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Every type of breast cancer, explained

Here's what to know about 8 different breast cancers

Every type of breast cancer, explained

Here's what to know about 8 different breast cancers

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Every type of breast cancer, explained

Here's what to know about 8 different breast cancers

Getting a breast cancer diagnosis is scary but knowing what type you have can help ease some of your fears ā€” and understanding the type will help you and your doctor determine the best treatment for you. When it comes to figuring out the type of breast cancer and how to treat it, there are usually three factors to consider, says Adam Brufsky, M.D., Ph.D., professor of medicine at the University of Pittsburgh and co-director of the Comprehensive Breast Cancer Center. ā€œIs it invasive? And is it hormone receptor positive or HER2 positive? Once you have those three factors together, you can figure out how to treat it,ā€ he explains.Most breast cancers are carcinomas, which means they start in cells that line organs and tissues throughout the body, according to the American Cancer Society. Breast cancers tend to fall into two categories: ā€œin situ,ā€ which means it hasnā€™t spread to surrounding tissue and is therefore more treatable, and ā€œinvasive,ā€ which means it has spread to surrounding tissue. Thereā€™s also ā€œmetastaticā€ breast cancer, which indicates that it has spread to other parts of your body, most commonly the lungs, bones, liver or brain. Here are the types of breast cancer you need to know about.In situ breast cancersDuctal carcinoma in situConsidered precancer, DCIS is the most common type of noninvasive breast cancer. It starts in a milk duct and is highly treatable. Nearly all women with this early stage of breast cancer can be cured, according to the American Cancer Society. Over time, DCIS may progress to invasive breast cancer. Lobular carcinoma in situAlso known as lobular neoplasia, LCIS is not cancer (even though it has carcinoma in its name). Instead, cells that look like cancer cells grow in the milk-producing lobules of the breast.Invasive breast cancersInvasive ductal carcinomaThis is the most common type of breast cancer, making up 80 percent of invasive cases. IDC starts in the cells that line a milk duct in the breast, breaks through the wall of the duct and grows into nearby breast tissues. From there, is can spread (metastasize) to other parts of the body through the lymph system and bloodstream. Invasive lobular carcinomaThis type of breast cancer starts in the lobules (milk-producing glands) and accounts for approximately 10 percent of invasive breast cancers. ILC may be harder to detect than IDC via a physical exam or imaging, like a mammogram. And compared to other kinds of invasive carcinoma, about 1 in 5 women with ILC might have cancer in both breasts. Like IDC, it can spread to other parts of the body.Rare breast cancersInflammatory breast cancer This rare breast cancer causes swelling and redness in the breast, which is caused by cancer cells blocking lymph vessels in the skin. In addition to swelling and redness, you might experience pitting or thickening of the skin causing it to look and feel like an orange peel. If you have any of these symptoms, see your doctor right away. Paget disease of the nippleThis rare type of breast cancer starts in the breast ducts and spreads to the nipple and areola (the darker circle of skin). It can look very similar to eczema (very dry skin) of the nipple. You may also experience blood or yellow fluid coming out of the nipple, and it may also burn or itch. Paget disease usually affects only one nipple and tends to be linked to either ductal carcinoma in situ or infiltrating ductal carcinoma.Phyllodes tumorThese are rare breast tumors that develop in the connective tissue of the breast (as opposed to carcinomas, which develop in the ducts or lobules). Most are benign (not cancer), but 1 out of 4 are malignant (cancer). Phyllodes tumors are most common in women in their 40s, but women of any age can have them.Angiosarcoma of the breastMaking up less than 1 percent of all breast cancers, angiosarcoma starts in the cells that line blood vessels or lymph vessels. It can involve the breast tissue or the skin of the breast, and is sometimes related to prior radiation treatment of the breast.Breast cancer subtypesā€œWe tend to think of breast cancer as one condition, but thereā€™s a lot of personalized care that goes into treating it,ā€ says Megan Kruse, M.D., an oncologist at the Cleveland Clinic in Ohio and assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine. ā€œAs we learn more about breast cancer, weā€™re dividing it into different subtypes, which can help improve outcomes.ā€ There are three main subtypes and theyā€™re grouped by three genetic markers your doctor will look for on a biopsy specimen: the estrogen receptor, progesterone receptor and a protein called HER2, notes Kruse. If the cancer is negative for all three of those things, itā€™s called triple negative breast cancer. Knowing cancerā€™s hormone receptor and HER2 status is critical when it comes to determining treatment. Hereā€™s what you need to know about each breast cancer subtype: Hormone receptor positive (luminal) breast cancerSome breast cancers are fueled by the hormones estrogen and/or progesterone. ā€œEstrogen is the female hormone that makes us women, but itā€™s also a growth factor that can help breast cancer cells grow,ā€ explains Jennifer Specht, M.D., an oncologist at Seattle Cancer Care Alliance and an associate member of the clinical research division at Fred Hutchinson Cancer Research Center. Knowing whether your cancer is sensitive to these hormones is a critical part of determining the best treatment. If you test positive for either the estrogen or progesterone hormone, your breast cancer is considered hormone receptor positive breast cancer and will likely be treated with hormonal therapies. HER2-positive breast cancerThis is the other main type of breast cancer, said Specht, and itā€™s called HER2-positive because it has too many copies of a protein called human epidermal growth factor receptor 2 (HER2). This type can include cancers that are hormone receptor positive or negative. Triple negative breast cancerMaking up about 17 percent of all breast cancers that are diagnosed, triple negative breast cancer gets its name because itā€™s negative for all three markers: estrogen, progesterone and HER2. ā€œTriple negative breast cancer tends to be the most aggressive in terms of the most difficult and hardest prognosis, and the more aggressive of the three types,ā€ says Specht. Itā€™s twice as common in black women as white women in the U.S., and itā€™s also more prevalent in premenopausal women and those with a BRCA1 gene mutation.Experts who contributed to this report:Adam Brufsky, M.D., Ph.D., professor of medicine at the University of Pittsburgh and co-director of the Comprehensive Breast Cancer CenterMegan Kruse, M.D., an oncologist at the Cleveland Clinic in Ohio and assistant professor of medicine at the Cleveland Clinic Lerner College of MedicineJennifer Specht, M.D., an oncologist at Seattle Cancer Care Alliance and an associate member of the clinical research division at Fred Hutchinson Cancer Research Center

