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Breast cancer

Breast cancer
Breast cancer Classification and external resources

carry milk from the lobules to the nipple), fatty and connective tissue, blood vessels, and lymph vessels. Most breast cancers begin in the cells that line the ducts, some begin in the lobules, and a small number start in other tissues. [3] Breast cancer is about 100 times as frequent among women as among men, but survival rates are equal in both sexes.[4][5][6]

Classification
Breast cancers are described along four different classification schemes, or groups, each based on different criteria and serving a different purpose: • Pathology - Each tumor is classified by its histological (microscopic anatomy) appearance and other criteria. • Grade of tumor - The histological grade of a tumor is determined by a pathologist under a microscope. A well-differentiated (low grade) tumor resembles normal tissue. A poorly differentiated (high grade) tumor is composed of disorganized cells and, therefore, does not look like normal tissue. Moderately differentiated (intermediate grade) tumors are somewhere in between. • Protein & gene expression status Currently, all breast cancers should be tested for expression, or detectable effect, of the estrogen receptor (ER), progesterone receptor (PR) and HER2/neu proteins. These tests are usually done by immunohistochemistry and are presented in a pathologist’s report. The profile of expression of a given tumor helps predict its prognosis, or outlook, and helps an oncologist choose the most appropriate treatment. More genes and/or proteins may be tested in the future. • Stage of a tumor - The currently accepted staging scheme for breast cancer is the TNM classification. This considers the Tumor itself, whether it has spread to lymph Nodes, and whether there are any Metastases to locations other than the breast and lymph nodes.

Mammogram showing breast cancer (indicated by arrow)

ICD-10 ICD-9 OMIM DiseasesDB MedlinePlus eMedicine MeSH

C50. 174-175,V10.3 114480 1598 000913 med/2808 med/3287 radio/115 plastic/521 D001943

Breast cancer is a cancer that starts in the cells of the breast in women and men. Worldwide, breast cancer is the second most common type of cancer after lung cancer (10.4% of all cancer incidence, both sexes counted)[1] and the fifth most common cause of cancer death.[2] In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths).[2] Breast cancer is a malignant tumor that starts from cells of the breast. A woman’s breast is made up of glands that make breast milk (called lobules), ducts (small tubes that

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Breast cancer is usually, but not always, primarily classified by its histological appearance. Rare variants are defined on the basis of physical exam findings. For example, inflammatory breast cancer (IBC), a form of ductal carcinoma or malignant cancer in the ducts, is distinguished from other carcinomas by the inflamed appearance of the affected breast.[7] In the future, some pathologic classifications may be changed. For example, a subset of ductal carcinomas may be re-named basal-like carcinoma (part of the "triple-negative" tumors).

Breast cancer
have an increased risk of breast cancer. Being active may help decrease risk by preventing weight gain and obesity. • Drinking alcohol: Studies suggest that the more alcohol a woman drinks, the greater her risk of breast cancer.[8]

Signs and symptoms
The first symptom, or subjective sign, of breast cancer is typically a lump that feels different from the surrounding breast tissue. According to the The Merck Manual, more than 80% of breast cancer cases are discovered when the woman feels a lump.[9] According to the American Cancer Society, the first medical sign, or objective indication of breast cancer as detected by a physician, is discovered by mammogram.[10] Lumps found in lymph nodes located in the armpits[9] and/ or collarbone can also indicate breast cancer. Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast health issues such as mastodynia.[10][9][11] When breast cancer cells invade the dermal lymphatics—small lymph vessels in the skin of the breast—its presentation can resemble skin inflammation and thus is known as inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer include pain, swelling, warmth and redness throughout the breast, as well as an orangepeel texture to the skin referred to as peau d’orange.[9] Another reported symptom complex of breast cancer is Paget’s disease of the breast. This syndrome presents as eczematoid skin changes such as redness and mild flaking of the nipple skin. As Paget’s advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharge from the nipple. Approximately half of women diagnosed with Paget’s also have a lump in the breast.[12] Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Metastatic breast cancer will cause symptoms that depend on the location of metastasis. Common sites of metastasis include bone, liver, lung and brain. Unexplained weight loss can

