Breast Cancer

Each type of breast cancer develops and responds to treatment differently. Breast cancer is categorized as either invasive or noninvasive (in situ).

Ductal Carcinoma in Situ (DCIS)

DCIS is a noninvasive breast cancer that begins in the cells that line milk ducts, but it’s contained and hasn’t spread to surrounding breast tissue.

Invasive Ductal Carcinoma (IDC)

IDC is the most common type of breast cancer. It begins in the milk duct lining and spreads to surrounding breast tissue. This type of breast cancer can spread further through the blood and lymph systems.

Lobular Carcinoma in Situ (LCIS)

LCIS begins in the milk glands (lobules) and is a noninvasive cancer.

Inflammatory Breast Cancer (IBC)

IBC is a fast and aggressive type of breast cancer in which the cells block the lymph vessels. IBC causes breasts to be red, swollen and warm. Breast skin may also be pitted (like an orange). IBC often grows rapidly and requires aggressive treatment.

Triple-Negative Breast Cancer (TNBC) 

A diagnosis of TNBC means cancer cells lack the three most common receptors known to fuel breast cancer growth: estrogen, progesterone and human epidermal growth factor receptor 2 (HER2). Without these receptors, common breast cancer treatment methods aren’t as effective. TNBC treatment depends on the stage and grade.

Hormone Receptor-Positive Breast Cancer

About 80% of all breast cancer types are hormone receptor-positive, also called ER-positive. ER-positive breast cancer is much more likely to respond to hormone therapy than other types of breast cancer.

HER2-Positive Breast Cancer

Breast cancer cells have too many HER2 receptors, making them grow and spread quickly. Treatments may target HER2-positive cells.

Metastatic Breast Cancer

Metastatic breast cancer is cancer that spreads from the place it began in the breast to other parts of the body, usually including the lungs, liver and bones. Metastatic is considered stage 4 breast cancer.

Male Breast Cancer

Less than 1% of breast cancer cases occur in men. Male breast cancer most often affects men between ages 60-70. Invasive ductal carcinoma is the most common type of male breast cancer. Less-common types include ductal carcinoma in situ, inflammatory breast cancer and Paget’s disease of the nipple – rare cancer in the skin of the nipple and areola.

What causes breast cancer? It develops when normal breast cells are damaged, resulting in abnormal cell growth. Some DNA changes are inherited. But many of the DNA changes linked to breast cancer are acquired, meaning they take place during your life over time. Certain risk factors, such as gender, age and genetics, are strongly linked to a higher risk of developing breast cancer.  

Gender & Age

Can men get breast cancer? Yes, but women are 100 times more likely to develop it. Your risk also increases with age, and breast cancer is more common in women over age 50.

Family History & Genetics

If a close relative has had breast, uterine, ovarian or colon cancer, your risk may be increased. Share any family history of cancer with your Mercy doctor. Having certain genes also increases your risk. The two genes most linked to breast cancer are BRCA1 and BRCA2. If you test positive for these genes, you’ll need to be screened for breast cancer more often and at a younger age.

Menstrual History

Women who get their periods at an early age (before age 12) or enter menopause late (after age 55) have an increased breast cancer risk.

Dense Breasts

Women whose breasts have more fibrous than fatty tissue are more prone to breast cancer. And dense breasts can make it hard to see cancer on mammograms.

Lifestyle Habits

Drinking alcohol, being overweight or physically inactive, never having children and using hormone therapy after menopause also affect your breast cancer risk.

Breast cancer affects people differently, and some don’t experience symptoms. Younger women may ignore breast cancer symptoms, believing they’re too young to get breast cancer. Unfortunately, this delays diagnosis and can lead to poorer outcomes. All women should be aware of the warning signs of breast cancer, which can include:

• A new lump in the breast or armpit
• Changes in breast size or shape
• Irritated or dimpled breast skin
• Nipple discharge other than breastmilk (including blood)
• Nipple pain or inverted nipple
• Pain anywhere in the breast
• Rash on breast
• Red or flaky skin on the breast or nipple
• Thick or swollen breasts

Breast Cancer Screening

Screening tests and exams help detect breast cancer earlier, when it’s easier to treat. Types of breast cancer screening include mammograms, self-exams and clinical breast exams. Beginning at age 19, women should perform regular breast self-exams and have a clinical breast exam by a Mercy doctor or Mercy OB/GYN annually. Clinical breast exams help detect lumps, pain or other changes in the breast and are an important part of early detection.

