Breast Cancer Types
Asma Dilawari, MD, Breast Oncologist with a MedStar Montgomery patient.

Breast Cancer Types at MedStar Georgetown Cancer Network

Learn more about the different breast cancer types and the symptoms, diagnosis and treatments associated with each kind. The experts at MedStar Georgetown Cancer Network can guide you through an individualized cancer treatment plan for depending on the breast cancer type you have been diagnosed with.

Ductal Carcinoma In Situ (DCIS)

Ductal carcinoma in situ, or DCIS, is a pre-cancer — a generally symptom-less condition that can lead to invasive cancer. Doctors do not yet have a way to predict which patients will develop the more intense disease, though, so most patients get treatment. 

Also called intraductal carcinoma, DCIS is considered stage 0 and is non-invasive, confined to the milk ducts. That means that unless it undergoes further changes and becomes cancerous, it will not push through the duct walls into surrounding tissue and will not spread outside the breast.

About 1 in 5 breast cancer-related diagnoses are DCIS, but almost all cases are curable. Our specialists have extensive experience diagnosing and successfully treating the condition.

Diagnosis and Treatment of Different Breast Cancer Types

DCIS is most often detected on a mammogram and confirmed with a biopsy.

Treatment for DCIS includes localized surgery, usually followed by radiation therapy. Sometimes a mastectomy is necessary for extensive cases, so your doctor will discuss all options with you. Your doctor may also talk to you about hormone therapy.

HER2-Positive Breast Cancer

Healthy breast tissue growth is controlled by a particular protein — human epidermal growth factor receptor type 2, also called HER2/neu, or more commonly, HER2. A random mutation can form cells with too much HER2 on their surface, potentially causing them to turn cancerous and multiple rapidly.

Left untreated, these HER2-positive cancers typically are aggressive and can easily spread. They are susceptible to drugs that target the protein, though. We offer the latest therapies and continue to develop new and promising approaches.

Diagnosis

To determine HER2 levels in the cancerous cells in your breast, our pathologists examine tissue using certain tests:

  • Immunohistochemistry (IHC) test
  • Fluorescence in Situ Hybridization (FISH) test

Treatment

Biologic therapies are drugs that can change the behavior of the cells in your breast, an approach first identified by our researchers. If the tumor tests positive for HER2, your doctor will likely recommend a targeted biologic therapy like Herceptin. Biologic therapies are drugs that can change the behavior of the cells in your breast, an approach first identified by our researchers. 

Inflammatory Breast Cancer (IBC)

Inflammatory breast cancer (IBC) is an uncommon form of breast cancer (less than 5% of cases) but aggressive. It blocks the lymphatic channels in the skin of your breast and can also spread to other areas of the body. Given its rarity, inflammatory breast cancer should be managed by experienced doctors like ours. Our specialists have the expertise to diagnose IBC promptly, and move to the treatment options that are right for you.

Symptoms

Symptoms of this breast cancer type may include:

  • Redness
  • Swelling
  • Sensations of warmth
  • Pink, purple or bruised breast skin that does not improve
  • Grooved, dimpled or uneven breast skin
  • Breast heaviness
  • Inverted or flattened nipples
  • Swollen lymph nodes under the arm, or above the collarbone

Other conditions can also cause these symptoms, so please see a breast expert for an accurate diagnosis.

Treatment

  • Surgery for breast cancer
  • Chemotherapy for breast cancer
  • Radiation for breast cancer
  • Targeted therapy for breast cancer
  • Hormone therapy for breast cancer

Locally Advanced Breast Cancer Types

Locally advanced breast cancer means the cancerous cells may involve a large portion of your breast or have spread to lymph nodes under your arm, behind your breastbone or around your collarbone. They also may have grown into your chest wall or into the skin of your breast. Locally advanced cancer has not spread (metastasized) to other organs.

