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Patient Education (3) Malignancies




Malignant lumps develop most often from mammary ducts or lobules. Unlike benign lumps, malignant lumps continue to grow in an uncontrolled manner and in time, if left untreated, will spread beyond the breast.

The basic structure of the breast is composed of:

1) lobules, which when appropriately stimulated will produce and secrete milk,

2) ducts, which carry the milk from the lobules to a network of ducts and then eventually to the nipple, and

3) supporting tissue.

Breast cancer can arise from each of these structures. The most common site is the ducts, and secondarily is the lobules. The terminology of ductal carcinoma and lobular carcinoma is derived from the location of their origin.

When breast cancer begins within the ducts of the breast, this is referred to as intraductal carcinoma in situ (DCIS), and it is considered to be the earliest, detectable stage of breast cancer. The most common progression of DCIS is that it may, and in most cases, will become an invasive carcinoma. It will go beyond the duct into the breast tissue. Once this has spread through the breast, it will spread to the lymph nodes. From the lymph nodes it may spread to other parts of the body, such as the bones, lungs, liver or brain.

If the breast cancer originates in the lobules of the breast it is called lobular carcinoma in situ (LCIS). The evolution of this cancer is similar to DCIS, but it has specific characteristics. These characteristics are:

1) It is not as aggressive as DCIS, and

2) It is viewed as a marker for breast cancer. This means that in patients found with LCIS they are at increased risks of developing cancer in both breasts.

There are other forms of breast carcinoma that are not discussed at this setting because of their rare occurrence.

Early breast cancer can be a nonpalpable lesion or a very small tumor located within the breast. A breast cancer most likely has been growing for several years before it is large enough to be felt. Women who examine their breasts each month, go to their doctor for routine breast examinations, and after age thirty-five have a baseline (your first) mammogram, are more likely to detect an early breast cancer.

Advanced breast cancer is a tumor that has spread beyond the breast to the lymph nodes or to another part of the body. Cancer cells break off from the primary tumor and are carried in the lymphatic system and/or the bloodstream to a distant part of the body where they will grow into a new tumor or metastasis.

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