Breast Carcinoma; Breast Neoplasm; Breast Tumor; Cancer of the Breast; Mammary Cancer
Breast cancer, cancer that forms in tissues of the breast, is the second most common cancer in women after skin cancer. Breast cancer occurs in both men and women, although male breast cancer is rare. Here's what you need to know about risk factors, symptoms, diagnosis, and treatment.
Woman with Breast Cancer, Stage 1
Image by TheVisualMD
Overview
Breast Anatomy With Cancer (Nipple)
Breast Anatomy With Cancer (Breast Tissue)
Breast Anatomy With Cancer (Fat)
Breast Anatomy With Cancer (Suspensory Ligaments)
Breast Anatomy With Cancer (Ducts)
Breast Anatomy With Cancer (Chest Wall Muscle)
Breast Anatomy With Cancer (Ribs)
Breast Anatomy With Cancer (Tumor)
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Breast Anatomy with Cancer
Interactive by TheVisualMD
Breast Anatomy With Cancer (Nipple)
Breast Anatomy With Cancer (Breast Tissue)
Breast Anatomy With Cancer (Fat)
Breast Anatomy With Cancer (Suspensory Ligaments)
Breast Anatomy With Cancer (Ducts)
Breast Anatomy With Cancer (Chest Wall Muscle)
Breast Anatomy With Cancer (Ribs)
Breast Anatomy With Cancer (Tumor)
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Breast Anatomy with Cancer
Structures of the breast with cancer are visible in a Breast MRI: Nipple, Breast tissue, Fat, Suspensory ligaments, Ducts, Chest wall muscle, Ribs, Tumor
Interactive by TheVisualMD
What Is Breast Cancer?
General Information About Breast Cancer
KEY POINTS
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.
A family history of breast cancer and other factors increase the risk of breast cancer.
Breast cancer is sometimes caused by inherited gene mutations (changes).
The use of certain medicines and other factors decrease the risk of breast cancer.
Signs of breast cancer include a lump or change in the breast.
Tests that examine the breasts are used to diagnose breast cancer.
If cancer is found, tests are done to study the cancer cells.
Certain factors affect prognosis (chance of recovery) and treatment options.
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast.
The breast is made up of lobes and ducts. Each breast has 15 to 20 sections called lobes. Each lobe has many smaller sections called lobules. Lobules end in dozens of tiny bulbs that can make milk. The lobes, lobules, and bulbs are linked by thin tubes called ducts.
Anatomy of the female breast. The nipple and areola are shown on the outside of the breast. The lymph nodes, lobes, lobules, ducts, and other parts of the inside of the breast are also shown.
Each breast also has blood vessels and lymph vessels. The lymph vessels carry an almost colorless, watery fluid called lymph. Lymph vessels carry lymph between lymph nodes. Lymph nodes are small, bean-shaped structures found throughout the body. They filter lymph and store white blood cells that help fight infection and disease. Groups of lymph nodes are found near the breast in the axilla (under the arm), above the collarbone, and in the chest.
The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Cancer that begins in the lobes or lobules is called lobular carcinoma and is more often found in both breasts than are other types of breast cancer. Inflammatory breast cancer is an uncommon type of breast cancer in which the breast is warm, red, and swollen.
Source: National Cancer Institute (NIH)
Additional Materials (50)
Lymph Nodes
Lymph Nodes
Lymph Nodes
Lymph Nodes
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Breast Lymph Nodes
Lymph vessels form a network in each breast, draining into lymph nodes in the underarm and along the breast bone. Cancer cells may break away from the main tumor and spread to other parts of the body through the lymphatic system.
Interactive by TheVisualMD
Tumour in the breast visualized by Breast-Computertomography (Breast-CT)
Tumor in der Brust, aufgenommen durch Brust-Computertomographie
Image by Rsmskns/Wikimedia
Breast Cancer
Breast Cancer
Image by BruceBlaus
Breast Cancer Overview
Breast imaging and early detection of breast cancer have evolved immensely over the last 25 years, leading to increased survival rates and improved quality of life for millions of women with breast cancer. This video takes you through the process of screening and diagnosis using various imaging modalities, including mammogram, ultrasound and MRI.
Image by TheVisualMD
How Does Cancer Form?
Cancer is a disease caused when cells divide uncontrollably and spread into surrounding tissues.
See also www.cancer.gov/about-cancer/understanding/what-is-cancer.
Image by National Cancer Institute (NCI)
Sensitive content
This media may include sensitive content
Mastectomy
Total (simple) Mastectomy Description Total (simple) mastectomy; drawing shows removal of the breast and lymph nodes. The dotted line shows where the entire breast is removed. Some lymph nodes under the arm may also be removed.
Image by National Cancer Institute
Breast cancer progression
Stages of cell changes that occur when normal duct epithelium of the breast becomes cancerous.
Image by Huckfinne
Sensitive content
This media may include sensitive content
Metastatic Breast Cancer in Pleural Fluid
Image by Ed Uthman/Flickr
Understanding Breast Cancer
Video by You and Breast Cancer/YouTube
This browser does not support the video element.
Breast Cancer Screening & Diagnosis
Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.
Video by TheVisualMD
This browser does not support the video element.
What Is Breast Cancer?
Breast imaging and early detection of breast cancer have evolved immensely over the last 25 years, leading to increased survival rates and improved quality of life for millions of women with breast cancer. This video takes you through the process of screening and diagnosis using various imaging modalities, including mammogram, ultrasound and MRI.
Video by TheVisualMD
This browser does not support the video element.
Obesity & Breast Cancer
Cancer is, for the most part, a preventable disease. Only 5-10% of all cancer cases are caused by genetic defects. The remaining 90-95% are brought about by environmental and lifestyle factors: overweight, lack of exercise, poor diet, smoking, overuse of alcohol, and overexposure to UV and other forms of radiation. Of all cancer-related deaths, it’s thought that 25–30% are due to tobacco, 30–35% are linked to diet, about 15–20% are due to infections. That’s good news, because most lifestyle and environmental factors can be changed or modified. There are even vaccines that can provide protection against certain forms of cancer.
Video by TheVisualMD
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Breast Cancer Cell
Frontal camera shot zooms into mammary (breast) tissue as it becomes transparent to focus on cancer cells. The camera zooms in at a fast pace so that the lobules, ducts and fatty tissue of the mammary glands are not clearly defined.
Video by TheVisualMD
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Cancer and Wellness
Voyage deep inside your body to see, on a cellular level, why 1 in 2 men and 1 in 3 women will be diagnosed with cancer during their lifetime. Watch a cell reproducing normally and a breast cancer cell dividing out of control. Dr. Jeremy Geffen, oncologist, and Dr. Kevin Gardner of the National Cancer Institute explain that damaged DNA causes cancer-and every cell in your body undergoes 10,000 DNA damage events each day. Dr. Candace Pert, neuroscientist, and Dr. Mark Liponis of Canyon Ranch talk about why cancer represents an immune system failure. Most of your risk for cancer is due to lifestyle factors. Watch as fat cells balloon in size and learn how they secrete cancer-inducing chemicals. View breast and colon cancer inside the body. Find out how you can dramatically decrease your risk of cancer.
Video by TheVisualMD
Breast Reconstruction after Breast Cancer Surgery
Video by Singapore Cancer Society/YouTube
What is DCIS Breast Cancer?
Video by Breast Cancer Answers®/YouTube
Pregnancy after Breast Cancer: Help us make it happen!
Video by Rethink Breast Cancer/YouTube
Breast Cancer in Women of Color: Controversies in Breast Cancer Screening
Video by NYU Langone Health/YouTube
How Will My Breast Look and Feel after Breast Reconstruction Surgery?
Video by Breast Cancer Answers®/YouTube
Breast Reconstruction Surgery: Understanding Breast Cancer | UPMC Magee-Womens Hospital
Video by UPMC/YouTube
Post Lumpectomy DCIS Probability, Can DCIS Return After A Lumpectomy?
Video by Breast Cancer Answers®/YouTube
Male breast cancer and other breast issues - Mayo Clinic
Video by Mayo Clinic/YouTube
Breast reconstruction following breast cancer treatment - Mayo Clinic
Video by Mayo Clinic/YouTube
How Serious is DCIS Breast Cancer?
Video by Breast Cancer Answers®/YouTube
Sentinel Node Biopsy: Breast Cancer Lymph Node Surgery
Video by Breast Cancer School for Patients/YouTube
Hormonal Therapy for Breast Cancer: We Teach You
Video by Breast Cancer School for Patients/YouTube
Fertility after Breast Cancer: Joanna's Story
Video by Rethink Breast Cancer/YouTube
Fertility After Breast Cancer: Baby Time Study
Video by Rethink Breast Cancer/YouTube
Why Am I at Risk of Developing Breast Cancer? | Being Jewish and Breast Cancer Risk
Video by Johns Hopkins Medicine/YouTube
How Common is Hereditary Breast & Ovarian Cancer?
Video by Breast Cancer Answers®/YouTube
Diabetics & Breast Cancer: The Correlation So Far
Video by Breast Cancer Answers®/YouTube
Breast Cancer Sub-types - Triple Negative Breast Cancer
Video by Dr. Susan Love Foundation/YouTube
DCIS Breast Cancer: Learn What You Need To Know
Video by Breast Cancer School for Patients/YouTube
A Survivor Talks About Breast Cancer Depression
Video by Breast Cancer Answers®/YouTube
If I have cysts, does that mean I will develop breast cancer? | Norton Cancer Institute
Video by Norton Healthcare/YouTube
Lumpectomy & Mastectomy for Treating Breast Cancer - SLUCare Breast Surgery
Video by SLUCare/YouTube
Is Nipple Discharge a Sign of Breast Cancer? - UF Health Breast Center – Jacksonville
Video by UF Health Jacksonville/YouTube
What is Hereditary Breast and Ovarian Cancer Syndrome?
Video by Breast Cancer Answers®/YouTube
NHS Breast Cancer Screening - Module 1
Video by ASKVisualScience/YouTube
NHS Breast Cancer Screening - Module 2
Video by ASKVisualScience/YouTube
NHS Breast Cancer Screening - Module 3
Video by ASKVisualScience/YouTube
NHS Breast Cancer Screening - Module 4
Video by ASKVisualScience/YouTube
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
Video by JAMA Network/YouTube
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
Video by TheJAMAReport/YouTube
What Are Tumor Markers for Breast Cancer?
Video by Breast Cancer Answers®/YouTube
Changes After Breast Cancer Lumpectomy
Video by Breast Cancer Answers®/YouTube
Can My Needle Biopsy Spread Breast Cancer?
Video by Breast Cancer Answers®/YouTube
Male Breast Cancer Symptoms and Treatment | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Paget's Disease Of The Breast, What Is It?
Video by Breast Cancer Answers®/YouTube
Breast Density: Higher Risk & New Screening Options
Video by Breast Cancer School for Patients/YouTube
Breast Lymph Nodes
TheVisualMD
Tumour in the breast visualized by Breast-Computertomography (Breast-CT)
Rsmskns/Wikimedia
Breast Cancer
BruceBlaus
Breast Cancer Overview
TheVisualMD
How Does Cancer Form?
National Cancer Institute (NCI)
Sensitive content
This media may include sensitive content
Mastectomy
National Cancer Institute
Breast cancer progression
Huckfinne
Sensitive content
This media may include sensitive content
Metastatic Breast Cancer in Pleural Fluid
Ed Uthman/Flickr
8:24
Understanding Breast Cancer
You and Breast Cancer/YouTube
4:57
Breast Cancer Screening & Diagnosis
TheVisualMD
4:47
What Is Breast Cancer?
TheVisualMD
0:42
Obesity & Breast Cancer
TheVisualMD
0:07
Breast Cancer Cell
TheVisualMD
4:42
Cancer and Wellness
TheVisualMD
9:14
Breast Reconstruction after Breast Cancer Surgery
Singapore Cancer Society/YouTube
3:29
What is DCIS Breast Cancer?
Breast Cancer Answers®/YouTube
1:14
Pregnancy after Breast Cancer: Help us make it happen!
Rethink Breast Cancer/YouTube
16:02
Breast Cancer in Women of Color: Controversies in Breast Cancer Screening
NYU Langone Health/YouTube
3:54
How Will My Breast Look and Feel after Breast Reconstruction Surgery?
Breast Cancer Answers®/YouTube
4:22
Breast Reconstruction Surgery: Understanding Breast Cancer | UPMC Magee-Womens Hospital
UPMC/YouTube
3:40
Post Lumpectomy DCIS Probability, Can DCIS Return After A Lumpectomy?
Breast Cancer Answers®/YouTube
3:14
Male breast cancer and other breast issues - Mayo Clinic
Mayo Clinic/YouTube
2:46
Breast reconstruction following breast cancer treatment - Mayo Clinic
Mayo Clinic/YouTube
3:49
How Serious is DCIS Breast Cancer?
Breast Cancer Answers®/YouTube
12:10
Sentinel Node Biopsy: Breast Cancer Lymph Node Surgery
Breast Cancer School for Patients/YouTube
13:39
Hormonal Therapy for Breast Cancer: We Teach You
Breast Cancer School for Patients/YouTube
3:31
Fertility after Breast Cancer: Joanna's Story
Rethink Breast Cancer/YouTube
4:25
Fertility After Breast Cancer: Baby Time Study
Rethink Breast Cancer/YouTube
3:36
Why Am I at Risk of Developing Breast Cancer? | Being Jewish and Breast Cancer Risk
Johns Hopkins Medicine/YouTube
2:17
How Common is Hereditary Breast & Ovarian Cancer?
Breast Cancer Answers®/YouTube
3:20
Diabetics & Breast Cancer: The Correlation So Far
Breast Cancer Answers®/YouTube
3:40
Breast Cancer Sub-types - Triple Negative Breast Cancer
Dr. Susan Love Foundation/YouTube
17:37
DCIS Breast Cancer: Learn What You Need To Know
Breast Cancer School for Patients/YouTube
3:58
A Survivor Talks About Breast Cancer Depression
Breast Cancer Answers®/YouTube
1:46
If I have cysts, does that mean I will develop breast cancer? | Norton Cancer Institute
Norton Healthcare/YouTube
1:48
Lumpectomy & Mastectomy for Treating Breast Cancer - SLUCare Breast Surgery
SLUCare/YouTube
1:13
Is Nipple Discharge a Sign of Breast Cancer? - UF Health Breast Center – Jacksonville
UF Health Jacksonville/YouTube
2:10
What is Hereditary Breast and Ovarian Cancer Syndrome?
Breast Cancer Answers®/YouTube
2:07
NHS Breast Cancer Screening - Module 1
ASKVisualScience/YouTube
1:22
NHS Breast Cancer Screening - Module 2
ASKVisualScience/YouTube
1:52
NHS Breast Cancer Screening - Module 3
ASKVisualScience/YouTube
2:05
NHS Breast Cancer Screening - Module 4
ASKVisualScience/YouTube
4:39
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
JAMA Network/YouTube
2:20
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
TheJAMAReport/YouTube
2:42
What Are Tumor Markers for Breast Cancer?
Breast Cancer Answers®/YouTube
3:23
Changes After Breast Cancer Lumpectomy
Breast Cancer Answers®/YouTube
1:44
Can My Needle Biopsy Spread Breast Cancer?
Breast Cancer Answers®/YouTube
2:24
Male Breast Cancer Symptoms and Treatment | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
4:41
Paget's Disease Of The Breast, What Is It?
Breast Cancer Answers®/YouTube
8:30
Breast Density: Higher Risk & New Screening Options
Breast Cancer School for Patients/YouTube
Breast Cancer
Breast cancer
Image by SMART-Servier Medical Art, part of Laboratoires Servier.
Breast cancer
Image by SMART-Servier Medical Art, part of Laboratoires Servier.
Breast Cancer
What is breast cancer?
Breast cancer is a cancer that starts in breast tissue. It happens when cells in the breast change and grow out of control. The cells usually form a tumor.
Sometimes the cancer does not spread any further. This is called "in situ." If the cancer spreads outside the breast, the cancer is called "invasive." It may just spread to nearby tissues and lymph nodes. Or the cancer may metastasize (spread to other parts of the body) through the lymph system or the blood.
Breast cancer is the second most common type of cancer in women in the United States. Rarely, it can also affect men.
What are the types of breast cancer?
There are different types of breast cancer. The types are based on which breast cells turn into cancer. The types include:
Ductal carcinoma, which begins in the cells of the ducts. This is the most common type.
Lobular carcinoma, which begins in the lobules. It is more often found in both breasts than other types of breast cancer.
Inflammatory breast cancer, in which cancer cells block lymph vessels in the skin of the breast. The breast becomes warm, red, and swollen. This is a rare type.
Paget's disease of the breast, which is a cancer involving the skin of the nipple. It usually also affects the darker skin around the nipple. It is also rare.
What causes breast cancer?
Breast cancer happens when there are changes in the genetic material (DNA). Often, the exact cause of these genetic changes is unknown.
But sometimes these genetic changes are inherited, meaning that you are born with them. Breast cancer that is caused by inherited genetic changes is called hereditary breast cancer.
There are also certain genetic changes that can raise your risk of breast cancer, including changes in the BRCA1 and BRCA2 genes. These two changes also raise your risk of ovarian and other cancers.
Besides genetics, your lifestyle and the environment can affect your risk of breast cancer.
Who is at risk for breast cancer?
The factors that raise your risk of breast cancer include:
Older age
History of breast cancer or benign (noncancer) breast disease
Inherited risk of breast cancer, including having BRCA1 and BRCA2 gene changes
Dense breast tissue
A reproductive history that leads to more exposure to the estrogen hormone, including
Menstruating at an early age
Being at an older age when you first gave birth or never having given birth
Starting menopause at a later age
Taking hormone therapy for symptoms of menopause
Radiation therapy to the breast or chest
Obesity
Drinking alcohol
What are the signs and symptoms of breast cancer?
The signs and symptoms of breast cancer include:
A new lump or thickening in or near the breast or in the armpit.
A change in the size or shape of the breast.
A dimple or puckering in the skin of the breast. It may look like the skin of an orange.
A nipple turned inward into the breast.
Nipple discharge other than breast milk. The discharge might happen suddenly, be bloody, or happen in only one breast.
Scaly, red, or swollen skin in the nipple area or the breast
Pain in any area of the breast.
How is breast cancer diagnosed?
Your health care provider may use many tools to diagnose breast cancer and figure out which type you have:
A physical exam, including a clinical breast exam (CBE). This involves checking for any lumps or anything else that seems unusual with the breasts and armpits.
A medical history.
Imaging tests, such as a mammogram, an ultrasound, or an MRI.
Breast biopsy.
Blood chemistry tests, which measure different substances in the blood, including electrolytes, fats, proteins, glucose (sugar), and enzymes. Some of the specific blood chemistry tests include a basic metabolic panel (BMP), a comprehensive metabolic panel (CMP), and an electrolyte panel.
If these tests show that you have breast cancer, you will have tests that study the cancer cells. These tests help your provider decide which treatment would be best for you. The tests may include:
Genetic tests for genetic changes such as in the BRCA and TP53 genes.
HER2 test. HER2 is a protein involved with cell growth. It is on the outside of all breast cells. If your breast cancer cells have more HER2 than normal, they can grow more quickly and spread to other parts of the body.
An estrogen and progesterone receptor test. This test measures the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly.
Another step is staging the cancer. Staging involves doing tests to find out whether the cancer has spread within the breast or to other parts of the body. The tests may include other diagnostic imaging tests and a sentinel lymph node biopsy. This biopsy is done to see whether the cancer has spread to the lymph nodes.
What are the treatments for breast cancer?
Treatments for breast cancer include:
Surgery such as
A mastectomy, which removes the whole breast
A lumpectomy to remove the cancer and some normal tissue around it, but not the breast itself
Radiation therapy
Chemotherapy
Hormone therapy, which blocks cancer cells from getting the hormones they need to grow
Targeted therapy, which uses drugs or other substances that attack specific cancer cells with less harm to normal cells
Immunotherapy
Can breast cancer be prevented?
You may be able to help prevent breast cancer by making healthy lifestyle changes such as:
Staying at a healthy weight
Limiting alcohol use
Getting enough exercisee
Limiting your exposure to estrogen by
Breastfeeding your babies if you can
Limiting hormone therapy
If you are at high risk, your health care provider may suggest that you take certain medicines to lower the risk. Some women at very high risk may decide to get a mastectomy (of their healthy breasts) to prevent breast cancer.
It's also important to get regular mammograms. They may be able to identify breast cancer in the early stages, when it is easier to treat.
Source: National Cancer Institute (NCI)
Additional Materials (12)
Breast cancer progression
Stages of cell changes that occur when normal duct epithelium of the breast becomes cancerous.
Image by Huckfinne
Diagram showing stage 1A breast cancer
Stage 1B breast cancer
Stage 2A breast cancer - Diagram 1 of 2
Stage 2A breast cancer - Diagram 2 of 2
Stage 2B breast cancer - Diagram 1 of 3
Stage 2B breast cancer - Diagram 2 of 3
Stage 2B breast cancer - Diagram 3 of 3
Stage 3A breast cancer- Diagram 1 of 3
Stage 3A breast cancer- Diagram 2 of 3
Stage 3A breast cancer- Diagram 3 of 3
Diagram 1 of 3 showing stage 3C breast cancer
Stage 3C breast cancer - Diagram 2 of 3
Stage 3C breast cancer - Diagram 3 of 3
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Stages of Breast Cancer
Interactive by Cancer Research UK / Wikimedia
Normal Breast Cross Section / Breast Cancer Cross Section
Normal Breast Cross Section / Breast Cancer Cross Section
Medical visualization of an anteriolateral view of healthy breast tissue. The most common type of breast cancer is infiltrating ductal carcinoma (over 70%) which begins in the lining of the ducts, followed by inflitrating lobular carcinoma (over 10%) which orginates in the lobules, medullary carcinoma, tubular carcinoma, mucinous carcinoma, and inflammatory breast cancer. Breast cancer affects approximately one in 93 women by the age of 45, and over the course of a lifetime one in eight women will be diagnosed with the disease. Early detection is critical - survival rates for those diagnosed at early stages is greater than 90 percent. Annual mammograms are recommended for women over 40, as are regular self-exams and clinical exams for all women. Women with a family history of breast cancer, especially premenopausal occurrence, as well as those who test positive for the BRCA1 and BRCA2 genes, are at a higher lifetime risk for developing breast cancer and should start detection screening earlier. Men comprise one percent of breast cancer patients. 1 of 2.
Interactive by TheVisualMD
Stage 0
Stage 1
Stage 2
Stage 2
Stage 4
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Breast Cancer Summary Staging
After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.
Interactive by TheVisualMD
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Woman with Breast Cancer, Stage 1
Woman with Breast Cancer, Stage 1 : Breast cancer is by far the most common cancer among women; worldwide, about 1.3 million women are diagnosed with breast cancer annually, and about 465,000 will die from it (North America has the highest rate of breast cancer in the world). In recent years, however, tremendous strides have been made in early diagnosis and treatment. Imaging techniques have been refined to spot ever-tinier tumors, biomarkers have been developed to reflect physiological changes produced by cancer, and genetic tests have been devised to reveal increased familial risk of breast cancer.
Image by TheVisualMD
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Metastatic Breast Cancer in Pleural Fluid
Image by Ed Uthman/Flickr
Understand.com | Breast Cancer Animation Library Demo
Video by Understand/YouTube
Beyond The Shock - Chapter 5 - Types & Stages - Breast Cancer During Pregnancy
Video by National Breast Cancer Foundation/YouTube
Understanding Breast Cancer
Video by You and Breast Cancer/YouTube
Why Am I at Risk of Developing Breast Cancer? | Being Jewish and Breast Cancer Risk
Video by Johns Hopkins Medicine/YouTube
Breast Cancer Sub-types - Triple Negative Breast Cancer
Video by Dr. Susan Love Foundation/YouTube
Breast Cancer 101: Our Oncologists Answer Questions On Breast Cancer
Video by Michigan Medicine/YouTube
Breast cancer progression
Huckfinne
Stages of Breast Cancer
Cancer Research UK / Wikimedia
Normal Breast Cross Section / Breast Cancer Cross Section
TheVisualMD
Breast Cancer Summary Staging
TheVisualMD
Sensitive content
This media may include sensitive content
Woman with Breast Cancer, Stage 1
TheVisualMD
Sensitive content
This media may include sensitive content
Metastatic Breast Cancer in Pleural Fluid
Ed Uthman/Flickr
3:44
Understand.com | Breast Cancer Animation Library Demo
Understand/YouTube
2:04
Beyond The Shock - Chapter 5 - Types & Stages - Breast Cancer During Pregnancy
National Breast Cancer Foundation/YouTube
8:24
Understanding Breast Cancer
You and Breast Cancer/YouTube
3:36
Why Am I at Risk of Developing Breast Cancer? | Being Jewish and Breast Cancer Risk
Johns Hopkins Medicine/YouTube
3:40
Breast Cancer Sub-types - Triple Negative Breast Cancer
Dr. Susan Love Foundation/YouTube
58:50
Breast Cancer 101: Our Oncologists Answer Questions On Breast Cancer
Michigan Medicine/YouTube
What You Need to Know
Breast cancer incidence by anatomical site (females)
Image by Cancer Research UK uploader/Wikimedia
Breast cancer incidence by anatomical site (females)
The largest proportion of breast cancer cases occur in the upper-outer quadrant of the breast, with much smaller proportions in the upper-inner, lower-outer and lower-inner quadrants, and the central portion of the breast (2010-2012).
Based on a Cancer Research UK graphic published in 2016.
http://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/breast-cancer/incidence-invasive#heading-Five
Original sources: cruk.org, 2016; Data provided on request - ONS 2014; ISD Scotland, 2014; Welsh Cancer Intelligence and Surveillance Unit, Northern Ireland Cancer Registry, 2014
Image by Cancer Research UK uploader/Wikimedia
Breast Cancer: What You Need to Know
Health Fast Facts
99%
If breast cancer is confined to the breast, the 5-year survival rate is 99%.
Source: National Cancer Institute
Breast cancer affects one in eight women in the U.S. and is the second most common type of cancer diagnosed in women, after skin cancer.
The good news is that breast cancer death rates slowly fell each year from 2008 to 2017. But more screening could help those rates drop faster.
How it happens
Breast cancer happens when cancerous cells form in the breast tissue. Health experts don't know exactly why cancerous cells form in the breast in some women but not others. However, they do know some of the risk factors, such as older age, smoking, and a family history of the disease.
Estimating risk
Some women who don't seem to have common risk factors may still develop the disease, while other women with a known risk factor may never develop it. This is why regular screening, such as mammograms, is key. Treatment for breast cancer is most effective and provides the best chance of survival when the disease is caught early.
Screening rates
Screening rates are increasing in some groups of women in the U.S. But for other groups, the rates are declining. According to the National Cancer Institute, screening rates have increased slightly among Hispanic women, but have dropped among other groups, including Asian women, women in rural areas, and women with public health insurance or no health insurance.
Who is more likely to get it?
Breast cancer is most common in middle-aged and older women.
Women aged 45 to 54 make up nearly 20% of new cases. Women aged 55 to 74 make up 51% of new cases.
The rate of new cases of breast cancer is highest in white women, followed by African American women. Breast cancer death rates are highest for African American women—40% higher than for white women.
How to lower your risk
The key is to get regular exams and screening. You can't do much about risk factors like age or family history of breast cancer. But there are other things you can do. These include:
Controlling your weight. Those who are obese have a 20% to 40% higher risk of developing breast cancer compared with women whose weight is in the normal range.
Limiting alcohol. Even one daily drink can raise your risk.
Getting regular exercise.
Quitting smoking.
Source: NIH MedlinePlus Magazine
Early Detection, Improved Treatments
Lobules and ducts of the breast
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: None
Mikael Häggström, M.D./Wikimedia
Lobules and ducts of the breast
Lobules and lactiferous ducts of the breast.
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: None
Mikael Häggström, M.D./Wikimedia
Understanding Breast Cancer: Early Detection, Improved Treatments Save Lives
More women are beating breast cancer these days, in part because of improved treatments and screening. When abnormal tissue or cancer is found in its early stages, it may be easier to treat.
NIH-funded scientists are searching for better ways to diagnose, treat, and even prevent breast cancer. Some are studying cancer at the cellular level to learn which tumors pose little danger and can be left alone. Others are developing targeted therapies with fewer side effects and seeking ways to boost survival. Certain drugs are already being used to help prevent breast cancer in some women at greatest risk.
Breast cancer is the second most common kind of cancer among women (after skin cancer). Men can get breast cancer too, although it’s rare. A woman’s risk of developing breast cancer rises as she gets older. Family and personal health history also affect her chances. Risk increases if a close relative has been diagnosed. Risk also goes up the longer a woman is exposed to the hormone estrogen. This means that risk is greater the earlier a woman starts menstruating, the later in life she has her first child, and the later she enters menopause. Exposure to radiation and other environmental factors can also raise the risk of breast cancer.
Warning signs of breast cancer can sometimes be seen or felt. Symptoms include a lump in the breast or armpit, breast pain, unusually firm breast skin, nipple discharge, or changes in the size or shape of the breast. Having one or more of these symptoms doesn’t necessarily indicate cancer. In fact, most lumps are not cancerous. But any of these changes should be discussed with a doctor.
Even before symptoms appear, screening tests can check for early cancer. Mammograms, or X-ray images of the breast, have helped reduce the number of deaths from breast cancer among women ages 40 to 70, especially those over age 50.
“Mammograms decrease the risk of dying of breast cancer, although no screening test is perfect,” says Dr. Barry Kramer, who heads cancer prevention research at NIH.
Mammograms, though, can have some drawbacks. Sometimes mammograms detect tumors that may not cause harm in the long run but are treated anyway. In these cases, women might receive toxic therapies for tumors that weren’t really a threat to their health. In addition, mammograms can sometimes have “false-positive” results; the tissue may look abnormal even though no cancer is present. False-positives can cause fear and anxiety and may lead to unnecessary follow-up testing.
Despite these concerns, mammograms remain an effective screening test. “Mammograms detect 80–85% of all breast cancers,” says Dr. Powel Brown, a breast oncologist at MD Anderson Cancer Center in Houston. “It’s still the best screening test we have, although imaging tests such as breast MRI, ultrasound, and breast tomograms are also being used, particularly in high-risk women.”
Experts recommend that women consult a health care provider at age 40, discuss their risks, and together decide when it’s best to start mammogram screening. Some women may not need to start these tests until age 50. “Screening, like treatment, should be individualized,” Brown says.
“Data shows an approximately 20% relative reduction in death for women who start getting mammograms at age 50 and have them every year or 2,” says Dr. Leslie Ford, who specializes in clinical research and cancer prevention at NIH.
When early-stage breast cancer is detected, the main treatments are surgery and radiation. A lumpectomy removes the affected area, but some women need a mastectomy, removal of the whole breast. Chemotherapy, or cancer-fighting medications, may also be used before or after surgery. In some cases, oncologists use targeted drugs or hormone therapy to treat certain types of tumors.
Once cancer spreads to other parts of the body, there’s no effective cure. Still, new therapies can control metastatic breast cancer to prolong life. Last year, one NIH-funded study found that a combination of 2 drugs can lengthen the lives of postmenopausal women with the most common type of metastatic breast cancer.
When it comes to preventing breast cancer, strategies can vary depending on each woman’s risk. Women at greatest risk include those who’ve already had cancer in one breast and those with a mother, sister, or daughter who’s had breast cancer, especially if they were diagnosed before age 50.
“If you have a strong family history of breast or ovarian cancer, get evaluated by a genetic expert,” Brown recommends. One genetic test looks at the BRCA genes. Women with certain BRCA mutations have a greatly increased risk of developing breast cancer, a risk that rises with age.
“If a woman has a BRCA mutation, she’s faced with deciding at what age to deal with it and how,” says Ford. “She must decide between preventive surgery and monitoring it closely.”
Preventive mastectomy—or surgical removal of a seemingly healthy breast—is an option for women at very high risk for breast cancer. A woman considering this aggressive surgery should talk with her doctor about her cancer risk, the surgical procedure, its potential complications, and alternatives to surgery.
Studies have shown that reducing prolonged exposure to the hormone estrogen might be another way to lower the risk of breast cancer. One preventive approach is to take medicine that blocks the effects of estrogen. Two such drugs, tamoxifen and raloxifene, are sometimes given to women at high risk for breast cancer. Raloxifene can only be given to postmenopausal women. Both of these medicines can have serious side effects. Still, their potential benefits for both prevention and treatment are encouraging. Large NIH-funded primary prevention studies of women at increased risk for breast cancer showed that “tamoxifen and raloxifene each reduced the risk of developing breast cancer by about 50%,” says Ford.
The drug exemestane, which decreases the amount of estrogen produced by the body, also shows promise for preventing breast cancer in at-risk postmenopausal women. Exemestane is usually given after breast cancer treatment to reduce the risk of the cancer returning.
“It’s a lost opportunity to not use these medicines,” says Brown. Women at elevated risk of breast cancer should talk with their doctor about the potential benefits and harms of taking these preventive medicines.
No matter what your risk for breast cancer, you can make healthy changes that might lower your chances of getting the disease. Eat a heart-healthy diet, reduce alcohol intake, don’t smoke, and get regular exercise. Talk to a health care provider about how you might lower your risk of cancer.
Talk To Your Doctor
if you notice a lump or firm tissue on your breast or under your arm.
if you see a change in the size or shape of your breast.
if cancer runs in your family.
about when to start and how often to get mammograms.
about treatment choices and possible risks if you’ve been diagnosed
about clinical research trials.
Source: NIH News in Health
Additional Materials (2)
Tumour in the breast visualized by Breast-Computertomography (Breast-CT)
Tumor in der Brust, aufgenommen durch Brust-Computertomographie
Image by Rsmskns/Wikimedia
Illustration of a woman talking with her doctor
Illustration of a woman talking with her doctor
No one knows why MS starts. But treatment may help stop it from getting worse.
Image by NIH News in Health
Tumour in the breast visualized by Breast-Computertomography (Breast-CT)
Rsmskns/Wikimedia
Illustration of a woman talking with her doctor
NIH News in Health
Screening and Treatment Get Personal
Breast cancer - Early Signs - Overview
Image by Raphseck
Breast cancer - Early Signs - Overview
Early signs of possible breast cancer
Image by Raphseck
Advances in Breast Cancer: Screening and Treatment Get Personal
Breast cancer is the second most common cancer among American women. Breast cancer death rates have been falling over the past 30 years. But nearly 13% of women are still diagnosed in their lifetime. Men can get breast cancer too, although it’s rare.
Cancer is caused by changes to genes that control the way our cells function. These changes affect how cells grow and divide. Cancer results when cells divide uncontrollably. In breast cancer, this happens in the breast tissue.
