UCSF Mini-Medical School Lecture on Breast Cancer summary

The program is talks about diagnostic imaging and minimal invasive treatment of breast cancer. It explains a new radiology strategy of diagnosing and treating breast cancer today. It also talks about who needs breast cancer imaging, why imaging should be done and when and how it should be done with respect to the concepts and controversies surrounding imaging.

The reason as to why breast cancer imaging is emphasized is because breast cancer is the leading non skin cancer among women. At the same time it is also the second leading cause of cancer death among women after lung cancer. According to a report from the American Cancer society (ACS), in 2009 alone there were 254 650 new cases of breast cancer among women in America while the figures of new cases in men was 1910. A more disturbing finding by the ACS is on the number of deaths. In women, there were 40,170 death cases during the same period while in men there were only 440 cases.

There are several types of breast cancer. The first one is referred to as pre-Invasive or non-invasive commonly known as “in-Situ” disease. It occurs when the abnormal cells or neo plastic cells are confined to the duct cells without invading into the tissues around them. The most common type of this category of breast cancer is the ductal carcinoma in-situ and it come from one out of five diagnosed breast cancer. It is considered as a pre cancer or a non invasive cancer but sometimes it has proven to proceed into invasive cancer. Such cases have a prevalence of between 14% and 70%. The other common type that falls in this category of non invasive cancer is the is the Lobular carcinoma in-situ which begins to develop in the lobular cells of the breast. It is not considered as breast cancer but once it is found in breast, then the risk of getting breast cancer is very high. This risk is also equally high with the opposite breast. The risk is much lower than the Ductal carcinoma by less than 30%. But the main type of breast cancer that normally kills people is the Ductal Carcinoma in-situ which comprises about 85% of all cases of breast cancer. Ductal carcinoma also has several mini types of cancers that fall under it. These subtypes include: medullary, mucinous, papillary, tubular, paget’s nipple. Most of these types are more specialized and concentrate on specific parts of the breast. Some would develop even in the blood vessels of the breast while some develop in the connective tissues of the breast.

There are also some special types of breast cancer that have become common especially in the media. These cancers are called the triple negative. They are an invasive Ductal type of cancer that lacks the receptors for three things: Estrogen, Progesterone, and HER2 protein. In this type of cancer, neither the hormonal therapy nor drug therapy that is used to target the HER2 proteins would be effective in treating it. Unfortunately this type of cancer has a quicker growth rate and spreads very fast and the prevalence rate is high with younger women and women from the African American descent. The other type is called the inflammatory cancer where the cancer cells block the lymphatic in the skin of the breast causing the skin to thicken, dimple, swell, become painful, tender and red. The good news with this type is that it is very rare.