Risk Factors
No one knows the exact causes of Breast Cancer. Doctors often cannot explain why one woman develops breast cancer and another does not. They do know that bumping, bruising, or touching the breast does not cause cancer. And breast cancer is not contagious. You cannot "catch" it from another person.Research has shown that women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of developing a disease. Studies have found the following risk factors for breast cancer: • Age: The chance of getting breast cancer goes up as a woman gets older. Most cases of breast cancer occur in women over 60. • Personal history of breast cancer: A woman who had breast cancer in one breast has an increased risk of getting cancer in her other breast. • Family history: A woman’s risk of breast cancer is higher if her mother, sister, or daughter had breast cancer. The risk is higher if her family member got breast cancer before age 40. Having other relatives with breast cancer (in either her mother’s or father’s family) may also increase a woman’s risk. • Certain breast changes: Some women have cells in the breast that look abnormal under a microscope. Having certain types of abnormal cells (atypical hyperplasia and lobular carcinoma in situ [LCIS]) increases the risk of breast cancer. • Race: Breast cancer is diagnosed more often in white women than Latina, Asian, or African American women. • No physical activity: Women who are physically inactive throughout life may

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occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are "non-specific", meaning they can also be manifestations of many other illnesses.[13] Most symptoms of breast disorder do not turn out to represent underlying breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorder symptoms. The appearance of a new symptom should be taken seriously by both patients and their doctors, because of the possibility of an underlying breast cancer at almost any age.[14]

Breast cancer
lower incidence rates than in developed countries. Experts believe that 95 percent of inherited breast cancer can be traced to one of two genes, which they call Breast Cancer 1 (BRCA1) and Breast Cancer 2 (BRCA2). Hereditary breast cancers can take the form of a site-specific hereditary breast cancercancers affecting the breast only- or breastovarian and other cancer syndromes. Breast cancer can be inherited both from female and male relatives. [20] Although many epidemiological risk factors have been identified, the cause of any individual breast cancer is often unknowable. In other words, epidemiological research informs the patterns of breast cancer incidence across certain populations, but not in a given individual. Due to breast cancer is vary in different racial and ethnic group. The primary risk factors that have been identified are sex,[21] age,[22] childbearing, hormones,[23] a high-fat diet,[24] alcohol intake,[25][26] [27] and environmental factors such obesity, as tobacco use, radiation[19] and shiftwork.[28] No etiology is known for 95% of breast cancer cases, while approximately 5% of new breast cancers are attributable to hereditary syndromes.[29] In particular, carriers of the breast cancer susceptibility genes, BRCA1 and BRCA2, are at a 30-40% increased risk for breast and ovarian cancer, depending on in which portion of the protein the mutation occurs.[30] Worldwide, breast cancer is by far the most common cancer amongst women, with an incidence rate more than twice that of colorectal cancer and cervical cancer and about three times that of lung cancer. However breast cancer mortality worldwide is just 25% greater than that of lung cancer in women.[1] In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths).[2] The number of cases worldwide has significantly increased since the 1970s, a phenomenon partly blamed on modern lifestyles in the Western world.[31][32] The incidence of breast cancer varies greatly around the world, being lower in lessdeveloped countries and greatest in the more-developed countries. In the twelve world regions, the annual age-standardized incidence rates per 100,000 women are as follows: in Eastern Asia, 18; South Central

