Different Types of Breast Cancer

There are several types of breast cancer. The type of cell affected in the breast determines the type of breast cancer.

  • Carcinoma- Majority of breast cancers are carcinomas which arise from epithelial cells. When the epithelial cells are from glandular tissue involving milk ducts and glands, such type of carcinoma is called as adenocarcinoma.
  • Sarcoma -Less common types of breast cancer include sarcomas which arise from cells of connective tissue of muscle, fat or blood vessels.

Depending on the extent of spread of cancer into surrounding tissues cancer can be categorized into two types

  1. Invasive (Infiltrating) breast cancer-where the breast cancer invades into the surrounding breast tissue by breaking through the duct and lobular wall. Invasive cancer becomes metastatic once it spreads to lymph nodes or distant organs.
  2. Non-invasive (In situ) breast cancer- where the breast cancer does not spread to surrounding fatty and connective tissue and remains in a particular location(ducts, lobules) of the breast.

Common types of breast cancer

  • Invasive/Infiltrating ductal carcinoma (IDC) not otherwise specified (NOS) is the most common invasive cancer accounting to about 80% of all breast cancers. It originates in the milk ducts of breast tissue and invades into the surrounding fatty tissue through the wall of the duct. It further metastasizes to distant organs through lymph nodes and blood stream. It is an aggressive invasive cancer and prognosis depends on the stage
  • Invasive/Infiltrating lobular carcinoma is second common invasive cancer accounting to about 5-15% of all breast cancers. It starts in the lobules of the breast and invades into the surrounding tissue with a tendency to metastasize.
  • Ductal carcinoma in situ (DCIS) is an early stage (stage 0) cancer which is non-invasive in nature. The tumor cells lining the duct do not spread to surrounding tissue and are confined to the lining of milk ducts. Most of the women in this stage can be treated. DCIS is rare in countries like India as most cases present at later stage.
  • Lobular carcinoma in situ (LCIS) begins typically in the lobules of the breast glands and doesn’t spread beyond the wall of lobules to the surrounding breast tissue. Women having this condition are more likely to develop invasive cancer in future.

Sub types of invasive breast cancer

There are some special subtypes of invasive breast cancer which are less common in occurrence. They are often named based on their microscopic appearance arising from the alignment of cancer cells. They have better prognosis than the common types of invasive ductal breast carcinoma and respond well to the treatment. These include

  •  Medullary carcinoma (3-5%) with soft, fleshy mass resembling the medulla of brain
  • Mucinous/Colloid carcinoma (1.1%) formed by mucous producing cancer cells appearing mucinous
  • Papillary carcinoma where cancer cells are arranged as finger like projections
  • Tubular carcinoma where cancer cells are arranged in tube like structures

Other rare types of breast cancer

  • Inflammatory breast cancer accounts to about 1-3% of all breast cancers. It is less common aggressive cancer that often affects the skin. Cancer cells often block lymph vessels of the breast giving rise to appearance of red, swollen and warm inflamed breasts. Other symptoms include dimpling of breast skin and pulling in of nipple.
  • Pagets disease of the nipple accounts to about 1-3% of cancers. It is rare form of breast cancer that starts from ducts of breast and spreads to the skin of nipple & areolar area.
  • Phyllodes is a rare tumor that can be benign, malignant or borderline. It develops from the connective tissue of breast that surrounds the ducts and lobules. It grows quickly but rarely spreads outside the breast.
  • Metastatic breast cancer is an advanced cancer (stage –IV) that spreads to distant organs like lung, liver, bone and brain
  • Male breast cancer accounts to about less than 1% of all breast cancers. Males have breast tissue that develops in the same way as in women. But it is uncommon in males as breasts in men have less developed ducts and are not exposed to growth promoting female hormones.
  • Metaplastic breast cancer is rare heterogeneous cancer which represents less than 1% of all breast cancers. It is characterized by presence of both epithelial and mesenchymal components and has poor prognosis compared to Invasive ductal carcinoma.
  • Angiosarcoma accounts to about less than 0.05% of all breast cancers. It arises from cells lining blood vessels or lymph vessels. It can either involve the breast tissue or skin of the breast. It is aggressive with poor prognosis compared to invasive ductal carcinoma.

