Breast Cancer – Types & Symptoms

Cancer is caused by genetically mutated cells in the body that grow abnormally in number. Typical breast cancer is seen in the milk secreting glands (lobules) or in the ducts that move the milk from lobules out of the nipple. Occasionally, breast cancer can also be seen in the fatty or fibrous tissue of the breast.

In cases when the detection or treatment of breast cancer is delayed, the cancer cells can travel to other parts of the body through the lymph nodes after invading the breast tissue. Lymph nodes act as a pathway for cancer cells to move across the body and settle in different organs.

Types of breast cancer

Broadly, breast cancer is divided into two types – invasive and non-invasive. Non-invasive is also called as ‘in situ’ in medical terms. Invasive cancer spreads to the healthy breast tissue and beyond whereas the non-invasive cancers haven’t spread beyond their origin.

Most common types of breast cancer are:

1. Ductal Carcinoma In Situ – (DCIS) – As the name suggests, this is ‘non invasive’ cancer present in the milk ducts. This type of cancer has not spread to the healthy breast tissue.
2. Lobular Carcinoma In Situ – (LCIS) – Cancer originates in the milk producing glands of the breast. Similar to DCIS, this too has not spread to other parts of the breast.
3. Invasive Ductal Carcinoma – In this medical condition, the cancer has originated in the milk ducts and has spread to nearby tissues of the breast.
4. Invasive Lobular Carcinoma – Cancer first develops in the milk secreting glands and has spread to the surrounding tissues in the breast.
5. Inflammatory breast cancer – A rare type of breast cancer which covers the lymphatic vessels on the skin of the breast. As a result, the skin on the breast turns red in colour; the breasts swell and become tender to touch. This is considered a locally advanced cancer because the cancer spreads to other parts of the breast and the lymph nodes very quickly. A breast lump or breast swelling needs a gynaecologist’s attention as soon as noticed.
6. Paget’s disease of the breast – Another rare cancerous condition that starts in the nipple and extends to the surrounding darker area around the nipple (Areola). This condition is typically seen in women above the age of 50.
7. Recurrent breast cancer – Once the patient is diagnosed with breast cancer and treated, some cancer cells manage to escape and survive the treatment without getting killed. Such cells can remain in the place of origin or have moved to different parts of the body. In such scenario, after few months or years, these cells resume multiplying and cancer condition returns.
8. Angiosarcoma – In this condition, the cancer cells grow in the lymph vessels or blood vessels in the breast
9. Phyllodes Tumour – In some cases, tumors begin to form in the connective tissue of the breast. Though most of the tumors are non-cancerous, you will need to see a gynaecologist when you find a breast lump.
10. Triple Negative Breast Cancer – Occurs only in 10 to 20% of the cases. In order to be classified as ‘triple negative’, the cancer tumour must satisfy the following three conditions:
    1. Lack of Estrogen receptors – Estrogen receptors of the cancer cells bind to estrogen hormone. This helps the cancer cells to grow and multiply.
    2. Lack of Progesterone receptors – The cancer cells don’t have progesterone receptors to attach to progesterone and grow.
    3. Absence of HER2 proteins on the surface of cancer cells – HER2 helps the cancer cells to grow.

This type of cancer can grow and spread very rapidly. Triple negative breast cancer can’t be treated with hormone therapy.

11. Metastatic breast cancer – When cancer cells move from the place of origin to other parts of the body and continue to multiply in those organs, cancer is said to be in ‘metastasized’ stage. Typically this is level 4 of cancer progression. Breast cancer can spread to lungs, liver or bones just like any other metastasized cancer.
12. Male breast cancer – Yes, men too get breast cancer but women see it more often.

Symptoms of breast cancer

1. Breast lumps are the very first thing that you may notice when checking your breasts as a part of self-examination. It is important that you see your gynaecologist when you find breast lumps, to make sure that they are not cancerous.
2. Changes in size, shape and appearance of breast. You can even notice breast swelling.
3. Changes to the skin on the breasts – change in colour, formation of wrinkles or dimples, peeling, scaling, flaking of skin may also be noticed.
4. Inverted nipple – typically the nipple on breast is projected outwards. In case of inverted nipple, the nipples turn back in, forming a dent kind of thing on the breasts.

When you must see your gynaecologist?

If you notice any of the symptoms mentioned above, you must fix an appointment with your gynaecologist at the earliest. If you find any lumps in breasts or if there is a discharge from your nipples or if there is any blood coming out of your nipples, you must not wait to see your doctor.

Your gynaecologist can check the symptoms and ask for couple of screening tests to determine the nature of the lumps and swelling and can start treatment accordingly.