Epidemiology and etiology
Epidemiological risk factors for a disease can provide important clues as to the etiology, or cause, of a disease. The first case-controlled study on breast cancer epidemiology was done by Janet Lane-Claypon, who published a comparative study in 1926 of 500 breast cancer cases and 500 control patients of the same background and lifestyle for the British Ministry of Health.[15][16] Today, breast cancer, like other forms of cancer, is considered to be the final outcome of multiple environmental and hereditary factors. Some of these factors include: 1. Lesions to DNA such as genetic mutations. Mutations that can lead to breast cancer have been experimentally linked to estrogen exposure.[17] Beyond the contribution of estrogen, research has implicated viral transformation and the contribution of ionizing radiation in causing genetic mutations. 2. Failure of immune surveillance, a theory in which the immune system removes malignant cells throughout one’s life.[18] 3. Abnormal growth factor signaling in the interaction between stromal cells and epithelial cells can facilitate malignant cell growth. For example, tumors can induce blood vessel growth (angiogenesis) by secreting various growth factors further facilitating cancer growth. 4. Inherited defects in DNA repair genes, such as BRCA1, BRCA2[19] and p53. People in less-developed countries report

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Asia, 22; sub-Saharan Africa, 22; SouthEastern Asia, 26; North Africa and Western Asia, 28; South and Central America, 42; Eastern Europe, 49; Southern Europe, 56; Northern Europe, 73; Oceania, 74; Western Europe, 78; and in North America, 90.[33]

Breast cancer

UK
45,000 cases diagnosed and 12,500 deaths per annum. 60% of cases are treated with Tamoxifen, of these the drug becomes ineffective in 35%.[46]

United States
Women in the United States have the highest incidence rates of breast cancer in the world; 141 among white women and 122 among African American women.[34][35] Among women in the US, breast cancer is the most common cancer and the second-most common cause of cancer death (after lung cancer).[35] Women in the US have a 1 in 8 (12.5%) lifetime chance of developing invasive breast cancer and a 1 in 35 (3%) chance of breast cancer causing their death.[35] In 2007, breast cancer was expected to cause 40,910 deaths in the US (7% of cancer deaths; almost 2% of all deaths).[10] In the US, both incidence and death rates for breast cancer have been declining in the last few years in Native Americans and Alaskan Natives.[36][10] Nevertheless, a US study conducted in 2005 by the Society for Women’s Health Research indicated that breast cancer remains the most feared disease,[37] even though heart disease is a much more common cause of death among women.[38] Many doctors say that women exaggerate their risk of breast cancer.[39]

Prevention
Further information: Epidemiology and etiology of breast cancer Several factors can influence breast cancer incidence either positively or negatively.

Screening
Breast cancer screening is an attempt to find cancer in otherwise healthy individuals. The most common screening method for women is a combination of x-ray mammography and clinical breast exam. In women at higher than normal risk, such as those with a strong family history of cancer, additional tools may include genetic testing or breast Magnetic Resonance Imaging. Breast self-examination was a form of screening that was heavily advocated in the past, but has since fallen into disfavour since several large studies have shown that it does not have a survival benefit for women and often causes considerably anxiety. This is thought to be because cancers that could be detected tended to be at a relatively advanced stage already, whereas other methods push to identify the cancer at an earlier stage where curative treatment is more often possible. X-ray mammography uses x-rays to examine the breast for any uncharacteristic masses or lumps. Regular mammograms is recommended in several countries in women over a certain age as a screening tool. Genetic testing for breast cancer typically involves testing for mutations in the BRCA genes. This is not generally a recommended technique except for those at elevated risk for breast cancer.

Racial disparities in diagnosis and treatment
Several studies have found that black women in the U.S. are more likely to die from breast cancer even though white women are more likely to be diagnosed with the disease. Even after diagnosis, black women are less likely to get treatment compared to white women.[40][41][42] Scholars have advanced several theories for the disparities, including inadequate access to screening, reduced availability of the most advanced surgical and medical techniques, or some biological characteristic of the disease in the African American population.[43] Some studies suggest that the racial disparity in breast cancer outcomes may reflect cultural biases more than biological disease differences.[44] Research is currently ongoing to define the contribution of both biological and cultural factors.[45][41]

Diagnosis
While screening techniques discussed above are useful in determining the possibility of cancer, a further testing is necessary to confirm whether a lump detected on screening is cancer, as opposed to a benign alternative such as a simple cyst.

