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Breast Cancer Stages

https://www.breastcancer.org/symptoms/diagnosis/staging

The stage of a breast cancer is determined by the cancer’s characteristics, such as how large it is and whether or not it has hormone receptors. The stage of the cancer helps you and your doctor:

  • figure out your prognosis, the likely outcome of the disease
  • decide on the best treatment options for you
  • determine if certain clinical trials may be a good option for you

Breast cancer stage is usually expressed as a number on a scale of 0 through IV — with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body.

How a breast cancer’s stage is determined

Your pathology report will include information that is used to calculate the stage of the breast cancer — that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.

The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer (AJCC). The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.

In the past, stage number was calculated based on just three clinical characteristics, T, N, and M:

  • the size of the cancer tumor and whether or not it has grown into nearby tissue (T)
  • whether cancer is in the lymph nodes (N)
  • whet…

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Mastectomy: What to Expect

https://www.breastcancer.org/treatment/surgery/mastectomy/expectations

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Before mastectomy surgery

In the hospital on the day of surgery, you’ll change into a hospital gown and wait in a preoperative holding area. Some hospitals will allow you to have one or two friends or family members with you in the room.

Your surgeon or a nurse may draw markings on your breast that show where the incision will be made. Usually this is done with a felt-tip marker. You’ll be sitting up while this happens so that the natural crease of your breast can be marked.

You will be taken into the anesthesia room, where a nurse will insert a needle connected to a long tube — an intravenous infusion (IV) line — into your hand or arm and tape it into place. Soon after this, you’ll be given relaxing medication through the IV line. Once you are wheeled into the operating room, you will be given general anesthesia.

During mastectomy surgery

Mastectomy with axillary dissection can take 2-3 hours. If reconstruction is performed at the same time, surgery will take longer.

Most mastectomy incisions are in the shape of an oval around the nipple, running across the width of the breast. If you are having a skin-sparing mastectomy, the incision will be smaller, including only the nipple, areola, and the original biopsy scar. If you’re having a nipple-sparing mastectomy, a variety of incisions can be used.

After the incision is made, the breast tissue is separated from the overlying skin and from the chest wall muscle underneath. All of the breast tissue — which lies between the collarbone and ribs, from the side of the body to the breastbone in the center — is removed. Your breast surgeon will also pe…

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Ductal Carcinoma In Situ (DCIS)

https://www.breastcancer.org/symptoms/types/dcis

Ductal carcinoma in situ (DCIS) is non-invasive breast cancer. Ductal means that the cancer starts inside the milk ducts, carcinoma refers to any cancer that begins in the skin or other tissues (including breast tissue) that cover or line the internal organs, and in situ means “in its original place.” DCIS is called “non-invasive” because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue. DCIS isn’t life-threatening, but having DCIS can increase the risk of developing an invasive breast cancer later on.

When you have had DCIS, you are at higher risk for the cancer coming back or for developing a new breast cancer than a person who has never had breast cancer before. Most recurrences happen within the 5 to 10 years after initial diagnosis. The chances of a recurrence are under 30%.

Women who have breast-conserving surgery (lumpectomy) for DCIS without radiation therapy have about a 25% to 30% chance of having a recurrence at some point in the future. Including radiation therapy in the treatment plan after surgery drops the risk of recurrence to about 15%. Learn what additional steps you can take to lower your risk of a new breast cancer diagnosis or a recurrence in the Lower Your Risk section. If breast cancer does come back after earlier DCIS treatment, the recurrence is non-invasive (DCIS again) about half the time and invasive about half the time. (DCIS itself is NOT invasive.)

According to the American Cancer Society, about 60,000 cases of DCIS are diagnosed in the United States each year, accounting for about 1 out of every 5 new breast cancer cases.

There are two main reasons this number is so large and has been increasing over time:

  • People are living much longer lives. As we grow older, our risk of breast cancer increases.
  • More people are getting mammograms, and the quality of the mammogra…

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High Number of Certain Skin Cancers Linked to Increased Risk of Breast Cancer

https://www.breastcancer.org/research-news/skin-cancers-linked-to-increased-bc-risk

People who are diagnosed with a higher-than-average number of basal cell carcinomas, a common type of skin cancer, have a higher risk of other cancers, including breast, colon, and prostate cancer, according to a study.

The researchers believe this increase in risk is likely caused by mutations in genes that are responsible for repairing DNA damage.

The research was published online on Aug. 9, 2018 by the journal JCI Insight. Read “Frequent basal cell cancer development is a clinical marker for inherited cancer susceptibility.”

Basal cell carcinoma begins in the basal cells, a type of skin cell that produces new cells as old cells die. Basal cell carcinoma appears most often on areas of your skin that are exposed to the sun, such as your head and neck. Basal cell carcinomas are common — more than 3 million cases a year are diagnosed in the United States alone — and usually highly treatable.

The skin is the largest organ of your body and is the most vulnerable to DNA damage caused by the sun’s ultraviolet rays. So, researchers wondered if the skin’s susceptibility to cancer could offer clues about a person’s overall likelihood of developing other cancers.

How DNA changes can lead to cancer

Genes are short segments of DNA (deoxyribonucleic acid) found in chromosomes. DNA contains the instructions for building proteins. And proteins control the structure and function of all the cells that make up your body.

Think of your genes as an instruction manual for cell growth and function. Changes or mistakes in the DNA are like typographical errors. They may provide the wrong set of instructions, leading to faulty cell growth or function. In any one person, if there is an error in a gene, that same mistake will appear in all the cells that contain the same gene. This is like having an instruction manual in which all the copies have the same typo…

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Triple-Negative Breast Cancer

https://www.breastcancer.org/symptoms/diagnosis/trip_neg

Your pathology report may say that the breast cancer cells tested negative for estrogen receptors (ER-), progesterone receptors (PR-), and HER2 (HER2-). Testing negative for all three means the cancer is triple-negative.

These negative results mean that the growth of the cancer is not supported by the hormones estrogen and progesterone, nor by the presence of too many HER2 receptors. Therefore, triple-negative breast cancer does not respond to hormonal therapy (such as tamoxifen or aromatase inhibitors) or therapies that target HER2 receptors, such as Herceptin (chemical name: trastuzumab). However, other medicines can be used to treat triple-negative breast cancer.

About 10-20% of breast cancers — more than one out of every 10 — are found to be triple-negative. For doctors and researchers, there is intense interest in finding new medications that can treat this kind of breast cancer. Early studies are trying to find out whether certain medications can interfere with the processes that cause triple-negative breast cancer to grow. In this section, you can learn about:

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