Breast Cancer

Breast cancers are malignancies that develop in the tissues of one or both breasts. Breast cancer is the most common cancer among women in the United States, other than Skin Cancer.

There are two main types of breast cancer:

• Ductal carcinoma is the most common breast cancer and starts in the tubes, or ducts, that move milk from the breast to the nipple.
• Lobular carcinoma originates from the lobules which produce milk.

Breast cancer can be invasive or noninvasive:

Invasive breast cancers includes cancers which have spread from the milk duct or lobule to other tissues in the breast.

• Representing 10-15% of invasive breast cancers, invasive ductal carcinoma occurs when cancer cells spread beyond the basement membrane, which covers the underlying connective tissue in the breast.
• Invasive lobular carcinoma describes 70-80% of breast cancers which spread through the wall of the milk producing lobule, and are characterized by branch-like growing patterns.

Noninvasive refers to breast cancer that has not invaded other breast tissue.

• Noninvasive breast cancers include Lobular carcinoma in situ (LCIS) and Ductal carcinoma in situ (DCIS).

Some breast cancers are sensitive to the hormone estrogen, which causes breast cancer to grow. These cancers have estrogen receptors and are called ER-positive cancer.

Some breast cancers are HER2-positive, which refers to a gene that helps cells to grow, divide and repair themselves faster than normal.

The major treatments of breast cancer are surgery, radiation, biological therapy (targeted drug therapy), hormone therapy, vaccine therapy, chemotherapy and clinical trials. Any or all therapies may be used separately or in combination, and depend on the stage of the cancer:

Stage 0 (Carcinoma in Situ).
Stage 0 breast cancer is considered non-invasive (in situ), and has not spread to surrounding tissues. Stage 0 cancer is classified as either Ductal carcinoma in situ (DCIS) or Lobular carcinoma in situ (LCIS).
Ductal carcinoma in situ (DCIS)
There are cancer cells present in the lining of a duct that have not invaded the surrounding breast tissue.
Treatment options for DCIS include:

• Breast-conserving surgery and radiation therapy, followed by hormone therapy for women with hormone-sensitive cancer
• Total mastectomy followed by hormone therapy for women with hormone-sensitive cancer
• Breast-conserving surgery without radiation therapy

Lobular carcinoma in situ (LCIS)
There are cancer cells in the lobules of the breast. LCIS rarely develops into invasive breast cancer, but having it in one breast increases the risk of developing cancer in the other breast.

Treatment options for LCIS include:

• Observation with regular exams and mammograms
• Hormone therapy to prevent development of breast cancer, for women with hormone-sensitive cancer

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Breast cancer trials, a not for profit online resource community
www.BreastCancerTrials.org
https://www.breastcancertrials.org/bct_nation/home.seam

American Society of Clinical Oncology
http://www.cancer.net/

Association of Cancer Online Resources
http://www.acor.org/

National Cancer Institute (NCI) Trials
The NCI, part of the National Institutes of Health, is the federal agency that provides funding for most U.S. cancer clinical trials. This site provides information on both open and closed cancer clinical trials that are funded by the government, as well as many sponsored by pharmaceutical companies, medical centers, and some international organizations.
http://www.cancer.gov/clinicaltrials/featured/types/breast

Center for Information and Study on Clinical Research Participation (CISCRP). CISCRP offers an online clinical trials search engine at SearchClinicalTrials.org. In addition, they provide a toll-free number where patients can receive help locating a clinical trial.
www.SearchClinicalTreials.org

Centerwatch This site helps people connect with clinical trials by offering a list of institutional review board (IRB)-approved clinical trials.
www.centerwatch.com

ClinicalTrials.gov This database of publicly and privately supported clinical trials is maintained by the National Library of Medicine at the NIH.
www.clinicaltrials.gov

Coalition of Cancer Cooperative Groups This organization provides resources and information in order for patients to search for clinical trials.
www.cancertrialshelp.org

EmergingMed Navigator- This organization helps to identify clinical trial options that match a patient’s specific diagnosis, stage and treatment history. Clinical trial specialists can also provide telephone support to help connect eligible patients with IRB-approved study sites that are enrolling new participants.
www.emergingmed.com