Researchers are studying the risk factors for different types of breast cancer. They’re also searching for more personalized treatments.
Unraveling The Risks
“Breast cancer is caused by a combination of factors,” says Dr. Montserrat García-Closas, a cancer researcher at NIH. Your genes, lifestyle, and environment all contribute to your risk. Researchers are trying to better understand how each plays a role.
People with a family history of breast cancer are at increased risk for the disease. Some are born with rare versions of certain genes that put them at high risk. These include the genes BRCA1 and BRCA2.
“But the vast majority of patients have no known family history and no known gene that causes cancer,” explains Dr. Margaret Gatti-Mays, a breast cancer treatment specialist at The Ohio State University.
So researchers are also searching for combinations of genes that may lead to breast cancer. “Women can inherit hundreds or thousands of common versions of genes that each have tiny effects, but in combination can put them at substantial risk for developing breast cancer,” García-Closas says. An NIH study called the Confluence Project is trying to unravel these combinations.
Other factors can increase your risk for breast cancer, too. These include your age, whether you’ve had children, alcohol use, and obesity.
Studies are examining how all these factors—genes, medical history, and lifestyle—interact to affect cancer risk. One is called Connect for Cancer Prevention. “It’s recruiting 200,000 people in the U.S. and following them for years to see who develops different types of cancers,” says García-Closas.
Staying Ahead of Breast Cancer
Another study, called the Wisdom Study, is exploring how to best personalize breast cancer screening. Screening tests look for signs of a disease before symptoms appear. Finding cancer early may increase the chance that it can be treated and cured.
If you’re at high risk for breast cancer, your doctor may advise you to get screenings at an earlier age than most, or more often.
“Women from 40 to 50 should talk with their doctor about when they should start screening. And that should be based on their personal risks,” says Dr. Brandy Heckman-Stoddard, an NIH expert on breast cancer.
Mammograms are the most common way to screen for breast cancer. These are X-ray pictures of the breast. An NIH study called TMIST is comparing whether 2D or 3D mammograms are better for screening. 2D mammograms are taken from two sides of the breast. 3D mammograms are taken from different angles around the breast. Then, a computer builds a 3D-like image.
Magnetic resonance imaging (MRI) is sometimes used to screen women at high risk of breast cancer. MRIs can create a clearer image of the breast and don’t use radiation.
Researchers are looking for other ways to detect breast cancer, too. García-Closas’ team is trying to detect cancer using blood samples. These “liquid biopsies” detect DNA from cancer cells, which travel around the body in the bloodstream.
“Liquid biopsies should reflect what’s going on in your whole body,” García-Closas says, “versus when you look at a tissue biopsy, you’re taking a tiny sample of tissue in a particular location.”
Liquid biopsies may one day be able to detect cancer before other clinical tests, she says. “And, they might be able to better monitor what’s happening in your body after cancer has been diagnosed.”
Fighting Back
When breast cancer is found, treatment depends on the type of tumor. Surgery and radiation are common. Chemotherapy may also be used. Doctors might recommend other treatments as well, depending on the type of breast cancer.
“There are three main types of breast cancer,” Gatti-Mays says. “The subtype is determined by the presence or absence of three receptors .” These receptors respond to the hormones estrogen or progesterone or a protein called HER2.
“If your tumor has estrogen and progesterone receptors, then you can be treated with hormone therapies,” says Heckman-Stoddard. These block the action of hormones that can cause certain cancers to grow.
Hormone treatments can also be used to prevent or lower the risk of cancer for certain women. One such drug is called tamoxifen. But it has side effects that make it unappealing for prevention. Heckman-Stoddard’s team is studying whether using the drug as a gel lessens the side effects.
There are newer treatment options called targeted treatments. These block specific proteins that control how cancer cells grow, divide, and spread. Targeted treatments for HER2-positive cancer have improved survival over the last decade.
The most recent type of cancer treatment is called immunotherapy. It trains your body to fight cancer using your own immune system .
“Immunotherapy is very promising, but the benefits are still limited to only some patients with triple negative breast cancer,” says Gatti-Mays. These cancers lack all three receptors. But researchers are trying to expand this treatment to more patients with breast cancer. They’re also testing whether using it in combination with other treatments will work better.
Scientists continue to look for ways to improve screening, prevention, and treatment. “In the next five to 10 years, there should be better ways for women to determine their risk of breast cancer,” says García-Closas. “That should help them have a conversation with their physicians on what will be the best tailored prevention strategies.”
No matter what your personal risk of cancer, a healthy lifestyle is the best way to prevent it. Eat a heart-healthy diet, reduce alcohol intake, don’t smoke, and get regular exercise. See the Wise Choices box and talk with your health care provider about ways to lower your risk.
Ask Your Doctor About Your Breast Cancer Risk
Certain factors put you at higher risk for breast cancer. These include:
Being 40 years old or older
A personal history of breast cancer or benign (noncancer) breast disease
Radiation exposure to the breast or chest
Having a close relative who’s had breast cancer
Greater exposure to estrogen over time. (Starting menstruation early or entering menopause later in life.)
Hormone therapy for symptoms of menopause
Obesity
Drinking alcohol
Source: NIH News in Health
Additional Materials (14)
Lumpectomy Section Removed
Nipple
Breast Tissue
Fat
Suspensory Ligaments
Ducts
Chest Wall Muscle
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Breast Anatomy Post Lumpectomy
The interactive shows structures of the breast post lumpectomy (breast conserving surgery), as well as the space where the tumor was removed are visible in a Breast MRI: Lumpectomy section removed; Nipple Breast tissue; Fat; Suspensory ligaments; Ducts; Chest wall muscle.
Interactive by TheVisualMD
Understanding Breast Changes: A Health Guide for Women
Explains next steps after an abnormal mammogram result, including information about how conditions are diagnosed and treated.
Document by National Cancer Institute
Understanding Breast Changes and Conditions: A Health Guide
Document by National Cancer Institute / NIH
Surgery Choices for Women with DCIS or Breast Cancer
Surgery Choices for Women with DCIS or Breast Cancer
Document by National Cancer Institute / NIH
Lumpectomy
Colorized MR of Breasts After Breast Conserving Surgery or Lumpectomy : Colorized breast MR of breasts, axial slice (horizontal view, as though seen from above). The breast on the right side of the image has had breast-conserving surgery, also called lumpectomy. This type of surgery removes the tumor, some breast tissue, and some lymph nodes, but preserves the chest muscles. The aim of the surgery is to take only as much tissue as is necessary to keep the chance of recurrence low, but to keep the breast looking as normal as possible.
Image by TheVisualMD
Front view of the breast
Diagram showing the front view of the breast.
Image by Centers for Disease Control and Prevention (CDC)
Estradiol PET/CT Imaging in Breast Cancer Patients
Purpose: It is known that the estrogen receptor (ER) status of a tumor is an important prognostic and predictive indicator in breast cancer. Women with ER-positive breast tumors have a better prognosis than women with ER-negative tumors in terms of responsiveness to anti-estrogen treatment. 16α-[18F]-Fluoro-17β-estradiol (18F-FES) has proven to be a promising tracer for in vivo imaging studies of the ER status of primary and metastatic breast cancer. Consequently, at our Institution positron emission tomography/computed tomography (PET/CT) using estradiol, labelled with fluorine-18, is an important diagnostic tool to be used in hormone-dependent breast cancer.
Image by Citation: Vaalavirta L, Rasulova N, Partanen K, Joensuu T, Kairemo K. [18F]-Estradiol PET/CT Imaging in Breast Cancer Patients. Journal of Diagnostic Imaging in Therapy
Anatomy of the breast
Inside the breast
Image by NCI NIH
Breast Density
Women with dense breast tissue often require a further look with ultrasound for screening. University of Chicago Medical Center breast radiologist Dr. Gillian Newstead and a breast cancer survivor with dense breast tissue explain.
Image by TheVisualMD
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Breast Cancer
Worldwide, breast cancer is by far the most common cancer among women. It occurs twice as often as colorectal cancer and cervical cancer and three times as often as lung cancer. About 1.3 million women are diagnosed with breast cancer annually, and about 465,000 will die from it. North America has the highest rate of breast cancer in the world. A woman living in the US has a 1-in-8 chance of having malignant breast cancer at some time during her life (up from 1 in 20 in 1960), and a 1-in-35 chance of dying from it. According to the American Cancer Society, about 182,500 women in the United States will have been diagnosed with invasive breast cancer in 2008.
Image by TheVisualMD
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Female Breast with Cancer
Computer generated image of a female breast with breast cancer. The sagittal cross-section reveals the cancerous cells within the breast tissue and mammary glands.
Image by TheVisualMD
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Breast Cancer Stages
Breast Cancer Stages (Summary Staging)
Image by TheVisualMD
Breast Cancer
Breast Cancer
Image by BruceBlaus
Chromosomes, Genes and Breast Cancer
Image by TheVisualMD
Breast Anatomy Post Lumpectomy
TheVisualMD
Understanding Breast Changes: A Health Guide for Women
National Cancer Institute
Understanding Breast Changes and Conditions: A Health Guide
National Cancer Institute / NIH
Surgery Choices for Women with DCIS or Breast Cancer
National Cancer Institute / NIH
Lumpectomy
TheVisualMD
Front view of the breast
Centers for Disease Control and Prevention (CDC)
Estradiol PET/CT Imaging in Breast Cancer Patients
Citation: Vaalavirta L, Rasulova N, Partanen K, Joensuu T, Kairemo K. [18F]-Estradiol PET/CT Imaging in Breast Cancer Patients. Journal of Diagnostic Imaging in Therapy
Anatomy of the breast
NCI NIH
Breast Density
TheVisualMD
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Breast Cancer
TheVisualMD
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This media may include sensitive content
Female Breast with Cancer
TheVisualMD
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Breast Cancer Stages
TheVisualMD
Breast Cancer
BruceBlaus
Chromosomes, Genes and Breast Cancer
TheVisualMD
Risk Factors
Obesity & Breast Cancer
Image by TheVisualMD
Obesity & Breast Cancer
Cancer is mostly preventable: 90-95% of cancer cases are due to lifestyle and environmental causes. Maintaining a normal body weight and exercising both help protect you against cancer.
Image by TheVisualMD
A Family History of Breast Cancer and Other Factors Increase the Risk of Breast Cancer
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for breast cancer.
Risk factors for breast cancer include the following:
A personal history of invasive breast cancer, ductal carcinoma in situ (DCIS), or lobular carcinoma in situ (LCIS).
A personal history of benign (noncancer) breast disease.
A family history of breast cancer in a first-degree relative (mother, daughter, or sister).
Inherited changes in the BRCA1 or BRCA2 genes or in other genes that increase the risk of breast cancer.
Breast tissue that is dense on a mammogram.
Exposure of breast tissue to estrogen made by the body. This may be caused by:
Menstruating at an early age.
Older age at first birth or never having given birth.
Starting menopause at a later age.
Taking hormones such as estrogen combined with progestin for symptoms of menopause.
Treatment with radiation therapy to the breast/chest.
Drinking alcohol.
Obesity.
Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.
Source: National Cancer Institute (NCI)
Additional Materials (28)
BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern
In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved. For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to increase a person's chance of developing cancer. Although breast cancer is more common in women than in men, the mutated gene can be inherited from either the mother or the father.
Image by YassineMrabet / NIH
Chances of Developing Breast Cancer by Age 70
Specific inherited mutations in the BRCA1 and BRCA2 genes increase the risk of breast and ovarian cancers.
Image by National Cancer Institute (NCI)
Possible inheritance of breast and ovarian cancer in a family
possible inheritance of breast and ovarian cancer in a family
Image by Huijts, thanks to the initial pedigree made by Rozzychan
Lower Your Breast Cancer Risk
Dust off your old goals or grab a pen and paper to write new ones. Need inspiration? These simple health activities will also lower your #BreastCancer risk
Image by Matthew Henry / CDC
BRCA1 and BRCA2 mutations and absolute cancer risk (Updated-2023)
Updated risks from Petrucelli N, Daly MB, Pal T. BRCA1- and BRCA2-Associated Hereditary Breast and Ovarian Cancer. 1998 Sep 4 [Updated 2022 May 26]. In: Adam MP, Mirzaa GM, Pagon RA, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK1247/
Image by Wshung/Wikimedia
Breastfeeding and Breast Cancer Risk
Decrease of breast cancer risk due to parity and breastfeeding; data source: Collaborative Group on Hormonal Factors in Breast Cancer: Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. The Lancet, Vol. 360 (9328), 20. July 2002, pp 187–195
Image by Stilfehler/Wikimedia
Hormone replacement therapy (HRT) and cancer risk in the UK
If 1,000 women take HRT from age 50 for five years, two more women get breast cancer, and one more woman gets ovarian cancer. This risk is small compared to many lifestyle risk factors.
Based on a Cancer Research UK graphic published in 2015
http://www.cancerresearchuk.org/cancer-info/healthyliving/hormones/HRT/
Original sources: cruk.org, 2015 (data from 2011); Lancet, 2015; Lancet, 1997;
Image by Cancer Research UK uploader/Wikimedia
Breast Cancer Risks
Video by Lee Health/YouTube
Classic BRCA2 Pedigree
Pedigree showing some of the classic features of a family with a deleterious BRCA2 mutation across three generations, including transmission occurring through maternal and paternal lineages. The unaffected female proband is shown as having an affected brother (breast cancer diagnosed at age 52 y), mother (breast cancer diagnosed at age 45 y and pancreatic cancer diagnosed at age 55 y), maternal aunt (ovarian cancer diagnosed at age 58 y), and maternal grandfather (prostate cancer diagnosed at age 55 y).
BRCA2 pedigree. This pedigree shows some of the classic features of a family with a deleterious BRCA2 mutation across three generations, including affected family members with breast (including male breast cancer), ovarian, pancreatic, or prostate cancers and a relatively young age at onset. BRCA2 families may exhibit some or all of these features. As an autosomal dominant syndrome, a deleterious BRCA2 mutation can be transmitted through maternal or paternal lineages, as depicted in the figure.
Image by National Cancer Institute / National Cancer Institute (Illustrator)
Classic BRCA1 Pedigree
Pedigree showing some of the classic features of a family with a deleterious BRCA1 mutation across three generations, including transmission occurring through maternal and paternal lineages. The unaffected female proband is shown as having an affected mother (breast cancer diagnosed at age 42 y), female cousin (breast cancer diagnosed at age 38 y), maternal aunt (ovarian cancer diagnosed at age 53 y), and maternal grandmother (ovarian cancer diagnosed at age 49 y).
BRCA1 pedigree. This pedigree shows some of the classic features of a family with a deleterious BRCA1 mutation across three generations, including affected family members with breast cancer or ovarian cancer and a young age at onset. BRCA1 families may exhibit some or all of these features. As an autosomal dominant syndrome, a deleterious BRCA1 mutation can be transmitted through maternal or paternal lineages, as depicted in the figure.
Image by National Cancer Institute / National Cancer Institute (artist)
MEN2A Pedigree
Pedigree showing some of the classic features of a family with a deleterious RET mutation across four generations, including transmission occurring through paternal lineage. The unaffected female proband is shown as having an affected brother (medullary thyroid cancer diagnosed at age 22 y and hyperparathyroidism diagnosed at age 24 y), father (medullary thyroid cancer diagnosed at age 54 y and pheochromocytoma diagnosed at age 67 y), and paternal aunt (medullary thyroid cancer diagnosed at age 38 y).
MEN2A pedigree. This pedigree shows some of the classic features of a family with a deleterious RET mutation across four generations, including affected family members with medullary thyroid cancer, pheochromocytoma, and hyperparathyroidism. Age at onset can vary widely, even within families. Medullary thyroid cancer can present with earlier onset and more aggressive disease in successive generations, depending on the genotype. MEN2A families may exhibit some or all of these features. As an autosomal dominant syndrome, transmission can occur through maternal or paternal lineages.
Image by National Cancer Institute / National Cancer Institute
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MEN1 Pedigree
Pedigree showing some of the features of a family with a deleterious MEN1 mutation across four generations, including transmission occurring through paternal lineage. The unaffected male proband is shown as having an affected sister (self-report of neck surgery confirmed upon review of medical records to be hyperparathyroidism diagnosed at age 18 y, parathyroidectomy, and pituitary adenoma), father (self-report of stomach cancer confirmed upon review of medical records to be gastrinoma diagnosed at age 45 y), and paternal grandmother (suspected hyperparathyroidism and/or pancreatic tumor).
MEN1 pedigree. MEN1 can be very difficult to identify in a pedigree. The pedigree on the left was constructed based on self-report, and the pedigree on the right depicts the same family following a review of available medical records. This pedigree shows some of the features of a family with a deleterious MEN1 mutation across four generations, including affected family members with hyperparathyroidism, a pituitary adenoma, gastrinoma, and a suspected pancreatic tumor. The tumors in MEN1 typically occur at an earlier age than their sporadic counterparts. MEN1 families may exhibit some or all o
Image by National Cancer Institute / National Cancer Institute
Types of cancers that may have TRK fusions
NTRK is a gene family that encodes tropomyosin receptor kinases (TRK) which can be fused to other genes abnormally leading to increased growth signals that lead to cancer, these fusions are rare but can occur in different types of cancers like lung, thyroid, and salivary gland cancers.
Image by Loxo Oncology, Inc.
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations Breast cancer
Mammography: Women 40 and older should have a mammogram every year.
Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year.
Breast self-exam: Women age 20 and older should perform one each month (considered optional).
If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.
Image by TheVisualMD
Signs of high risk breast cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Introduction to Early Onset Breast Cancer and Risk Factors
Video by Centers for Disease Control and Prevention (CDC)/YouTube
How To Identify Your Breast Cancer Risk And Steps To Reduce It
Video by TODAY/YouTube
Who is at high risk for breast cancer?
Video by Mayo Clinic/YouTube
Childbirth increases breast cancer risk according to new study
Video by CBS News/YouTube
Risk Factors for Breast Cancer
Video by AllHealthGo/YouTube
Breast Cancer Risk-reducing Medications
Video by Brigham And Women's Hospital/YouTube
No Matter Your Age, Know Your Breast Cancer Risk
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Why Does Breastfeeding Lower Your Risk of Breast Cancer?
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Identifying High Breast Cancer Risk - Mayo Clinic
Video by Mayo Clinic/YouTube
Risks Factors for Breast Cancer
Video by AllHealthGo/YouTube
Breast Cancer Risk Assessment Tool
Video by AllHealthGo/YouTube
Mutations on BRCA1
types of mutations on BRCA1
Image by NCI/Wikimedia
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Prophylactic Mastectomy
types of mutations on BRCA2
Image by NCI
BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern
YassineMrabet / NIH
Chances of Developing Breast Cancer by Age 70
National Cancer Institute (NCI)
Possible inheritance of breast and ovarian cancer in a family
Huijts, thanks to the initial pedigree made by Rozzychan
Lower Your Breast Cancer Risk
Matthew Henry / CDC
BRCA1 and BRCA2 mutations and absolute cancer risk (Updated-2023)
Wshung/Wikimedia
Breastfeeding and Breast Cancer Risk
Stilfehler/Wikimedia
Hormone replacement therapy (HRT) and cancer risk in the UK
Cancer Research UK uploader/Wikimedia
1:50
Breast Cancer Risks
Lee Health/YouTube
Classic BRCA2 Pedigree
National Cancer Institute / National Cancer Institute (Illustrator)
Classic BRCA1 Pedigree
National Cancer Institute / National Cancer Institute (artist)
MEN2A Pedigree
National Cancer Institute / National Cancer Institute
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MEN1 Pedigree
National Cancer Institute / National Cancer Institute
Types of cancers that may have TRK fusions
Loxo Oncology, Inc.
Screening for Cancer
TheVisualMD
2:38
Signs of high risk breast cancer - Mayo Clinic
Mayo Clinic/YouTube
4:10
Introduction to Early Onset Breast Cancer and Risk Factors
Centers for Disease Control and Prevention (CDC)/YouTube
5:49
How To Identify Your Breast Cancer Risk And Steps To Reduce It
TODAY/YouTube
0:40
Who is at high risk for breast cancer?
Mayo Clinic/YouTube
3:20
Childbirth increases breast cancer risk according to new study
CBS News/YouTube
2:30
Risk Factors for Breast Cancer
AllHealthGo/YouTube
16:45
Breast Cancer Risk-reducing Medications
Brigham And Women's Hospital/YouTube
0:32
No Matter Your Age, Know Your Breast Cancer Risk
Centers for Disease Control and Prevention (CDC)/YouTube
0:36
Why Does Breastfeeding Lower Your Risk of Breast Cancer?
Centers for Disease Control and Prevention (CDC)/YouTube
2:40
Identifying High Breast Cancer Risk - Mayo Clinic
Mayo Clinic/YouTube
6:55
Risks Factors for Breast Cancer
AllHealthGo/YouTube
2:21
Breast Cancer Risk Assessment Tool
AllHealthGo/YouTube
Mutations on BRCA1
NCI/Wikimedia
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Prophylactic Mastectomy
NCI
Signs
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Left Breast with Cancer
Image by TheVisualMD
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Left Breast with Cancer
Cancer of the left breast.
Image by TheVisualMD
What Are Signs of Breast Cancer?
These and other signs may be caused by breast cancer or by other conditions. Check with your doctor if you have any of the following:
A lump or thickening in or near the breast or in the underarm area.
A change in the size or shape of the breast.
A dimple or puckering in the skin of the breast.
A nipple turned inward into the breast.
Fluid, other than breast milk, from the nipple, especially if it's bloody.
Scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin around the nipple).
Dimples in the breast that look like the skin of an orange, called peau d’orange.
Source: National Cancer Institute (NIH)
Additional Materials (17)
Early signs of breast cancer.
Early signs of breast cancer.
Image by Morning2k
Signs & Symptoms
Image by TheVisualMD
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Breast with Rough, Scaly Skin, Symptom of Breast Cancer
Photograph of woman's breast showing scaly, rough skin, a possible symptom of breast cancer. Signs and symptoms of breast cancer are not always lumps or swelling.
Image by TheVisualMD
Breast Cancer
Image by BruceBlaus
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Breast with Inverted Nipple, Symptom of Breast Cancer
Photograph of woman's right breast showing inverted nipple, a possible symptom of breast cancer. Signs and symptoms of breast cancer are not always lumps or swelling.
Image by TheVisualMD
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Normal (left) versus cancerous (right) mammography image.
Normal (left) versus cancerous (right) mammography image.
Image by National Cancer Institute
How to Recognize Breast Cancer Symptoms
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What Are the Symptoms of Breast Cancer? | UPMC
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Invasive breast cancer
Invasive Breast Cancer Description Invasive breast cancer cells growing through the wall of a breast duct.
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Early Signs of Breast Cancer
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What Are the Signs of Breast Cancer?
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Warning Signs of Breast Cancer
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Breast Cancer Symptoms, How To Spot It Early - Cancer Research UK
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Signs and Symptoms of Inflammatory Breast Cancer
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Breast cancer - Symptoms and treatment
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Inflammatory Breast Cancer Signs | Duke Health
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Signs and Symptoms of Breast Cancer | Dana-Farber Cancer Institute
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Early signs of breast cancer.
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Signs & Symptoms
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Breast with Rough, Scaly Skin, Symptom of Breast Cancer
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Breast Cancer
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Breast with Inverted Nipple, Symptom of Breast Cancer
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Normal (left) versus cancerous (right) mammography image.
National Cancer Institute
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How to Recognize Breast Cancer Symptoms
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0:50
What Are the Symptoms of Breast Cancer? | UPMC
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Invasive breast cancer
National Cancer Institute
1:01
Early Signs of Breast Cancer
uvahealth/YouTube
1:50
What Are the Signs of Breast Cancer?
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2:48
Warning Signs of Breast Cancer
Cleveland Clinic/YouTube
2:14
Breast Cancer Symptoms, How To Spot It Early - Cancer Research UK
Cancer Research UK/YouTube
2:52
Signs and Symptoms of Inflammatory Breast Cancer
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2:35
Breast cancer - Symptoms and treatment
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Inflammatory Breast Cancer Signs | Duke Health
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2:25
Signs and Symptoms of Breast Cancer | Dana-Farber Cancer Institute
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Diagnosis
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Diagnosing Breast Cancer
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Diagnosing Breast Cancer
Breast imaging and early detection of breast cancer have evolved immensely over the last 25 years, leading to increased survival rates and improved quality of life for millions of women with breast cancer. This video takes you through the process of screening and diagnosis using various imaging modalities, including mammogram, ultrasound and MRI.
Video by TheVisualMD
Diagnosis of Breast Cancer
Check with your doctor if you notice any changes in your breasts. The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Clinical breast exam (CBE): An exam of the breast by a doctor or other health professional. The doctor will carefully feel the breasts and under the arms for lumps or anything else that seems unusual.
Mammogram: An x-ray of the breast.Mammography. The breast is pressed between two plates. X-rays are used to take pictures of breast tissue.
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of both breasts. This procedure is also called nuclear magnetic resonance imaging (NMRI).
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. If a lump in the breast is found, a biopsy may be done.
There are four types of biopsy used to check for breast cancer:
Excisional biopsy: The removal of an entire lump of tissue.
Incisional biopsy: The removal of part of a lump or a sample of tissue.
Core biopsy: The removal of tissue using a wide needle.
Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid, using a thin needle.
If cancer is found, tests are done to study the cancer cells.
Decisions about the best treatment are based on the results of these tests. The tests give information about:
how quickly the cancer may grow.
how likely it is that the cancer will spread through the body.
how well certain treatments might work.
how likely the cancer is to recur (come back).
Tests include the following:
Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.
Human epidermal growth factor type 2 receptor (HER2/neu) test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer is called HER2/neu positive. This type of breast cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab and pertuzumab.
Multigene tests: Tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back).
There are many types of multigene tests. The following multigene tests have been studied in clinical trials:
Oncotype DX: This test helps predict whether early-stage breast cancer that is estrogen receptor positive and node negative will spread to other parts of the body. If the risk that the cancer will spread is high, chemotherapy may be given to lower the risk.
MammaPrint: A laboratory test in which the activity of 70 different genes is looked at in the breast cancer tissue of women who have early-stage invasive breast cancer that has not spread to lymph nodes or has spread to 3 or fewer lymph nodes. The activity level of these genes helps predict whether breast cancer will spread to other parts of the body or come back. If the test shows that the risk that the cancer will spread or come back is high, chemotherapy may be given to lower the risk.
Based on these tests, breast cancer is described as one of the following types:
Triple negative (estrogen receptor, progesterone receptor, and HER2/neu negative).
This information helps the doctor decide which treatments will work best for your cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options depend on the following:
The stage of the cancer (the size of the tumor and whether it is in the breast only or has spread to lymph nodes or other places in the body).
The type of breast cancer.
Estrogen receptor and progesterone receptor levels in the tumor tissue.
Human epidermal growth factor type 2 receptor (HER2/neu) levels in the tumor tissue.
Whether the tumor tissue is triple negative (cells that do not have estrogen receptors, progesterone receptors, or high levels of HER2/neu).
How fast the tumor is growing.
How likely the tumor is to recur (come back).
A woman’s age, general health, and menopausal status (whether a woman is still having menstrual periods).
Whether the cancer has just been diagnosed or has recurred (come bac
Source: National Cancer Institute (NIH)
Additional Materials (39)
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Screening for Cancer
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Estradiol PET/CT Imaging in Breast Cancer Patients
Purpose: It is known that the estrogen receptor (ER) status of a tumor is an important prognostic and predictive indicator in breast cancer. Women with ER-positive breast tumors have a better prognosis than women with ER-negative tumors in terms of responsiveness to anti-estrogen treatment. 16α-[18F]-Fluoro-17β-estradiol (18F-FES) has proven to be a promising tracer for in vivo imaging studies of the ER status of primary and metastatic breast cancer. Consequently, at our Institution positron emission tomography/computed tomography (PET/CT) using estradiol, labelled with fluorine-18, is an important diagnostic tool to be used in hormone-dependent breast cancer.
Image by Citation: Vaalavirta L, Rasulova N, Partanen K, Joensuu T, Kairemo K. [18F]-Estradiol PET/CT Imaging in Breast Cancer Patients. Journal of Diagnostic Imaging in Therapy
Breast Cancer Screening and Diagnosis
We worked with a group of leading clinical oncologists to develop a comprehensive program on screening for colon, breast, cervical, and prostate cancer. The message is aimed at general practitioners and their patients.
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Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations
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Diagnosing Breast Cancer
If a woman has symptoms of breast cancer (such as a lump), or if a suspicious area is found in an imaging exam, the next step is to physically examine the breasts by noting any changes in their appearance and palpating the breast and the underarm region. A complete physical exam may be done as well. If symptoms or results of these exams suggest cancer might be present, then further tests will be done. (Note: The following diagnostic procedures are common to the US; procedures may vary in other countries.)
Image by TheVisualMD
Screening for Cancer
Cancer treatment has a better chance of success when the cancer is found at an early stage. Screening tests are available for cancers of the breast, prostate, testes, colon, rectum, mouth, and skin. Tumor markers are substances produced by tumors or other cells of the body in response to the presence of cancer. Tumor markers can be used to help diagnose cancer, predict response to therapy, check response to treatment, and determine if cancer has recurred. One tumor marker, prostate specific antigen (PSA) is commonly used to screen for prostate cancer in men who have no symptoms of the disease. Screening has risks, including overdiagnosis, false positives, and false negatives.
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Lymph Node Biopsy
Lymph Node Biopsy
Lymph Node Biopsy
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Breast Cancer - Lymph Node Biopsy
Lymph Node Biopsy : When breast cancer spreads beyond the primary tumor site, it usually spreads first to the sentinel lymph node or nodes, the first lymph nodes to receive drainage from a cancer-containing area of the breast. From there, breast cancer generally spreads to the axillary lymph nodes under the arm. So an important part of the breast cancer staging process is to determine whether the cancer has spread from the primary tumor to the sentinel lymph node, and from there into the axillary lymph nodes.
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Ultrasound Guided Breast Biopsy 1 / Ultrasound Guided Breast Biopsy 2
Breast Cancer - Ultrasound Guided Breast Biopsy
Ultrasound image of possible breast tumor before biopsy. The procedure is performed by a radiologist and sonographer. A local anesthetic is injected into the breast. The transducer is pressed to the breast and the suspicious area is located. The biopsy needle is inserted in the breast and guided in realtime by watching its movement through the breast on a computer monitor. The tissue sample is taken and the needle is removed.
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Needle Biopsy
Adult Black female breast visible. Physician's hands are seen performing a needle biopsy to determine nature of lump either fluid-filled cyst or solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
[18F]-Estradiol PET/CT Imaging in Breast Cancer Patients
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Elastography
Manual compression (quasistatic) elastography of invasive ductal carcinoma, a breast cancer.
Image by Copyright: Nevit Dilmen
Blausen 0628 Mammogram
Mammogram. See a related animation of this medical topic.
Image by BruceBlaus. When using this image in external sources it can be cited as:
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436./Wikimedia
BRCA-1 and BRCA-2 Genes, Breast Cancer
More than 225,000 cases of invasive breast cancer are diagnosed annually in the U.S. and 40,000 die from the disease. In recent years, however, great strides have been made in early diagnosis and treatment. Imaging techniques have been refined to spot ever-tinier tumors, biomarkers have been developed to reflect physiological changes produced by cancer, and genetic tests such as those for the BRCA1 and BRCA2 genes have been devised to identify increased familial risk of breast cancer. The majority of breast cancers start in the mammary ducts; most of the remainder arise in the lobules. Breast cancers are divided into in situ and invasive cancers. In situ cancers remain confined to the duct or gland where they began. Invasive cancers break through the walls of the duct or gland and penetrate into the surrounding tissue.
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Breast MRI 01 contrast agent gadolinium is injected
Breast MRI 02 contrast agent gadolinium is injected
Breast MRI 03 contrast agent gadolinium is injected
Breast MRI 04 contrast agent gadolinium is injected
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Breast MRI_contrast agent gadolinium is injected
A standard breast MRI image is taken for reference before the contrast agent gadolinium is injected. Gadolinium causes cancerous tissue to rapidly brighten in the MRI image about a minute after injection. It also quickly washes out of tumors faster than from normal tissue. Radiologists watch for the rapid brightening and washout in a series of MRI images taken roughly 1 minute apart.
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Breast
Colorized MRI of Normal Breast Showing Anatomy : Colorized MRI of female breast, sagittal (front-to-back) view, showing normal breast anatomy including nipple, ducts, lobule/gland tissue, fat tissue, and suspensory ligaments. Breasts hold a complex mix of blood and lymphatic vessels, nerves, tissues, and glands, but they are made up mainly of breast tissue and fat. Breast tissue is composed of lobules, lobes, and mammary ducts. Lobules are tiny milk-producing glands that are organized into lobes. Lobes drain into mammary ducts, and are arranged beneath the nipple like the petals of a flower. Together, lobules and ducts resemble clusters of grapes on their stalks. Fat covers the breast and gives breasts their distinctive, individual shapes.
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How Is Breast Cancer Diagnosed? | UPMC
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Breast MRI (VIDEO)
Dr. Nora Jaskowiak of The University of Chicago Medical Center explains why Magnetic Resonance Imaging, or MRI, is a critical tool in her role as breast surgeon.
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Breast MRI
Dr. Nora Jaskowiak of The University of Chicago Medical Center explains why Magnetic Resonance Imaging, or MRI, is a critical tool in her role as breast surgeon.
Video by TheVisualMD
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Breast Cancer Biopsy
If a woman has symptoms of breast cancer (such as a lump), or if a suspicious area is found in an imaging exam, the next step is to physically examine the breasts by noting any changes in their appearance and palpating the breast and the underarm region. A complete physical exam may be done as well. If symptoms or results of these exams suggest cancer might be present, then further tests will be done. (Note: The following diagnostic procedures are common to the US; procedures may vary in other countries.)
Video by TheVisualMD
Diagnosis of Inflammatory Breast Cancer
Video by MD Anderson Cancer Center/YouTube
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Breast Cancer Screening & Diagnosis
Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.
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PET/CT in Breast Cancer Treatment
National Cancer Institute radiologist Dr. Peter Choyke explains the role that PET scans can play in the treatment of breast cancer.
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A series of six illustrations showing how to do breast self examination (BSE)
A series of six illustrations showing how to do breast self examination (BSE)
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Breast Cancer Metastasis to Liver
The malignant breast cancer cells metastasized to the liver. A cluster of the cancer-cells with their brown-staining cytoplasm is within a portal tract of the liver (monoclonal antibody b1.1, abc immunoperoxidase method, hematoxylin counterstain, x500).
