I took some quick notes and made a small FAQ. It has some stats, info, and pointers to more info and stats. Hope this helps someone.
Updated: Sep 4, 2003
Breast cancer
- Angiosarcoma: more in young women, difficult to treat, tend to grow quickly, very rare.
- Inflammatory: very uncommon but very serious.
- Types of benign disorders: cysts, sclerosing adenosis, atypical hyperplasia, fibroadenomas, duct papillomas, duct ectasia, fibrosis, mastitis, metaplasia (apocrine or squamos).
- Poliferative tumors: moderate or florid hyperplasia, papilloma with fibrovascular core, atypical hyperplasia (ductal or lobular).
Misc facts
Ultrasound cannot detect calcifications (http://www.breastcancer.org/testing_ultrasound.html)
A tumor does not mean cancer.
In situ means the tumor has not spread. Invasive means it has spread beyond the original site.
A common sign of breast disease found by mammography is microcalcification -- very small deposits of calcium, deposited in breast tissue. These calcifications are usually of varying shapes frequently occur in tight groups, and are found in benign (NOT
CANCEROUS) and malignant (CANCEROUS) conditions. Sometimes these calcifications, seen on mammogram, occur without an associated mass.
Stages of cancer
Is determined by size of tumor, if lymph nodes are involved, and if it has spread.
Stage 0: abnormal cells lining a gland or duct.
Stage 1: tumor measures up to 2cm and no lymph nodes involved.
Stage 2: tumor measures 2-5cm and has spread to lymp nodes on same side of body as tumor.
Stage 3a: larger than 5cm OR tumor has spread to lymph nodes and nodes are clumping/sticking together.
Stage 3b: tumor has spread to breast skin, muscle or internal mammary lymph nodes.
Stage 4: tumor has spread beyond local lymph nodes and tissue to other organs.
Tumor grades
Grade 1: look a lot like normal cells and are slow growing.
Grade 2: do not look like normal cells, they are faster growing and tend to stick together.
Grade 3: have irregular shapes, are fast growing and tend to stick together.
The higher the grade the more susceptible the cells are to treatment like radiation.
Hormone receptors
Breast cancer cells can have hormone receptors. They are either ER positive or PR positive. These are more easily treatable. Score of 0 is no receptors (negative). Other grades are 1+, 2+ or 3+.
HER-2/neu receptors. The presence of estrogen and progesterone receptors is important because cancers that have those receptors can be treated with hormonal therapies. HER-2/neu expression may also help predict outcome. There are also some therapies directed specifically at tumors dependent on the presence of HER-2/nue.
If your cancer expresses it, you usually have a higher chance of having your tumor recur after surgery. A compound called Herceptin (or
Trastuzumab) is a substance that blocks this receptor and helps stop the breast cancer from growing. Some patients are candidates for this medicine.
Two of the most common regimens are AC (doxorubicin and cycolphosphamide) for 3 months or CMF (cyclophosphamide, methotrexate, and fluorouracil) for 6 months.
Breast cancer commonly receives radiation therapy. Radiation therapy uses high energy rays (similar to x-rays) to kill cancer cells. It comes from an external source, and it requires patients to come in 5 days a week for up to 6 weeks to a radiation therapy treatment center.
The treatment takes just a few minutes, and it is painless. Radiation therapy is used in all patients who receive breast conservation therapy (BCT). It is also recommended for patients after a mastectomy who had large tumors, lymph node involvement, or close/positive margins after the surgery. Radiation is important in reducing the risk of local recurrence and is often offered in more advanced cases to kill tumor cells that may be living in lymph nodes.
New Treatments
The current methods of treatment in use in the United States are: surgery (mastectomy and lumpectomy), radiation, chemotherapy, hormone therapy, and monoclonal antibody therapy.
Antibodies are proteins in the body that attach to unique proteins on foreign invaders and signal their presence to T-cells. ADEPT is a technique used to attach chemotherapy drugs to antibodies that are able to attach to tumor cells. This technique delivers the drugs straight to the tumor while sparing normal tissue. One German group of researchers has designed a novel ADEPT system that is likely to be more stable and efficient than current systems.
Indol-3-carbinol (I3C) is a natural chemical found in cabbage, brussel sprouts, and broccoli. One group of researchers from UCLA at Berkeley demonstrated that I3C stops both estrogen receptor-negative and estrogen receptor-positive breast cancer cells from reproducing. These researchers conducted additional experiments to identify the most potent synthetic and natural forms of I3C. Their studies suggested that I3C could potentially be developed into a new breast cancer treatment that may be more effective and have fewer side effects than current treatments.
Photodynamic therapy (PDT), also called photoradiation therapy, phototherapy, or photochemotherapy, is a treatment that combines a light source and a photosensitizing agent (a drug that is activated by light) to destroy cancer cells. It has been approved by the United
States Food and Drug Administration (FDA) for certain cases of cancer of the esophagus and non-small cell lung cancer (NSCLC), and was most recently approved to treat actinic keratosis, a precancerous skin condition.
PDT works because the photosensitizing agent collects more readily in cancer cells than in normal cells. When the agent is then exposed to light, it reacts with oxygen to create chemicals that can kill the cell. Because the approved light sources can only penetrate a limited depth through tissue, PDT is mainly used to treat areas on or just under the skin, or in the lining of internal organs.
9 out of 10 lumps are benign (also 8/10, 3/4)
1 out of 10 lumps show atypical hyperplasia: they are not cancer but are growing abnormally.
80% of women who get breast cancer have no family history of the disease. About 90% of women who develop breast cancer do not have a family history of the disease. (NBCC)
Fibrocystic breast disorders affect 50% of American women.
When the disease is confined to the breast, the 5-year survival rate is over 95%.
Breast cancer is the second leading cause of cancer death for women in the U.S; approximately 39,800 women in the U.S. will die from the disease this year. Breast cancer is the leading cause of cancer death for U.S. women between the ages of 20 and 59, and the leading cause of cancer death for women worldwide.
Most breast cancers -- about 77% -- occur in women ages 50 and older.
Less than 5% of all breast cancer cases occur in women under the age of 40.
Although scientists have discovered some risk factors for breast cancer, most factors account for only small increases in a person¢s chances of developing breast cancer.
Chances to get breast cancer by age: by age 30 1/2525 by age 40 1/217 age 50 1/50 age 60 1/24 age 70 1/14 age 80 1/10
DOD Breast cancer research program:
http://cdmrp.army.mil/bcrp
FDA Center for Drug Evaluation Research:
http://www.fda.gov/cder/
http://www.breastcancer.org/dia_pict_rate.html
http://www.cancer.org
http://www.nationalbreastcancer.org
expert)
National Breast Cancer Coalition:
www.natlbbc.org (600 orgs)
Nat'l Alliance of Breast Cancer Orgs:
http://www.nabco.org
Nat'l Cancer Inst.:
http://www.cancer.gov
Nat'l Cancer Inst:
http://seer.cancer.gov/csr/1973_1999