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In a clinical setting, breast cancer is commonly diagnosed using a "triple test" of clinical breast examination (breast examination by a trained medical practitioner), mammography, and fine needle aspiration cytology. Both mammography and clinical breast exam, also used for screening, can indicate an approximate likelihood that a lump is cancer, and may also identify any other lesions. Fine Needle Aspiration and Cytology (FNAC), which may be done in a GP’s office using local anaesthetic if required, involves attempting to extract a small portion of fluid from the lump. Clear fluid makes the lump highly unlikely to be cancerous, but bloody fluid may be sent off for inspection under a microscope for cancerous cells. Together, these three tools can be used to diagnose breast cancer with a good degree of accuracy. Other options for biopsy include core biopsy, where a section of the breast lump is removed, and an excisional biopsy, where the entire lump is removed.

Breast cancer
factor receptor 2, a protein also known as HER2, neu or erbB2. HER2 is a cell-surface protein involved in cell development. In normal cells, HER2 controls aspects of cell growth and division. When activated in cancer cells, HER2 accelerates tumor formation. About 20-30% of breast cancers overexpress HER2. Those patients may be candidates for the drug trastuzumab, both in the postsurgical setting (so-called "adjuvant" therapy), and in the metastatic setting.[49] HER2 status can be assessed by immunohistochemistry, fluorescent/chromogenic/silver in situ hybridization (FISH/CISH/SISH), or virtual karyotyping.

Treatment
The mainstay of breast cancer treatment is surgery when the tumor is localized, with possible adjuvant hormonal therapy (with tamoxifen or an aromatase inhibitor), chemotherapy, and/or radiotherapy. At present, the treatment recommendations after surgery (adjuvant therapy) follow a pattern. This pattern is subject to change, as every two years, a worldwide conference takes place in St. Gallen, Switzerland, to discuss the actual results of worldwide multi-center studies. Depending on clinical criteria (age, type of cancer, size, metastasis) patients are roughly divided to high risk and low risk cases, with each risk category following different rules for therapy. Treatment possibilities include radiation therapy, chemotherapy, hormone therapy, and immune therapy. In planning treatment, doctors can also use PCR tests like Oncotype DX or microarray tests like MammaPrint that predict breast cancer recurrence risk based on gene expression. In February 2007, the MammaPrint test became the first breast cancer predictor to win formal approval from the Food and Drug Administration. This is a new gene test to help predict whether women with early-stage breast cancer will relapse in 5 or 10 years, this could help influence how aggressively the initial tumor is treated.[50] Interstitial laser thermotherapy (ILT) is an innovative method of treating breast cancer in a minimally invasive manner and without the need for surgical removal, and with the absence of any adverse effect on the health and survival of the patient during intermediate followup.[51]

Staging
Breast cancer is staged according to the TNM system, updated in the AJCC Staging Manual, now on its sixth edition. Prognosis is closely linked to results of staging, and staging is also used to allocate patients to treatments both in clinical trials and clinical practice. For a more detailed discussion on staging of breast cancer, see here. Approximately 90% of new breast cancer cases in the US will be classified as "earlystage" cases (DCIS, Stage I,IIA, IIB or IIIA), due to early detection and prevention techniques. Early-stage treatment options are different from late-stage options.[47]

Hormone receptors
Breast lesions are examined for certain markers, notably sex steroid hormone receptors. About two thirds of postmenopausal breast cancers are estrogen receptor positive (ER+) and progesterone receptor positive (PR+).[48] Receptor status modifies the treatment as, for instance, only ER-positive tumors, not ERnegative tumors, are sensitive to hormonal therapy.

