Breast Cancer

Ductal carcinoma in situ, or DCIS, is an early stage of breast cancer that can lead to invasive cancer. About one in five breast cancer diagnoses are DCIS, but almost all cases are curable. Patients rarely have symptoms, and DCIS is typically detected on a mammogram and confirmed with a biopsy.

Also called intraductal carcinoma, DCIS is considered stage zero and is non-invasive, confined to the milk ducts. That means that unless it undergoes further changes and becomes cancerous, it will not push through the duct walls into surrounding tissue and spread outside the breast. However, doctors do not yet have a way to predict which patients will develop the more intense disease, so most patients with DCIS receive treatment.

Watch: Maen Farha, MD, director of the new comprehensive Breast Center at MedStar Good Samaritan Hospital, discusses DCIS during Think Pink House Calls on WMAR-2 News.

Invasive breast cancer means that cancerous cells have spread beyond their point of origin into the surrounding healthy tissue. It may also potentially spread outside of the breast to other parts of the body, including lymph nodes. Invasive breast cancer is further classified by where it begins and includes:

• Invasive ductal carcinoma (begins in the milk ducts)
• Invasive lobular carcinoma (begins in the breast's lobules)

Locally advanced breast cancer means the cancerous cells may involve a large portion of your breast or have spread to lymph nodes under your arm, behind your breastbone, or around your collarbone. They also may have grown into your chest wall or the skin of your breast. Locally advanced cancer has not spread (metastasized) to other organs.

Treatment for locally advanced breast cancer types usually begins with chemotherapy or hormone therapy to shrink the tumor, followed by surgery. Follow-up treatment may include radiation, hormone therapy, or targeted therapy. In addition, our team participates in several innovative clinical trials that may offer other promising options before or alongside surgery.

Metastatic breast cancer has spread to other organs and is also called stage four cancer. Metastatic breast cancer most often appears in the bones, lungs, liver, or brain. While some of our patients have metastatic breast cancer when they are first diagnosed, most have already been treated for the disease in its earlier stages. Unfortunately, even with top treatment, breast cancer can return months and even years later.

If we suspect metastatic breast cancer, our doctors will perform blood and imaging tests and possibly a biopsy to diagnose and appropriately treat the tumor. We provide a complete range of care and support for metastatic breast cancer: physical, emotional, and psychological. While there is no cure for the disease, recent advancements in treatment options, such as hormone-blocking therapy, allow women with metastatic disease to live longer with a good quality of life.

HER2-positive breast cancer

Healthy breast tissue growth is controlled by a particular protein—human epidermal growth factor receptor type 2 (HER2). However, a random mutation can form cells with too much HER2 on their surface, potentially causing them to turn cancerous and multiply rapidly. To determine HER2 levels in the cancerous cells in your breast, our pathologists examine tissue using certain tests, including an Immunohistochemistry (IHC) test and a Fluorescence in Situ Hybridization (FISH) test.

Left untreated, these HER2-positive cancers typically are aggressive and can quickly spread. However, we continue to develop new and promising approaches, including targeted therapies. Targeted, biological therapies are drugs that can change the behavior of the cells in your breast, an approach first identified by our researchers.

Watch: Learn more about HER2-positive breast cancer and how to treat it.

Triple-negative breast cancer

Triple-negative tumors are often aggressive and tend to return more often than other types of breast cancer. Unlike other breast cancer types, they lack protein and hormone receptors for:

• Estrogen
• Progesterone
• Human epidermal growth factor receptor 2 (HER2)

While treatment can be more challenging, triple-negative breast cancer often responds well to chemotherapy, among other treatments. Our researchers are working to develop more effective treatments for triple-negative breast cancer. We also participate in various clinical trials to provide you with access to a range of effective new therapies.

Breast cancer during pregnancy

Along with the rest of your body, your breasts change dramatically while pregnant. For example, it is normal for your breasts to become lumpier, larger, or firmer. But it is still important to inform your doctor if you discover a breast lump or notice changes that concern you.

Our breast care experts are experienced at diagnosing cancer in pregnant women and providing both physical care and emotional support. We understand the complicated decision-making process for a pregnant woman facing a breast cancer diagnosis.

If you are pregnant and diagnosed with breast cancer, please keep in mind that:

• Pregnancy does not affect your ability to survive breast cancer and does not increase your chance of experiencing cancer again later.
• You are just as likely to respond well to treatment while pregnant.
• Breast cancer cannot spread to your baby.

The health and safety of both you and your baby are our paramount concerns. Therefore, our diagnostic tools and treatment approach often require modification during pregnancy, and we take the time to help you weigh the benefits and risks of each option.

Watch: Shweta Kurian, MD, answers common questions about breast cancer treatment during pregnancy.

Inflammatory breast cancer (IBC)

Inflammatory breast cancer (IBC) is an aggressive but uncommon form of breast cancer (less than 5% of cases). It blocks the lymphatic channels in the skin of your breast and can also spread to other areas of the body. Given its rarity, inflammatory breast cancer should be managed by experienced doctors like ours. Our specialists have the expertise to diagnose IBC promptly and move to the treatment options that are right for you.

Male breast cancer

In rare cases, men can also develop breast cancer. Some known risk factors for breast cancer in men include:

• Klinefelter’s syndrome, a genetic disorder that often causes elevated estrogen levels
• Having an inherited predisposition to breast cancer, such as the BRCA2 genetic mutation
• Previous radiation exposure, such as treatment for lymphoma
• Older age
• Chronic liver problems
• Obesity
• Alcoholism

Our sensitivity and compassion to men’s unique circumstances when managing breast disease is a hallmark of our superior care.

Watch: When Michael Lyston started noticing pain, itching, and burning in his left nipple, he thought it would clear on its own. Hear how our experts treated this unique case.

Paget’s disease

Paget’s disease is a type of breast cancer that develops in the skin of the nipple and areola and often in the breast tissue itself. While it’s a rare form of cancer, our breast care experts have the expertise, training, and experience to treat it.