Breast Cancer Screening Guidelines

The American College of Obstetricians and Gynecologists recommends the following screening guidelines for breast cancer:

• Annual mammograms are recommended for women ages 40 - 74 who have no family history of breast cancer.
• Women with a family history of breast cancer should start screening before age 40.
• Healthy women ages 75 and older should continue to get mammograms if they’re in good health and are expected to live 10 years or longer.

Imaging is used to diagnose and evaluate the stage and extent of breast cancer. Three imaging methods are used to detect breast cancer: mammography, ultrasonography and breast magnetic resonance imaging (MRI).

Mammography

In addition to screening mammograms, Mercy provides 3D mammography, which provides more detailed breast images at several angles. It’s especially effective for women with dense breast tissue and other risk factors.

Ultrasonography

Also known as a breast ultrasound, this exam may be used along with mammography or MRI.

Breast MRI

A breast MRI is used to help determine the extent of breast cancer. Not every patient diagnosed with breast cancer needs a breast MRI.

A breast biopsy is performed when cancer is suspected during a mammogram, clinical breast exam or other imaging tests. Mercy offers several types of breast biopsy.

If you have a strong family history of breast cancer or you’ve been diagnosed yourself, your Mercy doctor may recommend genetic counseling or testing. Breast cancer genetic testing lets you know if you’ve inherited genes linked to breast cancer risk.

Local therapy treats a specific area of breast cancer without affecting the rest of the body. Local treatment for breast cancer typically includes surgery, which is sometimes followed by radiation therapy to the breast and nearby lymph nodes.

Breast Cancer Surgery

The most common breast cancer treatment is surgery. The two main types of breast cancer surgery are breast-conserving surgery and mastectomy. Mercy also offers breast reconstruction procedures that can be performed at the same time as lumpectomy or mastectomy in some cases.

• Breast-conserving surgery (BCS) - BCS surgery, also referred to as lumpectomy, quadrantectomy, segmental mastectomy or partial mastectomy, removes breast cancer while leaving as much healthy breast tissue as possible. This type of surgery is often followed by other therapies.
  
  
• Mastectomy - This procedure is the surgical removal of the breast, including the breast tissue and nearby tissue in some cases. Different types of mastectomies can be used to treat breast cancer, depending on the amount of tissue to be removed and the surgical approach needed.
  
  
• Lymph node surgery - Lymph nodes are removed to determine whether or not cancer has spread beyond the breast, such as to nodes under your arm or around your collarbone and neck. The two main types of lymph node surgery are sentinel lymph node biopsy and axillary lymph node dissection.

Radiation Therapy

Radiation therapy uses high-energy rays to destroy cancer cells. Two different types of radiation therapy may be used to treat breast cancer: external beam radiation therapy (EBRT) and brachytherapy.

Systemic therapies are medicines that travel throughout the body to treat cancer. They can be administered orally or directly into the bloodstream. Different types of drug treatment may be used depending on the type of breast cancer. Systemic treatments for breast cancer include chemotherapy, hormone therapy, targeted therapy and immunotherapy. 

Chemotherapy

Chemotherapy is used to treat all stages of breast cancer, including recurrent and metastatic breast cancer. Not all breast cancer patients benefit from chemo, but it may be recommended before surgery (neoadjuvant chemotherapy), after surgery (adjuvant chemotherapy) and for advanced breast cancer.

Hormone Therapy

Hormone therapy, also known as hormonal therapy, hormone treatment and endocrine therapy, slows or stops the growth of hormone-sensitive cancers. It works either by producing hormones or interfering with hormone receptors on cancer cells. Hormone therapy is more targeted than chemotherapy. For example, anti-estrogen therapy blocks the estrogen stimulation of cancer cells.

Targeted Cancer Therapies

Targeted cancer therapies target and act on specific molecules (molecular targets) that help cancer grow and spread. They're very focused and work differently than chemotherapy treatments for breast cancer. An example is anti-HER2 therapy, which targets the HER2 protein on cancer cells.

Immunotherapy

Immunotherapy, also called biologic therapy, uses medicine to help the immune system recognize and attack cancer cells. It works either by boosting immunity or changing how it functions. Immunotherapy is used to treat some types of breast cancer but not all.

Nurse Navigators

At Mercy, you’ll have a breast cancer nurse navigator to guide you throughout your care. Nurse navigators explain tests and treatments, make referrals to oncology specialists and surgeons, provide educational materials and connect you with support resources.