HER2
The breast cancer is also usually tested for the presence of human epidermal growth

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Radiation treatment is also used to help destroy cancer cells that may linger after surgery. Radiation can reduce the risk of recurrence by 50-66% (1/2 - 2/3rds reduction of risk) when delivered in the correct dose. [52]

Breast cancer
cells are positive for HER2/neu have more aggressive disease and may be treated with trastuzumab, a monoclonal antibody that targets this protein. Elevated CA15-3, in conjunction with alkaline phosphatase, was shown to increase chances of early recurrence in breast cancer.[53]

Prognosis
A prognosis is the medical team’s "best guess" in how cancer will affect a patient. There are many prognostic factors associated with breast cancer: staging, tumour size and location, grade, whether disease is systemic (has metastasized, or traveled to other parts of the body), recurrence of the disease, and age of patient. Stage is the most important, as it takes into consideration size, local involvement, lymph node status and whether metastatic disease is present. The higher the stage at diagnosis, the worse the prognosis. The stage is raised by the invasiveness of disease to lymph nodes, chest wall, skin or beyond, and the aggressiveness of the cancer cells. The stage is lowered by the presence of cancerfree zones and close-to-normal cell behaviour (grading). Size is not a factor in staging unless the cancer is invasive. Ductal Carcinoma in situ throughout the entire breast is stage zero. Grading is based on how biopsied, cultured cells behave. The closer to normal cancer cells are, the slower their growth and the better the prognosis. If cells are not well differentiated, they will appear immature, will divide more rapidly, and will tend to spread. Well differentiated is given a grade of 1, moderate is grade 2, while poor or undifferentiated is given a higher grade of 3 or 4 (depending upon the scale used). Younger women tend to have a poorer prognosis than post-menopausal women due to several factors. Their breasts are active with their cycles, they may be nursing infants, and may be unaware of changes in their breasts. Therefore, younger women are usually at a more advanced stage when diagnosed. The presence of estrogen and progesterone receptors in the cancer cell, while not prognostic, is important in guiding treatment. Those who do not test positive for these specific receptors will not respond to hormone therapy. Likewise, HER2/neu status directs the course of treatment. Patients whose cancer

Psychological aspects of diagnosis and treatment
The emotional impact of cancer diagnosis, symptoms, treatment, and related issues can be severe. Most larger hospitals are associated with cancer support groups which provide a supportive environment to help patients cope and gain perspective from cancer survivors. Online cancer support groups are also very beneficial to cancer patients, especially in dealing with uncertainty and bodyimage problems inherent in cancer treatment. Not all breast cancer patients experience their illness in the same manner. Factors such as age can have a significant impact on the way a patient copes with a breast cancer diagnosis. Premenopausal women with estrogen-receptor positive breast cancer must confront the issues of early menopause induced by many of the chemotherapy regimens used to treat their breast cancer, especially those that use hormones to counteract ovarian function. [54] On the other hand, a recent study conducted by researchers at the College of Public Health of the University of Georgia showed that older women may face a more difficult recovery from breast cancer than their younger counterparts.[55] As the incidence of breast cancer in women over 50 rises and survival rates increase, breast cancer is increasingly becoming a geriatric issue that warrants both further research and the expansion of specialized cancer support services tailored for specific age groups.[55]

Metastasis
Most people understand breast cancer as something that happens in the breast. However it can metastasize (spread) via lymphatics to nearby lymph nodes, usually those under the arm. That is why surgery for breast cancer always involves some type of surgery for the glands under the arm —

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Breast cancer
important finding could potentially alter the way in which breast cancer is treated.