WHO International Clinical Trials Registry Platform Search Portal The World Health Organization (WHO) coordinates health matters within the United Nations. This database allows people to search clinical trial registration information from many countries’ registries.
http://www.who.int/ictrp/en/

The National Cancer Institute’s Overview of Breast Cancer: (Includes treatment, causes and research)
http://cancer.gov/cancertopics/types/breast

Cancer.Net En Español: Read about breast cancer in Spanish. Infórmase sobre cáncer de mama en español.
http://www.cancer.net/cancernet-en-español/tipos-de-cáncer/cáncer-de-mama
http://www.cancer.net/sites/cancer.net/files/asco_answers_breast_esp.pdf

Breast Cancer Educational Resource:
http://www.breastcancer.org/symptoms/understand_bc

Promising Combo for Triple-Negative Breast Cancer, but Only With a BRCA Mutations
July 10, 2019
https://www.cancernetwork.com/immuno-oncology/promising-combo-triple-negative-breast-cancer-only-brca-mutation?rememberme=1&elq_mid=7682&elq_cid=31005&GUID=D05BB403-D400-4F32-A398-FE2D4019831F

Gene breakthrough could lead to new breast cancer treatments
March 12, 2018
https://www.telegraph.co.uk/news/2017/11/15/breakthrough-breast-cancer-drugs-stall-disease-months-available

Gene breakthrough could lead to new breast cancer treatments
March, 2018
https://medicalxpress.com/news/2018-03-treatment-aggressive-breast-cancer.html

Potential therapy identified for aggressive breast cancer
January 25, 2018
https://medicalxpress.com/news/2018-01-potential-therapy-aggressive-breast-cancer.html

Phase III Monarch2 Abemaciclib Breast Cancer Trial
February, 2018
http://www.targetedonc.com/news/expert-reviews-efficacy-safety-data-with-abemaciclib-in-breast-cancer

Potentially powerful new way to treat HER2-positive breast cancer validated
May 25, 2014
http://www.medicalnewstoday.com/releases/276998.php

City of Hope Researchers: MicroRNA’s rpal in breast cancer metastases identified
April14, 2014
http://www.sciencedaily.com/releases/2014/04/140414154410.htm

Tamoxifen May Lower Risk of Second Cancer in Women With Abnormal BRCA1 or BRCA2 Genes
September 4, 2013
http://www.breastcancer.org/research-news/20130904-5

BBC News;Tamoxifen administered preventively
June25, 2013
http://www.bbc.co.uk/news/health-23042587

A biomarker in breast cancer patients who do not respond, or who have become resistant to Tamoxifen has been discovered by researchers at the University of Manchester, England
November 1, 2012
http://www.medicalnewstoday.com/articles/252249.php

Olaparib Approved for Treating Some Breast Cancers with BRCA Gene Mutations
January 29, 2018
https://www.cancer.gov/news-events/cancer-currents-blog/2018/fda-olaparib-breast-brca-mutations

FDA Grants Full Approval to Sacituzumab Govitecan for Triple-Negative Breast Cancer
April, 2021
Following last year’s accelerated approval designation, the FDA granted regular approval to sacituzumab govitecan to treat patients with triple-negative breast cancer. The FDA announced it has granted full approval to sacituzumab govitecan (Trodelvy) for the treatment of adults patients with unresectable locally advanced or metastatic triple-negative breast cancer (mTNBC) who received 2 or more prior systemic therapies, with at least 1 therapy for metastatic disease, according to an FDA press release.
https://www.cancernetwork.com/view/fda-grants-full-approval-to-sacituzumab-govitecan-for-triple-negative-breast-cancer

Susan G. Komen Helpline 1-877 GO KOMEN (1-877-465-6636) provides free, professional support services and help finding local support groups and resources

Susan G. Komen Message Boards offer online forums for breast cancer survivors to share their experiences and advice with other breast cancer survivors. There are specific message boards for people who have side effects from hormone therapy. The Co-Survivor section has detailed information and resources for family and friends
http://ww5.komen.org/

Wellness Community Cancer: Education and online support resources
http://www.cancersupportcommunity.org/

Fighting Chance, A free New York counseling service for cancer patients and caregivers
http://fightingchance.org/resourceGuide.shtml