Image by National Cancer Institute / Unknown Photographer
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BRCA-1 and BRCA-2 Genes, Breast Examination
Mammograms use low-dose X-rays to create images of the breast on film. Screening mammograms typically image the breast from above and from an angled side view. Yearly mammograms are recommended for women 40 and over. Women at high risk should have an MRI scan and a mammogram every year, beginning at age 30. Mammograms can also be used for diagnosis of cancer and to guide biopsy of suspicious lesions. The National Cancer Institute estimates that women with certain mutations in the BRCA1 and BRCA2 genes have a 60% lifetime risk of breast cancer, which is five times higher than the general population. Only 0.2% of women have these specific mutations. Women who test negative for high-risk mutations in the BRCA1 and BRCA2 genes still have a 12% lifetime risk of breast cancer and a 1.4% lifetime risk of ovarian cancer, which means the most of these cancers are caused by factors other than BRCA genes.
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Mammogram of Breast with Possible Cancer Tumor
Breast mammogram revealing possible cancer tumor. Mammograms use low-dose X-rays to create images of the breast on film. Screening mammograms typically image the breast from above and from an angled side view. Yearly mammograms are recommended for women 40 and over. Women at high risk should have an MRI scan and a mammogram every year, beginning at age 30. Mammograms can also be used for diagnosis of cancer and to guide biopsy of suspicious lesions.
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Colorized Ultrasound of Possible Breast Tumor
Colorized ultrasound of possible breast tumor (center, with irregular edges). Ultrasound alone isn't used for screening because it can't produce an accurate picture of the entire breast. However, mammograms and ultrasound together catch more tumors than mammograms alone. Ultrasound is very good at telling if a lump is solid, and possibly cancerous, or a harmless cyst. It is particularly useful for women with dense breast tissue.
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Metastatic breast cancer
Brain Metastasis From Breast Cancer : CT scan of three brain metastasis (with large peripheral oedema) from breast cancer. Before (left image) and after (right image) injection of iodinated contrast. Patient of 75 years old.
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PET/CT study of breast cancer
PET/CT study of breast cancer.
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Breast Cancer
This is a high-resolution mid-range infrared image depicting cancer in the right breast by the high-energy blood vessels. Philip P. Hoekstra, III, Ph.D. This is a high-resolution mid-range infrared image depicting cancer in the right breast by the high-energy blood vessels. Philip P. Hoekstra, III, Ph.D.
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Breast Cancer Overview
Breast imaging and early detection of breast cancer have evolved immensely over the last 25 years, leading to increased survival rates and improved quality of life for millions of women with breast cancer. This video takes you through the process of screening and diagnosis using various imaging modalities, including mammogram, ultrasound and MRI.
Image by TheVisualMD
Mammogram Showing Normal Fatty Breast
A mammogram of a normal fatty breast, typical of older women. Diagnosis of abnormal lesions or cancer is more accurate in non-dense breasts.
Image by Dr. Dwight Kaufman. National Cancer Institute
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Breast Self-Exam (BSE)
When done correctly and regularly, breast self-exam (BSE) can help save lives. Women who perform BSE are more likely to be diagnosed with smaller tumors, and cancer is less likely to have spread to their underarm lymph nodes. An important part of BSE is self-awareness. Women should be aware of what their breasts normally feel and look like so that they notice any change, and they should bring that change to the attention of their doctor immediately.
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Breast Biopsy
Image Caption : Needle Breast Biopsy
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Mammogram Showing Normal Fatty Breast
A mammogram of a normal fatty breast, typical of older women. Diagnosis of abnormal lesions or cancer is more accurate in non-dense breasts.
Image by Dr. Dwight Kaufman. National Cancer Institute / Unknown Photographer
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Biopsy
A Caucasian woman patient is being operated on. Her nipple is being incised by the surgeon. The male surgeon and an operating room attendant are visible. A surgical biopsy is being performed to determine exact nature of solid tumor.
Image by National Cancer Institute / Linda Bartlett (Photographer)
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Thermography of breast
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Breast Self-Exam (3 Methods)
Breast Self-Exam (3 Methods)
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Woman Having Mammogram
Photograph of woman having mammogram. Mammograms are considered the gold standard for breast cancer screening. Mammography requires the breasts to be compressed between plates while the image is captured. Typically, two views are taken of the breast: cranial-caudal (top to bottom) and mediolateral oblique (angled side view).
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Screening for Cancer
TheVisualMD
Estradiol PET/CT Imaging in Breast Cancer Patients
Citation: Vaalavirta L, Rasulova N, Partanen K, Joensuu T, Kairemo K. [18F]-Estradiol PET/CT Imaging in Breast Cancer Patients. Journal of Diagnostic Imaging in Therapy
Breast Cancer Screening and Diagnosis
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Screening for Cancer
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Diagnosing Breast Cancer
TheVisualMD
Screening for Cancer
TheVisualMD
Breast Cancer - Lymph Node Biopsy
TheVisualMD
Breast Cancer - Ultrasound Guided Breast Biopsy
TheVisualMD
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Needle Biopsy
National Cancer Institute / Linda Bartlett (Photographer)
[18F]-Estradiol PET/CT Imaging in Breast Cancer Patients
openmedscience
Elastography
Copyright: Nevit Dilmen
Blausen 0628 Mammogram
BruceBlaus. When using this image in external sources it can be cited as:
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436./Wikimedia
BRCA-1 and BRCA-2 Genes, Breast Cancer
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Breast MRI_contrast agent gadolinium is injected
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Breast
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How Is Breast Cancer Diagnosed? | UPMC
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Breast MRI (VIDEO)
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Breast MRI
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Breast Cancer Biopsy
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Diagnosis of Inflammatory Breast Cancer
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Breast Cancer Screening & Diagnosis
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PET/CT in Breast Cancer Treatment
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A series of six illustrations showing how to do breast self examination (BSE)
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Breast Cancer Metastasis to Liver
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BRCA-1 and BRCA-2 Genes, Breast Examination
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Mammogram of Breast with Possible Cancer Tumor
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Colorized Ultrasound of Possible Breast Tumor
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Metastatic breast cancer
Jmarchn
PET/CT study of breast cancer
Hg6996
Breast Cancer
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Breast Cancer Overview
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Mammogram Showing Normal Fatty Breast
Dr. Dwight Kaufman. National Cancer Institute
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Breast Self-Exam (BSE)
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Breast Biopsy
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Mammogram Showing Normal Fatty Breast
Dr. Dwight Kaufman. National Cancer Institute / Unknown Photographer
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Biopsy
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Thermography of breast
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Breast Self-Exam (3 Methods)
Blausen Medical Communications, Inc.
Woman Having Mammogram
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BRCA Genetic Test
BRCA Genetic Test
Also called: BRCA Gene Mutation Analysis, BRCA1/2 Testing, BRCA Mutation Testing, BRCA Test, Breast Cancer Susceptibility Genes 1 and 2, Germline BRCA Testing
A BRCA gene test checks for certain changes (mutations) in your BRCA genes. BRCA1 and BRCA2 are called tumor suppressor genes. Certain BRCA mutations may put you at higher risk for getting breast, ovarian, prostate, and other cancers. Not everyone who has a harmful BRCA mutation will get cancer.
BRCA Genetic Test
Also called: BRCA Gene Mutation Analysis, BRCA1/2 Testing, BRCA Mutation Testing, BRCA Test, Breast Cancer Susceptibility Genes 1 and 2, Germline BRCA Testing
A BRCA gene test checks for certain changes (mutations) in your BRCA genes. BRCA1 and BRCA2 are called tumor suppressor genes. Certain BRCA mutations may put you at higher risk for getting breast, ovarian, prostate, and other cancers. Not everyone who has a harmful BRCA mutation will get cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative (normal) result means that the test didn't find any harmful changes in your BRCA genes. How this affects your cancer risk depends on whether you've already had cancer and whether a member of your family has a harmful BRCA variant.
Related conditions
A BRCA gene test uses a sample of your blood, saliva (spit), or cells from inside of your cheek to look for changes in your BRCA1 and BRCA2 genes that may increase your risk of cancer. Changes in your genes are called gene variants or mutations. Not all gene variants are harmful.
Genes are parts of DNA that you inherit from your parents. They carry information that controls what you look like and how your body works. BRCA genes repair damaged DNA in your cells and protect you from getting certain types of cancer. If you have a harmful variant in your BRCA genes, they may not work properly. This increases your risk of getting cancer.
The most common cancers linked to harmful BRCA variants are:
Breast cancer. BRCA is short for breast cancer gene. The increased risk for breast cancer mostly affects females. But the breast cancer risk for males who have a harmful BRCA variant is higher than for other males.
Ovarian cancer. This is cancer of the female reproductive glands where eggs form.
Prostate cancer. This is cancer of the male reproductive gland that makes fluid for semen.
Pancreatic cancer. This is cancer of the pancreas, an organ that helps you digest food and makes important hormones.
Not everyone who has a harmful variant in BRCA1 or BRCA2 will get cancer. And if you find out you have a harmful variant, you may be able to take steps to lower your risk and protect your health.
This test is used to find out if you have harmful changes in your BRCA1 or BRCA2 genes that increase your risk of getting certain cancers, especially breast, ovarian, prostate, and pancreatic cancer.
Harmful BRCA gene variants are rare. They affect only about 0.2 percent of the U.S. population. So, BRCA testing is not recommended for most people.
You and your family members are more likely to have a BRCA1 or BRCA2 variant if either side of your family has a strong history of breast or ovarian cancer. If you're concerned that you may have a harmful variant in the BRCA1 or BRCA2 gene, your health care provider or a genetic counselor can review your personal and family health history to see if you need this test.
In general, it's important to talk with a provider about BRCA testing if your personal or family health history includes:
Breast cancer, especially:
Before age 50
In both breasts
In a male
Triple negative breast cancer which has limited treatment options, including chemotherapy and/or surgery
Cancer of the ovaries, fallopian tubes (tubes connecting the ovaries to the uterus), or peritoneum (tissue that covers your belly organs).
Prostate cancer that spreads to other parts of the body (metastatic cancer).
Pancreatic cancer.
Ashkenazi (Eastern European) Jewish ancestry. BRCA variants are much more common in this group compared with the general population. They are also more common in people from other parts of Europe, including Iceland, Norway, and Denmark.
A relative already diagnosed with a harmful gene variant in BRCA1 or BRCA2.
When you think about your family health history, consider all breast, ovarian, prostate, and pancreatic cancers on both sides of your family. And consider the health of your grandparents, parents, aunts and uncles, siblings, half-siblings, nieces and nephews, and grandchildren.
A BRCA test can use either a sample of your blood, saliva, or a cheek swab.
For a blood test: A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For a saliva test: You'll spit into a container or use a cotton pad to soak up some saliva.
For a cheek swab: A health care professional will wipe the inside of your cheek with a small tool to remove some cells. You may have the option of doing it yourself.
An at-home test kit is available to buy without a prescription. It allows you to collect a saliva sample to send to a lab for testing. The test checks for the three most common harmful variants in BRCA genes. But there are more than 1000 known variants. So, a home test can't rule out the possibility that you have a variant. Ask your provider whether an at-home test is right for you.
For a blood test: You don't need any special preparations.
For a saliva test: A half hour before the test, you may need to stop eating, drinking, or smoking. Follow all the instructions your provider gives you or the instructions in an at-home kit.
For a cheek swab: You may be asked to rinse your mouth before the test.
With any type of genetic test, you may want to meet with a genetic counselor first to see if testing is right for you. Your counselor can explain the pros and cons of learning more about your cancer risk. After your test, a counselor can help with the medical and emotional impact that your results may have on you and your family.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
There are no risks linked to providing a saliva sample or having a cheek swab.
Your provider or genetic counselor will need to explain how your results affect your risk for certain cancers. That's because the meaning of your test results depends on the exact type of variant you have and your personal and family health history.
In general, your results may be reported using these terms:
A negative (normal) result means that the test didn't find any harmful changes in your BRCA genes. How this affects your cancer risk depends on whether you've already had cancer and whether a member of your family has a harmful BRCA variant.
An uncertain result may also be called a "variant of uncertain significance (VUS)". It means that a variant in your BRCA genes was found, but researchers don't know whether that variant causes cancer.
A positive result may also be called a "likely pathogenic variant." It means that you have a harmful gene variant that is known to increase the risk of certain cancers. But the test cannot tell whether you will develop cancer.
If your results show that you have a harmful variant in your BRCA genes, talk with your provider about ways to lower your cancer risk. You may discuss:
Your schedule for cancer screening tests. Should you get tested for cancer sooner and more often than usual? These are important questions for all adults who have a harmful BRCA variant.
Taking certain medicines and/or having surgery to reduce the risk of cancer. Surgery may include removing both breasts and/or the ovaries and fallopian tubes.
BRCA Genetic Test: MedlinePlus Medical Test [accessed on Dec 26, 2023]
BRCA Mutations: Cancer Risk and Genetic Testing Fact Sheet - National Cancer Institute [accessed on Dec 26, 2023]
BRCAssure BRCA1 and 2 Analysis [accessed on Dec 26, 2023]
BRCA Gene Mutation Testing - Testing.com. Nov 9, 2021 [accessed on Dec 26, 2023]
BRCA1 and BRCA2 gene testing: MedlinePlus Medical Encyclopedia [accessed on Dec 26, 2023]
Additional Materials (13)
Chances of Developing Breast Cancer by Age 70
Specific inherited mutations in the BRCA1 and BRCA2 genes increase the risk of breast and ovarian cancers.
Image by National Cancer Institute (NCI)
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BRCA-1 and BRCA-2 Genes, Breast Examination
Mammograms use low-dose X-rays to create images of the breast on film. Screening mammograms typically image the breast from above and from an angled side view. Yearly mammograms are recommended for women 40 and over. Women at high risk should have an MRI scan and a mammogram every year, beginning at age 30. Mammograms can also be used for diagnosis of cancer and to guide biopsy of suspicious lesions. The National Cancer Institute estimates that women with certain mutations in the BRCA1 and BRCA2 genes have a 60% lifetime risk of breast cancer, which is five times higher than the general population. Only 0.2% of women have these specific mutations. Women who test negative for high-risk mutations in the BRCA1 and BRCA2 genes still have a 12% lifetime risk of breast cancer and a 1.4% lifetime risk of ovarian cancer, which means the most of these cancers are caused by factors other than BRCA genes.
Image by TheVisualMD
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Breast Self-Exam (BSE)
When done correctly and regularly, breast self-exam (BSE) can help save lives. Women who perform BSE are more likely to be diagnosed with smaller tumors, and cancer is less likely to have spread to their underarm lymph nodes. An important part of BSE is self-awareness. Women should be aware of what their breasts normally feel and look like so that they notice any change, and they should bring that change to the attention of their doctor immediately.
Image by TheVisualMD
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BRCA: Breasts
In the 1990s, researchers discovered that certain inherited mutations of the genes increased a woman's risk of developing breast or ovarian cancer. But genes are not destiny; early detection, preventive surgery and drug therapies can also play roles.
Image by TheVisualMD
What is a BRCA Gene Mutation?
Video by Centers for Disease Control and Prevention (CDC)/YouTube
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
Video by JAMA Network/YouTube
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
Video by TheJAMAReport/YouTube
BRCA Genes and Breast Cancer
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Understanding BRCA Mutations and Risk
Video by Dr. Susan Love Foundation/YouTube
BRCA Genes
The BRCA genes are tumor suppressor genes pictured here on their respective chromosomes. BRCA 1 has the cytogenetic location 17q21 or the q arm of Chromosome 17 at position 21. BRCA 2 has the cytogenetic location 13q12.3 or the q arm of Chromosome 13 at position 12.3. Both genes produce proteins that help repair damaged DNA, keeping the genetic material of the cell stable. A damaged BRCA gene in either location can lead to increased risk of cancer, particularly breast or ovarian in women.
Image by Tessssa13/Wikimedia
BRCA-1 and BRCA-2 Genes, Breast Cancer
More than 225,000 cases of invasive breast cancer are diagnosed annually in the U.S. and 40,000 die from the disease. In recent years, however, great strides have been made in early diagnosis and treatment. Imaging techniques have been refined to spot ever-tinier tumors, biomarkers have been developed to reflect physiological changes produced by cancer, and genetic tests such as those for the BRCA1 and BRCA2 genes have been devised to identify increased familial risk of breast cancer. The majority of breast cancers start in the mammary ducts; most of the remainder arise in the lobules. Breast cancers are divided into in situ and invasive cancers. In situ cancers remain confined to the duct or gland where they began. Invasive cancers break through the walls of the duct or gland and penetrate into the surrounding tissue.
Image by TheVisualMD
BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern
In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved. For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to increase a person's chance of developing cancer. Although breast cancer is more common in women than in men, the mutated gene can be inherited from either the mother or the father.
Image by YassineMrabet / NIH
BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.
The breast cancer susceptibility genes BRCA-1 and BRCA-2 normally help prevent cancer by repairing damaged DNA. Certain inherited mutations in these genes, however, can impair this function and result in a greatly increased risk of breast cancer or ovarian cancer (there are hundreds of different BRCA mutations, but are very rare or not linked with an increased risk of cancer). Of 200,000 women diagnosed each year with breast cancer and 20,000 diagnosed with ovarian cancer, 5-10% are due to BRCA mutations.
Image by TheVisualMD
Chances of Developing Breast Cancer by Age 70
National Cancer Institute (NCI)
Sensitive content
This media may include sensitive content
BRCA-1 and BRCA-2 Genes, Breast Examination
TheVisualMD
Sensitive content
This media may include sensitive content
Breast Self-Exam (BSE)
TheVisualMD
Sensitive content
This media may include sensitive content
BRCA: Breasts
TheVisualMD
1:28
What is a BRCA Gene Mutation?
Centers for Disease Control and Prevention (CDC)/YouTube
4:39
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
JAMA Network/YouTube
2:20
BRCA1 and BRCA2 Mutation Testing in Young Women With Breast Cancer
TheJAMAReport/YouTube
3:12
BRCA Genes and Breast Cancer
Centers for Disease Control and Prevention (CDC)/YouTube
3:52
Understanding BRCA Mutations and Risk
Dr. Susan Love Foundation/YouTube
BRCA Genes
Tessssa13/Wikimedia
BRCA-1 and BRCA-2 Genes, Breast Cancer
TheVisualMD
BRCA1 and BRCA2 gene mutations: autosomal dominant (AD) inheritance pattern
YassineMrabet / NIH
BRCA1 and BRCA2 are genes that produce proteins that help repair damaged DNA.
TheVisualMD
Cancer Antigen 27.29 Test
Cancer Antigen 27.29 Test
Also called: CA 27-29 Tumor Marker, Truquant BR, CA-Breast, Cancer Antigen-Breast
The cancer antigen 27-29 (CA 27-29) test is mostly performed in women who have been diagnosed with breast cancer in order to monitor the response to treatment and to help watch for recurrence of the disease (return of cancer after treatment).
Cancer Antigen 27.29 Test
Also called: CA 27-29 Tumor Marker, Truquant BR, CA-Breast, Cancer Antigen-Breast
The cancer antigen 27-29 (CA 27-29) test is mostly performed in women who have been diagnosed with breast cancer in order to monitor the response to treatment and to help watch for recurrence of the disease (return of cancer after treatment).
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Use the slider below to see how your results affect your
health.
U/mL
38.6
Your result is Normal.
Having a normal CA 27-29 result doesn't mean you don't have breast cancer because some women with early breast cancer have a normal CA 27-29 level. This might also mean that your cancer is receding.
Related conditions
Cancer antigen 27-29 (CA 27-29) is a protein that can be found on the surface of certain cancer cells, especially in those of the breasts. Therefore, this antigen can be used as a tumor marker (meaning that if you have high levels of it, there is a good chance that you have cancer).
This test measures the levels of CA 27-29 in a sample of your blood.
Since not all women with breast cancer will have an increased CA 27-29 level, this test is not useful in all cases, and should not be used as a screening tool to detect breast cancer in healthy women.
Hence, your doctor might want to test your CA 27-29 levels to monitor your response to treatment after the diagnosis of breast cancer has already been made, and to control whether the disease has recurred.
A small amount of blood will be drawn from a vein in your arm by using a needle.
No fasting is needed. Your doctor may recommend you not to take multivitamins or dietary supplements containing biotin (vitamin B7) for 12 hours prior to the test.
Only the risks related to blood extraction, which are temporary discomfort, bruising, little bleeding, and risk of infection in the place where the needle was inserted.
Normal values of CA 27-29 are less than 38.6 units/mL. However, reference ranges can slightly vary from laboratory to laboratory.
Usually, the more advanced the breast cancer is, the higher the CA 27-29 level will be. The highest levels of CA 27-29 are often seen when the disease has already spread to other tissues (metastasized).
Besides breast cancer, CA 27-29 levels can be mild to moderately increased in other conditions, including:
Colon cancer
Pancreatic cancer
Ovarian cancer
Liver cancer
Liver disease (hepatitis, cirrhosis)
Kidney disorders
Benign breast disease
Ovary cysts
Having normal or elevated CA 27-29 levels does not discard or confirm the presence of cancer as this antigen should not be interpreted alone, but rather taking into consideration other tests and procedures.
Some women with breast cancer can have normal CA 27-29 levels because it may be too early in the disease process for this antigen to be detected, or the woman may fall in the category of individuals with advanced breast cancer whose tumor do not shed CA 27-29.
140293: Cancer Antigen (CA) 27.29 | LabCorp [accessed on Oct 02, 2018]
CA 27-29 - Health Encyclopedia - University of Rochester Medical Center [accessed on Oct 25, 2018]
Tumor Marker for Breast Cancer | OncoLink [accessed on Oct 25, 2018]
Cancer Antigen 27.29 Test for Breast Cancer [accessed on Oct 25, 2018]
Cancer Antigen 27.29 [accessed on Oct 25, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Multigene Tests for Breast Cancer
Multigene Tests for Breast Cancer
Also called: Molecular Tests for Breast Cancer Risk Assessment
Multigene tests are genomic tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back). The results are also used decide which treatments will work best for your cancer. There are many types of multigene tests.
Multigene Tests for Breast Cancer
Also called: Molecular Tests for Breast Cancer Risk Assessment
Multigene tests are genomic tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back). The results are also used decide which treatments will work best for your cancer. There are many types of multigene tests.
{"label":"Oncotype DX Breast Recurrence Score reference range","scale":"lin","step":1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Low risk","long":"Low risk","orientation":"horizontal"},"values":{"min":0,"max":26},"text":"A recurrence score between 0 and 25 means that the cancer has a low risk of recurrence. The benefits of chemotherapy likely will not outweigh the risks of side effects.","conditions":[]},{"flag":"abnormal","label":{"short":"High risk","long":"High risk","orientation":"horizontal"},"values":{"min":26,"max":100},"text":"A recurrence score between 26 and 100 means that the cancer has a high risk of recurrence. The benefits of chemotherapy are likely to be greater than the risks of side effects.","conditions":["Chemotherapy for breast cancer"]}],"value":13}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
26
Your result is Low risk.
A recurrence score between 0 and 25 means that the cancer has a low risk of recurrence. The benefits of chemotherapy likely will not outweigh the risks of side effects.
Related conditions
{"label":"MammaPrint reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"abnormal","label":{"short":"High risk","long":"High risk","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"This means that your risk of cancer recurrence is high (approximately 29%). Therefore, you may benefit from treatment with adjuvant chemotherapy.","conditions":["Breast cancer","Metastasis","Chemotherapy"]},{"flag":"normal","label":{"short":"Low risk","long":"Low risk","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"This means that your risk of cancer recurrence is low. Hence, you may not need chemotherapy and may be spared from the side effects this treatment produces.","conditions":["Breast cancer"]}],"value":1.5}[{"abnormal":0},{"normal":0}]
Use the slider below to see how your results affect your
health.
Your result is Low risk.
This means that your risk of cancer recurrence is low. Hence, you may not need chemotherapy and may be spared from the side effects this treatment produces.
Related conditions
Breast cancer
{"label":"EPclin risk score reference range","scale":"lin","step":0.0001,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Low risk","long":"Low risk","orientation":"horizontal"},"values":{"min":0,"max":3.3287},"text":"EndoPredict test results are given as an EPclin Risk score, a number between 1.1 and 6.2 that maps to a percentage risk of recurrence. An EPclin Risk score lower than 3.3287 (lower than a 10% risk of recurrence) is interpreted as the cancer having a low risk of recurrence.","conditions":[]},{"flag":"abnormal","label":{"short":"High risk","long":"High risk","orientation":"horizontal"},"values":{"min":3.3287,"max":6.2},"text":"EndoPredict test results are given as an EPclin Risk score, a number between 1.1 and 6.2 that maps to a percentage risk of recurrence. An EPclin Risk score higher than 3.3287 (higher than a 10% risk of recurrence) is interpreted as the cancer having a high risk of recurrence.","conditions":[]}],"value":1.6644}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
3.3287
Your result is Low risk.
EndoPredict test results are given as an EPclin Risk score, a number between 1.1 and 6.2 that maps to a percentage risk of recurrence. An EPclin Risk score lower than 3.3287 (lower than a 10% risk of recurrence) is interpreted as the cancer having a low risk of recurrence.
Related conditions
{"label":"Prosigna score reference range","scale":"lin","step":1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Low risk","long":"Low risk","orientation":"horizontal"},"values":{"min":0,"max":41},"text":"A low risk score means that the cancer has a low risk of recurrence. Therefore, you may receive hormone therapy alone, potentially avoiding chemotherapy and its side effects.","conditions":[]},{"flag":"borderline","label":{"short":"Intermediate risk","long":"Intermediate risk","orientation":"horizontal"},"values":{"min":41,"max":61},"text":"An intermediate risk score means that the risk of recurrence is not clear. You may need further testing to decide on a treatment plan that will work for you.","conditions":[]},{"flag":"abnormal","label":{"short":"High risk","long":"High risk","orientation":"horizontal"},"values":{"min":61,"max":100},"text":"A high risk score means that the cancer has a high risk of recurrence. Therefore, you may need a more aggressive treatment plan that includes both hormone therapy and chemotherapy.","conditions":["Hormone therapy for breast cancer","Chemotherapy for breast cancer"]}],"units":[{"printSymbol":"{score}","code":"{score}","name":"score"}],"value":21}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
{score}
41
61
Your result is Low risk.
A low risk score means that the cancer has a low risk of recurrence. Therefore, you may receive hormone therapy alone, potentially avoiding chemotherapy and its side effects.
Related conditions
{"label":"Breast cancer index reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Low risk","long":"Low risk","orientation":"horizontal"},"values":{"min":0,"max":5},"text":"A BCI score of 0 to 5 is classified as having a low risk of cancer coming back 5 to 10 years after diagnosis (late recurrence).","conditions":[]},{"flag":"borderline","label":{"short":"Intermediate risk","long":"Intermediate risk","orientation":"horizontal"},"values":{"min":5,"max":6.4},"text":"A BCI score of 5 to 6.4 is classified as having an intermediate or moderate risk of cancer coming back 5 to 10 years after diagnosis (late recurrence).","conditions":[]},{"flag":"abnormal","label":{"short":"High risk","long":"High risk","orientation":"horizontal"},"values":{"min":6.4,"max":20},"text":"A BCI score of greater than 6.4 is classified as having a high risk of cancer coming back 5 to 10 years after diagnosis (late recurrence).","conditions":[]}],"value":2.5}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
5
6.4
Your result is Low risk.
A BCI score of 0 to 5 is classified as having a low risk of cancer coming back 5 to 10 years after diagnosis (late recurrence).
Related conditions
Multigene testing is a type of genomic testing that looks for mutations in several genes at once in a sample of breast tumor. A multigene test is used to evaluate how likely it is that the cancer will grow, spread, or come back after treatment. They are also used to help decide which specific treatments would be beneficial for your cancer and which would not. Usually the tests are done on a sample of breast tumor that was already removed during a biopsy or surgery.
There are many types of multigene tests. The following multigene tests are available:
Oncotype DX: A laboratory test that analyzes the activity of 21 genes in the breast cancer tissue of women diagnosed with early-stage, estrogen receptor-positive (ER+), HER2-negative (HER2-) invasive breast cancer that has not spread to lymph nodes. This test helps predict whether the cancer will spread to other parts of the body. If the risk that the cancer will spread is high, chemotherapy may be given to lower the risk.
MammaPrint: A laboratory test in which the activity of 70 different genes is looked at in the breast cancer tissue of women who have early-stage invasive breast cancer that has not spread to lymph nodes or has spread to 3 or fewer lymph nodes. The activity level of these genes helps predict whether breast cancer will spread to other parts of the body or come back. If the test shows that the risk that the cancer will spread or come back is high, chemotherapy may be given to lower the risk.
EndoPredict: A laboratory test that analyzes the activity of 12 genes in breast cancer cells, linked to a 10-year risk of distant recurrence, in people newly diagnosed with early-stage, estrogen receptor-positive (ER+), HER2-negative (HER2-) breast cancer. It is used to assist in making decisions about whether chemotherapy or other treatments are needed after surgery. The test gives a score, known as an EPclin Risk score, that is reported as either low or high risk.
Prosigna: A laboratory test that analyzes the activity of 50 genes (known as the PAM50 gene signature) in the breast cancer tissue of postmenopausal women with early-stage breast cancer that is hormone-receptor positive (HR+) and HER-2 receptor negative (HER2-). It is to estimate the risk of cancer coming back in a part of the body away from the breast (distant recurrence) within 10 years after diagnosis. It may be also used to assist in deciding whether chemotherapy should be added to hormonal therapy and/or if hormonal therapy should be extended 5 more years (for a total of 10 years).
Breast Cancer Index: A laboratory test that analyzes the activity of 11 genes in breast cancer tissue of women who have early-stage hormone receptor–positive (HR+) breast cancer. It can help predict whether extending hormonal therapy 5 more years (for a total of 10 years) is likely to reduce the risk of the cancer coming back.
Breast Cancer Treatment - NCI. National Cancer Institute. Dec 6, 2023 [accessed on Dec 22, 2023]
Multigene Signature Result | EOD Data SEER*RSA [accessed on Dec 22, 2023]
A. Schneeweiss. Multigene Assays for Classification, Prognosis, and Prediction in
Breast Cancer: a Critical Review on the Background and Clinical
Utility. Geburtshilfe und Frauenheilkunde. Sep 1, 2013. doi:10.1055/s-0033-1350831 [accessed on Dec 22, 2023]
Sandro Barni. Multigene tests for breast cancer: the physician’s perspective. Oncotarget. Dec 22, 2023. doi:10.18632/oncotarget.27948 [accessed on Dec 22, 2023]
Screening and Testing for Breast Cancer [accessed on Dec 22, 2023]
MammaPrint Test
MammaPrint Test
Also called: 70-Gene Signature, MammaPrint Test for Early-Stage Invasive Breast Cancer
MammaPrint is a test that identifies the gene expression profile of 70 genes in a breast tumor sample in individuals with high clinical risk of cancer recurrence to help determine whether chemotherapy treatment is needed.
MammaPrint Test
Also called: 70-Gene Signature, MammaPrint Test for Early-Stage Invasive Breast Cancer
MammaPrint is a test that identifies the gene expression profile of 70 genes in a breast tumor sample in individuals with high clinical risk of cancer recurrence to help determine whether chemotherapy treatment is needed.
{"label":"MammaPrint reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"abnormal","label":{"short":"High risk","long":"High risk","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"This means that your risk of cancer recurrence is high (approximately 29%). Therefore, you may benefit from treatment with adjuvant chemotherapy.","conditions":["Breast cancer","Metastasis","Chemotherapy"]},{"flag":"normal","label":{"short":"Low risk","long":"Low risk","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"This means that your risk of cancer recurrence is low. Hence, you may not need chemotherapy and may be spared from the side effects this treatment produces.","conditions":["Breast cancer"]}],"value":1.5}[{"abnormal":0},{"normal":0}]
Use the slider below to see how your results affect your
health.
Your result is Low risk.
This means that your risk of cancer recurrence is low. Hence, you may not need chemotherapy and may be spared from the side effects this treatment produces.
Related conditions
Breast cancer
MammaPrint is a lab test that is used to help predict whether breast cancer will come back or spread to other parts of the body. The test looks at the activity level of 70 different genes in breast cancer tissue of people with early-stage (stage I, II, or IIIA) invasive breast cancer that is less than 5 cm and is either node-negative or has spread to 1 to 3 lymph nodes.
If the test shows that there is a high risk that the cancer will spread or come back, treatment with chemotherapy may be needed to lower the risk. Also called 70-gene signature.
Your doctor may want to use the MammaPrint test to help predict how high is your risk of breast cancer recurrence (come back) and to determine whether to use adjuvant chemotherapy or not.
Nevertheless, not everyone needs to get this test, and is mainly indicated in the following cases:
If you are under 55 years of age and you have a lymph node-negative breast cancer (N0).
If you have a high clinical risk of breast cancer recurrence, and your tumor is estrogen receptor-positive or progesterone receptor-positive, and HER2-negative.
After using anesthesia, a biopsy procedure (taking a small piece of the affected tissue) can be performed to collect a sample of the breast tumor. In other cases, the whole tumor may be surgically removed. Then, the collected piece will be sent to a pathologist for its evaluation.
You may be asked to refrain from eating, but usually, no further preparations are needed. Follow any instructions provided by your healthcare practitioner.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, and infection. You may also present a bad reaction to the anesthesia.
The MammaPrint test result can indicate that either you have:
High risk = Poor prognosis: this means that your risk of cancer recurrence is high. Therefore, you may benefit from treatment with adjuvant chemotherapy.
Low risk = Good prognosis: this means that your risk of cancer recurrence is low. Hence, you may not need chemotherapy and may be spared from the side effects this treatment produces.
MammaPrint should not be performed in individuals who have a low clinical risk for recurrence.
The MammaPrint result is not intended to be used as a diagnosis tool, nor to predict or monitor response to treatment in breast cancer.
Breast Cancer Treatment (PDQ®)—Patient Version - National Cancer Institute [accessed on Oct 03, 2018]
MammaPrint Test | Breastcancer.org [accessed on Oct 03, 2018]
MammaPrint Test | Agendia [accessed on Oct 03, 2018]
MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update | ASCO [accessed on Oct 03, 2018]
Validation and clinical application of MammaPrint® in patients with breast cancer - ScienceDirect [accessed on Oct 03, 2018]
Medscape: Medscape Access [accessed on Oct 03, 2018]
Identifying patients at high risk of breast cancer recurrence: strategies to improve patient outcomes [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Oncotype DX Test
Oncotype DX Test
Also called: 21-Gene Signature, Oncotype DX Tests for Early-Stage Breast Cancer and DCIS
Oncotype DX is a test that analyzes the activity of 21 genes in the breast cancer tissue of certain women with early-stage breast cancer and DCIS. The test measures how aggressive a woman’s breast cancer is and helps to decide if she should get chemotherapy after surgery.
