Chapter 16 - Appendix

Glossary of Breast Cancer Terms

Adjuvant therapy

Treatment that is added to increase the effectiveness of a primary therapy. It usually refers to hormonal therapy, chemotherapy or radiation added after surgery to kill any cancer cells still remaining and increase the chances of curing the disease or keeping it in check.

Advanced cancer

Describes a stage of cancer where the disease has spread to other parts of the body.

Alternative therapy

Use of an unproven therapy instead of a standard or proven therapy.

Antiestrogen

A substance (for example, the drug tamoxifen) that blocks the effects of estrogen on tumors. Antiestrogens are used to treat breast cancers that depend on estrogen for growth.

Areola

The small darkened area around the nipple of the breast.

Aromatase inhibitors

Drugs that block production of estrogens by the adrenal gland. They are used to treat hormone-sensitive breast cancer in post-menopausal women. These include anastrozole, letrozole and exemestane.

Axillary dissection

A surgical procedure in which the lymph nodes in the armpit (axillary nodes) are removed and examined to find out if breast cancer has spread to those nodes and to remove any cancerous lymph nodes.

Benign

Non-cancerous tumor or lesion.

Biopsy

Removal of a piece of tissue for examination under a microscope to see whether cancer cells are present.

Biophosphonates

Drugs that help strengthen bones weakened by cancer by encouraging the deposition of calcium. These include pamidronate and zoledronate.

BRCA1 and BRCA2

Genes which, when damaged, place a woman at greater risk of developing breast or ovarian cancer. Together, these two genes, when mutated, account for about 50% of the breast cancer in women with strong family histories of the disease. Also thought to raise the risk for breast cancer in men.

Breast-conserving therapy

Surgery to remove a breast cancer and a small amount of benign tissue around the cancer, without removing any other part of the breast. This procedure is also called lumpectomy, segmental excision or limited breast surgery. The method may require an axillary dissection and usually requires radiation therapy in addition to the breast conservation surgery.

Breast reconstruction

Surgery that rebuilds the breast contour after mastectomy. A breast implant or the woman’s own tissue provides the contour. If desired, the nipple and areola may also be re-created. Reconstruction can be done at the time of mastectomy or any time later.

Breast self-examination

A method of checking one’s own breasts for lumps or suspicious changes once a month.

Calcification

Tiny calcium deposits, usually found through mammography, that may be caused by benign breast conditions or by breast cancer.

Carcinoma in situ

An early stage of cancer, in which the tumor is still only within the structures of the organ where it first developed, and the disease does not invade other parts of the organ or spread to distant sites. Most in situ carcinomas are highly curable.

Chemotherapy

Treatment with drugs to destroy cancer cells. Chemotherapy is often used in addition to surgery or radiation to treat cancer when metastasis is proven or suspected, when the cancer has come back (recurred), or when there is a strong likelihood that the cancer could recur.

Clinical breast exam

A breast exam performed by a healthcare professional.

Clinical stage

Describes the extent of cancer present based on results of diagnostic tests and the physical examination.

Clinical trials

Research studies to test new drugs or treatments.

Complementary therapy

Treatment or therapy that is used in addition to standard medical treatment. Acupuncture and massage would be examples of complementary therapy.

Cyst

A fluid-filled mass that is usually benign. The fluid can be removed for analysis.

Diagnostic mammogram

A screening mammogram is performed on women with no evidence of lumps or other symptoms. This includes two X-ray views of each breast (top to bottom, side to side). A diagnostic mammogram includes additional X-ray views of areas of concern found on physical examination or on the screening mammogram to provide more information about the size and character of the abnormality.

Duct

A hollow passage for gland secretions. In the breast, a passage through which milk passes from the lobule (which makes the milk) to the nipple. These ducts are the starting point for most breast cancers.

Ductal carcinoma in situ (DCIS)

DCIS is a noninvasive, cancerous condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, DCIS may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive.

Estrogen

A female sex hormone produced primarily by the ovaries and in smaller amounts by the adrenal gland. In breast cancer, estrogen may promote the growth of cancer cells.

Estrogen receptor

Molecules that help circulate estrogen in the blood and determine how the cancer cells are likely to respond to hormonal therapy.

Fibroadenoma

A type of benign breast tumor composed of fibrous tissue and glandular tissue. On clinical examination or breast self-examination, it usually feels like a firm, round, smooth lump. These usually occur in young women.

