What to know about the different types of breast cancer

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Ductal carcinoma in situ (DCIS) is a cancer that forms in the milk ducts of the breast.

DCIS itself is a noninvasive cancer, which means that it remains in the tissue it formed in. However, DCIS can develop into an invasive cancer that spreads to other parts of the breast.

The ACS notes that DCIS accounts for around 1 in 5 new breast cancers.

Symptoms

A person who has DCIS will generally have no signs or symptoms. However, DCIS can occasionally cause a person to have a lump in their breast or experience discharge from their nipple.

According to the National Cancer Institute (NCI), doctors diagnose more than 90% of DCIS cases as the result of mammography alone.

Treatments

There are several treatment options available for DCIS. These include:

• Lumpectomy: Also known as breast-conserving surgery, this involves a surgeon removing the DCIS and a small amount of surrounding tissue. Radiation therapy, which reduces the risk of the cancer returning, usually comes next.
• Mastectomy: A mastectomy involves a surgeon removing a person’s entire breast.
• Hormonal therapy following surgery: DCIS tumors can be hormone receptor-positive. Hormone receptor-positive DCIS grows in the presence of hormones called estrogen or progesterone. After surgery, a person with this form of DCIS can undergo hormone therapy to lower the risk of the cancer returning.

Outlook

DCIS is not typically life threatening. This is because it is noninvasive. However, it can increase the risk of a person developing invasive breast cancer later on.

Those who have undergone a lumpectomy without radiation therapy have a 25–30% chance of DCIS recurring. The chance of DCIS returning is 15% if a person undergoes radiation therapy after surgery.

Most recurrences occur 5–10 years after a person has received the initial diagnosis.

Research from 2015 found that out of 100,000 females with DCIS, around 3.3% died from breast cancer over a span of 20 years.

Invasive, or infiltrating, ductal carcinoma (IDC) develops in the milk ducts of the breast, then spreads to surrounding breast tissue. In time, IDC can also spread to the lymph nodes and other areas of the body.

IDC accounts for about 50–70% of invasive breast cancers. Additionally, around two-thirds of females who receive an IDC diagnosis are aged 55 years or older. Males can also develop IDC.

There are less common forms of IDC, including:

Tubular carcinoma of the breast

Tubular carcinomas are forms of IDC that usually measure 1 centimeter or under. A tubular carcinoma is made of tubules, which are tube shaped structures.

Tubular carcinomas account for approximately 8–27% of all breast cancers, though this type is rare in males.

Tubular carcinomas respond well to treatment and are a less aggressive form of invasive breast cancer.

Medullary carcinoma of the breast

Medullary carcinoma is a rarer form of IDC, accounting for around 5% of all breast cancer cases. Tumors of medullary carcinomas are soft and fleshy.

Medullary carcinomas usually do not grow quickly or spread outside the breast, so it is generally easier to treat this type than other forms of breast cancer.

Papillary carcinoma of the breast

Papillary carcinomas are another rare form of IDC, accounting for under 1–2% of invasive breast cancers. Cases of papillary carcinomas often occur in postmenopausal females.

A papillary carcinoma is made up of small, finger-like protrusions. Papillary carcinomas have a medium level of growth.

Cribriform carcinoma of the breast

Cribriform carcinomas form in the stroma, or connective tissues, of the breast. Cribriform carcinoma tumors have holes between their cells, giving them a distinctive look.

Cribriform characteristics occur in approximately 5–6% of invasive breast cancer tumors. Cribriform carcinomas are low grade, meaning that their cells grow slowly and behave similarly to healthy cells.

Symptoms

IDC may not cause any symptoms. However, the following symptoms may indicate breast cancer:

• a new lump or mass in the breast
• swelling in part or all of the breast
• skin irritation or dimpling
• breast or nipple pain
• an inverted, or inward turning, nipple
• skin discoloration, thickening, or scaliness on the nipple or breast
• nipple discharge
• a lump in the armpit or surrounding area

Treatments

Treatment for IDC can include:

• lumpectomy
• mastectomy
• removal of the lymph nodes
• chemotherapy
• radiation therapy
• hormonal therapy
• targeted therapy, which are medications that target specific characteristics of cancer cells

Outlook

The ACS lists the following 5-year survival rates for people with invasive breast cancer:

• For cancer that is only in the breast, the survival rate is 99%.
• If the cancer has spread to the lymph nodes, the survival rate is 86%.
• If the cancer has spread to distant parts of the body, the survival rate is 28%.

Invasive, or infiltrating, lobular carcinoma (ILC) is the second most common form of breast cancer. ILCs account for about 10% of all invasive breast cancers.