Oncotype DX Test
Also called: 21-Gene Signature, Oncotype DX Tests for Early-Stage Breast Cancer and DCIS
Oncotype DX is a test that analyzes the activity of 21 genes in the breast cancer tissue of certain women with early-stage breast cancer and DCIS. The test measures how aggressive a woman’s breast cancer is and helps to decide if she should get chemotherapy after surgery.
{"label":"Oncotype DX Breast Recurrence Score reference range","scale":"lin","step":1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Low risk","long":"Low risk","orientation":"horizontal"},"values":{"min":0,"max":26},"text":"A recurrence score between 0 and 25 means that the cancer has a low risk of recurrence. The benefits of chemotherapy likely will not outweigh the risks of side effects.","conditions":[]},{"flag":"abnormal","label":{"short":"High risk","long":"High risk","orientation":"horizontal"},"values":{"min":26,"max":100},"text":"A recurrence score between 26 and 100 means that the cancer has a high risk of recurrence. The benefits of chemotherapy are likely to be greater than the risks of side effects.","conditions":["Chemotherapy for breast cancer"]}],"value":13}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
26
Your result is Low risk.
A recurrence score between 0 and 25 means that the cancer has a low risk of recurrence. The benefits of chemotherapy likely will not outweigh the risks of side effects.
Related conditions
{"label":"Oncotype DX Breast DCIS score reference range","scale":"lin","step":1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Low risk","long":"Low risk","orientation":"horizontal"},"values":{"min":0,"max":39},"text":"A recurrence score lower than 39 means that the DCIS has a low risk of recurrence. The benefit of radiation therapy is likely to be small and will not outweigh the risks of side effects.","conditions":[]},{"flag":"borderline","label":{"short":"Intermediate risk","long":"Intermediate risk","orientation":"horizontal"},"values":{"min":39,"max":54},"text":"A recurrence score between 39 and 54 means that the DCIS has an intermediate risk of recurrence. It\u2019s unclear whether the benefits of radiation therapy outweigh the risks of side effects.","conditions":[]},{"flag":"abnormal","label":{"short":"High risk","long":"High risk","orientation":"horizontal"},"values":{"min":54,"max":100},"text":"A recurrence score greater than 54 means that the DCIS has a high risk of recurrence, and the benefits of radiation therapy are likely to be greater than the risks of side effects.","conditions":["Radiation therapy"]}],"units":[{"printSymbol":"{score}","code":"{score}","name":"score"}],"value":20}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
{score}
39
54
Your result is Low risk.
A recurrence score lower than 39 means that the DCIS has a low risk of recurrence. The benefit of radiation therapy is likely to be small and will not outweigh the risks of side effects.
Related conditions
Oncotype DX is a gene expression profile that identifies the presence of 21 genes in a breast tumor sample (biopsy). This is done to help differentiate tumors which are likely to metastasize (spread to other tissues and organs) from tumors which are less aggressive and more likely to be cured with local treatment only.
Your doctor may want to use the Oncotype DX test to help predict how high is your risk of breast cancer recurrence and to determine whether you need adjuvant chemotherapy or not.
Not everyone needs to get this test, which is mainly indicated in the following cases:
If you have recently been diagnosed with early-stage (stage I or II) invasive breast cancer, especially if it has not yet spread to your lymph nodes.
If you have a high clinical risk of breast cancer recurrence, and your tumor is estrogen receptor-positive or progesterone receptor-positive (meaning that the cancer cells respond to treatment with hormones).
If you have recently been diagnosed with a type of breast cancer called ductal carcinoma in situ (DCIS), because it can help your doctor determine whether you need radiation therapy or not.
After using anesthesia, a biopsy procedure (taking a small piece of the affected tissue) can be performed to collect a sample of the breast tumor. In other cases, the whole tumor may be surgically removed. Then, the collected piece will be sent to a pathologist for its evaluation.
You may be asked to refrain from eating, but usually, no further preparations are needed. Follow any instructions provided by your healthcare practitioner.
Biopsies are considered to be low-risk procedures; however, as with most procedures, a biopsy also carries the risk of pain on the site, bleeding, and infection. You may also have a bad reaction to the anesthesia.
The Oncotype DX test assigns a recurrence score between 0 and 100, which correlates to the likelihood that your cancer returns within 10 years of diagnosis:
Recurrence score of 17 or lower: this means that your cancer has a low risk of recurrence. Hence, you may not need chemotherapy and can be spared from the side effects it produces.
Recurrence score between 18 and 30: this means that your cancer has an intermediate risk of recurrence. Chemotherapy might benefit some women in this range.
Recurrence score equal or higher than 31: this means that your risk of cancer recurrence is high. Therefore, you are likely to benefit from treatment with adjuvant chemotherapy.
If you have been diagnosed with ductal carcinoma in situ (DCIS), the results are different and are called a DCIS score:
Recurrence score of 38 or lower: this means that the DCIS has a low risk of recurrence. Hence, you may not need radiation therapy and can be spared from the side effects it produces.
Recurrence score between 39 and 54: this means that the DCIS has an intermediate risk of recurrence. Radiation therapy might benefit some women in this range.
Recurrence score higher than 54: this means that your risk of DCIS recurrence is high. Therefore, you are likely to benefit from treatment with adjuvant radiation therapy.
Oncotype DX Tests for Early-Stage Breast Cancer and DCIS [accessed on Dec 18, 2023]
BreastCancer.org: Oncotype DX Test [accessed on Sep 21, 2018]
Breast Cancer: Diagnosis | Cancer.Net [accessed on Sep 21, 2018]
Tumor Markers - National Cancer Institute [accessed on Sep 21, 2018]
Breast Cancer Gene Expression Tests [accessed on Sep 21, 2018]
Medscape: Medscape Access [accessed on Sep 21, 2018]
Oncotype DX Test for Breast Cancer [accessed on Sep 21, 2018]
Oncotype DX: Genomic Test to Inform Breast Cancer Treatment [accessed on Sep 21, 2018]
The impact of Oncotype DX testing on breast cancer management and chemotherapy prescribing patterns in a tertiary referral centre [accessed on Sep 21, 2018]
Additional Materials (7)
The Oncotype DX Test: Understanding Your Breast Cancer Tumor
Video by Breast Cancer Answers®/YouTube
DCIS (Stage 0) Breast Cancer and the Oncotype DX DCIS Score
Video by Oncotype IQ/YouTube
DCIS (Stage 0) Breast Cancer and the Oncotype DX DCIS Score
Video by Exact Sciences/Vimeo
What is DCIS Breast Cancer?
Video by Breast Cancer Answers®/YouTube
How Serious is DCIS Breast Cancer?
Video by Breast Cancer Answers®/YouTube
High-Grade DCIS, What Is It? -Dr. Jay Harness
Video by Breast Cancer Answers®/YouTube
Post Lumpectomy DCIS Probability, Can DCIS Return After A Lumpectomy?
Video by Breast Cancer Answers®/YouTube
1:52
The Oncotype DX Test: Understanding Your Breast Cancer Tumor
Breast Cancer Answers®/YouTube
2:53
DCIS (Stage 0) Breast Cancer and the Oncotype DX DCIS Score
Oncotype IQ/YouTube
3:03
DCIS (Stage 0) Breast Cancer and the Oncotype DX DCIS Score
Exact Sciences/Vimeo
3:29
What is DCIS Breast Cancer?
Breast Cancer Answers®/YouTube
3:49
How Serious is DCIS Breast Cancer?
Breast Cancer Answers®/YouTube
5:40
High-Grade DCIS, What Is It? -Dr. Jay Harness
Breast Cancer Answers®/YouTube
3:40
Post Lumpectomy DCIS Probability, Can DCIS Return After A Lumpectomy?
Breast Cancer Answers®/YouTube
Estrogen and Progesterone Receptor Tests
Estrogen and Progesterone Receptor Tests
Also called: Breast Cancer Hormone Receptor Status, ER/PR Testing, ER/PR IHC Testing, ERPR, Hormone Receptor (HR) Status
Receptors are proteins that attach to certain substances. Estrogen receptor/progesterone receptor tests look for receptors that attach to the hormones estrogen and/or progesterone in breast cancer cells. Breast cancers that have these receptors often respond well to some types of treatments.
Estrogen and Progesterone Receptor Tests
Also called: Breast Cancer Hormone Receptor Status, ER/PR Testing, ER/PR IHC Testing, ERPR, Hormone Receptor (HR) Status
Receptors are proteins that attach to certain substances. Estrogen receptor/progesterone receptor tests look for receptors that attach to the hormones estrogen and/or progesterone in breast cancer cells. Breast cancers that have these receptors often respond well to some types of treatments.
{"label":"ER\/PR status reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"ER\/PR-negative","long":"ER\/PR-negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"An ER\/PR-negative (also called a hormone receptor-negative or HR-) result means that your breast tumor does not have receptors for either estrogen (ER) or progesterone (PR). This means that you are not likely to benefit from treatment with hormonal therapy. About 25% of breast cancers have no hormone receptors.","conditions":[]},{"flag":"positive","label":{"short":"ER\/PR-positive","long":"ER\/PR-positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An ER\/PR-positive (also called a hormone receptor-positive or HR+) result means that your breast tumor has receptors for estrogen (ER) and\/or progesterone (PR). Therefore, you are likely to benefit from treatment with hormonal therapy. About 65% of breast cancers are both ER\/PR-positive.","conditions":["Hormone therapy for breast cancer"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is ER/PR-negative.
An ER/PR-negative (also called a hormone receptor-negative or HR-) result means that your breast tumor does not have receptors for either estrogen (ER) or progesterone (PR). This means that you are not likely to benefit from treatment with hormonal therapy. About 25% of breast cancers have no hormone receptors.
Related conditions
{"label":"Estrogen receptor status reference range","scale":"lin","step":1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative or normal result means that none or less than 1% of the cells stained positive for estrogen receptors. Cancers that have estrogen receptors are called ER-negative (or ER-) cancers. This result generally means that hormonal therapy will not be helpful in treating the cancer.","conditions":[]},{"flag":"borderline","label":{"short":"Low positive","long":"Low positive","orientation":"horizontal"},"values":{"min":1,"max":10},"text":"A low positive result means that less than 10% of the cells \u2014 or fewer than 1 in 10 \u2014 stained positive for estrogen receptors. These cancers may or may not respond to hormonal therapy.","conditions":[]},{"flag":"abnormal","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":10.1,"max":100},"text":"A positive or elevated result means that more than 10% \u2014 or more than 1 in 10 \u2014 stained positive for estrogen receptors. About 70%\u201380% of breast cancers in women and 90% in men are ER-positive (or ER+). This result generally means that hormonal therapy will be helpful in treating the cancer.","conditions":["Hormone therapy for breast cancer"]}],"units":[{"printSymbol":"%","code":"%","name":"percent"}],"value":1}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
%
1
10
Your result is Negative.
A negative or normal result means that none or less than 1% of the cells stained positive for estrogen receptors. Cancers that have estrogen receptors are called ER-negative (or ER-) cancers. This result generally means that hormonal therapy will not be helpful in treating the cancer.
Related conditions
{"label":"Progesterone receptor status reference range","scale":"lin","step":1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative or normal result means that none or less than 1% of the cells stained positive for progesterone receptors. Cancers that have progesterone receptors are called PR-negative (or PR-) cancers. This result generally means that hormonal therapy will not be helpful in treating the cancer.","conditions":[]},{"flag":"abnormal","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":100},"text":"A positive or elevated result means that more than 10% \u2014 or more than 1 in 10 \u2014 stained positive for progesterone receptors. Cancers that have progesterone receptors are called PR-positive (or PR+) cancers. This result generally means that hormonal therapy will be helpful in treating the cancer.","conditions":[]}],"units":[{"printSymbol":"%","code":"%","name":"percent"}],"value":1}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
%
1
Your result is Negative.
A negative or normal result means that none or less than 1% of the cells stained positive for progesterone receptors. Cancers that have progesterone receptors are called PR-negative (or PR-) cancers. This result generally means that hormonal therapy will not be helpful in treating the cancer.
Related conditions
Estrogen receptor/progesterone receptor (ER/PR) tests are used to help guide breast cancer treatment. Receptors are proteins that attach to certain substances. ER/PR tests look for receptors that attach to the hormones estrogen and progesterone in a sample of breast cancer tissue. Estrogen and progesterone play key roles in a woman's sexual development and reproductive functions. Men also have these hormones, but in much smaller amounts.
About 70 percent of all breast cancers in women have receptors that attach to estrogen and/or progesterone. About 80 percent to 90 percent of breast cancers in men have these receptors. Breast cancers with estrogen and/or progesterone receptors include the following types:
ER-positive (ER+): Cancers that have estrogen receptors (ER)
PR-positive (PR+): Cancers that have progesterone receptors (PR)
Hormone receptor-positive (HR+): Cancers that have one or both types of these receptors.
Breast cancers without ER or PR receptors are known as HR-negative (HR-).
ER/PR tests will show whether there are ER and/or PR receptors on your breast cancer cells. Test results are frequently referred to as the hormone receptor status. If your hormone receptor status shows you have one or both of these receptors on your cancer cells, you may respond well to certain types of treatments.
ER/PR tests are used to guide treatment for breast cancer patients.
You may need this test if you've been diagnosed with breast cancer. Knowing your hormone receptor status will help your health care provider decide how to treat it. If you have ER-positive, PR-positive, or HR-positive cancer, drugs that lower hormone levels or stop the hormones from fueling cancer growth can be very effective. If you have HR-negative cancer, these types of drugs won't work for you.
Your provider will need to take a sample of breast tissue in a procedure called a breast biopsy. There are three main types of breast biopsies:
Fine needle aspiration biopsy, which uses a very thin needle to remove a sample of breast cells or fluid
Core needle biopsy, which uses a larger needle to remove a sample
Surgical biopsy, which removes a sample in a minor, outpatient procedure
Fine needle aspiration and core needle biopsies usually include the following steps:
You will lay on your side or sit on an exam table.
A health care provider will clean the biopsy site and inject it with an anesthetic, so you won't feel any pain during the procedure.
Once the area is numb, the provider will insert either a fine aspiration needle or core biopsy needle into the biopsy site and remove a sample of tissue or fluid.
You may feel a little pressure when the sample is withdrawn.
Pressure will be applied to the biopsy site until the bleeding stops.
Your provider will apply a sterile bandage at the biopsy site.
In a surgical biopsy, a surgeon will make a small cut in your skin to remove all or part of a breast lump. A surgical biopsy is sometimes done if the lump can't be reached with a needle biopsy. Surgical biopsies usually include the following steps.
You will lie on an operating table. An IV (intravenous line) may be placed in your arm or hand.
You may be given medicine, called a sedative, to help you relax.
You will be given local or general anesthesia, so you won't feel pain during the procedure.
For local anesthesia, a health care provider will inject the biopsy site with medicine to numb the area.
For general anesthesia, a specialist called an anesthesiologist will give you medicine so you will be unconscious during the procedure.
Once the biopsy area is numb or you are unconscious, the surgeon will make a small cut into the breast and remove part or all of a lump. Some tissue around the lump may also be removed.
The cut in your skin will be closed with stitches or adhesive strips.
You won't need any special preparations if you are getting local anesthesia (numbing of the biopsy site). If you are getting general anesthesia, you will probably need to fast (not eat or drink) for several hours before surgery. Your surgeon will give you more specific instructions. Also, if you are getting a sedative or general anesthesia, be sure to arrange for someone to drive you home. You may be groggy and confused after you wake up from the procedure.
You may have a little bruising or bleeding at the biopsy site. Sometimes the site gets infected. If that happens, you will be treated with antibiotics. A surgical biopsy may cause some additional pain and discomfort. Your health care provider may recommend or prescribe medicine to help you feel better.
The results will show whether you have a hormone receptor-positive or negative type of cancer. If your hormone receptor status is positive, the test also shows the levels of estrogen and/or progesterone receptors. The higher the levels of receptors, the more effective certain medicines may be in treating your cancer. If your hormone receptor status is negative, these medicines will not be effective.
If you have questions about your results, talk to your health care provider.
HER2 testing is often done at the same time as ER/PR testing. That is because some hormone receptor cancers are also HER2-positive. HER2 is a protein found on the surface of all breast cells. Treatments for HER2-positive breast cancer can be very effective but are not effective for HER2-negative cancers.
Estrogen Receptor, Progesterone Receptor Tests: MedlinePlus Medical Test [accessed on Dec 22, 2023]
Breast Cancer Treatment - NCI. National Cancer Institute. Dec 6, 2023 [accessed on Dec 22, 2023]
Estrogen Receptor and Progesterone Receptor Test | Testing.com. Dec 3, 2021 [accessed on Dec 22, 2023]
Breast Cancer Hormone Receptor Status [accessed on Dec 22, 2023]
Immunohistochemical Test for Estrogen and Progesterone Receptors - Health Encyclopedia - University of Rochester Medical Center [accessed on Dec 22, 2023]
Additional Materials (6)
Hormone Receptor Positive Breast Cancer
Video by Dr. Susan Love Foundation/YouTube
Introduction to Cancer Biology (Part 1): Abnormal Signal Transduction
Video by Mechanisms in Medicine/YouTube
Breast cancer cells
Breast cancer cells typically have some combination of the estrogen receptor (ER), progesterone receptor (PR), and overexpressed HER2. But triple-negative breast cancer (TNBC) cells lack all three of these.
Image by National Cancer Institute
Sensitive content
This media may include sensitive content
Estrogen Receptor Assay
A culture dish containing frozen breast tissue. A technician's hands and test instruments are visible as well. This is used for analysis in estrogen receptor assay test. Results suggest whether removal of ovaries or use of antiestrogen drugs are likely to be effective.
Image by National Cancer Institute / Linda Bartlett (Photographer)
Using FFNP to “Light Up” Tumors
A new imaging test takes advantage of the fact that progesterone receptor levels in estrogen receptor-positive tumors go up in response to estrogen if the estrogen receptor is active. The test involves a PET scan that uses a radioactive tracer called FFNP, which binds specifically to progesterone receptors. When more progesterone receptors are present, the amount of FFNP taken up by tumor cells is greater and the signal from FFNP on a PET scan is stronger.
Image by National Cancer Institute
Circulating Progesterone May Increase Breast Cancer Risk
Research found that postmenopausal women with higher circulating progesterone levels experience a 16% increased risk of breast cancer. Additionally, associated risk from progesterone seemed to be modified by estradiol concentrations. Further research is needed to examine the relationship between progesterone and estradiol in breast cancer etiology and to validate these findings in diverse populations.
Image by National Cancer Institute (NCI)
2:57
Hormone Receptor Positive Breast Cancer
Dr. Susan Love Foundation/YouTube
7:47
Introduction to Cancer Biology (Part 1): Abnormal Signal Transduction
Mechanisms in Medicine/YouTube
Breast cancer cells
National Cancer Institute
Sensitive content
This media may include sensitive content
Estrogen Receptor Assay
National Cancer Institute / Linda Bartlett (Photographer)
Using FFNP to “Light Up” Tumors
National Cancer Institute
Circulating Progesterone May Increase Breast Cancer Risk
National Cancer Institute (NCI)
CA 15-3 Test
CA 15-3 Test
Also called: CA 15-3 Tumor Marker, Cancer Antigen 15-3, Cancer Antigen-Breast
CA 15-3 testing is mostly used in women who have been diagnosed with invasive breast cancer to monitor the response to treatment and to help watch for recurrence of the disease.
CA 15-3 Test
Also called: CA 15-3 Tumor Marker, Cancer Antigen 15-3, Cancer Antigen-Breast
CA 15-3 testing is mostly used in women who have been diagnosed with invasive breast cancer to monitor the response to treatment and to help watch for recurrence of the disease.
{"label":"CA 15-3 reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":30},"text":"Normal results vary based on the laboratory and the method used.","conditions":["Suggests limited tumor burden (less cancer is present)","Suggests breast-cancer patient is responding well to treatment"]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":30,"max":100},"text":"Usually, the more advanced the breast cancer is, the higher the CA 15-3 level will be. The highest levels of CA 15-3 often are seen when the disease has already spread to other tissues (metastasized).","conditions":["Localized breast cancer","Metastatic breast cancer","Colon cancer","Lung cancer","Pancreatic cancer","Ovarian cancer","Prostate cancer","Liver cancer","Liver disease (hepatitis, cirrhosis)","Benign breast disease"]}],"units":[{"printSymbol":"(i.U.)\/mL","code":"[IU]\/mL","name":"international unit per milliliter"}],"value":15}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
(i.U.)/mL
30
Your result is Normal.
Normal results vary based on the laboratory and the method used.
Related conditions
Suggests limited tumor burden (less cancer is present)
Suggests breast-cancer patient is responding well to treatment
Cancer antigen 15-3 (CA 15-3) is a protein that is produced by normal breast cells, and its production increases when cancerous breast tumors are present. Therefore, this antigen can be used as a tumor marker (meaning that if you have high levels of it, there is a good chance that you have cancer).
This test measures CA 15-3 levels in a sample of your blood.
Since not all women with breast cancer will have an increased CA 15-3 level, this test is not useful in all cases and should not be used as a screening tool to detect breast cancer in healthy women.
Hence, your doctor might want to test your CA 15-3 levels to monitor your response to treatment after the diagnosis of advanced breast cancer has already been made and to control whether the disease has recurred.
A small amount of blood will be drawn from a vein in your arm by using a needle.
No fasting is needed. Your doctor may recommend you not to take multivitamins or dietary supplements containing biotin (vitamin B7) for 12 hours prior to the test.
Only the risks related to blood extraction, which are temporary discomfort, bruising, little bleeding, and risk of infection in the place where the needle was inserted.
Normal values of CA 15-3 are less than 30 units/mL. However, reference ranges can slightly vary from laboratory to laboratory.
Usually, the more advanced the breast cancer is, the higher the CA 15-3 level will be. The highest levels of CA 15-3 often are seen when the disease has already spread to other tissues (metastasized).
Nevertheless, besides breast cancer, CA 15-3 levels can be mild to moderately increased in other conditions, including:
Colon cancer
Lung cancer
Pancreatic cancer
Ovarian cancer
Prostate cancer
Liver cancer
Liver disease (hepatitis, cirrhosis)
Benign breast disease
Having normal or elevated CA 15-3 levels does not discard or confirm the presence of cancer as this antigen should not be interpreted alone, but rather taking into consideration other tests and procedures.
Some women with breast cancer can have normal CA 15-3 levels because it may be too early in the disease process for this antigen to be detected, or the woman may fall in the category of individuals with advanced breast cancer whose tumor do not shed CA 15-3.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Cancer
Cancer is a group of diseases characterized by uncontrolled cell growth.
Image by National Human Genome Research Institute (NHGRI)
CA 15-3: Breast Tumor Size When Found by Imaging or Touch
The foods in the image represent the average size of breast cancer tumors when discovered by mammogram, by regular breast self-exam, or by accident. Breast calcifications too small to be felt can be seen as white spots on a mammogram, as shown by the sesame seeds (far left). The blueberry represents the average size of a lump detected by routine mammogram (.43 inches/1.1 cm). The hazelnut shows average tumor size when discovered in a first mammogram (.59 inches/1.5 cm). The grape represents average tumor size when detected by regular breast self-exam (.83 inches/2.1 cm), and the strawberry shows average tumor size when found accidentally (1.42 inches/3.6 cm).
Image by TheVisualMD
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This media may include sensitive content
CA 15-3: Breast Tissue and Lymph Node Network
Breast tissue isn't found only in the breast itself: It extends from the breastbone to the armpit, and from below the collarbone to the level of the sixth or seventh rib. The breast contains lymphatic vessels that drain into a network of lymph nodes. These nodes are located around the edges of the breast, in the underarm area, and near the collarbone. Breast cancer often spreads first to the underarm lymph nodes. That's why breast self-examination should include feeling and checking the appearance of the underarm area, with arm only slightly raised.
Image by TheVisualMD
What Are Tumor Markers for Breast Cancer?
Video by Breast Cancer Answers®/YouTube
Biomarker Testing
Video by Merck/YouTube
Cancer
National Human Genome Research Institute (NHGRI)
CA 15-3: Breast Tumor Size When Found by Imaging or Touch
TheVisualMD
Sensitive content
This media may include sensitive content
CA 15-3: Breast Tissue and Lymph Node Network
TheVisualMD
2:42
What Are Tumor Markers for Breast Cancer?
Breast Cancer Answers®/YouTube
1:36
Biomarker Testing
Merck/YouTube
CellSearch® Circulating Tumor Cell (CTC) Test
CellSearch® Circulating Tumor Cell (CTC) Test
Also called: CellSearch CTC Test, Circulating Tumor Cells
CellSearch CTC is a blood test, known as a liquid biopsy, that can help doctors predict the likely outcome for people with metastatic breast, prostate or colon cancer. The test detects circulating tumor cells (CTC) that have been released into the blood. Many CTCs in the blood are a sign of an unfavorable prognosis.
CellSearch® Circulating Tumor Cell (CTC) Test
Also called: CellSearch CTC Test, Circulating Tumor Cells
CellSearch CTC is a blood test, known as a liquid biopsy, that can help doctors predict the likely outcome for people with metastatic breast, prostate or colon cancer. The test detects circulating tumor cells (CTC) that have been released into the blood. Many CTCs in the blood are a sign of an unfavorable prognosis.
{"label":"Circulating Tumor Cells Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"CTCs\/7.5 mL","code":"{CTCs}\/(7.5.mL)","name":"circulating tumor cells per 7.5 mL blood"}],"items":[{"flag":"normal","label":{"short":"Favorable","long":"Favorable","orientation":"horizontal"},"values":{"min":0,"max":5},"text":"Less than 5 CTCs detected in the blood indicates favorable prognosis.","conditions":[]},{"flag":"abnormal","label":{"short":"Unfavorable","long":"Unfavorable","orientation":"horizontal"},"values":{"min":5,"max":10},"text":"5 or more CTCs detected in the blood indicates unfavorable prognosis.","conditions":[]}],"value":2.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
CTCs/7.5 mL
5
Your result is Favorable.
Less than 5 CTCs detected in the blood indicates favorable prognosis.
Related conditions
Liquid Biopsy: What It Is & Procedure Details. Cleveland Clinic [accessed on Nov 14, 2023]
CellSearch Circulating Tumor Cells, Colon [accessed on Oct 04, 2018]
CellSearch Circulating Tumor Cells, Prostate [accessed on Oct 04, 2018]
CellSearch Circulating Tumor Cells, Breast [accessed on Oct 04, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
HER2 Tumor Marker Testing
HER2 Tumor Marker Testing
Also called: Human Epidermal Growth Factor Receptor 2, HER2, HER2 Gene, ERBB2 Amplification, HER2 Overexpression, HER2/neu Tests
HER2 genes there are and how much HER2 protein is made in a sample of tissue. These tests can help guide treatment choices for certain cancers of the breast, stomach, and esophagus.
HER2 Tumor Marker Testing
Also called: Human Epidermal Growth Factor Receptor 2, HER2, HER2 Gene, ERBB2 Amplification, HER2 Overexpression, HER2/neu Tests
HER2 genes there are and how much HER2 protein is made in a sample of tissue. These tests can help guide treatment choices for certain cancers of the breast, stomach, and esophagus.
{"label":"HER2 overexpression reference range","scale":"lin","step":1,"hideunits":false,"items":[{"flag":"negative","label":{"short":"HER2-negative","long":"HER2-negative","orientation":"horizontal"},"values":{"min":0,"max":2},"text":"0 (zero) or 1+ means that your cancer cells don't have too much HER2 protein. Your cancer is HER2-negative and will not respond to HER2-targeted therapy. Your provider will discuss other treatment options.","conditions":[]},{"flag":"borderline","label":{"short":"Equivocal","long":"Equivocal","orientation":"horizontal"},"values":{"min":2,"max":3},"text":"2+ means that the amount of HER2 protein is borderline. This may be reported as \"equivocal.\" It means the test result is not clear. You may need to have a different type of HER2 tumor marker test. The test may be done on the same tissue sample, or you may need to provide a new sample.","conditions":[]},{"flag":"positive","label":{"short":"HER2-positive","long":"HER2-positive","orientation":"horizontal"},"values":{"min":3,"max":5},"text":"3+ means that your cancer cells have too much HER2 protein. Your cancer is HER2-positive and is likely to respond to HER2-targeted therapy.","conditions":["HER2-targeted therapy"]}],"units":[{"printSymbol":"{score}","code":"{score}","name":"score"}],"value":1}[{"negative":0},{"borderline":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
{score}
2
3
Your result is HER2-negative.
0 (zero) or 1+ means that your cancer cells don't have too much HER2 protein. Your cancer is HER2-negative and will not respond to HER2-targeted therapy. Your provider will discuss other treatment options.
Related conditions
{"label":"HER2\/neu gene status reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative or not detected result means that you don't have too many <em>HER2<\/em> genes in your cancer cells. HER2-targeted therapy won't help your cancer, so your provider will discuss other treatment options.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A positive or detected result means that your cancer cells have too many <em>HER2<\/em> genes. HER2-targeted therapy is likely to help your cancer.","conditions":["HER2-targeted therapy"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
HER2 genes in your cancer cells. HER2-targeted therapy won't help your cancer, so your provider will discuss other treatment options.
Related conditions
Tumor marker tests look for substances, called tumor markers, that are often made by cancer cells or normal cells in response to cancer. The test results can provide important information, such as how fast a cancer may grow and which treatments are most likely to work.
HER2 is a type of tumor marker. It stands for human epidermal growth factor receptor 2. It's also called HER2/neu. HER2 is a protein involved in normal cell growth. Some types of cancer cells make larger than normal amounts of HER2, including certain cancers of the breast, stomach, and esophagus.
Cancers with large amounts of HER2 protein tend to grow quickly and spread to other parts of the body. Certain medicines, called HER2 targeted therapy, can block or slow HER2 proteins and help control these cancers. But these medicines won't help cancers that don't have high levels of HER2 proteins. So, HER2 tumor marker testing is necessary to find out if targeted therapy will be helpful.
A HER2 tumor marker test usually uses a sample of tumor tissue to measure either:
The amount of HER2 protein on the surface of cancer cells
How many copies of the HER2 gene are inside the cancer cells
Genes are parts of DNA in your cells that you inherit from your parents. HER2 genes have instructions for making the HER2 protein. Normally, you have two HER2 genes in each cell, one from each parent. But certain cancers have extra copies of the HER2 gene, which leads to too much HER2 protein on the cancer cells.
A HER2 tumor marker test looks to see whether certain cancers are:
HER2 positive, which means the cancer has high levels of the HER2 protein or HER2 genes. These cancers are likely to respond to HER2 targeted therapy.
HER2 negative, which means your cancer cells have little to no HER2 protein or a normal number of HER2 genes. This type of cancer may grow more slowly than HER2-positive cancer. It is also less likely to come back after treatment or spread to other parts of the body. HER2 targeted therapy will not work for this type of cancer, but other treatment options may help.
There are different HER2 tumor marker tests for checking HER2 proteins and HER2 genes. Usually, a protein test is done first because those tests are faster and less expense. Blood tests to measure HER2 usually aren't recommended. That's because it's not clear how blood test results can plan cancer treatment.
HER2 tumor marker tests are mostly used to find out whether certain cancers are HER2 positive or negative. This information shows how fast cancer may grow and whether medicine to target HER2 proteins may be helpful.
HER2 tumor marker testing is mainly used for cancers that start in the:
Breast (most common)
Stomach
Esophagus
Ovaries
Bladder
Pancreas
You may need HER2 tumor marker testing to help guide cancer treatment decisions if you have:
Breast cancer that has:
Just been diagnosed and is growing in the normal breast tissue around the tumor. This is called "invasive" cancer.
Spread beyond your breast and is growing in other parts of your body. This is called metastatic cancer. The cancer growing outside of your breast should be tested to see if it's HER2 positive, even if your breast tumor was already tested.
Come back after treatment, usually after a period of time when no cancer could be found in your body. This is called recurrent cancer. The new tumor should be tested to see if it's HER2 positive even if your first tumor was tested. That's because cancer cells can change over time.
Stomach or esophageal cancer that:
Can't be removed using surgery.
Has come back after treatment.
Cancer of the pancreas, bladder, ovaries, or certain other cancers that may have high levels of HER2 which may be treated with medicines that target HER2.
Most HER2 testing uses a sample of tumor tissue. The tissue will be removed during a procedure called a biopsy. There are many ways to do a biopsy. The type of biopsy you have depends on where the tumor is located. In general, a biopsy may be done using:
A hollow needle inserted through your skin. Imaging tests, such as ultrasound, may be used to guide the needle:
A fine needle aspiration biopsy uses a very thin needle to remove a sample of cells and/or fluid.
A core needle biopsy uses a larger needle to remove a sample.
Surgery. A surgeon may remove a sample of the tumor (incisional biopsy) or the entire tumor (excisional biopsy).
Endoscopy. This procedure uses a scope to look inside your body. Special tools may be used with a scope to remove a tissue sample. An endoscopy may be used for a biopsy of a tumor in your stomach or esophagus.
Preparations for your test depend on how your tissue sample will be taken. Ask your health care provider how to prepare for your test.
If you are getting medicine to relax or sleep during the procedure, you will probably need to fast (not eat or drink) for several hours before surgery. You will also need to have someone take you home, because you may be sleepy after the procedure.
Risks depend on how your tissue sample is taken. In general, if you are having a biopsy, you may have a little bruising or bleeding where the tissue was removed. Ask your provider to explain any risks from the test you're having.
The results of HER2 tumor marker tests are reported differently, depending on the type of test you had. The main HER2 tumor marker tests are:
IHC (immunohistochemistry staining assay) to measure the amount of HER2 protein on cancer cells
FISH (fluorescence in situ hybridization) to check for extra copies of HER2 genes in cancer cells
IHC test results for cancer of the breast, stomach, or esophagus show the amount of HER2 protein as a score:
0 (zero) or 1+ means that your cancer cells don't have too much HER2 protein. Your cancer is HER2 negative and will not respond to HER2 targeted therapy. Your provider will discuss other treatment options.
2+ means that the amount of HER2 protein is borderline. This may be reported as "equivocal." It means the test result is not clear. You may need to have a different type of HER2 tumor marker test. The test may be done on the same tissue sample, or you may need to provide a new sample.
3+ means that your cancer cells have too much HER2 protein. Your cancer is HER2 positive and is likely to respond to HER2 targeted therapy.
FISH results for cancer of the breast, stomach, or esophagus will be reported as either:
HER2 negative, which means that you don't have too many HER2 genes in your cancer cells. HER2 targeted therapy won't help your cancer, so your provider will discuss other treatment options.
HER2 positive, which means that your cancer cells have too many HER2 genes. HER2 targeted therapy is likely to help your cancer.
Talk with your provider to learn what your results mean for your treatment.
HER2 Tumor Marker Test: MedlinePlus Medical Test [accessed on Dec 22, 2023]
Breast Cancer Treatment - NCI. National Cancer Institute. Dec 6, 2023 [accessed on Dec 22, 2023]
Additional Materials (6)
This browser does not support the video element.
