Glossary of Terms
Glossary—this is not meant to be a comprehensive glossary of breast cancer terms. If additional information is necessary, please consult the American Cancer Society website (www.cancer.org) from which these definitions were obtained.
axillary dissection: (ax-il-lair-ee): removal of the lymph nodes in the armpit (axillary nodes). They are examined for the presence of cancer.
benign: (be-nine): not cancer; not malignant. The main types of benign breast problems are fibroadenomas and fibrocystic changes. See also fibroadenoma, fibrocystic changes.
bilateral: (bi-lat-er-ul): on both sides of the body; for example, bilateral breast cancer is cancer in both breasts, either at the same time (synchronous) or at different times (metachronous).
biologic response modifiers: substances that boost the body's immune system to fight against cancer; interferon is one example. Also called biologic therapy. See also immunotherapy.
biopsy: (buy-op-see): the removal of a sample of tissue to see whether cancer cells are present. There are several kinds of biopsies. In a surgical biopsy, the surgeon makes an incision and removes the tissue. In a fine needle aspiration (FNA) biopsy, a very thin needle is used to draw fluid and cells from a lump. In a core biopsy, a larger needle is used to remove more tissue. See also surgical biopsy, needle aspiration, stereotactic needle biopsy
brachytherapy: internal radiation treatment given by placing radioactive material directly into the tumor or close to it. Also called interstitial radiation therapy or seed implantation.
BRCA1: a gene that when damaged (mutated) places a woman at greater risk of developing breast and/or ovarian cancer, compared with women who do not have the mutation. In a woman with a BRCA1 mutation, the estimated lifetime risk of developing breast cancer is up to 80% compared with about 13% in the general population. A woman who has this mutated gene has a 50% chance of passing on the gene to each of her children. A genetic test is available, but it is recommended only for women who are known to be at risk because other women in their family have had breast or ovarian cancer before menopause.
BRCA2: a gene that when damaged (mutated) puts the carrier at a much higher risk for developing breast cancer and/or ovarian cancer than the general population. In a woman with a BRCA2 mutation, the estimated lifetime risk of developing breast cancer is up to 80%. BRCA2 and BRCA1 account for about 80% of the breast cancer that occurs in women with strong family histories of the disease (although this is still a small portion of all breast cancers). BRCA2 is also thought to raise the risk for breast cancer in men. A genetic test for BRCA2 is available but is only recommended for those with strong family histories of breast or ovarian cancer.
breast augmentation: surgery to increase the size of the breast. See also breast implant, mammoplasty.
breast cancer: cancer that starts in the breast. The main types of breast cancer are ductal carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, medullary carcinoma, and Paget disease of the nipple (see definitions under these headings). Most breast specialists believe that lobular carcinoma in situ is not a true cancer.
breast implant: a sac used to increase breast size or restore the contour of a breast after mastectomy. The sac is filled with silicone gel (a synthetic material) or sterile saltwater (saline).
breast reconstruction: surgery that rebuilds the breast after mastectomy. A breast implant or the woman's own tissue is used. If desired, the nipple and areola may also be recreated. Reconstruction can be done at the time of mastectomy (immediate reconstruction) or any time later (delayed reconstruction).
breast self-exam (BSE): a method of checking one's own breasts for lumps or suspicious changes. BSE is an option for women in their 20s and older. The goal with BSE is to know what your breast tissue feels like and report any breast changes to a doctor or nurse right away.
breast-conserving therapy or breast conservation therapy: surgery to remove a breast cancer and a small amount of benign tissue around the cancer (margin), without removing any other part of the breast. The lymph nodes under the arm may be removed, and radiation therapy is also often given after the surgery. This method is also called lumpectomy, segmental excision, limited breast surgery, or tylectomy.
carcinoma in situ (car-sin-o-ma in sigh-too): an early stage of cancer, in which the tumor is still only in the structures of the organ where it first developed. The disease has not invaded other parts of the organ or spread to distant parts of the body. Most in situ carcinomas are highly curable
chemoprevention (key-mo-pre-VEN-shun): prevention or reversal of disease using drugs, chemicals, vitamins, or minerals. While this idea is not ready for widespread use, it is a very promising area of study.
chemotherapy (key-mo-THER-uh-pee): treatment with drugs to destroy cancer cells. Chemotherapy is often used in addition to surgery or radiation to treat cancer when it has spread, when it has come back (recurred), or when there is a strong chance that it could recur.
clinical breast exam (CBE): an examination of the breasts done by a health professional such as a doctor or nurse. Clinical breast exams are recommended every 3 years for women in their 20s and 30s, and every year for women over age 40.
