Breast Cancer (Facts, Stages) (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Breast cancer facts
- What is breast cancer?
- What are the risk factors for breast cancer?
- What causes breast cancer?
- What are the different types of breast cancer?
- What are the signs and symptoms of breast cancer?
- How is breast cancer diagnosed?
- Definitive diagnosis
- Specialized testing
- What are the stages of breast cancer?
- What is the treatment for breast cancer?
- Hormone therapy
- Targeted therapy
- Breast cancer treatment by stage
- What are the survival rates and prognosis for breast cancer?
- What research is being performed on breast cancer?
- Can breast cancer be prevented?
- Breast Cancer FAQs
- Find a local Oncologist in your town
Even if imaging tests show an abnormality or are suspicious for breast cancer, definitive diagnosis requires a tissue sample, or biopsy. A biopsy may be taken of a small area of the abnormality (an incisional biopsy), or the entire abnormal area may be removed at the time of biopsy (excisional biopsy). Biopsy allows the pathologist (a physician with special training in the diagnosis of diseases based on the morphology of tissue samples) to determine if cancer is present and if so, what type of cancer. Biopsy also provides a tissue sample for further tests that are done (see below) to determine the best type of treatment.
Certain tests are routinely performed on breast cancer tumor samples to help determine the optimum type of treatment. These include:
- Hormone receptor status: Breast cancer tissue is tested to look for the presence of receptors for the hormones estrogen and progesterone. Tumors are termed estrogen receptor-positive (ER+) or progesterone receptor-positive (PR+) if these receptors are present. This means that tumor growth is responsive to hormonal changes and that hormone-directed therapies may be effective in stopping growth.
- HER2: Another standard test measures the overexpression of a protein called HER2 on the breast cancer cells. If a tumor is HER2-positive (HER-2+), targeted therapies against this protein may be given.
About 15% of women have breast cancers that do not express any of these tumor markers (ER, PR, or HER2). These tumors are called triple-negative breast cancers.
Newer laboratory tests may be useful for some types of tumors to help determine the prognosis and treatment plan. These include, for example, studies of gene expression in the particular tumor or tests to look for circulating tumor cells.
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