Diagnosing Breast Cancer
Breast imaging and early detection of breast cancer have evolved immensely over the last 25 years, leading to increased survival rates and improved quality of life for millions of women with breast cancer. This video takes you through the process of screening and diagnosis using various imaging modalities, including mammogram, ultrasound and MRI.
Video by TheVisualMD
DNA Methylation and Cancer
Video by Armando Hasudungan/YouTube
How to Recognize Breast Cancer Symptoms
Video by Howcast/YouTube
Sensitive content
This media may include sensitive content
Human Epidermal Growth Factor Receptor 2 (HER2): Aggressive Breast Cancers
Most breast cancers begin in the lobules or ducts of the breast, which produce breast milk and carry it to the nipples after pregnancy. Invasive cancers spread outside of the lobules and ducts and penetrate into the surrounding breast tissue. From there, cancer cells may travel to lymph nodes in the armpit area. In stage IV breast cancer, cancer cells have spread into other parts of the body, such as the lungs or bones. HER2-positive breast cancer is aggressive and is likely to spread quickly. It is also resistant to hormone therapy. However, treatment with the drugs trastuzumab and/or lapatinib may help women who test positive for HER2.
Image by TheVisualMD
Human Epidermal Growth Factor Receptor 2 (HER2): Her2/neu Receptors on Cell Surface
HER2 is a cell surface receptor that responds to chemicals called growth factors. Normally, there are few HER2 receptors on the surface of the cell. But when a mutated gene causes the overproduction of HER2, it can spur the growth of tumors. The test called immunohistochemistry (IHC) measures the amount of HER2 protein present and can help with determining the patient's prognosis.
Image by TheVisualMD
Human Epidermal Growth Factor Receptor 2 (HER2): Breast Cancer and HER2
In about one out of five breast cancers, a protein called human epidermal growth factor receptor 2 (HER2) is overproduced due to a gene mutation. High levels of HER2 on cell surfaces spur the growth of cancerous tumors and also make the cancer less responsive to hormone therapy. This type of breast cancer usually occurs in younger women.
Image by TheVisualMD
4:47
Diagnosing Breast Cancer
TheVisualMD
5:17
DNA Methylation and Cancer
Armando Hasudungan/YouTube
3:01
How to Recognize Breast Cancer Symptoms
Howcast/YouTube
Sensitive content
This media may include sensitive content
Human Epidermal Growth Factor Receptor 2 (HER2): Aggressive Breast Cancers
TheVisualMD
Human Epidermal Growth Factor Receptor 2 (HER2): Her2/neu Receptors on Cell Surface
TheVisualMD
Human Epidermal Growth Factor Receptor 2 (HER2): Breast Cancer and HER2
TheVisualMD
VEGF (Vascular Endothelial Growth Factor) Test
VEGF (Vascular Endothelial Growth Factor) Test
Also called: VEGF, VEG Factor, Vascular Permeability Factor, VPF
This test measures the amount of vascular endothelial growth factor (VEGF) in a sample of your blood. VEGF is a substance made by cells that stimulates new blood vessel formation. High levels of VEGF have been linked to POEMS syndrome and many types of cancer.
VEGF (Vascular Endothelial Growth Factor) Test
Also called: VEGF, VEG Factor, Vascular Permeability Factor, VPF
This test measures the amount of vascular endothelial growth factor (VEGF) in a sample of your blood. VEGF is a substance made by cells that stimulates new blood vessel formation. High levels of VEGF have been linked to POEMS syndrome and many types of cancer.
{"label":"VEGF-A (plasma) reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":115},"text":"VEGF expression is regulated by hypoxia, with levels increasing when cells detect an environment low in oxygen.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":115,"max":300},"text":"Elevated VEGF is highly specific for POEMS syndrome \u2014 VEGF levels reflect disease activity, falling with treatment and rising with disease progression or relapse. Increased expression of VEGF has been associated with poorer prognosis in people with certain cancers.","conditions":["POEMS syndrome","Colon cancer","Stomach cancer","Pancreatic cancer","Breast cancer","Ovarian cancer","Prostate cancer","Liver cancer","Oral squamous cell cancer","Bone cancer","Melanoma"]}],"units":[{"printSymbol":"pg\/mL","code":"pg\/mL","name":"picogram per milliliter"}],"value":57.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
pg/mL
115
Your result is Normal.
VEGF expression is regulated by hypoxia, with levels increasing when cells detect an environment low in oxygen.
Related conditions
{"label":"VEGF-A (serum) reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":62,"max":707},"text":"VEGF expression is regulated by hypoxia, with levels increasing when cells detect an environment low in oxygen. Serum VEGF levels are significantly higher than plasma levels. This is thought to reflect the fact that VEGF is released into the serum from platelets as part of the clotting process.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":707,"max":1500},"text":"Elevated VEGF is highly specific for POEMS syndrome \u2014 VEGF levels reflect disease activity, falling with treatment and rising with disease progression or relapse. Increased expression of VEGF has been associated with poorer prognosis in people with certain cancers.","conditions":["POEMS syndrome","Colon cancer","Stomach cancer","Pancreatic cancer","Breast cancer","Ovarian cancer","Prostate cancer","Liver cancer","Oral squamous cell cancer","Bone cancer","Melanoma"]}],"units":[{"printSymbol":"pg\/mL","code":"pg\/mL","name":"picogram per milliliter"}],"value":384.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
pg/mL
707
Your result is Normal.
VEGF expression is regulated by hypoxia, with levels increasing when cells detect an environment low in oxygen. Serum VEGF levels are significantly higher than plasma levels. This is thought to reflect the fact that VEGF is released into the serum from platelets as part of the clotting process.
Related conditions
Vascular Endothelial Growth Factor - Health Encyclopedia - University of Rochester Medical Center [accessed on Jan 24, 2024]
117006: Vascular Endothelial Growth Factor, Plasma | Labcorp [accessed on Jan 24, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (11)
Vascular Endothelial Growth Factor | VEGF |
Video by BMH learning/YouTube
Anti-VEGF injections for ROP
Video by EyeSmart — American Academy of Ophthalmology/YouTube
Having an anti VEGF injection | Reg's story
Video by RNIB/YouTube
Anti VEGF Treatment for PDR
Video by EyeSmart — American Academy of Ophthalmology/YouTube
VEGF Trap
Video by Mitul Shah/YouTube
Intravitreal Injection of Anti-VEGF
Video by Stephen Odaibo/YouTube
Vascular endothelial growth factor (VEGF) - Animated Atlas of Breast and Gastric Cancer
Video by Focus Medica/YouTube
VEGF in Alzheimer's disease
Video by VJDementia/YouTube
Anti-VEGF intravitreal injection
Video by Waterloo Regional Eye Program/YouTube
Anti VEGF Treatment for AMD
Video by EyeSmart — American Academy of Ophthalmology/YouTube
Wet AMD: Understanding the Role of Anti-VEGF Therapy
Video by AJMCtv/YouTube
2:49
Vascular Endothelial Growth Factor | VEGF |
BMH learning/YouTube
0:44
Anti-VEGF injections for ROP
EyeSmart — American Academy of Ophthalmology/YouTube
2:54
Having an anti VEGF injection | Reg's story
RNIB/YouTube
0:49
Anti VEGF Treatment for PDR
EyeSmart — American Academy of Ophthalmology/YouTube
1:05
VEGF Trap
Mitul Shah/YouTube
2:19
Intravitreal Injection of Anti-VEGF
Stephen Odaibo/YouTube
0:46
Vascular endothelial growth factor (VEGF) - Animated Atlas of Breast and Gastric Cancer
Focus Medica/YouTube
1:48
VEGF in Alzheimer's disease
VJDementia/YouTube
2:50
Anti-VEGF intravitreal injection
Waterloo Regional Eye Program/YouTube
0:15
Anti VEGF Treatment for AMD
EyeSmart — American Academy of Ophthalmology/YouTube
6:19
Wet AMD: Understanding the Role of Anti-VEGF Therapy
AJMCtv/YouTube
TP53 Genetic Test
TP53 Genetic Test
Also called: TP53 Mutation Analysis; TP53 Gene Sequencing, TP53 Full Gene Analysis; TP53 Somatic Mutation
A TP53 genetic test looks for a mutation in the gene TP53 (tumor protein 53). TP53 is a type of gene called a tumor suppressor. If you have the mutation (acquired or inherited), you are at higher risk for getting cancer. The test can help choose treatment for people who have cancer.
TP53 Genetic Test
Also called: TP53 Mutation Analysis; TP53 Gene Sequencing, TP53 Full Gene Analysis; TP53 Somatic Mutation
A TP53 genetic test looks for a mutation in the gene TP53 (tumor protein 53). TP53 is a type of gene called a tumor suppressor. If you have the mutation (acquired or inherited), you are at higher risk for getting cancer. The test can help choose treatment for people who have cancer.
{"label":"TP53 mutations reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Your result is negative for known pathogenic mutations in the TP53 gene.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"Your result shows that you have a pathogenic mutation or a variant that is likely pathogenic in the TP53 gene. People with inherited TP53 mutations have Li-Fraumeni syndrome (LFS). Acquired TP53 mutations are much more common.","conditions":["Li-Fraumeni syndrome (LFS)","Soft tissue sarcoma","Osteosarcoma","Female breast cancer","Brain tumors","Adrenocortical carcinoma (ACC)","Leukemia"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
Your result is negative for known pathogenic mutations in the TP53 gene.
Related conditions
A TP53 genetic test usually uses a sample of your blood to look for changes in the tumor protein 53 gene, or TP53 for short. Changes in your genes are also called gene variants or mutations. Changes in the TP53 gene are linked to many different types of cancer.
Genes are parts of DNA in your cells that you inherit from your parents. You inherit two copies of each gene, one from each parent. Genes carry information that controls what you look like and how your body works.
TP53 is a type of gene called a "tumor suppressor." Tumor suppressor genes provide instructions for making proteins that control how fast your cells grow and divide to make new cells. TP53 proteins also help stop the growth of abnormal cells.
If you have certain changes in a TP53 gene, the gene or the protein it makes may not work well or may stop working completely. As a result, your cells may grow out of control, which can lead to tumors and cancer. Changes in your TP53 gene can be acquired or inherited.
Acquired changes in your genes develop at some time after you're born. Most changes in TP53 genes are acquired changes. More than half of all adult cancers involve a change in this gene.
Acquired changes in your TP53 gene:
Can happen if your cells make a mistake when they divide to make new cells
Can happen if you're exposed to substances that cause cancer
Show up only in certain types of cells
Usually aren't in sperm or egg cells, so you can't pass them down to children
Inherited changes in your genes are changes that you're born with. They show up in all the cells in your body, including your egg or sperm cells. That means they can be passed down to your children. Inherited changes in the TP53 gene cause a rare genetic condition called Li-Fraumeni syndrome (LFS). It increases your risk of developing certain types of cancer. Cancers that are linked to Li-Fraumeni syndrome commonly happen in the breast, bone, or muscles.
A TP53 genetic test is used to look for changes in your TP53 genes. It's not a routine test. It is often used to:
Help choose treatment for people who have cancer
Check for inherited changes in the TP53 gene in people who have a personal or family history of cancers that may be linked to Li-Fraumeni syndrome
You may need a TP53 test if you:
Have been diagnosed with cancer. The test can check whether an acquired change in your TP53 gene is causing your cancer. This information can help your provider select the right treatment and predict how your cancer may behave over time.
Have a personal and/or family health history that suggests you may have inherited Li-Fraumeni syndrome. Providers may use different sets of guidelines to decide who needs to be tested for Li-Fraumeni syndrome. Talk with your provider or a genetic counselor about testing if you or your family members have had cancers that are closely linked to Li-Fraumeni syndrome. These cancers include:
Osteosarcoma, a form of bone cancer
Soft tissue sarcoma, cancer of the muscle and connective tissues
Breast cancer
Brain tumors
Acute (sudden) leukemia
Adrenal cortical carcinoma, a type of adrenal gland cancer
A TP53 test is often done on a sample of blood. Tissue from a tumor or bone marrow may sometimes be used instead. Bone marrow is a spongy tissue found inside most bones.
For a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
For tumor tissue testing, tissue is removed during a procedure called a biopsy. A biopsy may be done in different ways depending on where the tumor is located. A provider may use a hollow needle or surgery to take a tissue sample from a tumor.
For a bone marrow test, a provider usually takes a sample from the back of your hip bone. You will be given an injection (shot) of medicine to numb the area. You may also be given medicine to help you relax or sleep.
A bone marrow test has two parts that are usually done one after the other:
For a bone marrow aspiration, the provider pushes a hollow thin needle into the bone. A sample of bone marrow fluid is removed using a syringe attached to the needle.
For a bone marrow biopsy, the provider inserts a larger hollow needle into the bone and twists the needle to take out a small piece of bone marrow tissue.
The procedure takes only a few minutes. You may feel pressure or a brief, sharp pain when the samples are being taken. Afterwards, the area will be bandaged. You'll stay lying down for about 15 minutes to make sure the bleeding stops. You may need to stay longer if you had medicine to relax or sleep.
A blood test usually doesn't require any preparation. If you're having a tissue biopsy or a bone marrow test, ask your provider how you should prepare. If you will be given medicine to relax or sleep, plan to have someone take you home after the test in case you are drowsy.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
After a tissue biopsy or a bone marrow test, you may have some soreness where the sample was taken. This usually goes away in a few days. If you need pain relief, talk with your provider.
If you have cancer and your results show you have an acquired change in your TP53 gene, ask your provider how this information affects your treatment plan and future health.
If your test results show you have an inherited change in one copy of your TP53 gene, you have Li-Fraumeni syndrome. This doesn't mean you have cancer. But your risk of getting cancer is higher than most people. Talk with your provider about the steps you can take to reduce your risk of cancer. Your provider may discuss:
Having frequent cancer screening tests to help find cancer early when it may be easier to treat
Having a yearly physical exam
Making lifestyle changes, such as getting more exercise, eating a healthier diet, and quitting smoking
Chemoprevention, which is taking certain medicines or other substances to reduce the risk of developing cancer or to keep it from coming back
Mastectomy to help prevent breast cancer
The right steps for you will depend on your age, health history, and family health history.
If you think you may have Li-Fraumeni syndrome, it may help to talk with a genetic counselor before getting tested. The counselor can help you understand the risks and benefits of testing for you and your family. This can help you make informed decisions.
If you are diagnosed with Li-Fraumeni syndrome, a counselor can explain your risk for cancer and discuss whether family members should be tested. A genetic counselor can also help you make plans to manage your risk over time.
TP53 Genetic Test: MedlinePlus Lab Test Information [accessed on Dec 19, 2018]
TP53 gene - Genetics Home Reference - NIH [accessed on Dec 19, 2018]
481044: p53 Tumor Suppressor Gene Protein,... | LabCorp [accessed on Dec 19, 2018]
https://www.ambrygen.com/sites/default/files/web/understanding_your_results/cancer/tp53_uyr.pdf [accessed on Dec 19, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (10)
p53 Tumour Suppressor and MDM2
Video by Neural Academy/YouTube
NEOPLASIA 4: p53 gene: The Guardian of the genome. functions, regulation and inactivation
Video by ilovepathology/YouTube
The Role of p53 in Cancer
Video by Maja Divjak/YouTube
Tumor suppressors | Biomolecules | MCAT | Khan Academy
Video by khanacademymedicine/YouTube
P53 animation - tumor supressor gene animation
Video by Biology animation videos/YouTube
Apoptotic Pathways
Video by Genentech/YouTube
P53
Cartoon representation of a complex between DNA and the protein p53 (described in Cho et al. Science 265 pp. 346, 1994 [1])
Image by Thomas Splettstoesser/Wikimedia
p53 tumor supressor
p53 tumor supressor. Flexible portions of the molecule that are not included in the structures are shown schematically.
Image by Protein Data Bank. David Goodsell./Wikimedia
Tumour suppressor p53-DNA complex
Image by /Wikimedia
Glioblastoma P53
Immunhistochemische Färbung der Tumorzellen für p53. Ansammlung von (defektem) p53-Protein in den Tumorzellkernen bei einem sekundären Glioblastom mit Mutation des TP53 Gens.
Image by Marvin 101/Wikimedia
3:34
p53 Tumour Suppressor and MDM2
Neural Academy/YouTube
10:22
NEOPLASIA 4: p53 gene: The Guardian of the genome. functions, regulation and inactivation
ilovepathology/YouTube
3:53
The Role of p53 in Cancer
Maja Divjak/YouTube
4:44
Tumor suppressors | Biomolecules | MCAT | Khan Academy
khanacademymedicine/YouTube
2:36
P53 animation - tumor supressor gene animation
Biology animation videos/YouTube
2:05
Apoptotic Pathways
Genentech/YouTube
P53
Thomas Splettstoesser/Wikimedia
p53 tumor supressor
Protein Data Bank. David Goodsell./Wikimedia
Tumour suppressor p53-DNA complex
/Wikimedia
Glioblastoma P53
Marvin 101/Wikimedia
Genetic Testing for Hereditary Cancer
Genetic Testing for Hereditary Cancer
Also called: Hereditary Cancer Panels, Genetic Testing for Inherited Cancer Susceptibility
Genetic testing looks for specific changes in your genes, chromosomes, or proteins that are linked to certain hereditary forms of cancer. Genetic tests are available for breast, ovarian, uterine, colorectal, melanoma, and prostate cancers. Test results can be used to evaluate the risk of developing cancer and may be used to guide preventive treatment.
Genetic Testing for Hereditary Cancer
Also called: Hereditary Cancer Panels, Genetic Testing for Inherited Cancer Susceptibility
Genetic testing looks for specific changes in your genes, chromosomes, or proteins that are linked to certain hereditary forms of cancer. Genetic tests are available for breast, ovarian, uterine, colorectal, melanoma, and prostate cancers. Test results can be used to evaluate the risk of developing cancer and may be used to guide preventive treatment.
{"label":"BRCA mutations reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative (normal) result means that the test didn't find any harmful changes in your BRCA genes. How this affects your cancer risk depends on whether you've already had cancer and whether a member of your family has a harmful BRCA variant.","conditions":[]},{"flag":"borderline","label":{"short":"Uncertain","long":"Uncertain","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An uncertain result may also be called a \"variant of uncertain significance (VUS)\". It means that a variant in your BRCA genes was found, but researchers don't know whether that variant causes cancer.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":2,"max":3},"text":"A positive result may also be called a \"likely pathogenic variant.\" It means that you have a harmful gene variant that is known to increase the risk of certain cancers. But the test cannot tell whether you will develop cancer.","conditions":["Breast cancer","Ovarian cancer","Pancreatic cancer","Cervical cancer","Uterine cancer","Colon cancer","Gallbladder cancer","Stomach cancer","Skin cancer","Melanoma","Prostate cancer","Testicular cancer","Fanconi anemia"]}],"value":0.5}[{"negative":0},{"borderline":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative (normal) result means that the test didn't find any harmful changes in your BRCA genes. How this affects your cancer risk depends on whether you've already had cancer and whether a member of your family has a harmful BRCA variant.
Related conditions
{"label":"PTEN mutations reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"<em>PTEN<\/em> is a type of gene called a \"tumor suppressor.\" Tumor suppressor genes provide instructions for making proteins that control how fast your cells grow and divide to make new cells. The proteins also help stop the growth of abnormal cells.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"Having a PTEN mutation doesn\u2019t mean you have cancer, but it does mean you\u2019re at a greater risk. Identifying a PTEN mutation can help you and your doctor plan treatment and prevention strategies.","conditions":["Cowden syndrome","Bannayan-Riley-Ruvalcaba syndrome","Proteus syndrome","Prostate cancer","Uterine cancer","Brain tumors"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
PTEN is a type of gene called a "tumor suppressor." Tumor suppressor genes provide instructions for making proteins that control how fast your cells grow and divide to make new cells. The proteins also help stop the growth of abnormal cells.
Related conditions
{"label":"TP53 mutations reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Your result is negative for known pathogenic mutations in the TP53 gene.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"Your result shows that you have a pathogenic mutation or a variant that is likely pathogenic in the TP53 gene. People with inherited TP53 mutations have Li-Fraumeni syndrome (LFS). Acquired TP53 mutations are much more common.","conditions":["Li-Fraumeni syndrome (LFS)","Soft tissue sarcoma","Osteosarcoma","Female breast cancer","Brain tumors","Adrenocortical carcinoma (ACC)","Leukemia"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
Your result is negative for known pathogenic mutations in the TP53 gene.
Related conditions
Genetic testing is a type of medical test that looks for changes (variants) in your DNA. DNA is short for deoxyribonucleic acid. It contains the genetic instructions in all living things. Genetic tests analyze your cells or tissue to look for any changes in:
Genes, which are parts of DNA that carry the information needed to make a protein
Chromosomes, which are thread-like structures in your cells. They contain DNA and proteins.
Proteins, which do most of the work in your cells. Testing can look for changes in the amount and activity level of proteins. If it finds changes, it might be due to changes in your DNA.
Changes in your DNA can be acquired or inherited from your parents:
Acquired changes, called somatic variants, develop sometime after you're born. These changes can happen if your cells make a mistake when they divide to make new cells. Changes can also happen if you're exposed to substances that cause cancer. Acquired changes show up only in certain types of cells. They're usually not in sperm or egg cells, so you can't pass them down to children.
Inherited changes, calledgermline variants, are changes that you're born with. All the cells in your body have the gene change, including your egg or sperm cells. That means you can pass the change down to your children.
This test looks only for inherited changes in certain genes. Certain harmful (pathogenic) variants are known to be associated with an increased risk of developing cancer.
Not everyone who has a harmful variant will get cancer. And if you find out you have a harmful variant, you may be able to take steps to lower your risk and protect your health.
The test can also help identify potentially cancer-associated hereditary variants in individuals with already-diagnosed cancer.
Genetic testing can look for changes in the main genes which cause a hereditary cancer type, such as BRCA1 and BRCA2, or in multiple genes associated with hereditary cancer. These tests are called "multigene panel tests."
Some of the most clinically significant genes that these tests identify are:
BRCA1 and BRCA2, genes that increase the risk of hereditary forms of breast and ovarian cancer as well as several additional types of cancer
MLH1, MSH2, MSH6, PMS2 and EPCAM, genes that are linked to Lynch syndrome, an inherited condition that increases the risk of developing various cancers
BRIP1, RAD51C and RAD51D, genes associated with increased risk for ovarian cancer
CDH1, mainly associated with hereditary diffuse gastric cancer, and lobular breast cancer
CHEK2, associated with increased risk of breast and colorectal cancers
PALB2,associated with increased risks of breast and pancreatic cancers
STK11, associated with Peutz-Jeghers syndrome, a condition that greatly increases the risk of developing certain types of cancer
PTEN, associated with Cowden syndrome, a condition that increases the risk for different types of benign and malignant tumors, including endometrial, thyroid, and breast cancer
TP53, associated with Li-Fraumeni syndrome, a condition that increases up to 78% the lifetime risk for cancer
Genetic tests are often done on a blood or cheek swab sample. But they may also be done on samples of hair, saliva, skin, amniotic fluid (the fluid that surrounds a fetus during pregnancy), or other tissue. The sample is sent to a laboratory. There, a lab technician will use one of several different techniques to look for genetic changes.
Positive – the test found a genetic change known to cause hereditary cancer. Other family members can have genetic testing to learn whether or not they have the change and the hereditary cancer syndrome.
Negative – the test did not find a genetic change known to cause hereditary cancer. However, hereditary risk cannot be completely eliminated as there could be a change not detectable or a change in a gene that was not tested.
Uncertain – a variant of unknown or uncertain significance means there isn’t enough information about that genetic change to determine whether it is benign (normal) or pathogenic (disease causing).
Genetic Testing: MedlinePlus. National Library of Medicine. Jun 11, 2021 [accessed on Dec 27, 2023]
Genetic Testing FAQ. Genome.gov [accessed on Dec 27, 2023]
Genetic testing and your cancer risk: MedlinePlus Medical Encyclopedia [accessed on Dec 27, 2023]
FDA Grants First Marketing Authorization for a DNA Test to Assess Predisposition for Dozens of Cancer Types | FDA. U.S. Food and Drug Administration. Sep 29, 2023 [accessed on Dec 27, 2023]
FDA Authorizes Blood Test for Hereditary Cancer Risk - NCI. National Cancer Institute. Nov 2, 2023 [accessed on Dec 27, 2023]
Hereditary Cancer Panels. The Jackson Laboratory [accessed on Dec 27, 2023]
Full Comprehensive Cancer Panel | Fulgent Genetics [accessed on Dec 27, 2023]
Additional Materials (1)
What is Panel Genetic Testing? | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
5:43
What is Panel Genetic Testing? | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
PTEN Genetic Test
PTEN Genetic Test
Also called: PTEN Gene Mutation Analysis, PTEN Testing, PTEN Mutation Testing, PTEN Sequencing and Deletion/Duplication
A PTEN genetic test looks for changes (mutations) in the PTEN gene. PTEN is a type of gene called a tumor suppressor. If you have a PTEN mutation (acquired or inherited), you are at higher risk for getting cancer.
PTEN Genetic Test
Also called: PTEN Gene Mutation Analysis, PTEN Testing, PTEN Mutation Testing, PTEN Sequencing and Deletion/Duplication
A PTEN genetic test looks for changes (mutations) in the PTEN gene. PTEN is a type of gene called a tumor suppressor. If you have a PTEN mutation (acquired or inherited), you are at higher risk for getting cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
PTEN is a type of gene called a "tumor suppressor." Tumor suppressor genes provide instructions for making proteins that control how fast your cells grow and divide to make new cells. The proteins also help stop the growth of abnormal cells.
Related conditions
A PTEN genetic test uses a sample of your blood or other body tissue to look for changes in a gene called PTEN. Changes in your genes are also called gene variants or mutations.
Genes are parts of DNA in your cells that you inherit from your parents. Genes carry information that controls what you look like and how your body works.
PTEN is a type of gene called a "tumor suppressor." Tumor suppressor genes provide instructions for making proteins that control how fast your cells grow and divide to make new cells. The proteins also help stop the growth of abnormal cells.
If you have changes in your PTEN gene, the gene or the protein it makes may not work well or may stop working completely. This can lead to serious health problems, including cancer. Changes in your PTEN gene can be acquired or inherited.
Acquired changes in your genes develop at some time after you're born. Acquired changes in the PTEN gene are commonly found in many different types of cancer, including prostate cancer, uterine cancer, and some types of brain tumors. Acquired changes in your PTEN gene:
Can happen if your cells make a mistake when they divide to make new cells
Can happen if you're exposed to substances that cause cancer
Show up only in certain types of cells
Usually aren't in sperm or egg cells, so they can't be passed down to children
Inherited changes in your genes are changes that you're born with. They show up in all the cells in your body, including your egg or sperm cells. That means they can be passed down to your children.
Inherited changes in the PTEN gene aren't common. But when they happen, they can cause several types of disorders. These disorders all include the growth of benign tumors (not cancer). These tumors are called hamartomas. The disorders are grouped together and called PTEN hamartoma tumor syndrome (PHTS). Cowden syndrome and Bannayan-Riley-Ruvalcaba syndrome are two types of PHTS disorders.
Hamartomas and other symptoms of PHTS can show up in infancy or later. PHTS increases your risk for certain types of cancer, but the cancer usually doesn't develop until adulthood.
The PTEN genetic test is used to look for changes in your PTEN gene. It's not a routine test. It may be used to:
Find out if a change in your PTEN gene is involved in cancer
Check for inherited changes in your PTEN gene if you have:
Family members who have PTEN gene changes
Symptoms of PTEN hamartoma tumor syndrome (PHTS)
If you have cancer, you may need a PTEN genetic test to check whether your cancer cells have a PTEN gene change. Genetic changes in cancer can affect how the disease responds to treatment and how it may behave over time. So, your test results can help guide your treatment plan.
If you have a family history of PTEN gene changes and/or symptoms of PHTS, a PTEN genetic test can help you understand and manage your cancer risk. The test can also show whether you have a genetic change that you could pass on to your children.
You or your child may need a test if you have symptoms of PHTS, which include:
Having many hamartomas, especially in the mouth, stomach, intestines, or skin
If you're pregnant and have a family history of PTEN gene changes, you may consider having the test as part of your prenatal testing. The test can show whether your baby could be born with PTEN hamartoma tumor syndrome.
If you're having a PTEN genetic test because you have cancer, the type of sample used will depend on your cancer:
For solid tumors, the test often uses a sample of tissue from the tumor. The tissue sample may be taken during surgery to remove the tumor. If you're not having surgery, you may have a biopsy of the tumor to remove a small amount of tissue.
For blood or bone marrow cancer, a bone marrow test is often used. Marrow is soft, spongy tissue found inside of bones. Most bone marrow samples are taken from the back of the hip bone.
If you're having the test to look for inherited gene changes, you may have:
A blood test. During a blood test, a health care professional will use a small needle to remove a blood sample from a vein in your arm.
A buccal (cheek) swab. A health care professional will insert a swab into your mouth and rub it across the inside of your cheek to gather a sample of cells.
If you're testing an unborn baby, a sample may be gathered using:
Amniocentesis. This procedure collects a sample of the amniotic fluid that surrounds the unborn baby during pregnancy. The fluid contains cells from the baby that can be tested. Amniocentesis is usually done between week 15 and 20 of pregnancy.
Chorionic villus sampling (CVS). This procedure collects tissue from the chorionic villi, which are parts of the placenta. The placenta is the organ that grows in the uterus to provide nutrients and oxygen to the baby. The chorionic villi usually have the same genes as the unborn baby. A CVS is usually done between week 10 and 13 of pregnancy.
If you're having a tissue biopsy or bone marrow test, ask your provider for instructions about how to prepare.
A blood test or cheek swab usually don't require any preparation.
For a CVS or amniocentesis, you may need to drink extra fluid and not urinate before your test so that your bladder is full.
The risks of a biopsy depend on the type of biopsy you have. In general, you may have soreness, pain, or bleeding where the tissue was removed.
After a bone marrow test, you may feel stiff or sore where the sample was taken. This usually goes away in a few days. Serious risks are rare, but may include swelling, bleeding at the site, or fever.
A blood test has very little risk. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
A cheek swab has no risks.
During amniocentesis or CVS, you may feel mild stinging or cramping. Both procedures are safe, but they do have a slight risk of causing miscarriage. Talk with your provider about the risks and benefits of these tests.
If you have cancer and your test results show you have an acquired change in your PTEN gene, your provider can explain what it means for your treatment plan and future health.
If your test results show that you have certain inherited changes in your PTEN gene, it doesn't mean you have cancer. But your risk of cancer may be higher than most people. Your provider may discuss steps you can take to reduce your cancer risk, including:
Having a yearly exam
Having frequent cancer screening tests to help find cancer early when it may be easier to treat
Making lifestyle changes, such as getting more exercise, eating healthy foods, and quitting smoking
Taking medicine or having surgery (mastectomy) to reduce the risk of breast cancer
Having surgery (hysterectomy) to reduce the risk of uterine cancer
For children, your provider may recommend a yearly exam that includes a skin check. Yearly thyroid ultrasound tests may begin at age seven. Your child may also need a checkup to see how their brain and nervous system are developing.
If you're thinking about getting tested for an inherited change in your PTEN gene, it may help to talk with a genetic counselor. Genetic counselors are specially trained to help you understand the risks and benefits of testing for you and your family. This can help you make informed decisions.
If you've been diagnosed with an inherited change in your PTEN gene, a counselor can explain your risk for cancer. The counselor can also help you decide about testing your children and how to manage your risk over time.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (10)
PTEN regulation image
Regulating mechanisms of PTEN gene and protein.
Image by BIOL3002012/Wikimedia
PTEN-Akt interactions
PTEN/Akt pathway and its downstream actions on cell proliferation and cell death adapted from Bangyan Stiles, Matthias Groszer, Shunyou Wang, Jing Jiao, Hong Wu. “PTENless means more”. Developmental Biology, Volume 273, Issue 2, 15. September 2004, Pages 175–184. https://dx.doi.org/10.1016/j.ydbio.2004.06.008
Image by 331pten/Wikimedia
Pten
PDB structure entry 1D5R
Image by /Wikimedia
Chromosome DNA Gene
A gene is a region of DNA that encodes function. A chromosome consists of a long strand of DNA containing many genes. A human chromosome can be up to 250 mega base pairs of DNA and contain thousands of genes.
Image by Thomas Shafee/Wikimedia
PTEN and Cancer
Video by Icahn School of Medicine/YouTube
David Soll describes the behavior of mutated PTEN genes
Video by University of Iowa/YouTube
Dr. Churpek Discusses the ATM, CHEK2, and PTEN Genes in Breast Cancer
Video by Targeted Oncology/YouTube
Alex's Story: PTEN Hamartoma Tumor Syndrome
Video by Mass Eye and Ear/YouTube
Tumor suppressors | Biomolecules | MCAT | Khan Academy
Video by khanacademymedicine/YouTube
Experimental Procedure
Injecting PTEN
Image by Danielchlu.1992/Wikimedia
PTEN regulation image
BIOL3002012/Wikimedia
PTEN-Akt interactions
331pten/Wikimedia
Pten
/Wikimedia
Chromosome DNA Gene
Thomas Shafee/Wikimedia
57:35
PTEN and Cancer
Icahn School of Medicine/YouTube
0:58
David Soll describes the behavior of mutated PTEN genes
University of Iowa/YouTube
1:27
Dr. Churpek Discusses the ATM, CHEK2, and PTEN Genes in Breast Cancer
Targeted Oncology/YouTube
2:08
Alex's Story: PTEN Hamartoma Tumor Syndrome
Mass Eye and Ear/YouTube
4:44
Tumor suppressors | Biomolecules | MCAT | Khan Academy
khanacademymedicine/YouTube
Experimental Procedure
Danielchlu.1992/Wikimedia
FoundationOne® Liquid CDx Test
FoundationOne® Liquid CDx Test
Also called: F1 Liquid CDx, Liquid Biopsy
FoundationOne Liquid CDx is a blood test, known as a liquid biopsy, that can help doctors pick the best treatments for some people with cancer. The test identifies over 300 cancer-related genetic changes in DNA from tumor cells that have been released into the blood.
FoundationOne® Liquid CDx Test
Also called: F1 Liquid CDx, Liquid Biopsy
FoundationOne Liquid CDx is a blood test, known as a liquid biopsy, that can help doctors pick the best treatments for some people with cancer. The test identifies over 300 cancer-related genetic changes in DNA from tumor cells that have been released into the blood.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
If your biopsy result showed that your type of cancer does not have a specific gene mutation, then you are not likely to benefit from treatment with a drug that targets that mutation.