History
Breast cancer may be one of the oldest known forms of cancerous tumors in humans. The oldest description of cancer was discovered in Egypt and dates back to approximately 1600 BC. The Edwin Smith Papyrus describes 8 cases of tumors or ulcers of the breast that were treated by cauterization.The writing says about the disease, "There is no treatment."[58] For centuries, physicians described similar cases in their practises, with the same conclusion. It was not until doctors achieved greater understanding of the circulatory system in the 17th century that they could establish a link between breast cancer and the lymph nodes in the armpit. The French surgeon Jean Louis Petit (1674–1750) and later the Scottish surgeon Benjamin Bell (1749–1806) were the first to remove the lymph nodes, breast tissue, and underlying chest muscle. Their successful work was carried on by William Stewart Halsted who started performing mastectomies in 1882. The Halsted radical mastectomy often involved removing both breasts, associated lymph nodes, and the underlying pectoral muscles. This often led to long-term pain and disability, but was seen as necessary in order to prevent the cancer from recurring.[59] Radical mastectomies remained the standard until the 1970s, when a new understanding of metastasis led to perceiving cancer as a systemic illness as well as a localized one, and more sparing procedures were developed that proved equally effective. Prominent women who died of breast cancer include Empress Theodora, wife of Justinian; Anne of Austria, mother of Louis XIV of France; Mary Washington, mother of George, and Rachel Carson, the environmentalist.[60]

A micrograph showing breast cancer (dark pink) in and around a lymph node (purple). either axillary clearance, sampling, or sentinel node biopsy. Breast cancer can also spread to other parts of the body via blood vessels or the lymphatic system. So it can spread to the lungs, pleura (the lining of the lungs), liver, brain, and most commonly to the bones.[56] Seventy percent of the time that breast cancer spreads to other locations, it spreads to bone, especially the vertebrae and the long bones of the arms, legs, and ribs. Usually when breast cancer spreads to bone, it eats away healthy bone, causing weak spots, where the bones can break easily. That is why breast cancer patients are often seen wearing braces or using a wheelchair, and have aching bones. When breast cancer is found in bones, it has usually spread to more than one site. At this stage, it is treatable, often for many years, but it is not curable. Alpharadin is a new pharmaceutical being developed against bone metastasis. A phase II study shows prolonged life time, reduced pain and improved life quality. Like normal breast cells, these tumors in the bone often thrive on female hormones, especially estrogen. Therefore treatment with medicines that lower estrogen levels may be prescribed. In 2008, scientists discovered that breast cancer becomes more invasive when a specific trio of cells are present together in the same anatomic region: an endothelial cell (a type of cell that lines the blood vessels), a perivascular macrophage (a type of immune cell found near blood vessels), and a tumor cell that produces the protein Mena [57]. This

Cultural references

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In the month of October, breast cancer is recognized by survivors, family and friends of survivors and/or victims of the disease.[61] A pink ribbon is worn to recognize the struggle that sufferers face when battling the cancer.[62] Pink for October is an initiative started by Matthew Oliphant, which asks that any sites willing to help make people aware of breast cancer, change their template or layout to include the color pink, so that when visitors view the site, they see that the majority of the site is pink. Then after reading a short amount of information about breast cancer, or being redirected to another site, they are aware of the disease itself.[63] The patron saint of breast cancer is Saint Agatha of Sicily.[64] The pink and blue ribbon was designed in 1996 by Nancy Nick, President and Founder of the John W. Nick Foundation to bring awareness that "Men Get Breast Cancer Too!"[65]

Breast cancer

Gallery

Woman undergoing mammogram Breast self exam Illustration of the early warning signs of breast cancer

Mammography pictures, normal (left) and cancerous (right)

Breastcancer Mastectomy in ultrasound patient Mammogram displaying breast cancer, indicated with an arrow Patient with Mastectomy advanced specimen

Breast prostheses used by some mastectomy patients local-regional recurrence of breast cancer with an ulcerating axillary mass Excised human breast tissue, containing a very large cancer of the breast (in this case, an invasive ductal carcinoma) appearance of the cut surface of a mastectomy specimen containing a cancer, in this case, an invasive ductal

Typical macroscopic (gross)

showing late area cancer 2c diameter lesion co felt clinic a hard m lump, no

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Breast cancer

immunos system.