ILCs form in the lobules of the breast, which are glands that produce milk. From the lobules, ILCs spread out to other breast tissues. In time, ILCs can also spread to lymph nodes and other parts of the body.

ILC is more common in females in their early 60s. Some research suggests that postmenopausal hormone treatments may increase a person’s risk of ILC.

Symptoms

ILC may not produce any symptoms, so it can be more difficult for doctors to find on mammograms.

However, aside from the usual breast cancer symptoms, ILCs can cause:

• thickening or hardening of the breast
• an area of swelling or fullness
• a change in the skin’s texture
• an inverted nipple

Treatments

Treatments for ILC include:

• lumpectomy
• mastectomy
• lymph node removal
• radiation therapy
• chemotherapy
• hormonal therapy
• HER2-targeted therapies, if the ILC is HER2-positive due to overproduction of the protein HER2, which encourages cell growth

Outlook

A 2015 study suggests that the long-term outlook for people with ILC is similar to or worse than that of people with other invasive cancers.

Inflammatory breast cancer (IBC) is a rare and aggressive form of cancer. According to the ACS, IBC accounts for around 1–5% of all breast cancers.

IBC is more common in females aged 40 years and under, and it occurs in more Black females than white females. IBC also tends to occur in females who have obesity. IBC can occur in males.

Symptoms

IBC can cause symptoms that develop within 3–6 months. These may include:

• swelling, thickening, or skin discoloration of the breast
• pitting of the breast skin, making it look similar to orange peel
• an inverted or retracted nipple
• one breast looking larger or feeling heavier and warmer than the other
• tender, itchy, painful breasts
• swelling of the lymph nodes near the armpit or collarbone

Treatments

Treatment for IBC may include:

• chemotherapy
• targeted therapy
• hormonal therapy
• HER2-targeted therapy
• radiation therapy
• mastectomy and lymph node removal

Outlook

According to the ACS, 1 in 3 cases of IBC have already spread to other parts of the body at the time of diagnosis. If IBC has spread, it can be hard to treat successfully.

Using data from 2009–2016, the ACS notes the following 5-year survival rates for a person with IBC: If the IBC has spread outside the breast to nearby structures or lymph nodes, the survival rate is 56%, and if the IBC has spread to distant parts of the body, such as the bones or lungs, the survival rate drops to 19%.

A breast cancer’s molecular subtype depends on the genes the cancer expresses. A gene is a unit that makes up DNA and has the information to develop certain characteristics.

There are five different molecular subtypes of breast cancer:

Luminal A

Luminal A breast cancer is:

• hormone receptor-positive
• HER2-negative
• low in the protein Ki-67, which helps control the speed of cancer cell growth

Luminal A breast cancer grows slowly and has a good outlook. It accounts for around 50–60% of all breast cancers.

Luminal B

Luminal B breast cancer is:

• hormone receptor-positive
• HER2-positive or -negative
• high in the protein Ki-67

Luminal B breast cancer grows slightly faster than luminal A breast cancer and has a worse outlook. It accounts for approximately 15–20% of breast cancers.

Triple-negative, or basal-like

Triple-negative breast cancer (TNBC) is:

• hormone receptor-negative
• HER2-negative
• more common in younger females and Black females

TNBC grows and spreads faster than other invasive breast cancers, and it has limited treatment options. TNBC also has a worse outlook than other invasive breast cancers. It accounts for about 10–15% of all breast cancers.

Triple-negative cancers disproportionately affect young Black females. These females are also more likely to have worse clinical outcomes. This is the result of health inequities, including:

• a lack of access to oncology treatment and care
• delays in receiving treatment
• a lack of access to screening for breast cancer

Learn more about how breast cancer affects Black women here.

HER2-enriched

HER2-enriched breast cancer is hormone receptor-negative and HER2-positive.

It grows faster and has a worse outlook than luminal cancers. However, HER2-enriched breast cancer responds well to HER2-targeted therapies. It accounts for around 15–20% of breast cancer subtypes.

Normal-like

Normal-like breast cancer is:

• hormone receptor-positive
• HER2-negative
• low in the protein Ki-67

Despite similarities, normal-like breast cancer has a slightly worse outlook than luminal A breast cancer. It accounts for approximately 5–10% of breast carcinomas.

Paget’s disease of the nipple is a rare form of breast cancer that involves the nipple and surrounding areas. It accounts for around 1–4% of all breast cancers.

Paget’s disease of the nipple generally forms in the ducts of the nipple before spreading to the nipple surface and areola. The areola is the dark skin that surrounds the nipple.

In about 80–90% of cases, Paget’s disease of the nipple occurs alongside DCIS or IDC.

