Breast cancers are divided into two main groups: noninvasive or in situ (not spreading) and invasive (having the potential to spread).
Invasive Cancers
Ductal carcinoma, which develops in the cells lining the breast ducts that carry milk out through the nipple, is the most common type of breast cancer. It is known that ductal carcinoma is in the in situ form if it has no ability to spread, and in the invasive form if it has the potential to spread.
Cancer that develops from the milk-producing glands (lobules) is called lobular carcinoma. Lobular carcinoma is also divided into two according to its ability to spread. If it has no ability to spread it is in the in situ form; if it has the potential to spread it is in the invasive form.
Inflammatory breast cancer is the worst and fastest-progressing type of breast cancer. It surrounds the breast completely and can be confused with inflammatory diseases of the breast. It progresses with widespread redness and hardness without giving any sign of a lump. In inflammatory diseases of the breast that do not heal despite antibiotic treatment, breast cancer must definitely be considered and a biopsy must be taken.
Noninvasive Cancers
Cancers that do not spread (in situ) are again divided among themselves into two groups: “ductal carcinoma in situ” and “lobular carcinoma in situ”. Especially after the 1980s, with screening mammography coming to the fore, the diagnosis of more cases has raised the frequency of non-spreading (in situ) cancers among all breast biopsies from 1.4 percent to 10 percent, and their share among all breast cancers from 5 percent to 15 percent.
Classic lobular carcinoma in situ: It is an important finding that increases the risk of breast cancer 8-10 times in both breasts. In such patients, in addition to follow-up, some protective drugs such as tamoxifen can be given. However, surgical interventions in the form of removing the breast tissue of both breasts (simple mastectomy) for protective purposes can also be preferred. By performing plastic surgery interventions together with surgical reconstructive procedures such as prostheses, cosmetically pleasing results can be obtained.
In situ ductal cancers (DCIS, intraductal cancer): They often do not make themselves known on examination.
Its sign is an irregular, small-sized calcification finding detected on mammography and/or (pleomorphic microcalcification) bloody, clear nipple discharge from a single duct. DCIS is accepted as a transition from normal cells to cancer cells that have the potential to spread (invasive). Since it does not form a mass, it can be removed after being marked with a wire or radioactive substances. If the cancer is in a single-focus situation, sufficient clean tissue is left around it. When radiotherapy (RT) is applied to the remaining breast tissue, the disease shows a clinically good course. If it is present widely in the breast, the whole breast tissue needs to be removed (simple mastectomy), and in this case complete recovery of up to 100 percent is seen. Involvement of the armpit lymph nodes is rarely encountered in DCIS. For this reason, in patients whose whole breast will be removed, and in some types showing worse features (high-grade, etc.), because they involve cancer cells in the armpit lymph nodes, removing the sentinel lymph nodes (sentinel lymph node biopsy) may be necessary.