Fibrocystic changes

A term that describes certain benign changes in the breast; also called fibrocystic disease. Symptoms of this condition are breast swelling or pain. The breasts often feel lumpy or nodular. Because these signs sometimes mimic breast cancer, diagnostic mammography or ultrasound or even a biopsy may be needed to show that there is no cancer.

Fibrosis

Formation of fibrous (scar-like) tissue. This can occur anywhere in the body.

FISH (fluorescence in situ hybridization) test.

This is a lab test that measures the amount of a certain gene in cells. It can be used to see if an invasive cancer has too many HER2 genes. A cancer with too many of these genes is called HER2-positive.

Grade

Cancer cells are graded using numbers 1 to 3 by how much they look like normal cells. Grade 1 (also called well-differentiated) means the cancer cells look like the normal cells; Grade 3 (poorly differentiated) cancer cells do not look like normal cells at all. Grade 1 cancers aren’t considered aggressive. In other words, they grow more slowly and metastasize slower. Grade 3 cancers are more likely to grow faster and metastasize. A cancer’s grade, along with its stage, is used to determine treatment.

Herceptin

A drug used to treat women with breast cancer that has too many HER2 genes, or too much HER2 protein. (This type of breast cancer is called HER2-positive). The drug is available for women with advanced disease.

HER-2/neu

A gene that produces a type of receptor that helps cells grow. Breast cancer cells with too many HER-2/neu receptors tend to be fast growing and may respond to treatment with an antibody called trastuzumab.

Hormone

A chemical substance released into the body by the glands, such as the thyroid, adrenal or ovaries. The substance travels through the bloodstream and sets in motion various body functions. For example, prolactin, which is produced in the pituitary gland, begins and sustains the production of milk in the breast after childbirth.

Hormone receptor assay

A test to see whether a breast tumor is likely to be affected by hormones or if it can be treated with hormones.

Hormone therapy

Treatment with hormones, drugs that interfere with hormone production or hormone action, or surgical removal of hormone-producing glands to kill cancer cells or slow their growth. The most common hormonal therapy for breast cancer is the drug tamoxifen. Other hormonal therapies include megestrol, aromatase inhibitors, androgens and surgical removal of the ovaries (oophorectomy).

Internal mammary lymph nodes

Lymph nodes located inside the chest, next to the junction of the sternum (breastbone) and the ribs.

Intraductal papillomas

Small, finger-like, polyp-like noncancerous growths in the breast ducts that may cause a bloody nipple discharge. These are most often found in women 45 to 50 years of age. When many papillomas exist, breast cancer risk is slightly increased.

Invasive cancer

Cancer that has spread to nearby tissues. Some invasive cancers spread to distant areas of the body while others do not.

Lobules

Milk-producing glands in the breasts.

Lobular carcinoma in situ (LCIS)

LCIS is a condition in which abnormal cells are found in the lobules of the breast. This condition seldom becomes invasive cancer; however, having lobular carcinoma in situ in one breast increases the risk of developing breast cancer in the other breast.

Lumpectomy

Surgery to remove the breast tumor and a small amount of surrounding normal tissue.

Lymph nodes

Small bean-shaped collections of immune system tissue such as lymphocytes, located along lymphatic vessels. They remove waste and fluids from the lymph system and help fight infections. Also called lymph glands.

Lymphedema

An infrequent complication after breast cancer treatment. Swelling in the arm caused by excess fluid that collects after lymph nodes and vessels are removed by surgery or treated by radiation.

Malignant tumor

A mass of cancer cells that may invade surrounding tissues or spread to distant areas of the body.

Mammogram or mammography

An X-ray method which detects breast cancers that cannot be felt.

Mastectomy

Removal of the entire breast. In a simple or total mastectomy, surgeons do not cut away any lymph nodes or muscle tissue. In a modified radical mastectomy, surgeons remove the breast and some armpit lymph nodes. In a radical mastectomy (now rarely performed) surgeons remove the breast, armpit lymph nodes, and chest wall muscles under the breast.

Menopause

The time in a woman’s life when monthly cycles of menstruation cease forever and the level of hormones produced by the ovaries decreases. Menopause usually occurs in the late 40s or early 50s, but it can also be caused by surgical removal of both ovaries (oophorectomy) or by chemotherapy, which often destroys ovarian function.

Metastatic or metastasis

The spread of cancer cells to distant areas of the body by way of the lymph system or bloodstream.