Paget’s disease of the nipple can occur in males or females, and it usually develops in people over 50 years of age.

Symptoms

Some symptoms of Paget’s disease of the nipple include:

• itching, tingling, or burning
• pain and sensitivity
• scaling and thickening of the nipple
• flattening of the nipple
• yellowish or bloody nipple discharge

The symptoms of Paget’s disease of the nipple can appear similar to those of eczema or dermatitis. If a person experiences any of the above symptoms despite treatment, they should speak with a doctor.

Treatments

Treatment options for Paget’s disease of the nipple include:

• mastectomy
• lumpectomy
• radiation therapy
• chemotherapy
• targeted therapy
• hormonal therapy

Outlook

If there is no lump in the breast tissue and the Paget’s disease of the nipple has not spread, the outlook tends to be excellent.

However, if Paget’s disease of the nipple has spread, the outlook may not be as good, and doctors will treat it similarly to other IDCs.

Phyllodes tumors are rare, accounting for under 1% of breast tumors. They grow quickly, though they rarely spread outside the breast.

Most phyllodes tumors are benign, meaning that they are noncancerous. However, they can also be malignant, which means that they are cancerous.

Phyllodes tumors can also be borderline cancerous and noncancerous.

They tend to occur in females in their 40s, and they only very rarely occur in males.

Symptoms

Symptoms of phyllodes tumors may include:

• a painless lump
• a visible bulge in the skin over a lump
• an ulcer or open wound on the skin

Treatments

Treatment for phyllodes tumors can include:

• lumpectomy
• partial mastectomy
• total mastectomy
• radiation therapy
• chemotherapy

Outlook

According to the Genetic and Rare Diseases Information Center, benign phyllodes tumors have an excellent outlook.

The 5-year survival rate for a person with malignant phyllodes tumors is 60–80%.

Angiosarcoma is a rare form of cancer that begins in the cells that line the blood or lymph vessels. It can develop as a result of radiation therapy.

According to the NCI, angiosarcoma accounts for around 1–2% of all sarcomas. It is most common in people over 70 years of age.

Symptoms

Symptoms of angiosarcoma can include:

• purple nodules on the skin that bleed easily
• a lump
• swelling
• pain around the lump

Treatments

Treatment may include:

• mastectomy
• radiation therapy
• chemotherapy

Outlook

The NCI notes that people with low grade breast angiosarcoma have higher survival rates than those with other types of angiosarcoma.

However, many people do not receive a diagnosis until it has already spread, leading to a worse outlook.

Metastatic breast cancer is also known as stage 4 cancer. Stage 4 breast cancer is cancer that has spread from the breast to other body parts.

Around 30% of females with early stage breast cancer will develop metastatic breast cancer.

Symptoms

Symptoms of metastatic breast cancer depend on where in the body the cancer has spread. They can include:

Bone metastasis

Symptoms of bone metastasis include:

• sudden new pain
• pain that gradually gets worse over time
• pain that feels the same or worse during rest
• sudden severe pain
• an inability to move
• pain in the back or neck
• numbness or weakness
• difficulty urinating or having bowel movements
• fatigue
• weakness
• nausea
• loss of appetite
• dehydration

Lung metastasis

Symptoms of lung metastasis include:

• pain or discomfort in the lung
• shortness of breath
• wheezing
• persistent cough
• coughing up blood or mucus

Brain metastasis

Symptoms of brain metastasis include:

• headache
• slurred speech
• blurred vision
• dizziness
• balance problems
• memory problems
• personality or mood changes
• seizures
• stroke

Liver metastasis

Symptoms of liver metastasis include:

• pain or discomfort in the mid-section
• fatigue or weakness
• weight loss
• poor appetite
• fever
• bloating
• swollen legs
• a yellow tint to the skin or eyes

Treatments

Treatment options for metastatic breast cancer include:

• radiation therapy
• lumpectomy
• cryoablation, which freezes cancer cells to destroy them
• chemotherapy
• hormonal therapy
• targeted therapy
• local treatments applied to areas where the cancer has spread
• immunotherapy, which helps the body’s immune system fight the cancer

Outlook

According to the ACS, the 5-year survival rate for late stage cancer is 28%. However, a person’s survival rate can vary based on their age, their general health, and how well the cancer responds to treatment.

Recurrent breast cancer means that the cancer has returned. This can happen when even a single cancer cell that escaped treatment grows and multiplies.

There are three general areas where breast cancer can return:

• Local recurrence: This refers to when the cancer returns to the breast area where the doctor originally diagnosed it.
• Regional recurrence: This refers to when the cancer returns in the lymph nodes near the collarbone or armpit.
• Distance recurrence: This refers to when the cancer comes back in the lungs, brain, or bones. Rarely, it can come back in the other breast.

