When breast cancers start to grow and spread outside of the lobules and milk ducts into the fatty and connective tissues of the breast, they are called invasive breast cancers.

More than 80% of breast cancers are invasive breast cancer. There are two main types of invasive breast cancers: invasive ductal carcinoma and invasive lobular carcinoma.

Invasive Ductal Carcinoma:
Invasive ductal carcinomas start in the milk ducts and then spread to the surrounding breast tissue. This is the most common type of invasive breast cancer and accounts for approximately 80% of all cases. There are several less common types of invasive ductal carcinoma, including medullary carcinoma, papillary carcinoma, tubular carcinoma, mucinous carcinoma, and cribriform carcinoma.

Invasive Lobular Carcinoma:
Invasive lobular carcinomas start in the lobules of the breast and then grow into the surrounding breast tissue. This type of breast cancer accounts for 10-15% of all invasive breast cancer cases. Invasive lobular carcinomas may be more challenging to detect on mammograms and ultrasound because they may not create a mass in the breast, and they infiltrate the tissues of the breast. Subtle changes may occur in the breast over time, including thickening of the breast tissue and skin, and the nipple may turn inward.

Breast Cancer Types

After a cancer diagnosis is made, several tests can be performed on the biopsy sample to determine the exact type of tumor and treatment options. There are three major subtypes of invasive breast cancer: hormone receptor-positive tumors, HER2-positive tumors, and triple-negative breast tumors.

Hormone receptors:
This test measures the amount of estrogen and progesterone (hormone) receptors in your cancer tissue.

Most breast cancers, approximately 75%, have estrogen receptors and/or progesterone receptors. For tumors that have these hormone receptors, one of the treatments that can be used is medicine, which reduces the activity of these hormone receptors by blocking the receptor or reducing estrogen production in the body. These medicines reduce the likelihood that the tumor will return, and they also decrease the risk of developing new breast cancers.

Human epidermal growth factor receptor 2 (HER2/neu) test:
This test measures the amount of HER2/neu receptor that is present in the breast cancer cells. When the HER2/neu receptor is present or expressed in higher amounts than normal, the breast cancer may grow faster. There are medicines that have been developed to target this receptor in breast cancer and other cancers. HER2/neu-positive breast cancers also require chemotherapy.

Triple negative breast cancer:
Breast cancers that do not have hormone receptors or overexpression of HER2/neu on the cancer cells are called triple-negative breast cancer. Triple-negative breast cancer is a more aggressive type of breast cancer that requires chemotherapy and sometimes immunotherapy for treatment.

Tests

Mammograms
Mammograms are the fastest, most accurate way of detecting an abnormal growth in your breast. With tomosynthesis, or 3D mammography, radiology technologists can get breast images from multiple angles, enhancing the accuracy of a reading and reducing the potential need for repeat scans.

Breast Ultrasound and MRI
Your doctor may request a noninvasive imaging exam, such as breast ultrasound or breast MRI, if you have dense breasts and you’re at a higher risk of breast cancer — especially for those with a 20 percent or higher lifetime risk for breast cancer.

Ductoscopy
More than 80 percent of breast cancer growths arise in milk ducts. If your symptoms include a watery, blood-tinged discharge from the nipple, your surgeon will use ductoscopy to find the lesion to sample or remove it. It uses a fiber-optic scope less than a millimeter thick inserted into the milk duct at the nipple to send images to a computer monitor.

Biopsies
A biopsy is a small sample of the suspicious breast tissue that’s removed and tested. Biopsies can be performed in several ways, depending on the circumstances: fine-needle aspiration (minimally invasive biopsy), image-guided core needle biopsy, cyst aspiration, ductoscopy (milk ducts) and surgical biopsy (excisional or incisional biopsy).

Estrogen and Progesterone Receptor Test
This test looks for estrogen and progesterone (hormone) receptors in your cancer tissue. If your breast cancer cells have estrogen and progesterone receptors, the cancer may grow more quickly. The test tells your doctor whether treatment to block estrogen and progesterone will be effective.

Human Epidermal Growth Factor Type 2 (HER2/neu) Receptor Test
This test measures how many HER2/neu breast cancer genes there are and how much HER2/neu protein is made in a sample of breast tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow or spread more quickly.

Multigene Tests
Because no tumor has a single mutation, genomic profiling allows the pathologist (cellular expert) to identify groups of mutations in your tumor tissue sample. We then can create a tumor profile for you. That profile helps us determine what type of treatment would be the most effective and how long you should have treatment.

Treatments

After determining the extent and location of your cancer, your oncology team will discuss options with you for surgery, radiation therapy, chemotherapy, and other leading-edge options available in clinical trials. Sylvester Comprehensive Cancer Center has the most breast cancer clinical trials in South Florida.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.

Renowned Braman Family Breast Cancer Institute at Sylvester. We offer one of the nation's best breast cancer diagnosis and care programs, offering treatments customized to your individual needs.

Breast Imaging Center of Excellence designation by the American College of Radiology. You get a more precise diagnosis, which then guides a more effective treatment plan.

Multidisciplinary breast cancer team. You receive care from a team of experts in all facets of breast cancer, offering you complete care for the best chance of success.