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Learning You Have Breast Cancer

If you have lots of questions and few answers at this stage, don't feel alone. Being newly diagnosed with breast cancer is perhaps the most difficult stage of your diagnosis because it is filled with so many unknowns and uncertainties.

The Florida Hospital Cancer Institute Breast Program is dedicated to giving you the answers you need as quickly as possible. To do so, we've assembled a team of highly experienced physicians, including breast surgeons, medical oncologists and radiation oncologists, to evaluate your breast cancer and develop a plan of care for treating it.

Coordinating your care often begins at the first sign of an abnormality in a mammogram. If one is present, we may immediately schedule additional imaging and perhaps a biopsy. To streamline the appointment and testing process, our Breast Care Coordinators will be by your side every step of the way to do the necessary scheduling. They'll also be happy to answer any of your questions.

To reach our Breast Care Coordinator, please call (407) 303-2514.

Types of Breast Cancer

Breast cancer is characterized by the abnormal growth of cells that line the ducts and lobules of the breast. The lobules produce the milk while the ducts deliver the milk to the nipples.

Doctors at the Florida Hospital Cancer Institute (FHCI) will usually refer to your breast cancer in two very broad groupings. The first is "noninvasive" or "carcinoma in situ". This form of breast cancer is still contained within the breast lobules or ducts. When the cancer spreads beyond the walls, it is often known as "infiltrating" or "invasive" breast cancer. A single tumor can be a mixture of both types. 

Carcinoma in Situ

This cancer has not yet spread into the fatty tissues of the breast or to other organs in the body. Rather, it is still confined to the ducts or lobules. There are two types of carcinoma in situ, lobular carcinoma in situ (LCIS) and ductal carcinoma (DCIS). Leading breast cancer experts don't believe that LCIS will become invasive. However, this does increase the risk of developing a form of invasive cancer in one or both breasts.

Invasive Breast Cancers

The term "invasive breast cancer" describes cancers that have started to grow and spread beyond the ducts and lobules in the breast. About 80% of invasive breast cancer is ductal while lobular accounts for about 10% of all cases. These are cancers that have penetrated through the duct wall and into the surrounding tissue. They have the potential to spread elsewhere, including nearby lymph nodes or more distant tissues and require more specialized treatment than the non-invasive forms of breast cancer.

Uncommon Breast Cancers

There are several uncommon types of breast cancers including medullary, metaplastic, colloid, or inflammatory.

For more information, contact our Breast Care Coordinator at (407) 303-2514.  

Breast Cancer Staging

The stage of your cancer is based on the size of the tumor, the invasive or non-invasive status, lymph nodes involvement and whether the cancer has spread beyond the breast.

By organizing these factors and other selected characteristics of the cancer, breast cancer specialists at the FHCI can make informed decisions about your treatment (including clinical trial eligibility) and better understand your prognosis. The staging creates a universal method for healthcare professionals around the world to communicate about breast cancer.

The following stages are used for breast cancer:

Stage 0 (carcinoma in situ)

Ductal carcinoma in situ (DCIS): The abnormal cells haven't yet spread outside the lining of the duct into other tissues in the breast. In some cases, DCIS could become invasive cancer and spread to other tissues, although there's no way to  predict which lesions will become invasive.

Lobular carcinoma in situ (LCIS): Abnormal cells have been found in the lobules of the breast. Seldom does it become a form of invasive cancer. However, the mere presence of lobular carcinoma in situ in one breast increases the risk of developing breast cancer in either breast.

Stage I

Stage I marks the formation of cancer. The tumor is 2 centimeters or smaller and has not yet spread outside of the breast.

Stage IIA

In stage IIA -

• No tumor has been found in the breast but it has been found in the axillary lymph nodes (they are under your arm); or
• The tumor is 2 centimeters or smaller and has spread to the axillary lymph nodes; or
• The tumor is largerer than 2 centimeters but not larger than 5 centimeters and has not yet spread to the axillary lymph nodes.

Stage IIB

In stage IIB -

• Larger than 2 centimeters but not larger than 5 centimeters and has spread to the axillary lymph nodes; or
• The tumor is larger than 5 centimeters, but hasn't spread to the axillary lymph nodes.

Stage IIIA

In stage IIIA -

• No tumor can be found in the breast. But cancer is found in axillary lymph nodes that are attached to each other or to other structures, or cancer may be found in lymph nodes near the breastbone; or
• The tumor is 2 centimeters or less. Cancer has also spread to the axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone; or
• The tumor is larger than 2 centimeters but not larger than 5 centimeters. Cancer has spread to axillary lymph node that are attached to each other or other structures, or the cancer may have spread to lymph nodes near the breastbone; or
• The tumor is larger than 5 centimeters. Cancer has spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may spread to lymph nodes near the breastbone.

Stage IIIB

In stage IIIB, the tumor may be any size, but the cancer -

• Has spread to the chest wall and/or skin of the breast; and
• May have spread to the axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.

Cancer has also spread to the skin of the breast is known as inflammatory breast cancer. See the section on inflammatory breast cancer for more information.

Stage IIIC

In stage IIIC there may be no sign of cancer in the breast or the tumor can be of any size. It may have spread to the chest wall and/or skin of the breast. Also, cancer -

• Has spread to lymph nodes above or below the collarbone; and
• May have spread to axillary lymph nodes or to lymph nodes near the breastbone.

Cancer which has spread to the skin of the breast is known as inflammatory breast cancer. See the section on inflammatory breast cancer for more information.

Stage IIIC breast cancer is divided into operable and inoperable stages.

In the operable stage IIIC, the cancer is found in:

• Ten or more axillary lymph nodes; or
• Lymph nodes below the collarbone; or
• Axillary lymph nodes as well as those near the breastbone.

In the inoperable stage, the cancer has spread to the lymph nodes above the collarbone.

Stage IV

The cancer has spread to other organs of the body, most often the bones, lungs, liver or brain.