Symptoms

Some symptoms to look out for in the chest and breast area include:

• swelling in the chest, armpit, and collarbone
• a change in the size and shape
• puckering or dimpling of the skin
• a rash around the nipple
• nipple discharge
• a lump
• an inverted nipple
• swelling in the hand or arm

Some other symptoms may include:

• severe and ongoing headaches
• dry cough
• shortness of breath
• unexplained weight loss
• appetite loss
• bone pain
• fatigue

Treatments

Treatment options differ depending on where the cancer has returned.

Local

A doctor may suggest hormone therapy, targeted therapy, and chemotherapy.

If a person underwent a lumpectomy, the doctor may suggest a mastectomy. If they underwent a mastectomy, the doctor will remove the tumor and administer radiation therapy.

Regional

A doctor may remove the lymph nodes then administer radiation therapy.

After surgery, a person may also receive chemotherapy, targeted therapy, or hormone therapy.

Distant

Treatment for cancer that has returned to other parts of the body requires similar treatment to stage 4 breast cancer. The previous treatment may affect the current treatment options.

Outlook

The general outlook for recurrent breast cancer is difficult to predict.

Doctors can often successfully treat local recurrent breast cancer. However, regional recurrence is harder to predict. There may be an increased risk of the cancer spreading to other parts of the body.

According to some 2019 research, under 5% of people live for 10 years or longer after experiencing a distant recurrence.

Both males and females have breast tissue. This means that anyone can get breast cancer.

According to the Centers for Disease Control and Prevention (CDC), male breast cancer accounts for around 1% of breast cancers.

The most common types of breast cancer to affect males are:

• IDC
• ILC
• DCIS

A male is more likely to develop breast cancer if they:

• are aged around 68 years old
• have high levels of estrogen
• have Klinefelter syndrome, which causes low androgen levels and high estrogen levels
• have a family history of breast cancer or genetic mutations
• have had exposure to radiation

Symptoms

Symptoms of male breast cancer can include:

• a lump in the breast
• nipple pain
• an inverted nipple
• nipple discharge
• sores on the nipple
• enlarged lymph nodes under the arm

Treatments

A doctor may suggest the following treatments for male breast cancer:

• mastectomy
• lymph node removal
• radiation therapy
• hormonal therapy
• chemotherapy
• targeted therapy

Outlook

The 5-year survival rates for male breast cancer are as follows:

• 97% if it is localized
• 83% if it is regional
• 22% if it is distant

There are many ways a doctor can diagnose breast cancer. For example, they may use:

• a breast ultrasound scan, wherein they use sound waves to take detailed photos inside the breast
• a mammogram, which is a detailed X-ray of the breast
• an MRI scan, which is a body scan that can take detailed pictures inside the breast
• a biopsy, wherein they take a sample of tissue or fluid from the breast for testing
• a clinical breast exam, wherein they manually feel the breast for lumps

According to the CDC, a female who is aged 50–74 years and has an average risk of breast cancer should have a mammogram every 2 years.

Additionally, females aged 40–49 years should speak with a doctor about how often they should have a mammogram.

The earlier a person has their breast cancer diagnosed, the better outlook they have for recovery.

The ACS notes that due to the rarity of male breast cancer, screening males in the general population is not beneficial. However, a male should contact a doctor if they notice any symptoms of breast cancer.

The National Breast and Cervical Cancer Early Detection Program can help provide breast cancer screening to those who:

• have no health insurance
• have insurance that does not cover screening exams
• have a yearly income of below 250% of the federal poverty level
• are aged 40–64 years

The CDC provides a tool to help a person understand who to contact.

Receiving a breast cancer diagnosis can be frightening and emotional.

If a person is having difficulty with their breast cancer diagnosis, they can seek support from the following areas:

• doctors and other healthcare professionals
• therapists
• friends and family members
• breast cancer support helplines or charities
• breast cancer support groups

A person who notices any unusual lumps, pains, or changes in their breast should be sure to speak with a doctor.

A person should become familiar with the usual shape, structure, and feel of their breasts. Regularly self-checking for lumps and changes can help a person receive an early diagnosis.

Learn more about how to perform a breast self-exam here.

There are many different types of breast cancer. There are also several ways in which a doctor can diagnose breast cancer.

A person should make sure that they regularly check their breasts for any symptoms of breast cancer. Older females should ensure that they have regular mammograms.

A person who notices any unusual lumps, pains, or changes in their breast should speak with a doctor as soon as possible.