Cáncer de mama: ¿Qué es?
Ever wonder what cancer is and how we get it? Here is a simple explanation to help you understand.
is an umbrella term that covers a wide range of cancer types, each with unique characteristics, growth rates, and behaviors. Within this broad category are various types, stages, treatment options, and outlooks. Treatment plans are highly individualized and may involve a combination of surgery, chemotherapy, radiation, or targeted therapies, tailored to the specific type and stage of cancer.
BREAST CANCER
Talk to your doctor about when to start screening based on your personal risk.
Our body is made up of millions of cells that constantly multiply. In the process of duplicating, occasional errors happen, and a new cell becomes damaged. When our body is working properly, cells naturally die off (apoptosis), or our immune system (T cells) attacks and gets rid of those cells.
But if our immune system is weakened or the cell has a genetic mutation that helps it hide, the damaged cell keeps duplicating. Over time, this forms a mass (tumor) that may becoming cancerous. In breast cancer, this process starts in the cells lining the milk ducts or milk-producing lobules. Most breast lumps are benign (not cancerous), but a biopsy can tell for sure.
How does a tumor become dangerous?
A benign tumor grows but stays in one place. A malignant tumor (cancer) can invade nearby tissue and, most seriously, send cells through the bloodstream or lymph system to other parts of the body. This spread is called metastasis, and it's why early detection is so important.
Not all breast cancers are the same.
Some are fueled by hormones like estrogen (ER) or progesterone (PR) (hormone receptor-positive). Others have too much of a protein called HER2 (HER2-positive). And some don't have any of these markers (triple-negative breast cancer). These differences matter because they guide which treatments will work best such as: hormone therapy, targeted therapy like Herceptin, chemotherapy, or a combination.
What about genetics?
A small number of breast cancers are inherited due to gene mutations like BRCA1 or BRCA2. These don't guarantee cancer, but they raise the risk. Most breast cancers, however, happen by chance as we age.
Once breast cancer is discovered, doctors work to destroy or remove the tumor. Options include surgery, radiation, chemotherapy, and newer treatments like immunotherapy. Caught early before it spreads, breast cancer is highly treatable. That's why regular self monitoring, mammograms, knowing your breast density, and family history matter.
Visit the BREAST CANCER & GENETICS page for more information
BREAST CANCER BREAKDOWN
Types of Breast Cancer: One disease. Many types. Every Journey is Unique.
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Ductal Carcinoma in Situ: DCIS is a non-invasive or pre-invasive breast cancer found in the milk ducts. Since it hasn’t spread beyond the ducts, it’s considered the earliest form of breast cancer and is very treatable.
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Invasive Ductal Carcinoma: IDC is the most common type of breast cancer, where cancer cells start in the milk ducts and spread to surrounding breast tissue. It can also spread to other body parts if untreated.
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Lobular Carcinoma in Situ: (LCIS) Not considered a true cancer, but a marker indicating an increased risk of developing breast cancer in either breast.
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Invasive Lobular Carcinoma: This cancer begins in the milk-producing lobules and spreads to nearby tissue. It’s the second most common invasive breast cancer.
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Triple-Negative Breast Cancer: TNBC lacks three common receptors (estrogen, progesterone, and HER2), While it does not respond to hormone or HER2-targeted therapies, newer treatments, including immunotherapy and targeted therapies, have significantly improved outcomes.
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HER2-Positive Breast Cancer: This type has high levels of the HER2 protein, which promotes cancer growth. Once considered aggressive, HER2-positive breast cancer now has highly effective targeted treatments that have greatly improved survival rates.
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Inflammatory Breast Cancer: A rare but aggressive cancer causing redness, swelling, and warmth in the breast. It often spreads quickly, requiring immediate treatment.
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Paget’s Disease of the Nipple: This rare cancer starts in the nipple’s ducts and can spread to the areola. It often appears with crusting or irritation of the nipple area.
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Metastatic (Stage IV): This advanced cancer has spread beyond the breast to other parts of the body, like bones, lungs, or liver. Treatment focuses on long-term disease control, maintaining quality of life, and extending survival, with many patients living for years with metastatic disease.
Understanding the Stages:
Breast cancer is usually categorized into stages, which describe the extent of the disease to help guide treatment decisions. The stages range from 0 to IV, reflecting how far the cancer has spread.
AJCC prognostic staging uses:
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Tumor size (T), Nodes (N), Metastasis (M),
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PLUS biologic factors (ER, PR, HER2, grade)
Breast cancer staging looks beyond size and spread to include tumor biology, helping guide the best treatment plan. Understanding the stage is key to choosing the right care and improving outcomes through early detection.
