Breast Cancer

Ductal carcinoma is breast cancer that starts in the milk ducts, tubes that carry milk from the breast to the nipple. It’s the most common kind of breast cancer. Most ductal carcinoma is invasive, meaning it spreads to tissue outside the milk duct and can spread to other parts of the body. Invasive ductal carcinoma is sometimes called infiltrating ductal carcinoma.

Ductal carcinoma in situ (DCIS) is breast cancer that is confined to the milk ducts. (“In situ” means “in its original place.”) It’s the earliest stage of ductal carcinoma and is sometimes called stage 0 breast cancer. DCIS can progress to invasive breast cancer, so it’s important to get treated.

Inflammatory breast cancer is a rare and aggressive form of cancer. The cancer cells block lymph vessels in the breast, which can cause the breast to become red and swollen. Inflammatory breast cancer tends to strike at a younger age than other forms of breast cancer, and it can progress quickly. Advances in diagnosis and treatment have greatly improved survival rates, which still tend to be lower than for other forms of breast cancer. 

Lobular carcinoma begins in the lobules, or milk glands, of the breast. Lobular carcinoma in situ rarely spreads outside the breast, but invasive lobular carcinoma — the second most common breast cancer type — can spread to surrounding tissue and through the blood and lymph systems to other parts of the body.

Triple-negative breast cancer is a subtype of breast cancer that is not driven by the hormones estrogen or progesterone, or the protein HER2. It can be more aggressive than other forms of breast cancer and tends to strike at a younger age. Triple negative breast cancer does not respond well to hormonal therapies or HER2-specific treatments, but many other treatment options are available.

Paget’s disease of the breast, also called Paget’s disease of the nipple, is a rare form of breast cancer that affects the nipple and the dark circle around it called the areola. It can cause skin irritation, itchiness, redness or flakiness. Most people with Paget’s disease of the breast also have another form of cancer inside the breast.

Fewer than 1 percent of breast cancer cases are in men. Most breast cancer in men is ductal carcinoma. Because men don't get mammograms and may not be aware of breast cancer risk, they tend to get diagnosed at later stages. Men with breast cancer may need different services and follow-up care than women; for instance, breast cancer treatment may cause sexual or reproductive side effects in men.

Although breast cancer affects all ages, most women who get it are older than 50, and most men who get it are older than 60.

More than 99 percent of cases are diagnosed in women.

If you’ve had breast cancer, your risk for getting it again is slightly higher than the breast cancer risk for someone who has never had it. However, newer treatments can lower the risk of a second breast cancer.

It’s important to remember that most people who get breast cancer have no family history of the disease. But about 10 percent of breast cancer cases are hereditary. You may be two to three times more likely to develop breast cancer if your mother, sister or daughter has had the disease. Many, but not all, cases of hereditary breast cancer are linked to mutations in the genes BRCA1 and BRCA2. If you have a family history of breast cancer, we may recommend genetic testing to determine your risk and create a plan for prevention and early diagnosis.

Breast cancer is sometimes linked to mutations (molecular changes) in the genes BRCA1, BRCA2 and PALB2. Having certain mutations in these genes raises the risk of breast cancer. These mutations are sometimes inherited, but not always.

The BRCA genes and the PALB2 gene normally function as caretakers. They help cells repair their DNA when it becomes damaged. Most people have two normal copies of these genes, and thus are at a lower risk of developing breast cancer than those with a mutation.

Women with a BRCA mutation also have an increased risk of developing ovarian cancer. Men with BRCA mutations may be at an increased risk of developing male breast cancer and prostate cancer. PALB2 mutations are also linked with pancreatic cancer.

Miami Cancer Institute can provide genetic testing and counseling to find out whether you and your relatives have these mutations. You and your relatives might benefit from genetic testing and counseling if:

• Several members of your family have had breast cancer, ovarian cancer or other types of cancer.
• You were diagnosed when you were younger than 50.
• You have had breast cancer in both breasts.
• Your breast cancer is triple negative, meaning it lacks the estrogen receptor, progesterone receptor and HER2 receptor.

If you had your first period before age 12 or went through menopause after age 55, your risk of breast cancer is slightly higher than average.

Some noncancerous breast conditions can increase the future likelihood of breast cancer.

If you had your first baby after the age of 30 or have never had children, you’re at a slightly higher risk of breast cancer than women who bore children before age 30.

Using some birth control pills can raise your risk of breast cancer very slightly. The increased risk disappears about a decade after you stop taking them. However, oral birth control may actually reduce the risk of ovarian cancer.

Using certain hormone replacement therapies after menopause slightly raises your risk of breast cancer. This added risk disappears about three to five years after you stop taking the hormones. The greatest risk is with combination hormone replacement therapy, which uses both estrogen and progestin, instead of estrogen alone.

Extra weight can increase your risk of breast cancer. It also increases the possibility that breast cancer will return after treatment, particularly after menopause. Being overweight means you have a body mass index (BMI) of 25 or higher. Obesity is defined as having a BMI of 30 or higher.

If you had radiation therapy to the chest or breasts before age 30, you may have a higher risk of getting breast cancer later in life.