound.
- Social Worker: a professional who can talk with you about your emotional or physical needs.
- Surgeon: a doctor who performs biopsies and other surgical procedures such as the removal of your lump (lumpectomy) or your breast (mastectomy).
Second Opinions
Second opinions are your right and are commonly asked for today. Get a second opinion if you:
- Want to confirm your diagnosis or treatment.
- Have concerns about your treatment plan.
- Feel uncomfortable with your doctor.
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