See also
• List of notable breast cancer patients according to occupation • List of notable breast cancer patients according to survival status • List of breast carcinogenic substances • Mammary tumor for breast cancer in other animals • Breast reconstruction attached to and cancer • Alcohol skin or chest wall. • Mammography Quality Standards Act • National Breast Cancer Coalition • National Comprehensive Cancer Network • Breast Cancer Action • Breakthrough Breast Cancer • Living Beyond Breast Cancer • International Agency for Research on Cancer • Susan G. Komen for the Cure Breast cancer • Breast Cancer Network of Strength (Infiltrating • Your Disease Risk ductal carcinoma of the breast) assayed with anti HER-2 [1] ^ World Health Organization (ErbB2) International Agency for Research on antibody Cancer (June 2003). "World Cancer Report". http://www.iarc.fr/en/ Publications/PDFs-online/World-CancerReport/World-Cancer-Report. Retrieved on 2009-03-26. [2] ^ World Health Organization (February 2006). "Fact sheet No. 297: Cancer". http://www.who.int/mediacentre/ factsheets/fs297/en/index.html. Retrieved on 2009-03-26. [3] "Lit Search - Last Hope." Last Hope Home - Last Hope. 20 May 2009 <http://breastzlcancer.wetpaint.com/ Histopathology page/Lit+Search>. of invasive Breast Cancer Treatment [4] "Male ductal carNational Cancer Institute". National cinoma of the Cancer Institute. 2006. breast represhttp://www.cancer.gov/cancertopics/pdq/ enting a scirtreatment/malebreast/healthprofessional. rhous growth. on 2006-10-16. Retrieved Core"Breast Cancer in Men: Cancer Research [5] needle biopsy. HER-2/ UK". Cancer Research UK. 2007. neu oncoprohttp://www.cancerhelp.org.uk/help/ tein expression default.asp?page=5075. Retrieved on by Ventana 2007-11-06.

carcinoma of the breast, pale area at the center

Infiltrating ductal carBenign granu- cinoma of the Infiltrating ductal carlar cell tumor breast cinoma of the removed from Breast assayed a woman’s with anti Mucin breast. Granu1 antibody lar cell tumors of the breast represent one of the few lesions that can impersonate an invasive breast cancer on gross examination.

References

Invasive lobular carcinoma of the breast demonstrating a predominantly lobular growth pattern

Metaplastic Histopathologic (sarcomatoid) image from carcinoma of ductal cell carthe breast. cinoma in situ (DCIS) of breast. Hematoxylineosin stain.

