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No Cancer Left Behind: What You Need to Know About Rare Breast Cancers

Detecting lumps in the breasts is a common indicator that an individual may have breast cancer. Still, it’s possible to have it without feeling lumps in a physical breast exam—making routine screenings vital. Mammograms provide X-ray images of the breasts and are essential because they can pick up small findings missed in exams to provide an early diagnosis. 

Not all breast cancers are the same, so identifying the type is essential for the best treatment, which can include surgery, chemotherapy, and/or radiation. Sometimes rare breast cancers are overlooked, but they can be just as deadly and more aggressive than most common types. Approximately 42,000 women and 500 men die yearly from breast cancer in the U.S. The earlier someone catches cancer and treats it, the better, so know the signs to watch out for to ensure proactive detection!

Ductal carcinoma in situ (DCIS) vs. invasive breast cancer

Ductal carcinoma in situ (DCIS) is a non-invasive form of breast cancer found in the early stage. Approximately 20 percent of breast cancers diagnosed from screenings are DCIS breast cancers. 

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Most people diagnosed with DCIS are curable in its early stage, referred to as stage zero. Slow-growing cancer cells line the ducts but don’t usually spread to other body parts. It’s often treated with a lumpectomy to surgically remove the cancerous tumor and a small amount of healthy tissue surrounding it. Radiation treatment, which uses high-energy beams to kill cancer cells, follows the lumpectomy. 

Two types of invasive cancers

Invasive ductal carcinoma breast cancers spread to other body parts, producing lumps in the breast or masses in the armpits caused by swollen lymph nodes. When cancer has spread too far, it’s called metastatic breast cancer, which may not be curable. Patients typically endure painful symptoms from the disease, but proper care can help make it more manageable. Larger cancers usually require Mastectomies, surgical procedures that remove the entire breast.

Invasive lobular carcinoma cancer cells grow in the lobules and then spread to nearby breast tissue or other body parts. 

Rare Types of Breast Cancer You Should Know

Inflammatory breast cancer

Inflammatory breast cancer (IBC) is an aggressive and rare form of breast cancer that has the potential to spread to distant parts of the body. It produces rapid onset of symptoms, and a mass can grow so large that it almost fills a woman’s entire breast within a month or two. It is most common among women under the age of 40 and overweight.

Anytime a woman experiences rapidly enlarging breast cancer, skin changes occur, and sometimes the skin will thicken and look like an orange rind. It is critical for anyone with visible inflammation and redness to seek medical attention and start treatment as soon as possible if recommended by their physician. However, IBC can be difficult to diagnose since there is usually no lump to feel in an exam or mammogram screening. A comprehensive treatment of the skin and breasts using chemotherapy, mastectomies, and radiation therapy is required to treat this type of breast cancer. 

Paget’s disease of the breast

Paget’s disease is a rare condition associated with breast cancer, but it’s possible to have it and not have cancer. Clinical features include eczema-like changes to the skin of the nipple and a darker color around the areola. It starts in the ducts and spreads to the nipple and areola.

Paget’s disease is usually treated with surgery by removing the breast in a mastectomy procedure or nipple in a breast-conserving surgery (BCS) then following it up with radiation therapy. 

If cancer spreads, it’s more difficult to cure and calls for more invasive treatment.

Triple-negative breast cancer

Triple-negative breast cancer is a subtype of invasive breast cancer with very aggressive biology. Thus, it grows fast as it spreads to lymph nodes and other body organs. 

Most breast cancers usually respond to estrogen, progesterone, and human epidermal growth factor (HER2) receptors. Triple-negative breast cancer doesn’t have any of these, which gives doctors fewer treatment options. It’s usually treated aggressively with multidisciplinary therapy. Chemotherapy is one of the most effective options if the patient is healthy enough to tolerate it. Chemo shrinks cancer, but patients become high risk for recurrence afterward. They must get regular scans to proactively detect if cancer starts growing back. 

Male breast cancer

Men don’t usually think about getting a mammogram since breast cancer is most common among women, but men are at risk too. The American Cancer Society estimates 2,710 new cases in 2022. Men typically find a lump on their pectoral muscle or chest wall before they notice and act. But men with a family history of breast cancer should know they are more at risk due to their genetics. Treatment is similar to females with non-invasive breast cancer, starting with a lumpectomy surgery followed by radiation.

Conclusion

A simple screening and physical exam every year could save someone’s life from even the most unusual forms of breast cancer. Men and women must know the critical steps to remain healthy and achieve the best outcomes – before and after a diagnosis. The first step is educating the public on the importance of screenings, different types of breast cancers, and treatment options. Know that if you’re ever in doubt, get it checked out.

About the Authors

Dr. Kristina Mirabeau-Beale, MD, MPH, is a board-certified radiation oncologist, a native Floridian, and has been practicing in SW Florida for over five years. She has served as a prior board member of the Cancer Alliance of Naples and on the NCH Cancer Outcomes Committee. Dr. Mirabeau currently serves as the chair of the breast cancer leadership program at the Regional Cancer Center with Lee Memorial Health – the only NAPBC-accredited program in SW Florida. Dr. Mirabeau-Beale has published extensively on patient quality of life after radiation therapy and spoken about breast cancer radiation therapy at national meetings. She has clinical expertise in treating breast, lung, skin, gastrointestinal and gynecologic malignancies. She is also interested in palliative care and integrative oncology. Dr. Mirabeau-Beale received her undergraduate and medical degrees at Harvard University and completed her residency in radiation oncology at the Harvard combined program at Massachusetts General Hospital and Dana Farber Cancer Institute in Boston, MA. She maintains a strong working relationship with colleagues in the Harvard Cancer Program and locally at Moffitt. Dr. Mirabeau-Beale is dedicated to providing high-quality, compassionate, evidence-based, and academic-center caliber care for our local community.

Dr. Bridget Koontz is a U.S. Chief Medical Officer & Deputy Global Chief Medical Officer at GenesisCare. She trained at Harvard Medical School, UNC-Chapel Hill, and Duke University School of Medicine and was tenured faculty at Duke Cancer Institute from 2007 to 2021. She is now leading the US oncology network for GenesisCare, a leading global oncology organization. Her interests are promoting excellent care for patients with genitourinary malignancies and research to improve cancer treatment and recovery. She has frequently been faculty at ASTRO and ASCO GU meetings and has published over 100 articles, chapters, and books. She was an associate senior editor for the International Journal of Radiation Oncology Biology Physics (2015 -2018) and the senior editor of the practical handbook Radiation Therapy Treatment Effects: An Evidence-Based Guide to Managing Toxicity (2017). She has conducted translational laboratory research developing models of radiation-induced pelvic toxicity, has led phase I and phase II trials in prostate cancer, and is the national PI of NRG-GU011, a trial of stereotactic radiotherapy for oligometastatic prostate cancer. She continues to investigate clinical efforts to improve the quality of life of cancer survivors through technology such as eHealth apps and activity trackers. She currently represents radiation oncology as a member of the NCI’s Genitourinary Steering Committee for NCTN trials.

About Genesiscare

GenesisCare is dedicated to designing innovative treatments and care for people with cancer and heart disease in the United States, the U.K., Spain, and Australia.

We provide the latest treatments and technologies proven to help patients achieve the best possible outcomes. They offer radiation therapy, urology and pulmonology care, surgery, medical oncology, and skinviva. Our highly trained team of over 5000 healthcare professionals and support staff sees more than 400,000 people globally.

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