Related conditions
The FoundationOne Liquid CDx assay is a laboratory test designed to detect several mutations in circulating cell-free DNA (cfDNA). This test helps doctors identify people with cancer who may benefit from specific FDA-approved treatments.
Cancer type
Genetic change
Corresponding targeted drug
Non-small cell lung cancer
ALK rearrangements
Alectinib (Alecensa)
EGFR exon 19 deletions and EGFR exon 21 L858R substitution
Erlotinib (Tarceva)
Gefitinib (Iressa)
Afatinib (Gilotrif)
Dacomitinib (Vizimpro)
Osimertinib (Tagrisso)
EGFR exon 20 insertions
Mobocertinib (Exkivity)
MET single nucleotide variants (SNVs) and indels that lead to MET exon 14 skipping
Capmatinib (Tabrecta)
ROS1 fusions
Entrectinib (Rozlytrek)
Prostate cancer
BRCA1, BRCA2, ATM mutations
Olaparib (Lynparza)
BRCA1, BRCA2 mutations
Rucaparib (Rubraca)
Breast cancer
PIK3CA mutations
Alpelisib (Piqray)
Solid tumors
NTRK1/2/3 fusions
Entrectinib (Rozlytrek)
Colorectal cancer
BRAF mutation
Encorafenib (Braftovi) in combination with cetuximab
FoundationOne Liquid CDx | Foundation Medicine [accessed on Nov 14, 2023]
Cancer “Liquid Biopsy” Blood Test Gets Expanded FDA Approval [accessed on Nov 30, 2020]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (13)
How Liquid Biopsy Can Revolutionise Medical Diagnostics | Dennis Lo
Video by Falling Walls Foundation/YouTube
Liquid biopsy: Mayo Clinic Radio
Video by Mayo Clinic/YouTube
Liquid Biopsy Promotes Precision Medicine By Tracking Patient’s Cancer
Video by Mayo Clinic/YouTube
How Does Liquid Biopsy Work?
Video by OncLiveTV/YouTube
Advances in liquid biopsy technology - IMAT spotlight: Dr. Shana Kelley
Video by National Cancer Institute/YouTube
What is a Liquid Biopsy?
Video by Prostate Cancer Foundation/YouTube
Precision Medicine and Liquid Biopsy: The Future of Diagnosing and Managing Disease
Video by City of Hope/YouTube
What is a liquid biopsy? Can cancer cells be detected in the blood?
Video by Mount Sinai Health System/YouTube
Cell-free DNA liquid biopsy in lung cancer
Video by VJOncology/YouTube
Liquid biopsies to monitor cancer
Video by Phospho Biomedical Animation/YouTube
How Liquid Biopsies Can Improve Brain Tumor Diagnoses
Video by MassGeneralHospital/YouTube
Genetic Testing for Advanced Prostate Cancer (Royal Stage) | Prostate Cancer Staging Guide
Video by Prostate Cancer Research Institute/YouTube
The FoundationOne Liquid CDx assay is a laboratory test designed to detect several mutations in circulating cell-free DNA (cfDNA). This test helps doctors identify people with cancer who may benefit from specific FDA-approved treatments.
Image by FDA
16:10
How Liquid Biopsy Can Revolutionise Medical Diagnostics | Dennis Lo
Falling Walls Foundation/YouTube
9:45
Liquid biopsy: Mayo Clinic Radio
Mayo Clinic/YouTube
3:14
Liquid Biopsy Promotes Precision Medicine By Tracking Patient’s Cancer
Mayo Clinic/YouTube
4:33
How Does Liquid Biopsy Work?
OncLiveTV/YouTube
2:27
Advances in liquid biopsy technology - IMAT spotlight: Dr. Shana Kelley
National Cancer Institute/YouTube
0:45
What is a Liquid Biopsy?
Prostate Cancer Foundation/YouTube
3:11
Precision Medicine and Liquid Biopsy: The Future of Diagnosing and Managing Disease
City of Hope/YouTube
2:12
What is a liquid biopsy? Can cancer cells be detected in the blood?
Mount Sinai Health System/YouTube
4:55
Cell-free DNA liquid biopsy in lung cancer
VJOncology/YouTube
1:49
Liquid biopsies to monitor cancer
Phospho Biomedical Animation/YouTube
3:24
How Liquid Biopsies Can Improve Brain Tumor Diagnoses
MassGeneralHospital/YouTube
5:30
Genetic Testing for Advanced Prostate Cancer (Royal Stage) | Prostate Cancer Staging Guide
Normal Breast Cross Section / Breast Cancer Cross Section
Normal Breast Cross Section / Breast Cancer Cross Section
Interactive by TheVisualMD
Normal Breast Cross Section / Breast Cancer Cross Section
Normal Breast Cross Section / Breast Cancer Cross Section
Medical visualization of an anteriolateral view of healthy breast tissue. The most common type of breast cancer is infiltrating ductal carcinoma (over 70%) which begins in the lining of the ducts, followed by inflitrating lobular carcinoma (over 10%) which orginates in the lobules, medullary carcinoma, tubular carcinoma, mucinous carcinoma, and inflammatory breast cancer. Breast cancer affects approximately one in 93 women by the age of 45, and over the course of a lifetime one in eight women will be diagnosed with the disease. Early detection is critical - survival rates for those diagnosed at early stages is greater than 90 percent. Annual mammograms are recommended for women over 40, as are regular self-exams and clinical exams for all women. Women with a family history of breast cancer, especially premenopausal occurrence, as well as those who test positive for the BRCA1 and BRCA2 genes, are at a higher lifetime risk for developing breast cancer and should start detection screening earlier. Men comprise one percent of breast cancer patients. 1 of 2.
Interactive by TheVisualMD
If Cancer Is Found, Tests Are Done to Study the Cancer Cells
If cancer is found, tests are done to study the cancer cells.
Decisions about the best treatment are based on the results of these tests. The tests give information about:
how quickly the cancer may grow.
how likely it is that the cancer will spread through the body.
how well certain treatments might work.
how likely the cancer is to recur (come back).
Tests include the following:
Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone (hormones) receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.
Human epidermal growth factor type 2 receptor (HER2/neu) test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer is called HER2/neu positive. This type of breast cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab and pertuzumab.
Multigene tests: Tests in which samples of tissue are studied to look at the activity of many genes at the same time. These tests may help predict whether cancer will spread to other parts of the body or recur (come back).
There are many types of multigene tests. The following multigene tests have been studied in clinical trials:
Oncotype DX: This test helps predict whether early-stage breast cancer that is estrogen receptor positive and node negative will spread to other parts of the body. If the risk that the cancer will spread is high, chemotherapy may be given to lower the risk.
MammaPrint: A laboratory test in which the activity of 70 different genes is looked at in the breast cancer tissue of women who have early-stage invasive breast cancer that has not spread to lymph nodes or has spread to 3 or fewer lymph nodes. The activity level of these genes helps predict whether breast cancer will spread to other parts of the body or come back. If the test shows that the risk that the cancer will spread or come back is high, chemotherapy may be given to lower the risk.
Based on these tests, breast cancer is described as one of the following types:
Triple negative (estrogen receptor, progesterone receptor, and HER2/neu negative).
This information helps the doctor decide which treatments will work best for your cancer.
Source: National Cancer Institute (NCI)
Additional Materials (16)
Sensitive content
This media may include sensitive content
Hurricane in a Cell - This image shows a polyploid giant cancer cell (PGCC) from triple-negative breast cancer.
This image shows a polyploid giant cancer cell (PGCC) from triple-negative breast cancer. PGCCs, a subtype of cancer cell, appear in a variety of solid tumors and appear to help the tumor invade surrounding tissues and migrate to other areas of the body (metastasis). Researchers would like to better understand how PGCCs form and function with the goal of improving treatments. Actin is red; mitochondria are green; nuclear DNA is blue.
Image by National Cancer Institute \ Univ. of Pittsburg Cancer Institute / Wei Qian
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Emerging Cancer Cells
Fusion of cell nuclei (red) in emerging cancer cells in a mouse model of human breast cancer. Actin filaments in the cell cytoplasm are stained green.
This image was originally submitted as part of the 2015 NCI Cancer Close Up project and selected for exhibit. This image is part of the NCI Cancer Close Up 2015 collection.
See also https://visualsonline.cancer.gov/closeup.
Image by NCI Center for Cancer Research / Thomas Ried
Sensitive content
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Breast Cancer Cell
A breast cancer cell, photographed by a scanning electron microscope, which produces a 3-dimensional images. The overall shape of the cell's surface at a very high magnification. Cancer cells are best identified by internal details, but research with a scanning electron microscope can show how cells respond in changing environments and can show mapping distribution of binding sites of hormones and other biological molecules.
Image by National Cancer Institute / Bruce Wetzel and Harry Schaefer (Photographers)
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Breast Cancer Metastasis to Liver
The malignant breast cancer cells metastasized to the liver. A cluster of the cancer-cells with their brown-staining cytoplasm is within a portal tract of the liver (monoclonal antibody b1.1, abc immunoperoxidase method, hematoxylin counterstain, x500).
Image by National Cancer Institute / Unknown Photographer
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Spatial Heterogeneity in the Tumor Microenvironment - HER2 (green), Ki-67 (red), PD-L1 (purple), immune cells (yellow), and endothelial cells (cyan).
The microenvironment that surrounds a tumor plays a crucial role in helping cancer to grow and evade destruction. This image of a mouse model for HER2-positive breast cancer uses a novel imaging technique called transparent tumor tomography that three-dimensionally visualizes the tumor microenvironment at a single cell resolution. HER2 (green), Ki-67 (red), PD-L1 (purple), immune cells (yellow), and endothelial cells (cyan).
Image by National Cancer Institute \ Univ. of Chicago Comprehensive Cancer Center / Steve Seung-Young Lee
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Dividing Breast Cancer Cell
This image shows a triple-negative breast cancer cell (MDA-MB-231) in metaphase during cell division. Tubulin in red; mitochondria in green; chromosomes in blue. A better understanding of how mitochondria play roles in tumor cell division may provide new therapeutic targeting strategies to stop tumor cell growth.
This image was originally submitted as part of the 2016 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2016 collection.
Image by National Cancer Institute \ Univ. of Pittsburgh Cancer Institute / Wei Qian
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Treating Triple-Negative Breast Cancer Cell
This image shows a triple-negative breast cancer cell undergoing retraction and apoptosis (cell death) after treatment with a combination of the chemotherapy drug cisplatin and a mitochondrial division inhibitor drug called mdivi-1. Actin in red; mitochondria in green; nuclei in blue. Understanding how drugs work at the molecular level contributes to better cancer treatments.
Image by National Cancer Institute \ Univ. of Pittsburgh Cancer Institute / Wei Qian
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Stress Fibers and Microtubules in Human Breast Cancer Cells 4
Image acquired with fluorescence microscopy showing stress fibers (red) and microtubules (green) in human breast cancer cells (nuclei, blue). Microtubules and actin-containing stress fibers are important structures of a cell's cytoskeleton. Microtubules extend throughout the cell and are invovled in the transport of large protein assemblies, vesicles, and cell organelles. Stress fibers are contractile bundles made up of actin and myosin. Contraction of actin-myosin bundles enables cells to move. Analyzing the cytoskeleton of cells helps scientists to study aspects of cancer metastasis such as the migratory phenotypes of migrating and invasive tumor cells.
This image was originally submitted as part of the 2015 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2015 collection.
See also https://visualsonline.cancer.gov/closeup.
Image by NCI Center for Cancer Research / Christina Stuelten, Carole Parent
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Stress Fibers and Microtubules in Human Breast Cancer Cells 2
Image acquired with fluorescence microscopy showing stress fibers (red) and microtubules (green) in human breast cancer cells (nuclei, blue). Microtubules and actin-containing stress fibers are important structures of a cell's cytoskeleton. Microtubules extend throughout the cell and are invovled in the transport of large protein assemblies, vesicles, and cell organelles. Stress fibers are contractile bundles made up of actin and myosin. Contraction of actin-myosin bundles enables cells to move. Analyzing the cytoskeleton of cells helps scientists to study aspects of cancer metastasis such as the migratory phenotypes of migrating and invasive tumor cells.
This image was originally submitted as part of the 2015 NCI Cancer Close Up project. This image is part of the NCI Cancer Close Up 2015 collection.
See also https://visualsonline.cancer.gov/closeup.
Image by NCI Center for Cancer Research / Christina Stuelten, Carole Parent
Breast Cancer Cell
Confocal microscopy of breast cancer cells. Breast cancer cells may be hormone receptor-positive if they contain binding sites for hormones such as estrogen or progesterone, or be hormone receptor-negative if they do not. Hormone receptor-positive breast cancer cells grow more slowly than hormone receptor-negative cells, and therefore women with tumors comprised of those kinds of cells may have a better prognosis as well as more treatment options.
Image by TheVisualMD
Methylation of DNA, Cancer Growth
In cancer, a cell's DNA is damaged. The damaged cell starts to reproduce in an uncontrolled way, creating more abnormal cells. It outlives the normal cells around it and forms a tumor (a lump or mass). A methyl group is a chemical unit found on DNA molecules; methyl groups are a normal part of DNA upkeep and crucial to cellular development. Methylation can sometimes change the function of genes, however; both too little and too much methylation have been linked to the development of cancer. Methylation changes often precede changes in a tumor's malignancy, which could aid diagnosis and treatment. Techniques to test methylation from blood samples are being developed that will be less invasive than biopsies.
Image by TheVisualMD
Breast Cancer Cells Dividing
Confocal microscopy of breast cancer cells dividing. In cancer, a cell's DNA is damaged. The damaged cell starts to reproduce in an uncontrolled way, creating more abnormal cells. It outlives the normal cells around it and forms a tumor (a lump or mass).
Image by TheVisualMD
What is Progesterone? When To Test #Progesterone Levels and What Can Affect Levels
Video by LetsGetChecked/YouTube
Estrogen & Progesterone - What You Need To Know
Video by Pandia Health/YouTube
Symptoms of low progesterone
Video by Proov Test/YouTube
DCIS (Stage 0) Breast Cancer and the Oncotype DX DCIS Score
Video by Oncotype IQ/YouTube
Sensitive content
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Hurricane in a Cell - This image shows a polyploid giant cancer cell (PGCC) from triple-negative breast cancer.
National Cancer Institute \ Univ. of Pittsburg Cancer Institute / Wei Qian
Sensitive content
This media may include sensitive content
Emerging Cancer Cells
NCI Center for Cancer Research / Thomas Ried
Sensitive content
This media may include sensitive content
Breast Cancer Cell
National Cancer Institute / Bruce Wetzel and Harry Schaefer (Photographers)
Sensitive content
This media may include sensitive content
Breast Cancer Metastasis to Liver
National Cancer Institute / Unknown Photographer
Sensitive content
This media may include sensitive content
Spatial Heterogeneity in the Tumor Microenvironment - HER2 (green), Ki-67 (red), PD-L1 (purple), immune cells (yellow), and endothelial cells (cyan).
National Cancer Institute \ Univ. of Chicago Comprehensive Cancer Center / Steve Seung-Young Lee
Sensitive content
This media may include sensitive content
Dividing Breast Cancer Cell
National Cancer Institute \ Univ. of Pittsburgh Cancer Institute / Wei Qian
Sensitive content
This media may include sensitive content
Treating Triple-Negative Breast Cancer Cell
National Cancer Institute \ Univ. of Pittsburgh Cancer Institute / Wei Qian
Sensitive content
This media may include sensitive content
Stress Fibers and Microtubules in Human Breast Cancer Cells 4
NCI Center for Cancer Research / Christina Stuelten, Carole Parent
Sensitive content
This media may include sensitive content
Stress Fibers and Microtubules in Human Breast Cancer Cells 2
NCI Center for Cancer Research / Christina Stuelten, Carole Parent
Breast Cancer Cell
TheVisualMD
Methylation of DNA, Cancer Growth
TheVisualMD
Breast Cancer Cells Dividing
TheVisualMD
2:35
What is Progesterone? When To Test #Progesterone Levels and What Can Affect Levels
LetsGetChecked/YouTube
1:58
Estrogen & Progesterone - What You Need To Know
Pandia Health/YouTube
1:11
Symptoms of low progesterone
Proov Test/YouTube
2:53
DCIS (Stage 0) Breast Cancer and the Oncotype DX DCIS Score
Oncotype IQ/YouTube
Prognosis
Breast Cancer Anxiety
Image by TheVisualMD
Breast Cancer Anxiety
Image by TheVisualMD
Breast Cancer - Prognosis
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options depend on the following:
The stage of the cancer (the size of the tumor and whether it is in the breast only or has spread to lymph nodes or other places in the body).
The type of breast cancer.
Estrogen receptor and progesterone receptor levels in the tumor tissue.
Human epidermal growth factor type 2 receptor (HER2/neu) levels in the tumor tissue.
Whether the tumor tissue is triple negative (cells that do not have estrogen receptors, progesterone receptors, or high levels of HER2/neu).
How fast the tumor is growing.
How likely the tumor is to recur (come back).
A woman’s age, general health, and menopausal status (whether a woman is still having menstrual periods).
Whether the cancer has just been diagnosed or has recurred (come back).
Source: National Cancer Institute (NIH)
Additional Materials (5)
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Breast Cancer Screening & Diagnosis
Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.
Video by TheVisualMD
Understanding Your Cancer Prognosis
Video by National Cancer Institute/YouTube
Understanding Prognosis: From Anger to Acceptance
Video by National Cancer Institute/YouTube
Understanding Prognosis: Diving out of the Dark
Video by National Cancer Institute/YouTube
Breast Cancer in Women of Color: Controversies in Breast Cancer Screening
Video by NYU Langone Health/YouTube
4:57
Breast Cancer Screening & Diagnosis
TheVisualMD
6:40
Understanding Your Cancer Prognosis
National Cancer Institute/YouTube
3:57
Understanding Prognosis: From Anger to Acceptance
National Cancer Institute/YouTube
4:10
Understanding Prognosis: Diving out of the Dark
National Cancer Institute/YouTube
16:02
Breast Cancer in Women of Color: Controversies in Breast Cancer Screening
NYU Langone Health/YouTube
Stages
Stage 0
Stage 1
Stage 2
Stage 2
Stage 4
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Breast Cancer Summary Staging
Interactive by TheVisualMD
Stage 0
Stage 1
Stage 2
Stage 2
Stage 4
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Breast Cancer Summary Staging
After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.
Interactive by TheVisualMD
Stages of Breast Cancer
KEY POINTS
After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other parts of the body.
In breast cancer, stage is based on the size and location of the primary tumor, the spread of cancer to nearby lymph nodes or other parts of the body, tumor grade, and whether certain biomarkers are present.
The TNM system is used to describe the size of the primary tumor and the spread of cancer to nearby lymph nodes or other parts of the body.
Tumor (T). The size and location of the tumor.
Lymph Node (N). The size and location of lymph nodes where cancer has spread.
Metastasis (M). The spread of cancer to other parts of the body.
The grading system is used to describe how quickly a breast tumor is likely to grow and spread.
Biomarker testing is used to find out whether breast cancer cells have certain receptors.
The TNM system, the grading system, and biomarker status are combined to find out the breast cancer stage.
Talk to your doctor to find out what your breast cancer stage is and how it is used to plan the best treatment for you.
The treatment of breast cancer depends partly on the stage of the disease.
After breast cancer has been diagnosed, tests are done to find out if cancer cells have spread within the breast or to other parts of the body.
The process used to find out whether the cancer has spread within the breast or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of some of the tests used to diagnose breast cancer are also used to stage the disease.
The following tests and procedures also may be used in the staging process:
Sentinel lymph node biopsy: The removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node in a group of lymph nodes to receive lymphatic drainage from the primary tumor. It is the first lymph node the cancer is likely to spread to from the primary tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes. Sometimes, a sentinel lymph node is found in more than one group of nodes.
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bone, the cancer cells in the bone are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
In breast cancer, stage is based on the size and location of the primary tumor, the spread of cancer to nearby lymph nodes or other parts of the body, tumor grade, and whether certain biomarkers are present.
To plan the best treatment and understand your prognosis, it is important to know the breast cancer stage.
There are 3 types of breast cancer stage groups:
Clinical Prognostic Stage is used first to assign a stage for all patients based on health history, physical exam, imaging tests (if done), and biopsies. The Clinical Prognostic Stage is described by the TNM system, tumor grade, and biomarker status (ER, PR, HER2). In clinical staging, mammography or ultrasound is used to check the lymph nodes for signs of cancer.
Pathological Prognostic Stage is then used for patients who have surgery as their first treatment. The Pathological Prognostic Stage is based on all clinical information, biomarker status, and laboratory test results from breast tissue and lymph nodes removed during surgery.
Anatomic Stage is based on the size and the spread of cancer as described by the TNM system. The Anatomic Stage is used in parts of the world where biomarker testing is not available. It is not used in the United States.
The TNM system is used to describe the size of the primary tumor and the spread of cancer to nearby lymph nodes or other parts of the body.
For breast cancer, the TNM system describes the tumor as follows:
Tumor (T). The size and location of the tumor.
Tumor sizes are often measured in millimeters (mm) or centimeters. Common items that can be used to show tumor size in mm include: a sharp pencil point (1 mm), a new crayon point (2 mm), a pencil-top eraser (5 mm), a pea (10 mm), a peanut (20 mm), and a lime (50 mm).
TX: Primary tumor cannot be assessed.
T0: No sign of a primary tumor in the breast.
Tis: Carcinoma in situ. There are 2 types of breast carcinoma in situ:
Tis (DCIS): DCIS is a condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive breast cancer that is able to spread to other tissues. At this time, there is no way to know which lesions can become invasive.
Tis (Paget disease): Paget disease of the nipple is a condition in which abnormal cells are found in the skin cells of the nipple and may spread to the areola. It is not staged according to the TNM system. If Paget disease AND an invasive breast cancer are present, the TNM system is used to stage the invasive breast cancer.
T1: The tumor is 20 millimeters or smaller. There are 4 subtypes of a T1 tumor depending on the size of the tumor:
T1mi: the tumor is 1 millimeter or smaller.
T1a: the tumor is larger than 1 millimeter but not larger than 5 millimeters.
T1b: the tumor is larger than 5 millimeters but not larger than 10 millimeters.
T1c: the tumor is larger than 10 millimeters but not larger than 20 millimeters.
T2: The tumor is larger than 20 millimeters but not larger than 50 millimeters.
T3: The tumor is larger than 50 millimeters.
T4: The tumor is described as one of the following:
T4a: the tumor has grown into the chest wall.
T4b: the tumor has grown into the skin—an ulcer has formed on the surface of the skin on the breast, small tumor nodules have formed in the same breast as the primary tumor, and/or there is swelling of the skin on the breast.
T4c: the tumor has grown into the chest wall and the skin.
T4d: inflammatory breast cancer—one-third or more of the skin on the breast is red and swollen (called peau d’orange).
Lymph Node (N). The size and location of lymph nodes where cancer has spread.
When the lymph nodes are removed by surgery and studied under a microscope by a pathologist, pathologic staging is used to describe the lymph nodes. The pathologic staging of lymph nodes is described below.
NX: The lymph nodes cannot be assessed.
N0: No sign of cancer in the lymph nodes, or tiny clusters of cancer cells not larger than 0.2 millimeters in the lymph nodes.
N1: Cancer is described as one of the following:
N1mi: cancer has spread to the axillary (armpit area) lymph nodes and is larger than 0.2 millimeters but not larger than 2 millimeters.
N1a: cancer has spread to 1 to 3 axillary lymph nodes and the cancer in at least one of the lymph nodes is larger than 2 millimeters.
N1b: cancer has spread to lymph nodes near the breastbone on the same side of the body as the primary tumor, and the cancer is larger than 0.2 millimeters and is found by sentinel lymph node biopsy. Cancer is not found in the axillary lymph nodes.
N1c: cancer has spread to 1 to 3 axillary lymph nodes and the cancer in at least one of the lymph nodes is larger than 2 millimeters. Cancer is also found by sentinel lymph node biopsy in the lymph nodes near the breastbone on the same side of the body as the primary tumor.
N2: Cancer is described as one of the following:
N2a: cancer has spread to 4 to 9 axillary lymph nodes and the cancer in at least one of the lymph nodes is larger than 2 millimeters.
N2b: cancer has spread to lymph nodes near the breastbone and the cancer is found by imaging tests. Cancer is not found in the axillary lymph nodes by sentinel lymph node biopsy or lymph node dissection.
N3: Cancer is described as one of the following:
N3a: cancer has spread to 10 or more axillary lymph nodes and the cancer in at least one of the lymph nodes is larger than 2 millimeters, or cancer has spread to lymph nodes below the collarbone.
N3b: cancer has spread to 1 to 9 axillary lymph nodes and the cancer in at least one of the lymph nodes is larger than 2 millimeters. Cancer has also spread to lymph nodes near the breastbone and the cancer is found by imaging tests;
or
cancer has spread to 4 to 9 axillary lymph nodes and cancer in at least one of the lymph nodes is larger than 2 millimeters. Cancer has also spread to lymph nodes near the breastbone on the same side of the body as the primary tumor, and the cancer is larger than 0.2 millimeters and is found by sentinel lymph node biopsy.
N3c: cancer has spread to lymph nodes above the collarbone on the same side of the body as the primary tumor.
When the lymph nodes are checked using mammography or ultrasound, it is called clinical staging. The clinical staging of lymph nodes is not described here.
Metastasis (M). The spread of cancer to other parts of the body.
M0: There is no sign that cancer has spread to other parts of the body.
M1: Cancer has spread to other parts of the body, most often the bones, lungs, liver, or brain. If cancer has spread to distant lymph nodes, the cancer in the lymph nodes is larger than 0.2 millimeters. The cancer is called metastatic breast cancer.
The grading system is used to describe how quickly a breast tumor is likely to grow and spread.
The grading system describes a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. Low-grade cancer cells look more like normal cells and tend to grow and spread more slowly than high-grade cancer cells. To describe how abnormal the cancer cells and tissue are, the pathologist will assess the following three features:
How much of the tumor tissue has normal breast ducts.
The size and shape of the nuclei in the tumor cells.
How many dividing cells are present, which is a measure of how fast the tumor cells are growing and dividing.
For each feature, the pathologist assigns a score of 1 to 3; a score of “1” means the cells and tumor tissue look the most like normal cells and tissue, and a score of “3” means the cells and tissue look the most abnormal. The scores for each feature are added together to get a total score between 3 and 9.
Three grades are possible:
Total score of 3 to 5: G1 (Low grade or well differentiated).
Total score of 6 to 7: G2 (Intermediate grade or moderately differentiated).
Total score of 8 to 9: G3 (High grade or poorly differentiated).
Biomarker testing is used to find out whether breast cancer cells have certain receptors.
Healthy breast cells, and some breast cancer cells, have receptors (biomarkers) that attach to the hormones estrogen and progesterone. These hormones are needed for healthy cells, and some breast cancer cells, to grow and divide. To check for these biomarkers, samples of tissue containing breast cancer cells are removed during a biopsy or surgery. The samples are tested in a laboratory to see whether the breast cancer cells have estrogen or progesterone receptors.
Another type of receptor (biomarker) that is found on the surface of all breast cancer cells is called HER2. HER2 receptors are needed for the breast cancer cells to grow and divide.
For breast cancer, biomarker testing includes the following:
Estrogen receptor (ER). If the breast cancer cells have estrogen receptors, the cancer cells are called ER positive (ER+). If the breast cancer cells do not have estrogen receptors, the cancer cells are called ER negative (ER-).
Progesterone receptor (PR). If the breast cancer cells have progesterone receptors, the cancer cells are called PR positive (PR+). If the breast cancer cells do not have progesterone receptors, the cancer cells are called PR negative (PR-).
Human epidermal growth factor type 2 receptor (HER2/neu or HER2). If the breast cancer cells have larger than normal amounts of HER2 receptors on their surface, the cancer cells are called HER2 positive (HER2+). If the breast cancer cells have a normal amount of HER2 on their surface, the cancer cells are called HER2 negative (HER2-). HER2+ breast cancer is more likely to grow and divide faster than HER2- breast cancer.
Sometimes the breast cancer cells will be described as triple negative or triple positive.
Triple negative. If the breast cancer cells do not have estrogen receptors, progesterone receptors, or a larger than normal amount of HER2 receptors, the cancer cells are called triple negative.
Triple positive. If the breast cancer cells do have estrogen receptors, progesterone receptors, and a larger than normal amount of HER2 receptors, the cancer cells are called triple positive.
It is important to know the estrogen receptor, progesterone receptor, and HER2 receptor status to choose the best treatment. There are drugs that can stop the receptors from attaching to the hormones estrogen and progesterone and stop the cancer from growing. Other drugs may be used to block the HER2 receptors on the surface of the breast cancer cells and stop the cancer from growing.
The TNM system, the grading system, and biomarker status are combined to find out the breast cancer stage.
Here are 3 examples that combine the TNM system, the grading system, and the biomarker status to find out the Pathological Prognostic breast cancer stage for a woman whose first treatment was surgery:
If the tumor size is 30 millimeters (T2), has not spread to nearby lymph nodes (N0), has not spread to distant parts of the body (M0), and is:
Grade 1
HER2+
ER-
PR-
The cancer is stage IIA.
If the tumor size is 53 millimeters (T3), has spread to 4 to 9 axillary lymph nodes (N2), has not spread to other parts of the body (M0), and is:
Grade 2
HER2+
ER+
PR-
The tumor is stage IIIA.
If the tumor size is 65 millimeters (T3), has spread to 3 axillary lymph nodes (N1a), has spread to the lungs (M1), and is:
Grade 1
HER2+
ER-
PR-
The cancer is stage IV (metastatic breast cancer).
Talk to your doctor to find out what your breast cancer stage is and how it is used to plan the best treatment for you.
After surgery, your doctor will receive a pathology report that describes the size and location of the primary tumor, the spread of cancer to nearby lymph nodes, tumor grade, and whether certain biomarkers are present. The pathology report and other test results are used to determine your breast cancer stage.
You are likely to have many questions. Ask your doctor to explain how staging is used to decide the best options to treat your cancer and whether there are clinical trials that might be right for you.
The treatment of breast cancer depends partly on the stage of the disease.
For ductal carcinoma in situ (DCIS) treatment options, see Treatment of Ductal Carcinoma in Situ.
For treatment options for stage I, stage II, stage IIIA, and operable stage IIIC breast cancer, see Treatment of Early, Localized or Operable Breast Cancer.
For treatment options for stage IIIB, inoperable stage IIIC, and inflammatory breast cancer, see Treatment of Locally Advanced Inflammatory Breast Cancer.
For treatment options for cancer that has recurred near the area where it first formed (such as in the breast, in the skin of the breast, in the chest wall, or in nearby lymph nodes), see Treatment of Locoregional Recurrent Breast Cancer.
For treatment options for stage IV (metastatic) breast cancer or breast cancer that has recurred in distant parts of the body, see Treatment of Metastatic Breast Cancer.
Inflammatory Breast Cancer
In inflammatory breast cancer, cancer has spread to the skin of the breast and the breast looks red and swollen and feels warm. The redness and warmth occur because the cancer cells block the lymph vessels in the skin. The skin of the breast may also show the dimpled appearance called peau d’orange (like the skin of an orange). There may not be any lumps in the breast that can be felt. Inflammatory breast cancer may be stage IIIB, stage IIIC, or stage IV.
Inflammatory breast cancer of the left breast showing peau d’orange and inverted nipple.
Source: National Cancer Institute (NIH)
Additional Materials (12)
T1 - the tumor is 2 cm across or less.
T2 - the tumor is more than 2 cm but no more than 5 cm across.
T3 - the tumor is bigger than 5 cm across.
Stage 3B breast cancer - Diagram 1 of 2
3D medical animation still showing metastatic or stage 4 Breast Cancer
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TNM Staging for Breast Cancer
The breast cancer TNM staging system is the most common way that doctors stage breast cancer. TNM stands for Tumor, Node, Metastasis. Your scans and tests give some information about the stage of your cancer. But your doctor might not be able to tell you the exact stage until you have surgery.
Interactive by Cancer Research UK
Diagram showing stage 1A breast cancer
Stage 1B breast cancer
Stage 2A breast cancer - Diagram 1 of 2
Stage 2A breast cancer - Diagram 2 of 2
Stage 2B breast cancer - Diagram 1 of 3
Stage 2B breast cancer - Diagram 2 of 3
Stage 2B breast cancer - Diagram 3 of 3
Stage 3A breast cancer- Diagram 1 of 3
Stage 3A breast cancer- Diagram 2 of 3
Stage 3A breast cancer- Diagram 3 of 3
Diagram 1 of 3 showing stage 3C breast cancer
Stage 3C breast cancer - Diagram 2 of 3
Stage 3C breast cancer - Diagram 3 of 3
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Stages of Breast Cancer
Interactive by Cancer Research UK / Wikimedia
What Are Tumor Markers for Breast Cancer?
Video by Breast Cancer Answers®/YouTube
The Staging and Grading of Cancer
Video by Learn Oncology/YouTube
3D medical animation TNM Staging System
3D medical illustration depicting the Tumor (left), Node (middle) and Metastasis (right) staging system for cancer
Image by https://www.scientificanimations.com
Cancer Spreading to the auxiliary Lymph Nodes
Cancer Spreading to the auxiliary Lymph Nodes
Image by TheVisualMD
Cancer staging
Staging Cancer : Staging is the process of finding out the amount of cancer in the body and if it has spread. Most tumorous cancers are staged using the TNM system. In the TNM system, T = extent of the primary tumor, N = extent of spread to lymph nodes, M = presence of metastasis. After the TNM description has been decided, the cancer can be designated as Stage 0-IV. Stage 0 =carcinoma in situ. In Stage I, Stage II, and Stage III, higher numbers indicate more extensive disease, ie, greater tumor size, and/or spread of the cancer to nearby lymph nodes, and/or organs adjacent to the primary tumor. In Stage IV, the cancer has spread to another organ.
Image by TheVisualMD
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Breast MRI for Cancer Staging
Magnetic Resonance Imaging (MRI)
Video by TheVisualMD
Metastasis: How Cancer Spreads
Video by National Cancer Institute/YouTube
Breast Cancer Staging
Video by Mount Sinai Health System/YouTube
What Is the Difference Between Staging and Grading in Breast Cancer?
Video by Cleveland Clinic/YouTube
What is breast cancer staging?
Video by National Breast Cancer Foundation/YouTube
TNM Staging for Breast Cancer
Cancer Research UK
Stages of Breast Cancer
Cancer Research UK / Wikimedia
2:42
What Are Tumor Markers for Breast Cancer?
Breast Cancer Answers®/YouTube
5:40
The Staging and Grading of Cancer
Learn Oncology/YouTube
3D medical animation TNM Staging System
https://www.scientificanimations.com
Cancer Spreading to the auxiliary Lymph Nodes
TheVisualMD
Cancer staging
TheVisualMD
0:52
Breast MRI for Cancer Staging
TheVisualMD
1:49
Metastasis: How Cancer Spreads
National Cancer Institute/YouTube
1:17
Breast Cancer Staging
Mount Sinai Health System/YouTube
2:30
What Is the Difference Between Staging and Grading in Breast Cancer?