Symptoms

Symptoms of locally advanced breast cancer include:

  • Lump(s) in the breast
  • Skin changes
  • Underarm lymph node swelling
  • Nipple changes

Other conditions can also cause these symptoms, so please see a breast expert for an accurate diagnosis.

Treatment

Treatment for locally advanced breast cancer types usually begins with chemotherapy or hormone therapy to shrink the tumor, followed by surgery. Follow-up treatment may include radiation, hormone therapy or a targeted therapy. MedStar Georgetown participates in a number of innovative clinical trials that may offer other options before surgery.

Our locally advanced breast cancer treatment options include:

  • Surgery for breast cancer
  • Chemotherapy for breast cancer
  • Radiation for breast cancer
  • Targeted therapy for breast cancer
  • Hormone therapy for breast cancer

Male Breast Cancer

In rare cases, men can develop breast cancer — about one in 1,000 men, compared to one in eight women.

Our breast care experts have the knowledge and experience to diagnose and treat men with breast disease. Our sensitivity and compassion to men’s unique circumstances when managing breast disease is a hallmark of our superior care.

Risk Factors

Some known risk factors for breast cancer in men include:

  • Klinefelter’s syndrome, a genetic disorder that often causes elevated estrogen levels
  • Having an inherited predisposition to breast cancer, such as the BRCA2 genetic mutation
  • Previous radiation exposure, such as treatment for lymphoma
  • Older age
  • Chronic liver problems
  • Obesity
  • Alcoholism

Symptoms

Breast cancer in men can cause:

  • Changes in the nipple
  • Nipple discharge
  • A lump in the area around the nipple
  • Dimpled skin on the breast

Other conditions can also cause these symptoms, so please see a breast expert for an accurate diagnosis. Imaging might be ordered,  including a mammogram or ultrasound. 

Treatment

Our locally advanced breast cancer treatment options include:

  • Surgery for breast cancer
  • Chemotherapy for breast cancer
  • Radiation for breast cancer
  • Hormone therapy for breast cancer

Metastatic Breast Cancer

Metastatic breast cancer has spread (metastasized) to other organs and is also called stage IV cancer. Metastatic breast cancer most often appears in the bones, lungs, liver or brain.

We provide a complete range of care and support for metastatic breast cancer: physical, emotional and psychological. While there is no cure for the disease, our doctors have the experience and the full array of treatment options needed to relieve pain and prolong your life, focusing on providing the best quality of life possible.

We’re ready to help you with making the difficult decisions about therapy choices and their possible side effects.

Symptoms

While metastatic breast cancer might not cause symptoms, some patients experience:

  • Shortness of breath
  • Weight loss
  • Bone pain

Other conditions can cause these symptoms, too; see your breast expert for guidance.

Diagnosis

While some of our patients have metastatic breast cancer when they are first diagnosed, most have already been treated for the disease in its earlier stages. Unfortunately, even with top treatment, breast cancer can return months and even years later.

If metastatic breast cancer is suspected, our doctors will perform blood and imaging tests and possibly biopsy to diagnosis and appropriately treat the cancer.

Treatment

Even if cancer is found elsewhere in your body, it is still treated based on where it started —in this case, the breast. Treatment for metastatic breast cancer depends on:

  • The cancer’s characteristics, such as its appearance under a microscope and whether it has receptors for the hormones estrogen or progesterone
  • The spread
  • Symptoms
  • Past breast cancer treatments

Treatments for metastatic breast cancer include:

  • Breast hormone therapy - often the first option if the cancer is hormone receptor-positive
  • Breast targeted therapy - trastuzumab (i.e., Herceptin),pertuzumab (i.e., Perjeta) or trastuzumab plus the chemotherapy drug emtansine (a combination drug called T-DM1)
  • Chemotherapy for breast cancer
  • Breast surgery - when the number of tumors is limited
  • Breast radiation - aimed either at the breast or other parts of the body

Certain patients may be eligible to participate in clinical trials of therapies under investigation.

