When the Diagnosis is Breast Cancer

When the Diagnosis is Breast Cancer

By: Alexa Nicole Fiffick, DO, MBS, MSCP • Posted on September 29, 2022

This column kicks off my series of breast cancer columns in honor of Breast Cancer Awareness Month in October. Tune in as I discuss the latest on breast cancer risks, symptoms and treatment.

Breast Cancer Diagnosis

If you or someone you care for has recently been diagnosed with breast cancer, it can be a very overwhelming and difficult time - especially those first few days. It can take a few days until the diagnosis seems real and you can begin to think about next steps and treatment options.

When faced with breast cancer, there are many difficult decisions to make regarding treatment and care. It is often helpful to gather more information about the disease as well as to talk to members of your health care team.

What is Breast Cancer?

Breast cancer is a condition in which breast cells grow abnormally and divide without control or order. Breast cancer is the most common form of cancer in women. Early detection and prompt treatment help many women live long, full lives.

Are there different types of breast cancer?

There are several types of breast cancer:

  • Ductal Carcinoma - The most common type of breast cancer is ductal carcinoma that starts in the lining of the milk ducts of the breast (the little tubes that carry breast milk from the lobules to the nipple).
  • Lobular Carcinoma - The other type of breast cancer is lobular carcinoma. This begins in the lobules of the breast where breast milk is produced.
  • Inflammatory Breast Cancer - Inflammatory breast cancer is an aggressive and rapidly growing breast cancer in which the cancer cells infiltrate the skin and lymph vessels of the breast. Thus, there is often no distinct tumor or lump that can be felt within the breast. Symptoms can occur when the lymph vessels are infiltrated, instead.
  • Metastatic Breast Cancer - Metastatic breast cancer is when the original type of breast cancer spreads into healthy surrounding tissues. The most common locations for breast cancer to metastasize include the liver, brain, lungs, and bones.

What is non-invasive breast cancer?

With non-invasive breast cancer, the cancer cells are confined to the ducts or lobules. This is also known as carcinoma in-situ. There are two types of non-invasive breast cancer:

  1. The first is ductal carcinoma in-situ (DCIS). This is when the ductal cells divide abnormally but stay within the ducts.
  2. The second type of non-invasive breast cancer is lobular carcinoma in-situ (LCIS). This is when the cells divide abnormally, but stay within the lobules. Lobular carcinoma in-situ is an indicator that a woman might be at an increased risk of developing invasive breast cancer.

What is invasive breast cancer?

Invasive breast cancer occurs when cells spread beyond the ducts or lobules. These cells first invade the surrounding breast tissue and can possibly travel to the lymph nodes.

What are my surgical options?

Your surgeon might discuss different surgical options with you. Doctors have found that different types of surgery can work equally well depending upon the situation.

  • Modified radical mastectomy: This procedure removes all of the breast tissue along with the nipple. Lymph nodes in the axilla (arm pit) are also removed. The chest muscles are left intact.
  • Simple mastectomy: There are no lymph nodes removed in this procedure. The entire breast is removed. This procedure is most frequently used for further cancer prevention.
  • Lumpectomy: This is also referred to as breast conservation. The surgeon removes the cancerous area with a margin of normal tissue. A second incision might be made in order to remove the lymph nodes. Following a lumpectomy, the entire breast is treated with radiation therapy to kill any remaining cancer cells.

What are my non-surgical options?

Depending on what receptors are present in the cancer cells, you may benefit from hormone receptor-specific medications or chemotherapy. You may also benefit from radiation. All these options will be offered to you by the oncology team, so it may be helpful to be aware of the broad groups of options prior to this discussion.

Be Strong, Be Healthy, Be in Charge!

- Alexa Fiffick, DO, MBS

About Alexa Nicole Fiffick, DO, MBS

Dr. Alexa Nicole Fiffick is a Board Certified Family Medicine physician. She is a senior clinical Specialized Women’s Health Fellow at the Cleveland Clinic Center for Specialized Women’s Health.

Dr. Fiffick was born and raised in Greater Cleveland, Ohio. She graduated from Case Western Reserve University in 2012 with a Bachelor’s in Sociology with minors in Dance and Chemistry. She achieved a Master’s in Biomedical Science at The Commonwealth Medical College in 2013. She spent a year working in research at the Cleveland Clinic. Then, she went to medical school at Alabama College of Osteopathic Medicine, graduating in 2018.

Dr. Fiffick graduated from Doctors Hospital Family Medicine program for residency, with a certified focus on Women’s Health. She spent time working with underserved communities via Mobile Medicine in residency. Through this she fell in love with caring for underserved women and women in mid through later life.

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