Stage 0 (Carcinoma in Situ):
- Abnormal cells present but have not invaded surrounding tissues (e.g., DCIS or LCIS).
Stage I:
- Stage IA: Tumor is 2 cm or smaller, with no lymph node involvement.
- Stage IB: Small clusters of cancer cells in nearby lymph nodes; no tumor in the breast or tumor is 2 cm or smaller.
Stage II:
- Stage IIA: Tumor is 2-5 cm with or without lymph node involvement.
- Stage IIB: Tumor is 2–5 cm + lymph nodes
-OR- tumor greater than 5 cm without nodes.
Stage III (Locally Advanced):
- Cancer has spread to nearby lymph nodes or tissues but not to distant sites.
- Stage IIIA: Spread to 1-3 axillary lymph nodes.
- Stage IIIB: Tumor has invaded chest wall or skin.
- Stage IIIC: Multiple lymph nodes involved.
Stage IV (Metastatic):
- Cancer has spread to distant organs (e.g., bones, liver, lungs, brain). Treatment focuses on symptom management and prolonging life.
Types of Treatment:
The choice of treatment depends on various factors, including the type and stage of breast cancer, hormone receptor status, and the patient's overall health and preferences. A multidisciplinary team typically collaborates to create a personalized treatment plan.
Breast cancer is an umbrella term, covering many unique and varying treatment plans.
Surgery:
- Lumpectomy: Removal of the tumor and a small margin of surrounding tissue. Often followed by radiation therapy.
- Mastectomy: Removal of one (unilateral) or both (bilateral) breasts. May be necessary for larger tumors or in certain genetic cases.
Radiation Therapy:
- Uses high-energy rays to target and kill cancer cells, typically administered after surgery to eliminate any remaining cancerous cells in the breast or chest wall.
Chemotherapy:
- Involves using powerful drugs to kill rapidly dividing cancer cells. It can be used before surgery (neoadjuvant) to shrink tumors or after surgery (adjuvant) to reduce recurrence risk.
Hormone Therapy:
- For cancers that are hormone receptor-positive, medications (such as tamoxifen or aromatase inhibitors) block hormones like estrogen from fueling cancer growth treatment plan tailored to the individual patient.
Antibody-Drug Conjugates (ADCs):
- These targeted treatments deliver chemotherapy directly to cancer cells (e.g., trastuzumab deruxtecan), improving effectiveness while limiting damage to healthy cells.
Targeted Therapy:
- Focuses on specific characteristics of cancer cells, such as the HER2 protein. Drugs like trastuzumab (Herceptin) are used to target and inhibit growth in HER2-positive breast cancers.
Immunotherapy:
- Boosts the body’s immune system to help it fight cancer. Immunotherapy is most often used in certain triple-negative breast cancers, particularly those expressing PD-L1.
CDK4/6 inhibitors:
- CDK4/6 inhibitors (such as palbociclib) are commonly used in hormone receptor-positive breast cancer to slow cancer cell growth.
Clinical Trials:
- Patients may consider participating in clinical trials to access new and experimental treatments that are being tested for safety and effectiveness.
Personal Care Team:
A breast cancer patient’s medical care team consists of a group of specialists who work together to provide comprehensive care. Here’s an overview of the key members:
Medical Oncologist: Manages chemotherapy, hormone therapy, and targeted therapy. Coordinates overall treatment and monitors the patient’s response to therapy.
Surgical Oncologist: Performs surgical procedures, such as lumpectomy or mastectomy, to remove the cancerous tissue. They often play a primary role in staging the cancer as well.
Radiation Oncologist: Administers radiation therapy to target any remaining cancer cells post-surgery or to shrink tumors before surgery.
Radiologist: Interprets imaging tests like mammograms, ultrasounds, and MRIs to help detect, diagnose, and monitor the cancer's progress.
Pathologist: Examines tissue samples from biopsies to confirm the cancer diagnosis, determine the type, and assess the tumor's characteristics, including hormone receptor status.
Plastic/Reconstructive Surgeon: Specializes in reconstructive procedures, such as breast reconstruction following a mastectomy, to restore appearance and confidence.
Nurse Navigator/Oncology Nurse: Provides support throughout the treatment process, coordinating appointments, assisting with education, and helping manage symptoms or side effects.
Genetic Counselor: Offers genetic testing and counseling to assess hereditary cancer risks, especially for patients with a family history of breast cancer.
Social Worker/Psychologist: Supports the emotional and mental health of patients, helping them cope with the psychological impacts of diagnosis and treatment. They can also connect patients with support groups and financial resources.
Lymphedema Specialist/Physical Therapist: Helps manage swelling and mobility issues after surgery or lymph node removal.
Oncology Dietitian: Supports nutrition during treatment and recovery.