Getting a breast cancer diagnosis is scary but knowing what type you have can help ease some of your fears ā€” and understanding the type will help you and your doctor determine the best treatment for you.

When it comes to figuring out the type of breast cancer and how to treat it, there are usually three factors to consider, says ., professor of medicine at the University of Pittsburgh and co-director of the Comprehensive Breast Cancer Center.

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ā€œIs it invasive? And is it hormone receptor positive or HER2 positive? Once you have those three factors together, you can figure out how to treat it,ā€ he explains.

Most breast cancers are carcinomas, which means they start in cells that line organs and tissues throughout the body, according to the . Breast cancers tend to fall into two categories: ā€œin situ,ā€ which means it hasnā€™t spread to surrounding tissue and is therefore more treatable, and ā€œinvasive,ā€ which means it has spread to surrounding tissue. Thereā€™s also ā€œmetastaticā€ breast cancer, which indicates that it has spread to other parts of your body, most commonly the lungs, bones, liver or brain.

Here are the types of breast cancer you need to know about.


Breast Cancer: DCIS
Getty Imagesrightdx
Ductal carcinoma in situ (DCIS):

In situ breast cancers

Ductal carcinoma in situ

Considered precancer, DCIS is the most common type of noninvasive breast cancer. It starts in a milk duct and is highly treatable. Nearly all women with this early stage of breast cancer can be cured, according to the . Over time, DCIS may progress to invasive breast cancer.

Lobular carcinoma in situ

Also known as lobular neoplasia, LCIS is not cancer (even though it has carcinoma in its name). Instead, cells that look like cancer cells grow in the milk-producing lobules of the breast.


Breast Cancer: Invasive Ductal Carcinoma, Grade 3
Getty Imagesrightdx
Invasive ductal carcinoma, grade 3

Invasive breast cancers

Invasive ductal carcinoma

This is the most common type of breast cancer, making up 80 percent of invasive cases. IDC starts in the cells that line a milk duct in the breast, breaks through the wall of the duct and grows into nearby breast tissues. From there, is can spread (metastasize) to other parts of the body through the lymph system and bloodstream.