clinical trials: research studies to test new drugs or other treatments to compare current, standard treatments with others that may be better. Before a new treatment is used on people, it is studied in the lab. If lab studies suggest the treatment will work, the next step is to test its value for patients. These human studies are called clinical trials, and are often available to patients who are being treated for cancer. The main questions the researchers want to answer are: Does this treatment work? Does it work better than what we're now using? What side effects does it cause? Do the benefits outweigh the risks? Which patients are most likely to find this treatment helpful?
ductal carcinoma in situ (DCIS): cancer that starts in cells in the milk passages (ducts) and does not penetrate the duct walls into the surrounding tissue. This is a highly curable form of breast cancer that is treated with surgery or surgery plus radiation therapy. Also called intraductal carcinoma.
fibroadenoma: a type of benign breast tumor composed of fibrous and glandular tissue. On a clinical breast exam or breast self-exam, it usually feels like a firm, round, smooth lump. These usually occur in young women.
fibrocystic changes (fi-bro-sis-tick changes): a term that describes certain benign changes in the breast. 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, ultrasound, or even a biopsy of the breast may be needed to show that there is no cancer.
frozen section: a very thin slice of tissue that has been quick-frozen and then examined under a microscope. This method is sometimes used during an operation because it gives a quick diagnosis and can help a surgeon decide whether to continue with the procedure. The diagnosis is confirmed within a few days by a more detailed study called a permanent section.
grade: a cancer's grade reflects how abnormal its cells look under a microscope. There are several grading systems, but all divide cancers into the most abnormal (grade 3, poorly differentiated), the least abnormal (grade 1, well differentiated) and those in between (grade 2, moderately differentiated). The pathologist who looks at the specimen assigns the grade. Higher-grade cancers tend to grow and spread faster, and have a worse outlook. Along with the cancer's stage, the grade is used to choose the best treatment.
inflammatory carcinoma: a type of invasive breast cancer with spread to lymphatic vessels in the skin covering the breast. The skin of the affected breast is red, feels warm, and may thicken to the consistency of an orange peel. About 1% of invasive breast cancers are inflammatory carcinomas.
invasive ductal carcinoma: a cancer that starts in the milk passages (ducts) of the breast and then breaks through the duct wall, where it invades the fatty tissue of the breast. When it reaches this point, it has the potential to spread (metastasize) elsewhere in the breast, as well as to other parts of the body through the bloodstream and lymphatic system. Invasive ductal carcinoma is the most common type of breast cancer, accounting for about 80% of breast malignancies. Also known as infiltrating ductal carcinoma.
invasive lobular carcinoma: a cancer that starts in the milk-producing glands (lobules) of the breast and then breaks through the lobule walls to involve the nearby fatty tissue. From this site, it may then spread elsewhere in the breast. About 10% of invasive breast cancers are invasive lobular carcinomas. It is often difficult to detect by physical examination or even by mammography. Also called infiltrating lobular carcinoma.
lumpectomy (lum-peck-to-me): surgery to remove the breast tumor and a small amount of surrounding normal tissue.
lymphedema (limf-uh-dee-muh): swelling due to a collection of excess fluid in the arms or legs. This complication may happen after the lymph nodes and vessels are removed during surgery, or are injured from radiation. It may also happen when a tumor interferes with normal drainage of the fluid. Lymphedema can persist and interfere with activities of daily living.
magnetic resonance imaging (MRI): a method of taking pictures of the inside of the body. Instead of using x-rays, MRI uses a powerful magnet to send radio waves through the body; the images appear on a computer screen as well as on film. Like x-rays, the procedure is physically painless, but some people may feel confined inside the MRI machine.
malignant: cancerous.
malignant tumor (muh-lig-nant): a mass of cancer cells that may invade surrounding tissues or spread (metastasize) to distant areas of the body.
mammogram, mammography: an x-ray of the breast; a method of detecting breast cancers that cannot be felt. Mammograms are done with a special type of x-ray machine that is used only for this purpose. A mammogram can show a developing breast tumor before it is large enough to be felt by a woman or even by a highly skilled health care professional. Screening mammography is used to help find breast cancer early in women without any lumps or symptoms. Diagnostic mammography helps the doctor learn more about breast masses that have been found by clinical breast exam, or the cause of other breast symptoms. See also digital mammography.
mammoplasty: any plastic surgery to reconstruct the breast or to change the shape, size, or position of the breast. Reduction mammoplasty reduces the size of the breast. Augmentation mammoplasty enlarges a woman's breast, usually with implants. See also breast reconstruction.
