Cleveland Clinic

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Breast cancer: What determines the diagnosis and treatment? If you've been diagnosed with breast canoer, it's important to understand the many factors involved in creating an effective treatment plan. Timothy Adamowicz, DO, a Cleveland Clinic Cancer Center medical oncologist in Sandusky, provides information about how doctors classify breast cancers, which helps them determine a patient's prognosis and treatment options. Origin (where the cancer cells originate) is a factor in how the cancer can behave. Timothy Adamowicz, DO Infiltrating or invasive ductal carcinomas-70 percent to 80 percent of breast cancers start in the milk ducts, break through the duct's wall and proliferate in the breast's fatty and fibrous tissue. Invasive lobular carcinomas 10 percent of breast cancers start in the milk producing glands (lobules) and can spread Ductal carcinoma in situ (DCIS)-These breast cancers are non-invasive, meaning they don't have the ability to spread. They're contained within the milk ducts Tumor size is estimated by physical exam, mammogram and an ultrasound or MRI of the breast. The precise size isn't known until a pathologist studies the tumor after surgical removal Lymph node status is an important predictor of breast cancer severity. Once breast Staging is a standardized way to classify the cancer's severity. Stages I through IV Grading. The more abnormal the cells look under a microscope, the more likely Hormones, such as estrogen and progesterone, may play a role in how breast cancer cells spread to the lymph nodes, more aggressive treatment options are considered reflect a tumor's size, lymph node involvement and the extent of metastasis. Higher stages mean more advanced cancer. they are to quickly grow and spread. Grades usually run from 1 to 3. Grade 3 tumors tend to grow rapidly and spread faster cancer progresses. Normal cells have receptors that allow them to receive information from circulating hormones. .Breast cancer cells with estrogen and progesterone receptors can detect estrogen's signal and use it to fuel growth. This is the case in about 70 percent of patients Doctors can use drugs to block the receptors or lower estrogen levels to deprive the cancer cells of fuel. Breast cancer cells that lack these receptors can't hear the growth-signaling message. Chemotherapy is generally the preferred treatment Human epidermal growth factor receptor 2 (HER2) is another type of growth signal receptor About 25 percent of breast cancers are HER2-positive. While these tumors tend to grow more aggressively, targeted medicines can switch HER2 growth receptors off. Outcomes have improved with the advent of specific targeted therapies that can be given in combination. To schedule an appointment with Dr. Adamowicz or another Clevefand Clinic Cancer Center oncologist in Sandusky, Clyde or Norwalk, please call 419.626.9090. Same-day appointments 419.626.9090 Cleveland Clinic Every life deserves world class care.