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[6] American Cancer Society (September 27, London: Her Majesty’s Stationery Office 2007). "What Are the Key Statistics (HMSO). OCLC 14713036. About Breast Cancer in Men?". [16] Alfredo Morabia (2004). A History of http://www.cancer.org/docroot/CRI/ Epidemiologic Methods and Concepts. content/ Boston: Birkhauser. pp. 301–302. ISBN CRI_2_4_1X_What_are_the_key_statistics_for_male_breast_cancer_28.asp?sitearea=. 3-7643-6818-7. http://books.google.com/ Retrieved on 2008-02-03. books?id=E[7] Giordano SH, Hortobagyi GN (2003). OZbEmPSTkC&pg=PA301&lpg=PA301&dq=%22lan "Inflammatory breast cancer: clinical Sx0&sig=3arOIXuwGU_w_Omza11lEDj2TEo#PPA30 progress and the main problems that Retrieved on 2007-12-31. must be addressed". Breast Cancer Res. [17] Cavalieri E, Chakravarti D, Guttenplan J, et al (2006). "Catechol estrogen quinones 5 (6): 284–8. doi:10.1186/bcr608. PMID as initiators of breast and other human 14580242. Free Full Text. cancers: implications for biomarkers of [8] "Risk Factors for Breast Cancer." Last susceptibility and cancer prevention". Hope. 20 May 2009. 20 May 2009 <http://breastzlcancer.wetpaint.com/ Biochim. Biophys. Acta 1766 (1): 63–78. page/ doi:10.1016/j.bbcan.2006.03.001. PMID Risk+Factors+for+Breast+Cancer>. 16675129. [9] ^ Merck Manual of Diagnosis and [18] Farlex (2005). ">immunological Therapy (February 2003). "Breast surveillance "The Free Dictionary: Disorders: Cancer". Immunological Surveilliance". http://www.merck.com/mmhe/sec22/ http://medicalch251/ dictionary.thefreedictionary.com/ ch251f.html#sec22-ch251-ch251f-525. immunological+surveillance">immunological Retrieved on 2008-02-05. surveillance. Retrieved on 2008-02-10. [10] ^ American Cancer Society (2007). [19] ^ American Cancer Society (2005). "Cancer Facts & Figures 2007" (PDF). "Breast Cancer Facts & Figures http://www.cancer.org/downloads/STT/ 2005-2006" (PDF). CAFF2007PWSecured.pdf. Retrieved on http://www.cancer.org/downloads/STT/ 2007-04-26. CAFF2005BrFacspdf2005.pdf. Retrieved [11] eMedicine (August 23, 2006). "Breast on 2007-04-26. Cancer Evaluation". [20] Braddock, Suzanne W., Jane M. Kercher, http://www.emedicine.com/med/ John J. Edney, and Melanie M. Clark. TOPIC3287.HTM. Retrieved on Straight talk about breast cancer from 2008-02-05. diagnosis to recovery : a guide for the [12] National Cancer Institute (June 27, whole family. Omaha, Neb: Addicus 2005). "Paget’s Disease of the Nipple: Books, 1994. Questions and Answers". [21] Giordano, Sharon H; Cohen DS, Buzdar http://www.cancer.gov/cancertopics/ AU, Perkins G, Hortobagyi GN (May factsheet/Sites-Types/pagets-breast. 2004). "Breast carcinoma in men". Retrieved on 2008-02-06. Cancer (American Cancer Society) 101 [13] National Cancer Institute (September 1, (1): 51–57. doi:10.1002/cncr.20312. 2004). "Metastatic Cancer: Questions http://www3.interscience.wiley.com/cgiand Answers". http://www.cancer.gov/ bin/fulltext/108565241/HTMLSTART. cancertopics/factsheet/Sites-Types/ [22] "Individual Risk Factors". metastatic. Retrieved on 2008-02-06. BreastCancer.org. [14] Merck Manual of Diagnosis and Therapy http://www.breastcancer.org/symptoms/ (February 2003). "Breast Disorders: understand_bc/who_gets/ind_risk.jsp. Introduction". http://www.merck.com/ Retrieved on 2007-03-11. mmhe/sec22/ch251/ch251a.html. [23] Yager JD; Davidson NE (2006). "Estrogen Retrieved on 2008-02-05. carcinogenesis in breast cancer". New [15] Lane-Claypon, Janet Elizabeth (1926). A Engl J Med 354 (3): 270–82. doi:10.1056/ further report on cancer of the breast, NEJMra050776. PMID 16421368. with special reference to its associated [24] Chlebowski RT, Blackburn GL, Thomson antecedent conditions. London, Greater CA, Nixon DW, Shapiro A, Hoy MK, et al.. "Dietary fat reduction and breast

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pdf/booklet04bc.pdf. Retrieved on 2007-11-03. • Napieralski, Julie A.; Carol Devine (1988-03). "Alcohol and the Risk of Breast Cancer". Program on Breast Cancer and Environmental Risk Factors in New York State. Cornell University. http://envirocancer.cornell.edu/FactSheet/ Diet/fs13.alcohol.cfm. Retrieved on 2007-11-03. • "Radiology Info - Breast Cancer". Radiological Society of North America. Radiological Society of North America. http://www.radiologyinfo.org/en/

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External links
• Breast cancer at the Open Directory Project • Breast cancer at the Yahoo! Directory

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