margin: the edge of a cancerous sample or lump removed during surgery. A negative surgical margin is a sign that no cancer was left behind. A positive surgical margin means that cancer cells are found at the outer edge of the removed sample, and is usually a sign that some cancer is still in the body.
mass: lump or tumor, which may be cancerous or not.
mastectomy (mas-tek-to-me): surgery to remove all or part of the breast and sometimes other tissue.
medullary carcinoma: a special type of infiltrating ductal carcinoma with especially sharp boundaries between tumor tissue and normal tissue. About 5% of breast cancers are medullary carcinomas. The outlook (prognosis) for this kind of cancer is considered to be better than average.
metastasis (meh-tas-teh-sis): the spread of cancer cells from the primary site to distant areas of the body by way of the lymph system or bloodstream.
metastasize: to spread from one part of the body to another.
micrometastases: the spread of cancer cells in groups that are still so small they can only be seen under a microscope
MRI: see magnetic resonance imaging
mutation: a change in the DNA of a cell. Most mutations do not produce cancer, and some may even be helpful. However, all types of cancer are thought to be due to mutations that damage a cellÂ?s DNA. A few cancer-related mutations can be inherited, which means that the person is born with the mutated DNA in all the bodyÂ?s cells. However, most mutations happen after the person is born, and are called sporadic mutations. This type of mutation happens in one cell at a time, and only affects cells that arise from the single mutated cell.
needle localization: a procedure used to guide a surgical breast biopsy when the lump is hard to locate or when there are areas that look suspicious on the mammogram but there is not a distinct lump. A thin needle is placed into the breast. X-rays are then used to guide the needle to the suspicious area. The surgeon then uses the path of the needle as a guide to locate the abnormal area to be removed. See also wire localization.
nodal status: 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.
Paget's disease of the nipple: a rare form of breast cancer that begins in the milk passages (ducts) and spreads to the skin of the nipple and areola, which may appear crusted, scaly, red, or oozing. The prognosis (outlook) is generally better if these nipple changes are the only sign of breast disease and no lump can be felt.
PET: see positron emission tomography
positron emission tomography (PET): a type of imaging test that uses a form of sugar linked to a slightly radioactive substance. The small amount of this solution is injected into a vein, and cancer cells absorb large amounts of sugar. A special camera makes detailed images of places where the radioactive sugar collects.
radiation therapy: treatment with high-energy rays (such as x-rays) to kill cancer cells. The radiation may come from outside of the body (external radiation) or from radioactive materials placed directly in the tumor (brachytherapy or internal radiation). Radiation therapy may be used to reduce the size of a cancer before surgery, to destroy any remaining cancer cells after surgery, or in some cases, as the main treatment.
risk factor: anything linked to an increased a person's chance of getting a disease such as cancer. Some known risk factors for breast cancer include: family history of the disease especially in one's mother or sister; beginning menstrual periods at a young age (early menarche) and ending periods at an older age (late menopause); and obesity. Risk factors often do not cause a disease, but may go along with the illness. For example, older age is linked to higher risk of many types of cancers, but the actual cause appears to be gene mutation, which increases with age.
sentinel lymph node biopsy (SLNB): Blue dye and/or a radioactive tracer is injected into the breast at the time of surgery, and the first (sentinel) node that picks up the dye is removed and biopsied. If the node is cancer-free, fewer nodes are removed. Also known as sentinel node biopsy. Compare to axillary lymph node dissection.
staging: see TNM staging
surgical biopsy: a method of biopsy in which all or part of a lump is removed by a surgeon for examination.
TNM staging: the staging system of the American Joint Committee on Cancer, sometimes called the TNM system. It gives 3 key pieces of information: The letter T with a number from 0 to 4 describes the tumor's size and whether it has spread to the skin or chest. Higher T numbers mean a larger tumor and/or more spread to nearby tissues. The letter N with a number from 0 to 3 says whether the cancer has spread to nearby lymph nodes and, if so, whether the nodes are fixed (stuck) to other structures. The letter M with a 0 or 1 tells if the cancer has spread to distant organs (like the lungs or bones) or to lymph nodes that are not next to the breast.
wire localization: a procedure used to guide a surgical breast biopsy when the lump is hard to find or when there is an area that looks suspicious on a mammogram. A thin hollow needle is placed into the breast and x-rays are taken to guide the needle to the area in question. A fine thin wire is inserted through the center of the needle. A small hook at the end of the wire keeps it in place. The hollow needle is then removed, and the surgeon uses the path of the wire as a guide to locate the abnormal area to be removed.
