Although the term ‘breast cancer’ is often thought of as a distinct, single entity, labelling cancer that has formed in the general tissues of the breast, there are many different types of breast cancer. The most common type is adenocarcinomacancer arising from mucus-producing glands in organs of the breast – ductal (forming in the narrow tubes carrying milk to the nipple) and lobular (forming in the milk glands of the breast).
Sometimes these cancers can become invasive, spreading from its origin into the surrounding tissues, making them more aggressive and difficult to treat.
However, despite breast tissue being one of the most common sites for a primary cancer to develop, there are many unique sub-types of breast cancers that are much more rare than these adenocarcinomas, all with very different characteristics. Even within a subtype, there can be different forms of the disease based on its behaviour, hormone receptor expression, and mutations, leading to varying management options and prognoses. And whilst breast cancers are relatively common among women, men can develop breast cancers also – which are considered rare.
There are factors that may contribute to breast cancer developing or increase your likelihood of getting it, however, these are often not definitive, nor are they necessarily associated with lifestyle or choices. Some breast cancers are related to underlying inherited gene mutations – such as BRCA1 or BRCA2. Fortunately, there are now tests that can detect these mutated genes, so as to give the patient a clearer picture of risk, allowing her/him to decide whether to take preventative measures.
Rare types of breast cancer include mucinous, tubular, medullary, papillary and micropapillary, adenoid cystic, secretory, apocrine, metaplastic, solid neuroendocrine, and neuroendocrine small cell carcinomacancer arising from tissues that line organs. And because they’re so unusual, it proves difficult to gather enough patients to allow for large or randomised trials to study optimal treatments.
Frustratingly, breast cancer often carries with it the ‘stigma’ of being common, treatable, and curable. Which means that those with a rarer subtype, finding it difficult to access expertise, information and treatment, are often also battling possible community apathy.
Breast cancer is like an umbrella term, covering many different individual sub-types of cancers that originate in the breast. Some can be caught earlier than others; some have a more straightforward treatment and a better prognosisto predict how a disease/condition may progress and what the outcome might be than others. Regardless, it’s important to remember that no matter what type of cancer it is, early detection and treatment can make a huge difference to outcomes.
Despite the current COVID-19 pandemic, hospitals are still operating, oncology clinics are still running, and GPs are still working – either seeing patients face-to-face or via Telehealth.
Please remember to check your breasts regularly. If you notice any of the following signs or symptoms, please contact your GP as soon as possible for further investigation:
- a change in the shape or size of your breast
- a lump / thickening in or near the breast or in your armpit
- a dimple or puckering of your breast skin
- a nipple inverted or changing direction in the breast
- fluid (not breastmilk) discharge from the nipple – especially if bloody
- scaly, red or swollen skin on the breast, nipple or areola (dark area around the nipple)
- dimples in the breast that look like the skin of an orange
If you present to your GP with a sign or symptom, it’s likely that they will take a full history, do a physical exam (including your breasts). They will then probably proceed to investigations, such as a mammograma type of medical imaging that uses x-rays to create detailed images of breast tissue; ultrasounda type of medical imaging that uses soundwaves to create detailed images of the body or MRI to see into the breast tissues, possibly some blood teststesting done to measure the levels of certain substances in the blood, and to gain further information, they might proceed to referring for a biopsyremoval of a section of tissue to analyse for cancer cells to check exactly what kind of cells are growing.
This month is Breast Cancer Awareness Month. Remember to check your breasts, and go to your GP if you have concerns. If you are uncertain about anything along the way, please contact us at Rare Cancers Australia on 1800 257 600 or email [email protected].
Authored by Dr Emily Isham