types of breast cancer
Everyone’s breast cancer is different. We have a number of ways to try to classify the, in order to work out what the best treatment for each person is. One of the ways we do this is by looking at the ‘type’ of breast cancer.All breast cancers develop from the same cell lining the milk ducts. They can grow in different ways though, and these can be recognised under the microscope. These different types of breast cancer can behave in slightly different ways. The most common types of breast cancer are ductal and lobular cancers. These terms do not describe where the cancer has come from, but how it looks.
Ductal cancer (also called invasive or infiltrative ductal carcinoma) is the commonest type of breast cancer. It occurs in ~70% of women with breast cancer, and virtually all men with breast cancer. It may also be described as ‘no special type’ or NST. Ductal cancers often form a palpable lump or a typical mammographic abnormality. They often feel hard and firm because they set up a reaction and scarring in the surrounding breast tissue.
Lobular cancer is the next most common type, and accounts for ~10% of breast cancers. It often, like ductal cancer, forms a mass that can be felt or seen on a mammogram, but it may be less obvious. Sometimes there is only a vague thickening or a change in the shape of the breast. It used to be said that lobular cancers were much more likely to be in several areas of the breast (multifocal) or in both breasts. Recent studies have shown that this is only fractionally more likely with lobular cancer than with ductal cancer. Your doctor will still want to check this carefully though, especially if the cancer has been difficult to find.
The prognosis (outlook) for both ductal and lobular cancers is equally good. It is also possible to have a tumour which has mixed ductal and lobular features.
There are a number of ‘special types’ of breast cancers. All of these are uncommon, but they all have a better prognosis than ductal or lobular cancers of the same grade. These different types include:
Tubular cancer. This is a very slow growing cancer and is often picked up on a mammogram whilst still very small. It has an excellent prognosis and rarely spreads outside the breast.
Mucinous cancer. This cancer is typically seen in older ladies, and again has a very good prognosis.
Medullary cancer. This is seen more often in women who carry mutations in BRCA1.
Papillary cancer.
Metaplastic cancer.