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How Is Breast Cancer Diagnosed?

The type of breast cancer you have helps doctors decide the best method to treat your disease. To confirm a breast cancer diagnosis as by a gynecologist, a pathologist analyzes a tissue sample by biopsy taken from the lump or suspicious area that you feel. This sampling tells if you have cancer or some other non-cancerous benign condition.

If the biopsy does show breast cancer, the results provide your oncologist doctor with information about the type of carcinoma and helps determine treatment options such as surgery lumpectomy or mastectomy, chemotherapy and radiation therapy. Biopsy results appear on a pathology report, which provides detailed information including the type of breast cancer and whether it is invasive or noninvasive which affects staging.

The biopsy also helps determine the tumor grade or how closely the breast cancer cells resemble normal tissue, and if the tumor is sensitive to hormonal therapies and if it has too much of a protein called HER-2. Sophisticated lab tests can also analyze breast tissue for molecular and genetic features of the cancer cells. Understanding all these aspects of cancerous tissue helps your oncologist doctor tailor a treatment plan.

What Are Types Of Breast Cancer?

Common types of breast cancer include cancerous cells that begin either in your breast's milk ducts (ductal carcinoma) or in the milk-producing glands (lobular or glandular carcinoma). The point of cancerous cell origin is determined by the appearance of the cancer cells under a lab microscope.

In situ breast cancer referred to as noninvasive means the cells have remained within their location of origin so they have not spread to tissue around the duct or lobule. The most common type of non-invasive breast cancer is ductal carcinoma in situ (DCIS), which is limited to the lining of your milk ducts. Abnormal cells have not spread thru the duct walls into surrounding tissues. With aggressive treatment, DCIS has an excellent prognosis.

Invasive breast cancer referred to as infiltrating means there is cancerous spread outside the membrane that lines a breast duct or lobule, invading the surrounding tissues. The cancer cells can then travel to other parts of your body, such as the lymph nodes which means there is disease metastasis. Medial or lateral lymph node involvement (metastases) are found present in initial diagnoses of 60% of cases of lump or tumor disease malignancy.

Metastasized invasive ductal carcinoma (IDC) accounts for about 70 percent of all breast cancers. The tumor cells lining the milk ducts break through the ductal wall and invade nearby breast tissue. These cancerous cells may remain localized or marginalized staying near the origin site or may spread (metastasize) thru the body's blood and lymph system.

Metastasized invasive lobular carcinoma (ILC), less common than IDC, is a type of female breast cancer invading similarly, starting in the milk-producing lobules and then breaking into the surrounding breast tissue. ILC can also spread throughout your body. With this cancer type, you generally do not feel a distinct lump but rather a full or thickened area.

What is Breast Tumor Grading?

When breast cancer is invasive, the pathologist assigns it a grade. Grading is based on how closely cells in the tissue sample resemble normal cells under the microscope. The grade classification, along with the cellular type, helps your oncologic doctor determine treatment options. Breast cancers are graded on a scale of 1 to 3:

• Grade 1 means breast cells still look fairly normal or well differentiated.

• Grade 2 means breast cells are somewhat abnormal or moderately differentiated.

• Grade 3 means breast cells have lost their structure and function or poorly differentiated.

The pathologist determines the grade by looking at the size and shape of both the breast cell and its nucleus (center) and counting how many cells are in the process of dividing. A higher grade suggests a faster growing cancer that's more likely to spread (metastasize). Our medical malpractice lawyers and doctors can answer your breast cancer questions.

What is Breast Tumor Staging?

Breast cancer staging classifies how widespread the breast cancer is when diagnosed. Depending on the results of your physical exam and biopsy, your doctor may want you to have imaging tests such as a chest x-ray, mammograms, bone scans, CT, MRI, or PET scans. Blood tests to evaluate your overall health and help detect whether cancerous cells have spread (metastasized) to certain body organs may also be done.

Staging is a standardized way for a breast cancer oncology care team to summarize how the disease has spread. A common system to describe the stages of breast cancer is the  TNM system. The stages can be based either on the physical exam, biopsy, and imaging tests (clinical stage), or on the results of such tests plus outcome of surgery (pathologic stage) more accurate after a pathologist has looked at the breast mass and lymph nodes.

What is Hormone Receptor Status?
 

Breast cancer tests determine the presence of estrogen and progesterone receptors. A receptor is a protein on the outside of a cell that can attach to certain chemicals, hormones or drugs moving thru your blood. Normal breast cells and some cancerous cells have receptors that bind to these female hormones.

Hormones signal the cells to increase or turn on cell growth. Breast cancer can be hormone receptor positive or HR negative. HR+ tumors are categorized as receptor positive for estrogen (ER+) or progesterone (PR+). With ER+ or PR+ breast cancer, hormone-blocking medications, such as tamoxifen, slow cancerous growth. Positive cancers typically grow more slowly than do HR negative cancers, and our malpractice attorneys understand this.

Determining if a cancer has too many copies of the HER-2 gene influences treatment decisions. This gene drives production of the growth-promoting HER-2 protein. About one out of every five breast cancers is positive for this, meaning these breast cancers have greater than normal protein amounts tending to grow and spread more aggressively.

Breast cancers that are HER-2 negative and also lack receptors for estrogen and progesterone are referred to as a "triple negative." This form of breast disease tends to be aggressive and may respond better to different or multiple cancer treatments. It appears to be more common in young black and Hispanic women.

What is Breast Cancer Malpractice?

Medical malpractice means that a doctor, whether a family physician, internist, ob-gyn, or even an oncologist, fails to properly diagnose and treat illness or disease, such as breast cancer. If you feel a possible lump or tumor during your self-exam, make an appointment to see your ob-gyn or primary care doctor immediately and you should probably have a mammogram or breast biopsy done. Our lawyer-attorney and doctors are here to answer your legal-medical questions.

When a medical doctor fails to properly diagnose you, or causes a delay in proper diagnosis by not sending you for test, misreading or ignoring testing results, that doctor, clinic or hospital may be liable to you for malpractice injury or premature death due to breast cancer, especially if a contained cancer spreads to lymph node or body tissues and organs.

Once misdiagnosis is made, you should consult an attorney-lawyer to get answers to questions you may have about the possibility of brining a medical malpractice case or lawsuit. Laws differ from state to state in the U.S., and our job is assist you with a medical review and either advise you or refer you to an appropriate law firm in your area.

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