Paget’s disease

Paget’s disease is a type of breast cancer that develops in the skin of the nipple and areola and often in the breast tissue itself. While it’s a rare form of cancer, our breast care experts have the expertise, training and experience to treat it.

Symptoms

Symptoms of Paget’s disease include:

  • Redness and irritation of the skin around the nipple and areola
  • Crusting and flaking of the skin around the nipple area
  • Tingling, itching, or burning in the nipple area
  • Change in the general appearance of the nipple

Other conditions can also cause these symptoms, so please see a breast expert for an accurate diagnosis.

Treatment

Treatment options for Paget’s disease include:

  • Breast surgery
  • Breast radiation

Breast Cancer During Pregnancy

Along with the rest of your body, your breasts change dramatically while you are pregnant. You may feel your breasts become lumpier, larger or firmer when you are pregnant, which is normal. But it is still important to inform your doctor if you discover a lump or notice changes that concern you.

Our breast care experts are experienced at diagnosing cancer in pregnant women and providing care — including emotional support. While sensitivity and compassion are always hallmarks of our care, we understand the especially difficult decision-making process for a woman who is pregnant and facing a breast cancer diagnosis.

Diagnosis

Some diagnostic tools are safer than others for pregnant women. Our approaches (and their limitations) include:

  • Digital Mammogram: If you have a mammogram during pregnancy, we cover your abdomen with a shield, to make it as safe as possible for your baby. Every situation is different, and your doctor will discuss your options, taking into account the age of the fetus and other significant factors. The ability to interpret the results may be limited because of the lactational changes occurring in your breasts.
  • Ultrasound: Ultrasound is safe for pregnant women, and can help distinguish between a non-cancerous, fluid-filled cyst and a solid lump. It is also the gold standard for imaging pregnant women with breast lumps. However, it may not be able to distinguish between cancerous and non-cancerous solid lumps.
  • MRI: Although used in non-pregnant women with breast cancer, we do not recommend it for pregnant women because it requires a dye called gadolinium whose effect on your baby is not known.
  • Biopsy: A biopsy removes some of the affected tissue for further investigation under a microscope and is safe for pregnant women and women who are breastfeeding. However, the results of a biopsy taken during pregnancy may be complicated, and breastfeeding mothers are sometimes advised to wean in advance of the procedure to minimize complications.

Treatment

The health and safety of both you and your baby is our paramount concern, and we take the time to help you weigh the benefits and risks of treatment. Treatments often require modification during pregnancy, and some types we would normally use are unsafe. Safe options include:

  • Breast surgery
  • Breast chemotherapy - used to shrink tumors and broaden the range of treatment options (only during the second and third trimesters)

If you are pregnant and diagnosed with breast cancer, please keep in mind that:

  • Pregnancy does not affect your ability to survive breast cancer, and does not increase your chance of experiencing cancer again later.
  • You are just as likely to respond well to treatment while pregnant.
  • Breast cancer cannot spread to your baby.

Triple-Negative Breast Cancer

Triple-negative tumors are often aggressive and tend to return more often than other types of breast cancer. Unlike other breast cancer types, they lack protein and hormone receptors for:

  • Estrogen
  • Progesterone
  • Human epidermal growth factor receptor 2 (HER2)

These are often aggressive tumors and tend to return more often than other types of breast cancer. The lack of receptors for targeted control of cancerous cell growth can make the treatment of triple-negative breast cancer more challenging. Fortunately, triple-negative breast cancer often responds well to chemotherapy, among other treatments.

Treatment

Treatment options for triple-negative breast cancer include: 

  • Breast surgery
  • Breast chemotherapy
  • Breast radiation

Our researchers are working to develop more effective treatments for triple-negative breast cancer. We are also participating in a number of clinical trials, to provide you with access to a range of effective new therapies.

Make an Appointment

To schedule an appointment with a breast health specialist, please call our scheduling line.

855-546-0701