MRI (magnetic resonance imaging)

This is a test that looks at areas inside your body. Detailed pictures are made by a magnet linked to a computer. These are read by a radiologist. MRI is used for breast screening in some special cases.

Muscle guarding

A protective response in muscle that results from pain or fear of movement.

Needle location biopsy

Some microcalcifications cannot be targeted by stereotactic biopsy. Before surgical biopsy, a needle (or needles) is used to help the surgeon locate the area to be tested.

Neoadjuvant therapy

This is treatment that is given first to help make the next treatment step go more smoothly. For example, chemotherapy, radiation or hormones may be given before surgery. In breast cancer, this therapy is mainly used to shrink a large tumor so that it is easier to remove.

Node status

Indicates whether a breast cancer has spread (node positive) or has not spread (node negative) to lymph nodes in the armpit (axillary nodes). The number and site of positive axillary nodes can help predict the risk of cancer recurrence.

Oophorectomy

Surgery to remove the ovaries.

Ovary

Reproductive organ in the female pelvis. Normally, a woman has two ovaries. They contain the eggs (ova) that, when joined with sperm, result in pregnancy. Ovaries also produce estrogen.

Palliative treatment

Relieves symptoms and improves the patient’s quality of life.

Pathologic stage

Describes the extent of cancer present based on surgical removal and examination of tissue.

Preoperative therapy

Systemic therapy, such as chemotherapy or hormone therapy, given before surgery. Preoperative therapy can shrink some breast cancers, so that surgical removal can be accomplished with a less extensive operation that would otherwise be needed.

Primary site

Place where cancer begins, usually named after the organ in which it starts.

Progesterone

A female sex hormone released by the ovaries during every menstrual cycle to prepare the uterus for pregnancy and the breasts for milk production (lactation).

Prognosis

A prediction of the course of disease; the outlook for the cure of the patient. For example, women with breast cancer that was detected early and who received prompt treatment have a good prognosis.

Prophylactic mastectomy

The removal of healthy breasts as a preventive measure for women with very high risk of contracting breast cancer.

Prosthesis

An artificial breast made from silicone gel, foam, fiberfill or other materials that feel similar to the natural breast.

Radiation therapy

Treatment to destroy cancer cells, to reduce the size of a tumor before surgery or to destroy remaining cancer cells after surgery.

Sentinel node biopsy

In a sentinel lymph node biopsy, the surgeon injects a radioactive substance and/or blue dye into the area around the tumor. Lymphatic vessels carry these materials to the sentinel lymph node (also called the sentinel node). The doctor can see the blue dye or detect the radioactivity (with a Geiger counter) in the sentinel node, which is cut out and examined. If the sentinel node contains cancer, more axillary lymph nodes are removed. But if it is free of cancer, the patient can avoid additional axillary surgery and its potential side effects.

Staging

The size of the tumor, whether the lymph nodes are involved, and if the disease has spread are all considered when determining the stage of the cancer. Staging is critical to selecting treatment and predicting prognosis.

Standard therapy or treatment

Proven, mainstream medical treatments that have been tested,following strict guidelines, and found to be safe and effective.

Stereotactic needle biopsy

A method of biopsy that is useful in some cases in which calcifications or a mass can be seen on mammogram but cannot be located by touch. Computerized equipment maps the location of the mass, and this is used as a guide for the placement of the needle, which extracts a small amount of tissue to be biopsied.

Supportive care

Measures taken to relieve symptoms and improve quality of life, but not expected to destroy the cancer. Pain medication is an example of supportive care.

Supraclavicular lymph nodes

Lymph nodes located in the area above the clavicle (collarbone).

Systemic therapy

Treatment that reaches and affects cells throughout the body; for example, chemotherapy.

Tamoxifen

This drug blocks the effects of estrogen on many organs, such as the breast. Blocking estrogen is generally desirable in cases of breast cancer in which estrogen promotes their growth. Recent research suggests that tamoxifen may lower risk of developing breast cancer in women with certain risk factors.

Toremifene

Another anti-estrogen.

Triple-Negative Breast Cancer Diagnosis

A triple negative breast cancer diagnosis means that the tumor is estrogen receptor-negative, progesterone receptor-negative and HER2-negative. Because of its triple negative status, however, triple negative tumors generally do not respond to receptor targeted treatments

Ultrasound

High-frequency sound waves used to produce images of the breast.

Source: Breast Cancer: Treatment Guidelines for Patients, Version IV, September 2002, by American Cancer Society and National Comprehensive Cancer Network; and Imaginis.com