Invasive lobular carcinoma

This type of breast cancer starts in the lobules (milk-producing glands) and accounts for approximately 10 percent of invasive breast cancers. ILC may be harder to detect than IDC via a physical exam or imaging, like a mammogram. And compared to other kinds of invasive carcinoma, about 1 in 5 women with ILC might have cancer in both breasts. Like IDC, it can spread to other parts of the body.


Micrograph of angiosarcoma of the breast
Getty ImagesOGphoto
Angiosarcoma of the breast

Rare breast cancers

Inflammatory breast cancer

This rare breast cancer causes swelling and redness in the breast, which is caused by cancer cells blocking lymph vessels in the skin. In addition to swelling and redness, you might experience pitting or thickening of the skin causing it to look and feel like an orange peel. If you have any of these symptoms, see your doctor right away.

Paget disease of the nipple

This rare type of breast cancer starts in the breast ducts and spreads to the nipple and areola (the darker circle of skin). It can look very similar to (very dry skin) of the nipple. You may also experience blood or yellow fluid coming out of the nipple, and it may also burn or itch. Paget disease usually affects only one nipple and tends to be linked to either ductal carcinoma in situ or infiltrating ductal carcinoma.

Phyllodes tumor

These are rare breast tumors that develop in the connective tissue of the breast (as opposed to carcinomas, which develop in the ducts or lobules). Most are benign (not cancer), but 1 out of 4 are malignant (cancer). Phyllodes tumors are most common in women in their 40s, but women of any age can have them.

Angiosarcoma of the breast

Making up less than 1 percent of all breast cancers, angiosarcoma starts in the cells that line blood vessels or lymph vessels. It can involve the breast tissue or the skin of the breast, and is sometimes related to prior radiation treatment of the breast.


Breast cancer subtypes

ā€œWe tend to think of breast cancer as one condition, but thereā€™s a lot of personalized care that goes into treating it,ā€ says ., an oncologist at the Cleveland Clinic in Ohio and assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine. ā€œAs we learn more about breast cancer, weā€™re dividing it into different subtypes, which can help improve outcomes.ā€

There are three main subtypes and theyā€™re grouped by three genetic markers your doctor will look for on a biopsy specimen: the estrogen receptor, progesterone receptor and a protein called HER2, notes Kruse. If the cancer is negative for all three of those things, itā€™s called triple negative breast cancer.

Knowing cancerā€™s hormone receptor and HER2 status is critical when it comes to determining treatment. Hereā€™s what you need to know about each breast cancer subtype:

Hormone receptor positive (luminal) breast cancer

Some breast cancers are fueled by the hormones estrogen and/or progesterone.

ā€œEstrogen is the female hormone that makes us women, but itā€™s also a growth factor that can help breast cancer cells grow,ā€ explains ., an oncologist at Seattle Cancer Care Alliance and an associate member of the clinical research division at Fred Hutchinson Cancer Research Center.

Knowing whether your cancer is sensitive to these hormones is a critical part of determining the best treatment. If you test positive for either the estrogen or progesterone hormone, your breast cancer is considered hormone receptor positive breast cancer and will likely be treated with hormonal therapies.

HER2-positive breast cancer

This is the other main type of breast cancer, said Specht, and itā€™s called HER2-positive because it has too many copies of a protein called human epidermal growth factor receptor 2 (HER2). This type can include cancers that are hormone receptor positive or negative.

Triple negative breast cancer

Making up about 17 percent of all breast cancers that are diagnosed, triple negative breast cancer gets its name because itā€™s negative for all three markers: estrogen, progesterone and HER2.

ā€œTriple negative breast cancer tends to be the most aggressive in terms of the most difficult and hardest prognosis, and the more aggressive of the three types,ā€ says Specht. Itā€™s twice as common in black women as white women in the U.S., and itā€™s also more prevalent in premenopausal women and those with a BRCA1 gene mutation.


Experts who contributed to this report:

  • ., professor of medicine at the University of Pittsburgh and co-director of the Comprehensive Breast Cancer Center
  • ., an oncologist at the Cleveland Clinic in Ohio and assistant professor of medicine at the Cleveland Clinic Lerner College of Medicine
  • ., an oncologist at Seattle Cancer Care Alliance and an associate member of the clinical research division at Fred Hutchinson Cancer Research Center