Breast cancer is often a lifelong concern for many women and men, affecting millions of Americans every year. At Penn Medicine, our world-class breast cancer care team of nationally renowned oncologists, breast surgeons, and nurses provides an unparalleled level of expertise, addressing every facet of a patient's journey with precision and empathy.
Understanding breast cancer
Breast cancer is a disease in which the breast cells of the lobules, ducts, or surrounding connective tissue begin to grow abnormally. Rapid division of these breast cells causes the formation of a breast lump or mass that grows and, in certain cases, metastasizes (spreads) to blood vessels, lymph nodes, or other areas of the body.
Breast cancer behavior, progression, and characteristics vary by type, with each requiring a specific approach to treatment and management. Our specialized breast pathologists use their in-depth understanding of tumor characteristics to recognize all types of breast cancer.
Breast cancer type is determined by two factors—where the cancer began and whether it has spread. Most breast cancers start in the breast ducts, which carry milk to the nipples (ductal cancers). Breast cancer may also begin in the breast lobules, the glands that produce milk (lobular cancers).
Breast cancer may also be non-invasive or invasive. Breast cancer is non-invasive if it has not spread to nearby breast tissue, whereas invasive (or infiltrating) breast cancers spread to surrounding connective tissue.
No matter where breast cancer originates in the breast, it can spread to other areas of breast tissue, lymph nodes under the armpit, or even to other parts of the body. When breast cancer has metastasized, it is considered in stage 4.
We test the cancer cells for hormone receptors and genetic expression. Depending on the results of those tests, we may use specialized therapies to further personalize your treatment.
- Hormone receptor status: Some breast cancers use the hormones estrogen and progesterone to grow. Those cancer cells have receptors that “feed” on the hormones. These tumors are considered hormone receptor-positive (HR+), or hormone-positive. About 80 percent of all breast cancers are HR+. Breast cancer may test positive for estrogen (ER+), progesterone (PR+), or both (ER/PR+).
- HER2 status: We typically test invasive breast cancer tissue for HER2, or human epidermal growth factor receptor 2. Normal breast tissue has HER2 receptors (produced by the HER2 gene) on each cell. These receptors control breast tissue growth and repair. In some cases, an excess of HER2 receptors causes cells to grow too rapidly, leading to a tumor.
Types of breast cancer
Breast cancer signs and symptoms
Recognizing the symptoms of breast cancer can be challenging. The signs may look different for each person and may depend on your breast cancer stage of progression (0 to IV). Small, early-stage breast cancer rarely has symptoms. In those cases, breast cancer screening is vital to early detection.
Breast cancer symptoms to look for include:
- A hard, typically painless lump in the breast or underarm
- Swelling, skin dimpling, or puckering
- Red, flaky, or thickened breast/nipple skin
- Persistent breast pain or heaviness
- Nipple retraction or non-milk discharge
- Noticeable changes in breast size or shape
In some cases, breast pain or lumps may be caused by a benign (non-cancerous) issue. Our specialized nurse practitioners work to determine the cause of your symptoms.
Diagnosing and treating breast cancer
We believe successful cancer treatment begins with an accurate diagnosis made by a skilled pathologist, who will perform a breast biopsy to evaluate the breast tissue. Your breast cancer diagnosis will identify the type of cancer you have, the stage of your breast cancer, your cancer’s HER2 status, and your cancer’s hormone receptor status.
After we make a diagnosis and determine which breast cancer type you have, our breast cancer oncology team works with you to develop a personalized breast cancer treatment plan. Along with standard care, we offer unique access to novel therapies and the newest treatments through our breast cancer research.
Comprehensive breast cancer care at Penn Medicine
As an active member of the National Accreditation Program for Breast Centers (NAPBC), our Breast Cancer Program delivers comprehensive, patient-centered care based on innovative research. When you trust us with your breast cancer care, you can expect:
- Complete multidisciplinary care and expertise: We deliver high-level care for every stage of breast cancer. Our fellowship-trained physicians and surgeons specialize in breast cancer and sit on committees within the National Comprehensive Cancer Network (NCCN) to help create guidelines for all breast cancer care nationwide.
- Access to innovate research and clinical trials: O We are leaders in breast cancer research, addressing the most pressing needs in breast cancer care. Our 2-PREVENT Breast Cancer Translational Center of Excellence is a national leader in research dedicated to breast cancer recurrence. Through this program, patients will also have access to industry-leading breast cancer clinical trials.
- Wide-ranging support and expert guidance: Our support services include access to a social worker, nutritionist, and counselor. Experienced nurse navigators work closely with you to coordinate appointments, offer guidance and support, and facilitate communication with your providers.
- Care close to home: We offer expert evaluation and treatment at all Penn Medicine breast cancer care locations. Our specialists and staff collaborate across the network to ensure you receive the best care possible, no matter where you live.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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