Based on Hormone receptor status

All invasive and in situ cancers are tested for hormone receptors. Hormone receptor positive tumors contain many hormone receptors. Such tumors can be treated by hormone therapy. Majority of breast cancer cases are hormone receptor positive.

Triple negative breast cancer involves tumours where the cells are negative for progesterone, estrogen and HER2/neu receptors. These cancers do not respond to hormone therapy. They are aggressive high grade tumors common in younger women and often have a ductal origin.

Different types of breast cancers tend to have different outcomes requiring different treatments. Tests like Niramai which can detect cancer accurately in its early stages compared to other modalities would always be a big plus in improving treatment effectiveness.

References 

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ISHA Diagnostics and NIRAMAI conduct joint seminar for Continued Medical Education

NIRAMAI hosted a Continuing Medical Education seminar as part of the launch of NIRAMAI Thermal Mammography at ISHA diagnostics on Wednesday, 21st March 2018.

The seminar that saw the participation of gynaecologists/healthcare professionals across North Bangalore with sessions on latest development in the field of women health delivered by experts.

Dr. Balakrishna Shetty, Chief of Radiology, ISHA Diagnostics and Vice Chancellor, Siddhartha University, officially announced the availability of NIRAMAI solution at Isha Diagnostics. Niramai solution was so far available at ISHA for its patients free of cost, and both organizations have been working together to prepare for this launch. NIRAMAI test is now available at ISHA as a part of their regular diagnostic test offerings and preventive health packages.

Dr. Shylaja, a Senior Radiologist at ISHA Diagnostics then gave an overview of the four key breast imaging methods used for breast cancer screening – namely mammography, sonomammography, MRI and thermography. She also shared her experience and observations of evaluating NIRAMAI test with her peer group. “I screened 20 women as part of NIRMAI’s Women’s Day Celebrations at ISHA to convince myself with the NIRAMAI technology. NIRAMAI Thermal Mammography results had a fairly good correlation with sonomammography. Only lesions which had high thermal index were picked up. The cysts that were not picked up were very benign. I wouldn’t have even bothered about them”, she mentioned. “So, it is really very useful.”

 

The CME also saw participation by Karnataka Cancer Society which has been a long-time partner of NIRAMAI. “Earlier, we

were only doing clinical breast (CBE) examination in our screening camps till NIRAMAI approached us with Thermal Mammography. Our association with them has been very good. Over the past 6 months, they have conducted over 25 camps and screened more than 750 women,” said Mr. Suresh, Vice President of Karnataka Cancer Society.

“The portability of NIRAMAI Thermal Mammography makes it very useful in rural areas, especially for women who cannot afford regular breast cancer screening. Hats off to the team for their unwavering dedication,” he added.

The seminar also included a talk by Dr. Girish on “Pre-eclampsia and FGR screening” that was very well-received by the participating doctors.

NIRAMAI’s CME seminar at ISHA received an overwhelmingly positive response. The team is looking forward to working with the participating doctors in enabling better healthcare access to Breast Cancer patients.

 

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Niramai won the Open-F@b Call4ideas 2017 promoted by BNP Paribas Cardif

Niramai (the winner), AliveCor (the runner up) and InSensus (3rd place) : these are the winners of Open-F@b Call4ideas 2017 proclaimed during the final event of the fourth edition of the international contest promoted by BNP Paribas Cardif, among the first ten insurance companies in Italy, in collaboration with Insurance UpOpen Up and Medici. To select in real time the best ideas on Preventive Insurance, a new concept of insurance no longer based just on mere compensation but on prevention, protection, assistance and interaction with the customers, were both a jury of experts and the audience in the hall. They voted the winners during an exciting Innovation Battle, where finalists promoted their ideas by challenging each other with passion and creativity. The three winners will now be supported by the BNP Paribas Cardif R&D team in the development of their project, by taking into account the needs of the market and of the Company.

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