There are different types of treatment for patients with breast cancer.
Six types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Hormone therapy
Targeted therapy
Immunotherapy
New types of treatment are being tested in clinical trials.
Treatment for breast cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with breast cancer.
Different types of treatment are available for patients with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Six types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Hormone therapy
Targeted therapy
Immunotherapy
New types of treatment are being tested in clinical trials.
Information about clinical trials is available from the NCI website.
Treatment for breast cancer may cause side effects.
For information about side effects that begin during treatment for cancer, see our Side Effects page.
Some treatments for breast cancer may cause side effects that continue or appear months or years after treatment has ended. These are called late effects.
Late effects of radiation therapy are not common, but may include:
Inflammation of the lung after radiation therapy to the breast, especially when chemotherapy is given at the same time.
Arm lymphedema, especially when radiation therapy is given after lymph node dissection.
In women younger than 45 years who receive radiation therapy to the chest wall after mastectomy, there may be a higher risk of developing breast cancer in the other breast.
Late effects of chemotherapy depend on the drugs used, but may include:
Heart failure.
Blood clots.
Premature menopause.
Second cancer, such as leukemia.
Late effects of targeted therapy with trastuzumab, lapatinib, or pertuzumab may include:
Heart problems such as heart failure.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Source: National Cancer Institute (NIH)
Additional Materials (19)
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Mastectomy
Total (simple) Mastectomy Description Total (simple) mastectomy; drawing shows removal of the breast and lymph nodes. The dotted line shows where the entire breast is removed. Some lymph nodes under the arm may also be removed.
Image by National Cancer Institute
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Breast Cancer Surgery
Breast surgeon Dr. Nora Jaskowiak of The University of Chicago Medical Center explains how far mastectomies and other breast surgeries have come and the impact on the patient's life.
Video by TheVisualMD
This browser does not support the video element.
Radiation for Breast Cancer
Radiation therapy is a common treatment for breast cancer. Here, breast surgeon Dr. Nora Jaskowiak explains standard prescription of radiation therapy in conjunction with lumpectomy surgery. Then dosimetrist Carla Rash walks you through part of a high-tech radiation treatment planning session. A dosimetrist is a member of the radiation oncology team who specializes in the physics behind radiation therapy treatment.
Video by TheVisualMD
This browser does not support the video element.
PET/CT in Breast Cancer Treatment
National Cancer Institute radiologist Dr. Peter Choyke explains the role that PET scans can play in the treatment of breast cancer.
Video by TheVisualMD
This browser does not support the video element.
Chemotherapy for Breast Cancer
Here, University Chicago Medical Center breast surgeon Dr. Nora Jaskowiak explains why patients are given chemotherapy; and Wendy, a breast cancer survivor, explains her experience with chemo first hand.
Video by TheVisualMD
This browser does not support the video element.
Patient Describes Radiation Treatment for Breast Cancer
Wendy, a breast cancer survivor, discusses her experience with radiation treatment.
Video by TheVisualMD
How Monoclonal Antibodies Treat Cancer
Video by National Cancer Institute/YouTube
Immune Checkpoint Inhibitors
Video by National Cancer Institute/YouTube
Breast Reconstructive Surgery TRAM part 1
Breast Reconstructive Surgery TRAM part 2
Breast Reconstructive Surgery TRAM part 3
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Breast Reconstructive Surgery - transverse rectus abdominis myocutaneous (TRAM)
One form of breast reconstruction is the transverse rectus abdominis myocutaneous (TRAM) flap procedure. In a TRAM flap procedure, skin, fat, muscle, and some blood vessels are taken from the abdomen.They are either cut away from the abdomen completely (free flap) or tunneled under the skin to the breast area (pedicle flap).
Interactive by TheVisualMD
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Male Breast Cancer - Treatment
1 week + 4 days I take these shots after removing the dressings and then showering. The warm water is soothing and also makes me look better. I might be taking post-surgical shots, but I'm still vain.
Image by Charles Hutchins
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Breast Cancer Treatment Using Iridium Seeds
The breast of an African-American woman is exposed and highlighted. Some scarring is visible on the breast below the nipple marking the tumor area. Surgeons are visible looking over the patient examining the patient. They will mark and place tubes for later implantation of radioactive iridium seeds.
Image by National Cancer Institute / Linda Bartlett (Photographer)
NCI Minute: Immunotherapy for Metastatic Breast Cancer
Video by National Cancer Institute/YouTube
Immunotherapy Means Life: Karen’s Breast Cancer Story
Video by Cancer Research Institute/YouTube
Immunotherapy and breast cancer: how does it work?
Video by Top Doctors UK/YouTube
How Do Doctors Diagnose and Treat Breast Cancer?
Video by Columbia University Department of Surgery/YouTube
Breast Cancer - What It Is, Types, Causes, Signs, Diagnosis, Treatments & Prevention
Video by Rehealthify/YouTube
Leave my lymph nodes alone! When less is more - Maggie DiNome, MD | UCLAMDChat
Video by UCLA Health/YouTube
Questions Breast Cancer Patients Should Ask Their Oncologist
Video by Breast Cancer Answers®/YouTube
Mayo Clinic Q&A podcast: Systemic therapies for breast cancer
Video by Mayo Clinic/YouTube
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Mastectomy
National Cancer Institute
0:32
Breast Cancer Surgery
TheVisualMD
1:24
Radiation for Breast Cancer
TheVisualMD
0:58
PET/CT in Breast Cancer Treatment
TheVisualMD
1:23
Chemotherapy for Breast Cancer
TheVisualMD
0:34
Patient Describes Radiation Treatment for Breast Cancer
TheVisualMD
3:20
How Monoclonal Antibodies Treat Cancer
National Cancer Institute/YouTube
1:49
Immune Checkpoint Inhibitors
National Cancer Institute/YouTube
Breast Reconstructive Surgery - transverse rectus abdominis myocutaneous (TRAM)
TheVisualMD
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Male Breast Cancer - Treatment
Charles Hutchins
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Breast Cancer Treatment Using Iridium Seeds
National Cancer Institute / Linda Bartlett (Photographer)
1:24
NCI Minute: Immunotherapy for Metastatic Breast Cancer
National Cancer Institute/YouTube
1:00
Immunotherapy Means Life: Karen’s Breast Cancer Story
Cancer Research Institute/YouTube
5:50
Immunotherapy and breast cancer: how does it work?
Top Doctors UK/YouTube
1:45
How Do Doctors Diagnose and Treat Breast Cancer?
Columbia University Department of Surgery/YouTube
6:17
Breast Cancer - What It Is, Types, Causes, Signs, Diagnosis, Treatments & Prevention
Rehealthify/YouTube
36:36
Leave my lymph nodes alone! When less is more - Maggie DiNome, MD | UCLAMDChat
UCLA Health/YouTube
2:15
Questions Breast Cancer Patients Should Ask Their Oncologist
Breast Cancer Answers®/YouTube
21:49
Mayo Clinic Q&A podcast: Systemic therapies for breast cancer
Mayo Clinic/YouTube
Surgery
Lumpectomy
Image by TheVisualMD
Lumpectomy
Colorized MR of Breasts After Breast Conserving Surgery or Lumpectomy : Colorized breast MR of breasts, axial slice (horizontal view, as though seen from above). The breast on the right side of the image has had breast-conserving surgery, also called lumpectomy. This type of surgery removes the tumor, some breast tissue, and some lymph nodes, but preserves the chest muscles. The aim of the surgery is to take only as much tissue as is necessary to keep the chance of recurrence low, but to keep the breast looking as normal as possible.
Image by TheVisualMD
Types of Treatment for Breast Cancer: Surgery
Most patients with breast cancer have surgery to remove the cancer.
Sentinel lymph node biopsy is the removal of the sentinel lymph node during surgery. The sentinel lymph node is the first lymph node in a group of lymph nodes to receive lymphatic drainage from the primary tumor. It is the first lymph node the cancer is likely to spread to from the primary tumor. A radioactive substance and/or blue dye is injected near the tumor. The substance or dye flows through the lymph ducts to the lymph nodes. The first lymph node to receive the substance or dye is removed. A pathologist views the tissue under a microscope to look for cancer cells. If cancer cells are not found, it may not be necessary to remove more lymph nodes. Sometimes, a sentinel lymph node is found in more than one group of nodes. After the sentinel lymph node biopsy, the surgeon removes the tumor using breast-conserving surgery or mastectomy. If cancer cells were found, more lymph nodes will be removed through a separate incision. This is called a lymph node dissection.
Types of surgery include the following:
Breast-conserving surgery is an operation to remove the cancer and some normal tissue around it, but not the breast itself. Part of the chest wall lining may also be removed if the cancer is near it. This type of surgery may also be called lumpectomy, partial mastectomy, segmental mastectomy, quadrantectomy, or breast-sparing surgery. Breast-conserving surgery. The tumor and some normal tissue around it are removed, but not the breast itself. Some lymph nodes under the arm may be removed. Part of the chest wall lining may also be removed if the cancer is near it.
Total mastectomy: Surgery to remove the whole breast that has cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed and checked for cancer. This may be done at the same time as the breast surgery or after. This is done through a separate incision. Total (simple) mastectomy. The dotted line shows where the entire breast is removed. Some lymph nodes under the arm may also be removed.
Modified radical mastectomy: Surgery to remove the whole breast that has cancer. This may include removal of the nipple, areola (the dark-colored skin around the nipple), and skin over the breast. Most of the lymph nodes under the arm are also removed. Modified radical mastectomy. The whole breast and most of the lymph nodes under the arm are removed.
Chemotherapy may be given before surgery to remove the tumor. When given before surgery, chemotherapy will shrink the tumor and reduce the amount of tissue that needs to be removed during surgery. Treatment given before surgery is called preoperative therapy or neoadjuvant therapy.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy, chemotherapy, targeted therapy, or hormone therapy after surgery, to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called postoperative therapy or adjuvant therapy.
If a patient is going to have a mastectomy, breast reconstruction (surgery to rebuild a breast’s shape after a mastectomy) may be considered. Breast reconstruction may be done at the time of the mastectomy or at some time after. The reconstructed breast may be made with the patient’s own (nonbreast) tissue or by using implants filled with saline or silicone gel. Before the decision to get an implant is made, patients can call the Food and Drug Administration's (FDA) Center for Devices and Radiologic Health at 1-888-INFO-FDA (1-888-463-6332) or visit the FDA website for more information on breast implants.
Source: National Cancer Institute (NCI)
Additional Materials (12)
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Breast Cancer Surgery
Breast surgeon Dr. Nora Jaskowiak of The University of Chicago Medical Center explains how far mastectomies and other breast surgeries have come and the impact on the patient's life.
Image by TheVisualMD
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Breast Reconstructive Surgery TRAM Procedure
Diagram showing a TRAM flap reconstruction with an implant
Image by Cancer Research UK uploader
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Breast Reconstructive Surgery TRAM part 1
After having a mastectomy, many women decide to have breast reconstruction done. In a mastectomy, the breast is surgically removed. One form of breast reconstruction is the transverse rectus abdominis myocutaneous (TRAM) flap procedure. Image 1 of 2.
Image by TheVisualMD
Breast-Conserving Surgery (Male)
Breast-conserving surgery; the drawing on the left shows removal of the tumor and some of the normal tissue around it. The drawing on the right shows removal of some of the lymph nodes under the arm and removal of the tumor and part of the chest wall lining near the tumor. Also shown is fatty tissue in the breast.
Breast-conserving surgery. The tumor and some normal tissue around it are removed, but not the breast itself. Some lymph nodes under the arm may be removed. Part of the chest wall lining may also be removed if the cancer is near it.
Breast Cancer Surgery: Start with your Breast Surgeon
Breast Cancer School for Patients/YouTube
1:48
Lumpectomy & Mastectomy for Treating Breast Cancer - SLUCare Breast Surgery
SLUCare/YouTube
3:54
How Will My Breast Look and Feel after Breast Reconstruction Surgery?
Breast Cancer Answers®/YouTube
6:41
Exercises After Breast Cancer Surgery | Cancer Research UK
Cancer Research UK/YouTube
3:58
Breast Surgery
Covenant Health/YouTube
4:02
Breast Cancer Surgery Lumpectomy Mastectomy Breast Cancer Care Manipal H Full HD
Regnald Msangi/YouTube
3:23
Changes After Breast Cancer Lumpectomy
Breast Cancer Answers®/YouTube
Radiation Therapy
Radiation for Breast Cancer
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Radiation for Breast Cancer
Radiation therapy is a common treatment for breast cancer. Here, breast surgeon Dr. Nora Jaskowiak explains standard prescription of radiation therapy in conjunction with lumpectomy surgery. Then dosimetrist Carla Rash walks you through part of a high-tech radiation treatment planning session. A dosimetrist is a member of the radiation oncology team who specializes in the physics behind radiation therapy treatment.
Image by TheVisualMD
Types of Treatment for Breast Cancer - Radiation Therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.
Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat breast cancer. Internal radiation therapy with strontium-89 (a radionuclide) is used to relieve bone pain caused by breast cancer that has spread to the bones. Strontium-89 is injected into a vein and travels to the surface of the bones. Radiation is released and kills cancer cells in the bones.
Source: National Cancer Institute (NCI)
Additional Materials (9)
Patient Describes Radiation Treatment for Breast Cancer
Wendy, a breast cancer survivor, discusses her experience with radiation treatment.
Image by TheVisualMD
Treatment - Image-Guided Radiation Therapy (IGRT) for Breast Cancer
Image-Guided Radiation Therapy (IGRT)
Image by TheVisualMD
Lumpectomy & Radiation Therapy: Understanding Breast Cancer | UPMC Magee-Womens Hospital
Video by UPMC/YouTube
Lumpectomy Plus Radiation May Offer Survival Benefits for Early-Stage Breast Cancer
Video by Breastcancer.org/YouTube
Timing Of Radiation After Lumpectomy
Video by Breast Cancer Answers®/YouTube
Breast Cancer Recurrence: It can be a threat to you
Video by Breast Cancer School for Patients/YouTube
Radiation Therapy of the Breast or Chest-wall: Acute side effects and self-care recommendations
Video by Mayo Clinic/YouTube
PreOp® Breast Biopsy Wire Guide Patient Education - Patient Engagement
Video by PreOp.com Patient Engagement - Patient Education/YouTube
How to Treat Stage II (2) Breast Cancer
Video by Yerbba – Breast Cancer/YouTube
Patient Describes Radiation Treatment for Breast Cancer
TheVisualMD
Treatment - Image-Guided Radiation Therapy (IGRT) for Breast Cancer
TheVisualMD
5:52
Lumpectomy & Radiation Therapy: Understanding Breast Cancer | UPMC Magee-Womens Hospital
UPMC/YouTube
2:05
Lumpectomy Plus Radiation May Offer Survival Benefits for Early-Stage Breast Cancer
Breastcancer.org/YouTube
1:47
Timing Of Radiation After Lumpectomy
Breast Cancer Answers®/YouTube
6:19
Breast Cancer Recurrence: It can be a threat to you
Breast Cancer School for Patients/YouTube
4:59
Radiation Therapy of the Breast or Chest-wall: Acute side effects and self-care recommendations
Mayo Clinic/YouTube
2:22
PreOp® Breast Biopsy Wire Guide Patient Education - Patient Engagement
Cancer treatment seeks to completely destroy tumors and prevent cancer from recurring or spreading. If all reasonable approaches to curing the cancer have been tried, and the cancer still is not cured, then the goal of the treatment will be to relieve symptoms and ease discomfort as much as possible.
Image by TheVisualMD
Types of Treatment for Breast Cancer - Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy).
Source: National Cancer Institute (NCI)
Additional Materials (20)
Treating Cancer
Cancer treatment seeks to completely destroy tumors and prevent cancer from recurring or spreading. If all reasonable approaches to curing the cancer have been tried, and the cancer still is not cured, then the goal of the treatment will be to relieve symptoms and ease discomfort as much as possible.
Image by TheVisualMD
Treating Cancer
Because cancers differ from one another in many ways, and because each patient is unique, there isn`t just one approach to treatment. Cancer treatment aims to eliminate the primary tumor, prevent the recurrence or spread of the cancer, and relieve symptoms. Types of cancer treatment include surgery; radiation therapy, which targets specific cancer cells; chemotherapy, which targets cancer cells throughout the body; and biological therapy, which works with the body`s own immune system. If you have cancer, it`s important to educate yourself about the type of cancer you have and the options for its treatment so that you can make informed decisions.
Image by TheVisualMD
Tracey's Battle with Breast Cancer
U.S. Air Force Master Sgt. Tracey Drake, 60th Medical Operations Squadron undergoes chemotherapy for her treatment for breast cancer, Travis Air Force Base, Calif., Dec. 13, 2016. Drake was diagnosed with metastatic breast cancer during her retirement physical in July 2016, 3 weeks before starting terminal leave. Drake faces more chemotherapy, surgery, radiation, targeted infusion, and reconstruction surgery.
Image by U.S. Air Force/Louis Briscese
Tracey's Battle with Breast Cancer
U.S. Air Force Master Sgt. Tracey Drake, 60th Medical Operations Squadron poses with a picture of herself prior to losing her hair from chemotherapy treatment, Travis Air Force Base, Calif., Dec. 15, 2016. Drake was diagnosed with metastatic breast cancer during her retirement physical in July 2016, 3 weeks before starting terminal leave. Drake faces more chemotherapy, surgery, radiation, targeted infusion, and reconstruction surgery.
Image by U.S. Air Force/Louis Briscese
Tracey's Battle with Breast Cancer
U.S. Air Force Master Sgt. Tracey Drake, 60th Medical Operations Squadron and Dr. Sareena Malhi, Hematology & Medical Oncology, enjoy a laugh before Drake is administered her chemotherapy treatment, Travis Air Force Base, Calif., Dec. 13, 2016. Drake was diagnosed with metastatic breast cancer during her retirement physical in July 2016, 3 weeks before starting terminal leave. Drake faces more chemotherapy, surgery, radiation, targeted infusion, and reconstruction surgery.
Image by U.S. Air Force/Louis Briscese
Breast Cancer: treatment for triple negative breast cancer
U.S. Air Force Capt. Candice Adams reacts to the effects of a chemotherapy treatment Jan. 25, 2011 at Walter Reed Army Medical Center. Adams was diagnosed with triple negative breast cancer at age 29. (U.S. Air Force photo by Staff Sgt. Russ Scalf)
Here, University Chicago Medical Center breast surgeon Dr. Nora Jaskowiak explains why patients are given chemotherapy; and Wendy, a breast cancer survivor, explains her experience with chemo first hand.
Video by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
Whether CEA is tested during systemic treatment for colorectal cancer depends on the stage of the cancer. After surgery, the American Society of Clinical Oncologists (ASCO) recommends that patients with stage II or stage III cancer have a CEA test every 3 months, for a minimum of 3 years. However, if the patient is receiving chemotherapy, CEA testing should be delayed until after chemotherapy is completed. On the other hand, CEA is the marker of choice for monitoring stage IV (metastatic) colorectal cancer during systemic treatment. Patients with metastatic cancer, in which the cancer has spread to distant parts of the body, should have a CEA test every 1-3 months during chemotherapy to see if the treatment is working and whether the cancer is still spreading. ASCO recommends other tests be done in conjunction with the CEA tests.
Image by TheVisualMD
Chemotherapy IV
A closeup of a chemotherapy IV in a patient's hand.
Image by National Cancer Institute / Linda Bartlett (Photographer)
White Blood Cells, Chemotherapy
White blood cells (also called leukocytes or WBCs) are in the front lines in the fight against harmful viruses, bacteria, and fungi. Blood levels of WBCs rise when the body is under attack. Levels of WBCs can be depressed, however, by many different factors. One of the most common is cancer treatment. Chemotherapy and radiation can cause a decrease in the production of WBCs; exposure to radiation from a nuclear power plant accident will do the same.
Image by TheVisualMD
Breast Cancer Neoadjuvant Chemotherapy: For Patients
Video by Breast Cancer School for Patients/YouTube
Chemotherapy for Breast Cancer: Options, Duration, and Side Effects
Video by Yerbba – Breast Cancer/YouTube
What Is the Cost of Chemotherapy?
Video by Breast Cancer Answers®/YouTube
Long Term Side Effects of Chemotherapy During Breast Cancer Treatment
Video by Yerbba – Breast Cancer/YouTube
Chemotherapy: Are there different types? | Norton Cancer Institute
Video by Norton Healthcare/YouTube
Breast Cancer Chemotherapy
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Chemotherapy Options for Triple Negative Breast Cancer
Video by Hartford HealthCare/YouTube
Having chemotherapy for breast cancer - patient guide
Video by ouhnhs/YouTube
Do You Need Chemotherapy?
Video by Dr. Susan Love Foundation/YouTube
What is CMF Chemotherapy and what are the side effects of oral CMF | OncoPower
Video by OncoPower/YouTube
Treating Cancer
TheVisualMD
Treating Cancer
TheVisualMD
Tracey's Battle with Breast Cancer
U.S. Air Force/Louis Briscese
Tracey's Battle with Breast Cancer
U.S. Air Force/Louis Briscese
Tracey's Battle with Breast Cancer
U.S. Air Force/Louis Briscese
Breast Cancer: treatment for triple negative breast cancer
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
TheVisualMD
Chemotherapy IV
National Cancer Institute / Linda Bartlett (Photographer)
White Blood Cells, Chemotherapy
TheVisualMD
14:51
Breast Cancer Neoadjuvant Chemotherapy: For Patients
Breast Cancer School for Patients/YouTube
14:58
Chemotherapy for Breast Cancer: Options, Duration, and Side Effects
Yerbba – Breast Cancer/YouTube
3:08
What Is the Cost of Chemotherapy?
Breast Cancer Answers®/YouTube
10:33
Long Term Side Effects of Chemotherapy During Breast Cancer Treatment
Yerbba – Breast Cancer/YouTube
1:58
Chemotherapy: Are there different types? | Norton Cancer Institute
Norton Healthcare/YouTube
0:31
Breast Cancer Chemotherapy
Centers for Disease Control and Prevention (CDC)/YouTube
3:38
Chemotherapy Options for Triple Negative Breast Cancer
Hartford HealthCare/YouTube
16:11
Having chemotherapy for breast cancer - patient guide
ouhnhs/YouTube
2:44
Do You Need Chemotherapy?
Dr. Susan Love Foundation/YouTube
5:59
What is CMF Chemotherapy and what are the side effects of oral CMF | OncoPower
OncoPower/YouTube
Hormone Therapy
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Hormone Therapy for Breast Cancer
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Hormone Therapy for Breast Cancer
Hormone Therapy for Breast Cancer
Image by TheVisualMD
Types of Treatment for Breast Cancer - Hormone Therapy
Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy is used to reduce the production of hormones or block them from working. The hormone estrogen, which makes some breast cancers grow, is made mainly by the ovaries. Treatment to stop the ovaries from making estrogen is called ovarian ablation.
Hormone therapy with tamoxifen is often given to patients with early localized breast cancer that can be removed by surgery and those with metastatic breast cancer (cancer that has spread to other parts of the body). Hormone therapy with tamoxifen or estrogens can act on cells all over the body and may increase the chance of developing endometrial cancer. Women taking tamoxifen should have a pelvic exam every year to look for any signs of cancer. Any vaginal bleeding, other than menstrual bleeding, should be reported to a doctor as soon as possible.
Hormone therapy with a luteinizing hormone-releasing hormone (LHRH) agonist is given to some premenopausal women who have just been diagnosed with hormone receptor positive breast cancer. LHRH agonists decrease the body's estrogen and progesterone.
Hormone therapy with an aromatase inhibitor is given to some postmenopausal women who have hormone receptor positive breast cancer. Aromatase inhibitors decrease the body's estrogen by blocking an enzyme called aromatase from turning androgen into estrogen. Anastrozole, letrozole, and exemestane are types of aromatase inhibitors.
For the treatment of early localized breast cancer that can be removed by surgery, certain aromatase inhibitors may be used as adjuvant therapy instead of tamoxifen or after 2 to 3 years of tamoxifen use. For the treatment of metastatic breast cancer, aromatase inhibitors are being tested in clinical trials to compare them to hormone therapy with tamoxifen.
In women with hormone receptor positive breast cancer, at least 5 years of adjuvant hormone therapy reduces the risk that the cancer will recur (come back).
Other types of hormone therapy include megestrol acetate or anti-estrogen therapy such as fulvestrant.
Source: National Cancer Institute (NCI)
Additional Materials (9)
Hormone Therapy for Breast Cancer
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Estradiol PET/CT Imaging in Breast Cancer Patients
Purpose: It is known that the estrogen receptor (ER) status of a tumor is an important prognostic and predictive indicator in breast cancer. Women with ER-positive breast tumors have a better prognosis than women with ER-negative tumors in terms of responsiveness to anti-estrogen treatment. 16α-[18F]-Fluoro-17β-estradiol (18F-FES) has proven to be a promising tracer for in vivo imaging studies of the ER status of primary and metastatic breast cancer. Consequently, at our Institution positron emission tomography/computed tomography (PET/CT) using estradiol, labelled with fluorine-18, is an important diagnostic tool to be used in hormone-dependent breast cancer.
Image by Citation: Vaalavirta L, Rasulova N, Partanen K, Joensuu T, Kairemo K. [18F]-Estradiol PET/CT Imaging in Breast Cancer Patients. Journal of Diagnostic Imaging in Therapy
Breast Cancer Cell
Confocal microscopy of breast cancer cells. Breast cancer cells may be hormone receptor-positive if they contain binding sites for hormones such as estrogen or progesterone, or be hormone receptor-negative if they do not. Hormone receptor-positive breast cancer cells grow more slowly than hormone receptor-negative cells, and therefore women with tumors comprised of those kinds of cells may have a better prognosis as well as more treatment options.
Image by TheVisualMD
Breast tenderness and hormone replacement therapy (HRT) - from Tonic TV
Video by NPS MedicineWise/YouTube
Hormone Replacement Therapy & Breast Cancer
Video by SMHCS/YouTube
Hormone Therapy for Breast Cancer and the Side Effects of Tamoxifen
Video by Seattle Cancer Care Alliance/YouTube
Hormone replacement therapy and breast cancer risk
Video by MD Anderson Cancer Center/YouTube
Do I Need Hormonal Therapy to Treat Breast Cancer?
Video by Yerbba – Breast Cancer/YouTube
Hormone Receptor Positive Breast Cancer
Video by Dr. Susan Love Foundation/YouTube
Hormone Therapy for Breast Cancer
TheVisualMD
Estradiol PET/CT Imaging in Breast Cancer Patients
Citation: Vaalavirta L, Rasulova N, Partanen K, Joensuu T, Kairemo K. [18F]-Estradiol PET/CT Imaging in Breast Cancer Patients. Journal of Diagnostic Imaging in Therapy
Breast Cancer Cell
TheVisualMD
6:33
Breast tenderness and hormone replacement therapy (HRT) - from Tonic TV
NPS MedicineWise/YouTube
32:05
Hormone Replacement Therapy & Breast Cancer
SMHCS/YouTube
3:42
Hormone Therapy for Breast Cancer and the Side Effects of Tamoxifen
Seattle Cancer Care Alliance/YouTube
4:05
Hormone replacement therapy and breast cancer risk
MD Anderson Cancer Center/YouTube
9:37
Do I Need Hormonal Therapy to Treat Breast Cancer?
Yerbba – Breast Cancer/YouTube
2:57
Hormone Receptor Positive Breast Cancer
Dr. Susan Love Foundation/YouTube
Targeted Therapy
Targeted Therapy
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Targeted Therapy
A summary of targeted therapy. Patients and their diseases are profiled in order to identify the most effective treatment for their specific case.
Image by Simon Caulton
Types of Treatment for Breast Cancer - Targeted Therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. Monoclonal antibodies, tyrosine kinase inhibitors, cyclin-dependent kinase inhibitors, mammalian target of rapamycin (mTOR) inhibitors, and PARP inhibitors are types of targeted therapies used in the treatment of breast cancer.
Monoclonal antibodies: Monoclonal antibodies are immune system proteins made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Monoclonal antibodies may be used in combination with chemotherapy as adjuvant therapy.
Types of monoclonal antibody therapy include the following:
Trastuzumab is a monoclonal antibody that blocks the effects of the growth factor protein HER2, which sends growth signals to breast cancer cells. It may be used with other therapies to treat HER2 positive breast cancer.
Trastuzumab deruxtecan is an antibody-drug conjugate that links trastuzumab to a type of chemotherapy. When this linked therapy binds to HER2 positive breast cancer cells, the chemotherapy enters the cells and kills them. Trastuzumab deruxtecan may be used to treat certain patients with HER2 positive breast cancer that has already been treated and has metastasized (spread to other parts of the body).
Pertuzumab is a monoclonal antibody that may be combined with trastuzumab and chemotherapy to treat breast cancer. It may be used to treat certain patients with HER2 positive breast cancer that has metastasized (spread to other parts of the body). It may also be used as neoadjuvant therapy in patients with locally advanced, inflammatory, or early-stage breast cancer. It may also be used as adjuvant therapy in certain patients with early-stage HER2 positive breast cancer.
Ado-trastuzumab emtansine is a monoclonal antibody linked to an anticancer drug. This is called an antibody-drug conjugate. It is used to treat HER2 positive breast cancer that has spread to other parts of the body or recurred (come back). It is also used as adjuvant therapy to treat HER2 positive breast cancer in patients who have residual disease after surgery.
Sacituzumab govitecan is a monoclonal antibody that carries an anticancer drug to the tumor. This is called an antibody-drug conjugate. It is used to treat metastatic triple-negative breast cancer in patients who have received at least two previous chemotherapy regimens.
Tyrosine kinase inhibitors: This treatment block signals needed for tumors to grow. Tyrosine kinase inhibitors may be used with other anticancer drugs as adjuvant therapy. Tyrosine kinase inhibitors include the following:
Tucatinib is a tyrosine kinase inhibitor used with trastuzumab and capecitabine to treat HER2 positive breast cancer that is advanced and cannot be removed by surgery or has spread to other parts of the body, including the brain. It is used in patients whose cancer has already been treated with at least one other anti-HER2 therapy.
Neratinib is a tyrosine kinase inhibitor that blocks the effects of the HER2 protein and other proteins inside tumor cells. It is used with capecitabine in adults whose disease is advanced or has spread to other parts of the body and has already been treated with at least two other anti-HER2 therapies. It may also be used to treat patients with early-stage HER2 positive breast cancer after treatment with trastuzumab.
Lapatinib is a tyrosine kinase inhibitor that blocks the effects of the HER2 protein and other proteins inside tumor cells. It may be used with other drugs to treat patients with HER2 positive breast cancer that has progressed after treatment with trastuzumab.
Cyclin-dependent kinase inhibitors: This treatment blocks proteins called cyclin-dependent kinases (CDKs), which cause the growth of cancer cells. Combining CDK4/6 inhibitors with hormone therapy may be effective in treating advanced hormone receptor–positive HER2 negative breast cancer. Cyclin-dependent kinase inhibitors include the following:
Palbociclib is a cyclin-dependent kinase inhibitor used with the drug letrozole to treat breast cancer that is estrogen receptor positive and HER2 negative and has spread to other parts of the body. It is used in postmenopausal women whose cancer has not been treated with hormone therapy. Palbociclib may also be used with fulvestrant in women whose disease has gotten worse after treatment with hormone therapy.
Ribociclib is a cyclin-dependent kinase inhibitor used with letrozole to treat breast cancer that is hormone receptor positive and HER2 negative and has come back or spread to other parts of the body. It is used in postmenopausal women whose cancer has not been treated with hormone therapy. It is also used with fulvestrant in postmenopausal women with hormone receptor positive and HER2 negative breast cancer that has spread to other parts of the body or has recurred. It is also used in premenopausal women with hormone receptor positive and HER2 negative breast cancer that has spread to other parts of the body or has recurred.
Abemaciclib is a cyclin-dependent kinase inhibitor used to treat hormone receptor positive and HER2 negative breast cancer that is advanced or has spread to other parts of the body. It may be used alone or with other drugs.
Alpelisib is a cylin-dependent kinase inhibitor used with the drug fulvestrant to treat hormone receptor positive and HER2 negative breast cancer that has a certain gene change and is advanced or has spread to other parts of the body. It is used in postmenopausal women whose breast cancer has gotten worse during or after treatment with hormone therapy.
Mammalian target of rapamycin (mTOR) inhibitors: This treatment blocks a protein called mTOR, which may keep cancer cells from growing and prevent the growth of new blood vessels that tumors need to grow. mTOR inhibitors include the following:
Everolimus is an mTOR inhibitor used in postmenopausal women with advanced hormone receptor positive breast cancer that is also HER2 negative and has not gotten better with other treatment.
PARP inhibitors: This treatment blocks DNA repair and may cause cancer cells to die. PARP inhibitors include the following:
Olaparib is a PARP inhibitor used to treat patients with mutations in the BRCA1 or BRCA2 gene and HER2 negative breast cancer that has spread to other parts of the body. PARP inhibitor therapy is being studied for the treatment of patients with triple-negative breast cancer and as adjuvant therapy in patients with HER2 negative early breast cancer and mutations in the BRCA1 or BRCA2 gene.
Talazoparib is a PARP inhibitor used to treat patients with mutations in the BRCA1 or BRCA2 genes and HER2 negative breast cancer that is locally advanced or has spread to other parts of the body.
Source: National Cancer Institute (NCI)
Additional Materials (17)
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Nanoclusters in Breast Tumor
Nanoclusters are made when different nanoparticles and agents are linked together. Gold nanoparticles were linked to a short protein (DAPTA peptide) that binds to C-C chemokine receptor type 5 (CCR5), as well as a PET imaging agent, 64Cu. CCR5 has been identified as a biomarker for triple-negative breast cancer. This PET/CT image of the targeted gold nanocluster (64Cu-AuNCs-DAPTA) was acquired 24 hours after intravenous injection in a mouse model of triple-negative breast cancer. The image shows specific tumor accumulation of the nanoclusters (left side, contrast area).
This image is part of the following collections:
NCI Cancer Close Up 2017
Nanotechnology Image Library
Image by National Cancer Institute \ Washington University in St. Louis / Yongjian Liu, Samuel Achilefu
Targeted Therapy
A gram illustrating the disctinction between cancer stem cell targeted (above) and conventional (below) cancer therapies
Image by Peter Znamenskiy
Targeted Therapy
Image Caption : Antibody-dependent cell-mediated cytotoxicity. When the Fc receptors on natural killer (NK) cells interact with Fc regions of antibodies bound to cancer cells, the NK cell releases perforin and granzyme, leading to cancer cell apoptosis.
Image by Simon Caulton
Targeted Therapy
Monoclonal Antibody - Cetuximab mode of action
Image by Florian Schaub at Merck KGaA
Genomic information
This image was created by the NHS HEE Genomics Education Programme. For further information and resources please visit our website www.genomicseducation.hee.nhs.uk
Image by NHS HEE Genomics Education Programme
Adoptive T-cell therapy
Cancer specific T-cells can be obtained by fragmentation and isolation of tumour infiltrating lymphocytes, or by genetically engineering cells from peripheral blood. The cells are activated and grown prior to transfusion into the recipient (tumour bearer).
Image by Simon Caulton
Targeted Cancer Therapy
Video by capathologists/YouTube
Dr. Dy on Side Effects From Targeted Therapies in Clinical Trials
Video by Targeted Oncology/YouTube
How Does Targeted Cancer Therapy Work?
Video by CancerIS/YouTube
Taking Hope from Molecularly Targeted Therapy
Video by American Association for Cancer Research/YouTube
Targeted Cancer Therapy vs. Traditional Chemo
Video by Lee Health/YouTube
Immunotherapy vs. targeted therapy for cancer treatment
Video by MD Anderson Cancer Center/YouTube
Cancer Treatment: Targeted Therapy
Video by Stand Up To Cancer/YouTube
For patients: targeted therapy treatment risks | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Epigenetic Targeted Therapy of Gene Expression in Leukemic Cells
Video by Shilatifard Laboratory at NU/YouTube
Side Effects of Targeted and Immunotherapy Treatment (Conditions A-Z)
Video by Healthguru/YouTube
How targeted therapies work – Macmillan Cancer Support
Video by Macmillan Cancer Support/YouTube
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Nanoclusters in Breast Tumor
National Cancer Institute \ Washington University in St. Louis / Yongjian Liu, Samuel Achilefu
Targeted Therapy
Peter Znamenskiy
Targeted Therapy
Simon Caulton
Targeted Therapy
Florian Schaub at Merck KGaA
Genomic information
NHS HEE Genomics Education Programme
Adoptive T-cell therapy
Simon Caulton
3:08
Targeted Cancer Therapy
capathologists/YouTube
1:53
Dr. Dy on Side Effects From Targeted Therapies in Clinical Trials
Targeted Oncology/YouTube
4:01
How Does Targeted Cancer Therapy Work?
CancerIS/YouTube
4:45
Taking Hope from Molecularly Targeted Therapy
American Association for Cancer Research/YouTube
2:10
Targeted Cancer Therapy vs. Traditional Chemo
Lee Health/YouTube
7:19
Immunotherapy vs. targeted therapy for cancer treatment
MD Anderson Cancer Center/YouTube
0:50
Cancer Treatment: Targeted Therapy
Stand Up To Cancer/YouTube
1:17
For patients: targeted therapy treatment risks | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
2:25
Epigenetic Targeted Therapy of Gene Expression in Leukemic Cells
Shilatifard Laboratory at NU/YouTube
1:10
Side Effects of Targeted and Immunotherapy Treatment (Conditions A-Z)
Healthguru/YouTube
2:41
How targeted therapies work – Macmillan Cancer Support
Macmillan Cancer Support/YouTube
Immunotherapy
immunotherapy for metastatic breast cancer
Image by National Cancer Institute
immunotherapy for metastatic breast cancer
Before TIL therapy, a woman with breast cancer had metastatic lesions in her chest wall (top, left) and liver (bottom, left). After receiving the immunotherapy, her tumors shrank completely, and recent scans (right) show that she remains cancer free more than 5 years later.
Image by National Cancer Institute
Types of Treatment for Breast Cancer - Immunotherapy
Immunotherapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This cancer treatment is a type of biologic therapy.
There are different types of immunotherapy:
PD-1 and PD-L1 inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. Atezolizumab is a PD-L1 inhibitor used to treat breast cancer that has spread to other parts of the body.
Source: National Cancer Institute (NCI)
Additional Materials (15)
immunotherapy combination for metastatic breast cancer
The combination of immunotherapy agents can augment key components of a successful anti-tumor immune response.
Image by National Cancer Institute
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Anti-Tumor Immune Response
Using a novel imaging technique called transparent tumor tomography that three-dimensionally visualizes the tumor microenvironment at a single cell resolution, researchers obtained this image from a mouse model for HER2-positive breast cancer. Shown are cytotoxic T cells (CD3 in yellow; CD8 in red; , CD31 in blue) attacking the tumor after treatment with radiation and a PD-L1 immune checkpoint blockade therapy. New knowledge about the mechanism of inducing anti-tumor immune responses may lead to better treatments.
Image by Steve Seung-Young Lee / National Cancer Institute \ Univ. of Chicago Comprehensive Cancer Center
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Anti-Tumor Immune Response
Using a novel imaging technique called transparent tumor tomography that three-dimensionally visualizes the tumor microenvironment at a single cell resolution, researchers obtained this image from a mouse model for HER2-positive breast cancer. Shown are cytotoxic T cells (CD3 in yellow; CD8 in red; , CD31 in blue) attacking the tumor after treatment with radiation and a PD-L1 immune checkpoint blockade therapy. New knowledge about the mechanism of inducing anti-tumor immune responses may lead to better treatments.
Image by Steve Seung-Young Lee / National Cancer Institute \ Univ. of Chicago Comprehensive Cancer Center
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CAR T-Cell Therapy
This schematic shows the steps for creating CAR T-cell therapy, a type of treatment in which a patient's T cells (a type of immune system cell) are changed in the laboratory so they will attack cancer cells.
Image by National Cancer Institute (NCI)
Returning to Life After Breast Cancer: Emily's Immunotherapy Story
Video by Cancer Research Institute/YouTube
Immunotherapy Means Life: Karen’s Breast Cancer Story
Video by Cancer Research Institute/YouTube
NCI Minute: Immunotherapy for Metastatic Breast Cancer
Video by National Cancer Institute/YouTube
Immunotherapy and breast cancer: how does it work?
Video by Top Doctors UK/YouTube
Immunotherapy and Triple Negative Breast Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
How immunotherapy might be effective for triple-negative breast cancer
Video by Dana-Farber Cancer Institute/YouTube
Encouraging developments in triple negative breast cancer immunotherapy
Video by VJOncology/YouTube
Chemo and immunotherapy together may help triple-negative breast cancer patients
Video by CBS Mornings/YouTube
First immunotherapy success for triple-negative breast cancer
Video by QMULOfficial/YouTube
Immunotherapy Keytruda Shows Benefit in Early Triple-Negative Breast Cancer
Video by Breastcancer.org/YouTube
Role of Immunotherapy inTriple Negative Breast Cancer
Video by Max Healthcare/YouTube
immunotherapy combination for metastatic breast cancer
National Cancer Institute
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Anti-Tumor Immune Response
Steve Seung-Young Lee / National Cancer Institute \ Univ. of Chicago Comprehensive Cancer Center
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Anti-Tumor Immune Response
Steve Seung-Young Lee / National Cancer Institute \ Univ. of Chicago Comprehensive Cancer Center
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CAR T-Cell Therapy
National Cancer Institute (NCI)
4:06
Returning to Life After Breast Cancer: Emily's Immunotherapy Story
Cancer Research Institute/YouTube
1:00
Immunotherapy Means Life: Karen’s Breast Cancer Story
Cancer Research Institute/YouTube
1:24
NCI Minute: Immunotherapy for Metastatic Breast Cancer
National Cancer Institute/YouTube
5:50
Immunotherapy and breast cancer: how does it work?
Top Doctors UK/YouTube
5:04
Immunotherapy and Triple Negative Breast Cancer - Mayo Clinic
Mayo Clinic/YouTube
2:21
How immunotherapy might be effective for triple-negative breast cancer
Dana-Farber Cancer Institute/YouTube
1:39
Encouraging developments in triple negative breast cancer immunotherapy
VJOncology/YouTube
2:48
Chemo and immunotherapy together may help triple-negative breast cancer patients
CBS Mornings/YouTube
1:26
First immunotherapy success for triple-negative breast cancer
QMULOfficial/YouTube
1:29
Immunotherapy Keytruda Shows Benefit in Early Triple-Negative Breast Cancer
Breastcancer.org/YouTube
1:34
Role of Immunotherapy inTriple Negative Breast Cancer
Max Healthcare/YouTube
Treatment by Stage
Diagram showing stage 1A breast cancer
Stage 1B breast cancer
Stage 2A breast cancer - Diagram 1 of 2
Stage 2A breast cancer - Diagram 2 of 2
Stage 2B breast cancer - Diagram 1 of 3
Stage 2B breast cancer - Diagram 2 of 3
Stage 2B breast cancer - Diagram 3 of 3
Stage 3A breast cancer- Diagram 1 of 3
Stage 3A breast cancer- Diagram 2 of 3
Stage 3A breast cancer- Diagram 3 of 3
Diagram 1 of 3 showing stage 3C breast cancer
Stage 3C breast cancer - Diagram 2 of 3
Stage 3C breast cancer - Diagram 3 of 3
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Stages of Breast Cancer
Interactive by Cancer Research UK / Wikimedia
Diagram showing stage 1A breast cancer
Stage 1B breast cancer
Stage 2A breast cancer - Diagram 1 of 2
Stage 2A breast cancer - Diagram 2 of 2
Stage 2B breast cancer - Diagram 1 of 3
Stage 2B breast cancer - Diagram 2 of 3
Stage 2B breast cancer - Diagram 3 of 3
Stage 3A breast cancer- Diagram 1 of 3
Stage 3A breast cancer- Diagram 2 of 3
Stage 3A breast cancer- Diagram 3 of 3
Diagram 1 of 3 showing stage 3C breast cancer
Stage 3C breast cancer - Diagram 2 of 3
Stage 3C breast cancer - Diagram 3 of 3
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Stages of Breast Cancer
Interactive by Cancer Research UK / Wikimedia
Treatment by Stage of Breast Cancer
Treatment of Early, Localized, or Operable Breast Cancer
Treatment of early, localized, or operable breast cancer may include the following:
Surgery
Breast-conserving surgery and sentinel lymph node biopsy. If cancer is found in the lymph nodes, a lymph node dissection may be done.
Modified radical mastectomy. Breast reconstruction surgery may also be done.
Postoperative radiation therapy
For women who had breast-conserving surgery, radiation therapy is given to the whole breast to lessen the chance the cancer will come back. Radiation therapy may also be given to lymph nodes in the area.
For women who had a modified radical mastectomy, radiation therapy may be given to lessen the chance the cancer will come back if any of the following are true:
Cancer was found in 4 or more lymph nodes.
Cancer had spread to tissue around the lymph nodes.
The tumor was large.
There is tumor close to or remaining in the tissue near the edges of where the tumor was removed.
Postoperative systemic therapy
Systemic therapy is the use of drugs that can enter the bloodstream and reach cancer cells throughout the body. Postoperative systemic therapy is given to lessen the chance the cancer will come back after surgery to remove the tumor.
Postoperative systemic therapy is given depending on whether:
The tumor is hormone receptor negative or positive.
The tumor is HER2/neu negative or positive.
The tumor is hormone receptor negative and HER2/neu negative (triple negative).
The size of the tumor.
In premenopausal women with hormone receptor positive tumors, no more treatment may be needed or postoperative therapy may include:
Tamoxifen therapy with or without chemotherapy.
Tamoxifen therapy and treatment to stop or lessen how much estrogen is made by the ovaries. Drug therapy, surgery to remove the ovaries, or radiation therapy to the ovaries may be used.
Aromatase inhibitor therapy and treatment to stop or lessen how much estrogen is made by the ovaries. Drug therapy, surgery to remove the ovaries, or radiation therapy to the ovaries may be used.
In postmenopausal women with hormone receptor positive tumors, no more treatment may be needed or postoperative therapy may include:
Aromatase inhibitor therapy with or without chemotherapy.
Tamoxifen followed by aromatase inhibitor therapy, with or without chemotherapy.
In women with hormone receptor negative tumors, no more treatment may be needed or postoperative therapy may include:
Chemotherapy.
In women with HER2/neu negative tumors, postoperative therapy may include:
Chemotherapy.
In women with small, HER2/neu positive tumors, and no cancer in the lymph nodes, no more treatment may be needed. If there is cancer in the lymph nodes, or the tumor is large, postoperative therapy may include:
Chemotherapy and targeted therapy (trastuzumab).
Hormone therapy, such as tamoxifen or aromatase inhibitor therapy, for tumors that are also hormone receptor positive.
Antibody-drug conjugate therapy with ado-trastuzumab emtansine.
In women with small, hormone receptor negative and HER2/neu negative tumors (triple negative) and no cancer in the lymph nodes, no more treatment may be needed. If there is cancer in the lymph nodes or the tumor is large, postoperative therapy may include:
Chemotherapy.
Radiation therapy.
A clinical trial of a new chemotherapy regimen.
A clinical trial of PARP inhibitor therapy.
Preoperative systemic therapy
Systemic therapy is the use of drugs that can enter the bloodstream and reach cancer cells throughout the body. Preoperative systemic therapy is given to shrink the tumor before surgery.
Preoperative chemotherapy may make breast-sparing surgery possible in patients who are not eligible otherwise. Preoperative chemotherapy may also lessen the need for lymph node dissection in patients with disease that has spread to the lymph nodes.
In postmenopausal women with hormone receptor positive tumors, preoperative therapy may include:
Chemotherapy.
Hormone therapy, such as tamoxifen or aromatase inhibitor therapy, for women who cannot have chemotherapy.
In premenopausal women with hormone receptor positive tumors, preoperative therapy may include:
A clinical trial of hormone therapy, such as tamoxifen or aromatase inhibitor therapy.
In women with HER2/neu positive tumors, preoperative therapy may include:
Chemotherapy and targeted therapy (trastuzumab).
Targeted therapy (pertuzumab).
In women with HER2/neu negative tumors or triple negative tumors, preoperative therapy may include:
Chemotherapy.
A clinical trial of a new chemotherapy regimen.
A clinical trial of monoclonal antibody therapy.
For patients with triple-negative or HER2-positive disease, the response to preoperative therapy may be used as a guide in choosing the best treatment after surgery.
Source: National Cancer Institute (NIH)
Additional Materials (8)
Breast cancer
Image by SMART-Servier Medical Art, part of Laboratoires Servier.
3D medical animation still showing metastatic or stage 4 Breast Cancer
Metastatic or stage 4 cancer has spread beyond the breast and nearby lymph nodes to other parts of the body.
Image by Scientific Animations, Inc.
Screening for Cancer, cancer screening
Image by TheVisualMD
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Mastectomy
Total (simple) Mastectomy Description Total (simple) mastectomy; drawing shows removal of the breast and lymph nodes. The dotted line shows where the entire breast is removed. Some lymph nodes under the arm may also be removed.
Image by National Cancer Institute
What Is the Difference Between Staging and Grading in Breast Cancer?
Video by Cleveland Clinic/YouTube
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Breast MRI for Cancer Staging
Magnetic Resonance Imaging (MRI)
Video by TheVisualMD
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Breast Cancer Screening & Diagnosis
Breast cancer is one of the most common cancers among women in the U.S., with about 1 in 8 women developing the disease within her lifetime. Breast cancer is an uncontrolled growth of breast cells that has the potential to spread into the breast and possibly to other parts of the body. Early detection through screening saves the lives of thousands of women every year. If there is a history of breast cancer in the family, women should consider the BReast CAncer susceptibility test (or BRCA) to identify a gene that may indicate an increased risk of developing the disease. Women forty and over should be screened for abnormalities yearly to detect and evaluate changes in breast tissue. If an abnormality is found, a biopsy and pathological exam are necessary for a definitive diagnosis and prognosis. After diagnosis, your doctor may want to learn more about your specific cancer through immunohistochemistry (IHC) and HER2 protein tests. IHC testing can help determine if a specific abnormality is present in the cancer cells. HER2 tests can tell your physician if the breast cancer is turned on by the HER2 gene, and can help determine the best course of treatment. Knowing what type of breast cancer is involved, what stage the cancer is, and the characteristics of that specific cancer, allows a woman's physician to determine best possible therapy for her individual case.
Video by TheVisualMD
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Spread of Breast Cancer
Image by TheVisualMD
Breast cancer
SMART-Servier Medical Art, part of Laboratoires Servier.
3D medical animation still showing metastatic or stage 4 Breast Cancer
Scientific Animations, Inc.
Screening for Cancer, cancer screening
TheVisualMD
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Mastectomy
National Cancer Institute
2:30
What Is the Difference Between Staging and Grading in Breast Cancer?
Cleveland Clinic/YouTube
0:52
Breast MRI for Cancer Staging
TheVisualMD
4:57
Breast Cancer Screening & Diagnosis
TheVisualMD
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Spread of Breast Cancer
TheVisualMD
Locally Advanced or Inflammatory
Treating Cancer
Image by TheVisualMD
Treating Cancer
Cancer treatment seeks to completely destroy tumors and prevent cancer from recurring or spreading. If all reasonable approaches to curing the cancer have been tried, and the cancer still is not cured, then the goal of the treatment will be to relieve symptoms and ease discomfort as much as possible.
Image by TheVisualMD
Treatment for Locally Advanced or Inflammatory Breast Cancer
Treatment of locally advanced or inflammatory breast cancer is a combination of therapies that may include the following:
Surgery (breast-conserving surgery or total mastectomy) with lymph node dissection.
Chemotherapy before and/or after surgery.
Radiation therapy after surgery.
Hormone therapy after surgery for tumors that are estrogen receptor positive or estrogen receptor unknown.
Targeted therapy (trastuzumab and pertuzumab).
Clinical trials testing new anticancer drugs, new drug combinations, and new ways of giving treatment.
Source: National Cancer Institute (NCI)
Additional Materials (12)
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Chemotherapy into the abdomen
Diagram showing how you have chemotherapy into the abdomen.
Image by Cancer Research UK / Wikimedia Commons
Catheter for Chemotherapy
A close-up view of a catheter (a soft thin tube) placed in an African-American woman's arm to deliver chemotherapy.
Image by National Cancer Institute / Rhoda Baer (Photographer)
Radiation for Breast Cancer
Radiation therapy is a common treatment for breast cancer. Here, breast surgeon Dr. Nora Jaskowiak explains standard prescription of radiation therapy in conjunction with lumpectomy surgery. Then dosimetrist Carla Rash walks you through part of a high-tech radiation treatment planning session. A dosimetrist is a member of the radiation oncology team who specializes in the physics behind radiation therapy treatment.
Image by TheVisualMD
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Breast Cancer Surgery
Breast surgeon Dr. Nora Jaskowiak of The University of Chicago Medical Center explains how far mastectomies and other breast surgeries have come and the impact on the patient's life.
Image by TheVisualMD
Breast and Lymph anatomy
The lobes and ducts of the breast, and nearby lymph nodes (above) are areas that cancer can attack. The temporary inconvenience of a mammogram can save you from troublesome and costly treatment and surgery by catching breast cancer early, when it is easiest to treat.
Image by NIH
Hormonal Therapy for Breast Cancer: We Teach You
Video by Breast Cancer School for Patients/YouTube
Do I Need Hormonal Therapy to Treat Breast Cancer?
Video by Yerbba – Breast Cancer/YouTube
Breast Cancer Chemotherapy
Video by Centers for Disease Control and Prevention (CDC)/YouTube
Chemotherapy: Are there different types? | Norton Cancer Institute
Video by Norton Healthcare/YouTube
Do You Need Chemotherapy?
Video by Dr. Susan Love Foundation/YouTube
What Are the Side Effects of Radiation Treatment?
Video by Roswell Park Comprehensive Cancer Center/YouTube
Turing up the Heat on Cancer
Video by Lee Health/YouTube
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Chemotherapy into the abdomen
Cancer Research UK / Wikimedia Commons
Catheter for Chemotherapy
National Cancer Institute / Rhoda Baer (Photographer)
Radiation for Breast Cancer
TheVisualMD
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Breast Cancer Surgery
TheVisualMD
Breast and Lymph anatomy
NIH
13:39
Hormonal Therapy for Breast Cancer: We Teach You
Breast Cancer School for Patients/YouTube
9:37
Do I Need Hormonal Therapy to Treat Breast Cancer?
Yerbba – Breast Cancer/YouTube
0:31
Breast Cancer Chemotherapy
Centers for Disease Control and Prevention (CDC)/YouTube
1:58
Chemotherapy: Are there different types? | Norton Cancer Institute
Norton Healthcare/YouTube
2:44
Do You Need Chemotherapy?
Dr. Susan Love Foundation/YouTube
3:41
What Are the Side Effects of Radiation Treatment?
Roswell Park Comprehensive Cancer Center/YouTube
1:40
Turing up the Heat on Cancer
Lee Health/YouTube
Locoregional Recurrent
Enhertu binds to the HER2 protein (light green) on tumor cells, then moves inside the cell, where the deruxtecan portion of the drug (yellow) is released and kills the cell.
Image by Int J Mol Sci. April 2021. DOI: 10.3390/ijms22094774.
Enhertu binds to the HER2 protein (light green) on tumor cells, then moves inside the cell, where the deruxtecan portion of the drug (yellow) is released and kills the cell.
Image by Int J Mol Sci. April 2021. DOI: 10.3390/ijms22094774.
Treatment of Locoregional Recurrent Breast Cancer
Treatment of locoregional recurrent breast cancer (cancer that has come back after treatment in the breast, in the chest wall, or in nearby lymph nodes), may include the following:
Chemotherapy.
Hormone therapy for tumors that are hormone receptor positive.
Radiation therapy.
Surgery.
Targeted therapy (trastuzumab and pertuzumab).
A clinical trial of a new treatment.
Source: National Cancer Institute (NCI)
Additional Materials (7)
Cell signalling can occur through a ligand binding to a receptor on the cancer cell surface
Cell signalling can occur through a ligand binding to a receptor on the cancer cell surface. Antibodies can bind to the ligand (as in bevacizumab-VEGF) or to the receptor (Trastuzumab-Her2/neu) in order to prevent this signalling.
Image by Simon Caulton
Monoclonal Antibody
Antibody-drug conjugate
Image by Bioconjugator
Treating Cancer
Cancer treatment seeks to completely destroy tumors and prevent cancer from recurring or spreading. If all reasonable approaches to curing the cancer have been tried, and the cancer still is not cured, then the goal of the treatment will be to relieve symptoms and ease discomfort as much as possible.
Image by TheVisualMD
Treatment - Image-Guided Radiation Therapy (IGRT) for Breast Cancer
Image-Guided Radiation Therapy (IGRT)
Image by TheVisualMD
Chest Bracing; An Alternative to Surgery for Chest Wall Deformities
Video by Presbyterian/St. Luke's Medical Center/YouTube
MechanismofactionPertuzumab
The complementary mechanisms of pertuzumab and trastuzumab. (Left) HER2 receptors on the surface of the HER2-expressing breast cancer cells can dimerize with themselves or with other HER receptors in a ligand-dependent or independent manner, thus activating downstream signalling pathways promoting tumor cell proliferation, survival and invasion. Trastuzumab that binds to the domain IV of HER2, prevents the constitutive activation of HER2 by blocking its ligand-independent dimerization, induces its internalization and degradation, and stimulates the immune system to recognize and eliminate HER2-overexpressing cells. (Middle) However, trastuzumab does not prevent the ligand-induced heterodimerization of the receptor with HER3. Following the heregulin (HRG) binding to HER3, a switch from the closed to the open state is induced, exposing the domain II dimerization arm to allow the formation of a HER2/HER3 heterodimer and intracellular signaling. (Right) Adding pertuzumab to trastuzumab promotes binding of pertuzumab to HER2 domain II and prevents HRG-mediated HER2/HER3 dimerization and signalling.
Image by Sandrine Richard , Frédéric Selle, Jean-Pierre Lotz , Ahmed Khalil , Joseph Gligorov , Daniele G Soares/Wikimedia
Trastuzumab-HER2 complex 1N8Z
Structure of HER2(ErbB2) extracellular domain and trastuzumab(anti-HER2 antibody) complex. This file is created from PDB file IN8Z.
Image by Takuma-sa/Wikimedia
Cell signalling can occur through a ligand binding to a receptor on the cancer cell surface
Simon Caulton
Monoclonal Antibody
Bioconjugator
Treating Cancer
TheVisualMD
Treatment - Image-Guided Radiation Therapy (IGRT) for Breast Cancer
TheVisualMD
3:01
Chest Bracing; An Alternative to Surgery for Chest Wall Deformities
Presbyterian/St. Luke's Medical Center/YouTube
MechanismofactionPertuzumab
Sandrine Richard , Frédéric Selle, Jean-Pierre Lotz , Ahmed Khalil , Joseph Gligorov , Daniele G Soares/Wikimedia
Trastuzumab-HER2 complex 1N8Z
Takuma-sa/Wikimedia
Metastatic
Estradiol PET/CT Imaging in Breast Cancer Patients
Image by Citation: Vaalavirta L, Rasulova N, Partanen K, Joensuu T, Kairemo K. [18F]-Estradiol PET/CT Imaging in Breast Cancer Patients. Journal of Diagnostic Imaging in Therapy
Estradiol PET/CT Imaging in Breast Cancer Patients
Purpose: It is known that the estrogen receptor (ER) status of a tumor is an important prognostic and predictive indicator in breast cancer. Women with ER-positive breast tumors have a better prognosis than women with ER-negative tumors in terms of responsiveness to anti-estrogen treatment. 16α-[18F]-Fluoro-17β-estradiol (18F-FES) has proven to be a promising tracer for in vivo imaging studies of the ER status of primary and metastatic breast cancer. Consequently, at our Institution positron emission tomography/computed tomography (PET/CT) using estradiol, labelled with fluorine-18, is an important diagnostic tool to be used in hormone-dependent breast cancer.
Image by Citation: Vaalavirta L, Rasulova N, Partanen K, Joensuu T, Kairemo K. [18F]-Estradiol PET/CT Imaging in Breast Cancer Patients. Journal of Diagnostic Imaging in Therapy
Treatment of Metastatic Breast Cancer
Treatment options for metastatic breast cancer (cancer that has spread to distant parts of the body) may include the following:
Hormone therapy
In postmenopausal women who have just been diagnosed with metastatic breast cancer that is hormone receptor positive or if the hormone receptor status is not known, treatment may include:
Tamoxifen therapy.
Aromatase inhibitor therapy (anastrozole, letrozole, or exemestane). Sometimes cyclin-dependent kinase inhibitor therapy (palbociclib, ribociclib, abemaciclib, or alpelisib) is also given.
In premenopausal women who have just been diagnosed with metastatic breast cancer that is hormone receptor positive, treatment may include:
In women whose tumors are hormone receptor positive or hormone receptor unknown, with spread to the bone or soft tissue only, and who have been treated with tamoxifen, treatment may include:
Aromatase inhibitor therapy.
Other hormone therapy such as megestrol acetate, estrogen or androgen therapy, or anti-estrogen therapy such as fulvestrant.
Targeted therapy
In women with metastatic breast cancer that is hormone receptor positive and has not responded to other treatments, options may include targeted therapy such as:
Trastuzumab, lapatinib, pertuzumab, or mTOR inhibitors.
Antibody-drug conjugate therapy with ado-trastuzumab emtansine.
Cyclin-dependent kinase inhibitor therapy (palbociclib, ribociclib, or abemaciclib) which may be combined with hormone therapy.
In women with metastatic breast cancer that is HER2/neu positive, treatment may include:
Targeted therapy such as trastuzumab, trastuzumab deruxtecan, pertuzumab, ado-trastuzumab emtansine, or lapatinib.
Targeted therapy with tucatinib, a tyrosine kinase inhibitor used with trastuzumab and capecitabine
In women with metastatic breast cancer that is HER2 negative, with mutations in the BRCA1 or BRCA2 genes, and who have been treated with chemotherapy, treatment may include:
Targeted therapy with a PARP inhibitor (olaparib or talazoparib).
Chemotherapy
In women with metastatic breast cancer that is hormone receptor negative, has not responded to hormone therapy, has spread to other organs or has caused symptoms, treatment may include:
Chemotherapy with one or more drugs.
Chemotherapy and immunotherapy
In women with metastatic breast cancer that is hormone receptor negative and HER2 negative, treatment may include:
Chemotherapy and immunotherapy (atezolizumab).
Surgery
Total mastectomy for women with open or painful breast lesions. Radiation therapy may be given after surgery.
Surgery to remove cancer that has spread to the brain or spine. Radiation therapy may be given after surgery.
Surgery to remove cancer that has spread to the lung.
Surgery to repair or help support weak or broken bones. Radiation therapy may be given after surgery.
Surgery to remove fluid that has collected around the lungs or heart.
Radiation therapy
Radiation therapy to the bones, brain, spinal cord, breast, or chest wall to relieve symptoms and improve quality of life.
Strontium-89 (a radionuclide) to relieve pain from cancer that has spread to bones throughout the body.
Other treatment options
Other treatment options for metastatic breast cancer include:
Drug therapy with bisphosphonates or denosumab to reduce bone disease and pain when cancer has spread to the bone. (See the PDQ summary on Cancer Pain for more information about bisphosphonates.)
Antibody-drug conjugate therapy with sacituzumab govitecan for certain patients with metastatic triple-negative breast cancer.
A clinical trial of high-dose chemotherapy with stem cell transplant.
Clinical trials testing new anticancer drugs, new drug combinations, and new ways of giving treatment.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Source: National Cancer Institute (NCI)
Additional Materials (7)
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Breast Cancer in the Pleural Fluid
Human metastatic breast cancer in the pleural fluid. Stained with H&E and magnified to 400x.
Image by Dr. Lance Liotta Laboratory / Unknown Photographer
Metastatic Breast Cancer in Pleural Fluid
This carcinoma in an elderly woman recurred 4-1/2 years after diagnosis. Her mastectomy specimen showed 3 of 9 nodes positive for tumor, an infiltrating ductal carcinoma of no special type. Now, in addition to her malignant pleural effusion, her bone scan shows multiple skeletal metastases.
Image by Ed Uthman/Flickr
Metastatic Breast Cancer - You Have Metastatic Disease. Now What?
Video by Dr. Susan Love Foundation/YouTube
Metastatic Breast Cancer - How We Treat Metastatic Disease
Video by Dr. Susan Love Foundation/YouTube
Planning a Metastatic Breast Cancer Retreat | Johns Hopkins Kimmel Cancer Center
Video by Johns Hopkins Medicine/YouTube
Metastatic Breast Cancer Research Initiative
Video by Breast Cancer Research Foundation/YouTube
Metastatic Breast Cancer - What to Expect During Treatment
Video by Dr. Susan Love Foundation/YouTube
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Breast Cancer in the Pleural Fluid
Dr. Lance Liotta Laboratory / Unknown Photographer
Metastatic Breast Cancer in Pleural Fluid
Ed Uthman/Flickr
2:23
Metastatic Breast Cancer - You Have Metastatic Disease. Now What?
Dr. Susan Love Foundation/YouTube
2:20
Metastatic Breast Cancer - How We Treat Metastatic Disease
Dr. Susan Love Foundation/YouTube
12:27
Planning a Metastatic Breast Cancer Retreat | Johns Hopkins Kimmel Cancer Center
Johns Hopkins Medicine/YouTube
2:45
Metastatic Breast Cancer Research Initiative
Breast Cancer Research Foundation/YouTube
2:21
Metastatic Breast Cancer - What to Expect During Treatment
Dr. Susan Love Foundation/YouTube
Ductal Carcinoma In Situ (DCIS)
Lobules and ducts of the breast
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: None
Mikael Häggström, M.D./Wikimedia
Lobules and ducts of the breast
Lobules and lactiferous ducts of the breast.
Image by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: None
Mikael Häggström, M.D./Wikimedia
Treatment of Ductal Carcinoma In Situ (DCIS)
Treatment of ductal carcinoma in situ may include the following:
Breast-conserving surgery and radiation therapy, with or without tamoxifen.
Total mastectomy with or without tamoxifen. Radiation therapy may also be given.
Source: National Cancer Institute (NCI)
Additional Materials (10)
Breast cancer progression
Stages of cell changes that occur when normal duct epithelium of the breast becomes cancerous.
Image by Huckfinne
Histopathology of microinvasive ductal carcinoma in situ
Histopathology of microinvasive ductal carcinoma in situ. H&E stain.
Image by Moatasim A, Mamoon N.Annotated by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D./Wikimedia
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Ductal carcinoma in situ
Diagram showing ductal carcinoma in situ (DCIS)
Image by Cancer Research UK / Wikimedia Commons
Elastography
Manual compression (quasistatic) elastography of invasive ductal carcinoma, a breast cancer.
Image by Copyright: Nevit Dilmen
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Breast Cancer Ductal Carcinoma in Situ
A breast duct with ductal carcinoma in situ (DCIS). Image is included in this publication:
See also http://www.cancer.gov/cancerinfo/wyntk/breast.
Image by National Cancer Institute (NCI) / Don Bliss (Illustrator)
Ductal carcinoma in situ (DCIS): Mayo Clinic Radio
Video by Mayo Clinic/YouTube
Ductal Carcinoma In Situ (DCIS) explained
Video by Breast Cancer Network Australia/YouTube
What Is Atypical Ductal Hyperplasia?
Video by Breast Cancer Answers®/YouTube
Post Lumpectomy DCIS Probability, Can DCIS Return After A Lumpectomy?
Video by Breast Cancer Answers®/YouTube
How Serious is DCIS Breast Cancer?
Video by Breast Cancer Answers®/YouTube
Breast cancer progression
Huckfinne
Histopathology of microinvasive ductal carcinoma in situ
Moatasim A, Mamoon N.Annotated by Mikael Häggström, M.D. Author info - Reusing images- Conflicts of interest: NoneMikael Häggström, M.D./Wikimedia
Sensitive content
This media may include sensitive content
Ductal carcinoma in situ
Cancer Research UK / Wikimedia Commons
Elastography
Copyright: Nevit Dilmen
Sensitive content
This media may include sensitive content
Breast Cancer Ductal Carcinoma in Situ
National Cancer Institute (NCI) / Don Bliss (Illustrator)
9:05
Ductal carcinoma in situ (DCIS): Mayo Clinic Radio
Mayo Clinic/YouTube
3:43
Ductal Carcinoma In Situ (DCIS) explained
Breast Cancer Network Australia/YouTube
2:58
What Is Atypical Ductal Hyperplasia?
Breast Cancer Answers®/YouTube
3:40
Post Lumpectomy DCIS Probability, Can DCIS Return After A Lumpectomy?
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Breast Cancer
Breast cancer, cancer that forms in tissues of the breast, is the second most common cancer in women after skin cancer. Breast cancer occurs in both men and women, although male breast cancer is rare. Here's what you need to know about risk factors, symptoms, diagnosis, and treatment.