Three-dimensional (3-D) mammography Newer mammographic technique that sections through the breast rather than taking single pictures. Reduces call-back rates for potential abnormalities by eliminating false positives related to tissue overlap. Slightly higher radiation exposure per examination.
Adenoid cystic carcinoma Rare subtype of breast cancer.
Alcohol intake The amount of alcohol you consume, typically measured as drinks per day (one shot of alcohol, one glass of wine, and one beer each equal one drink). More than one to two drinks per day (more than seven to ten per week) is thought to increase your risk of developing breast cancer and, for women with breast cancer, increase risk of recurrence. Recommendations are for moderate alcohol intake at most: no more than five drinks per week.
Alternative medicine Treatments or therapies that are outside of standard proven medical modalities for treating disease, often chosen in lieu of standard treatment.
Anti-hormonal therapy Synonymous with “Endocrine therapy.” Medical treatment, usually in pill form, that treats estrogen-receptor-positive (ER-positive) breast cancer. Used to treat in a variety of different settings: (1) for metastatic breast cancer to control disease, (2) to reduce the risk of breast cancer recurrence for cancers that are ER-positive, and (3) to prevent breast cancer in women at increased risk for developing the disease. See also “Aromatase inhibitors” and “Tamoxifen.”
Areola The darker-colored skin circle on the breast surrounding the nipple.
Aromatase inhibitors (AI) A class of anti-hormonal therapy drugs that work by reducing estrogen production by the body. Only effective in postmenopausal women. See also “Endocrine therapy,” “Anti-hormonal therapy,” and “Tamoxifen.”
Asymmetry An area of distortion seen on the mammogram that is not symmetric with the surrounding breast tissue or with the other side. Asymmetry suggests something is pulling or distorting the surrounding tissue. Can be caused by many things, such as a scar from a previous biopsy or injury, but also can be a sign of cancer. Usually requires further evaluation, especially if new when compared to previous images. See also “Density,” “Mass,” and “Lump.”
Atypia or atypical hyperplasia (includes atypical ductal hyperplasia and atypical lobular hyperplasia) A specific type of change to cells that can be seen under the microscope when breast tissue is examined, showing cells that are “atypical,” or not typical-looking. Can be seen adjacent to areas of cancer; thus atypia seen on a needle biopsy usually warrants a small surgery or excision of the surrounding area to make sure there is no cancer present. The finding of atypia does mean a moderately increased risk of future breast cancer, approximately 15 percent over one’s lifetime. See also “Tamoxifen.”
Autologous tissue The use of one’s own tissue to reconstruct a breast removed by mastectomy. Most common site from which tissue is taken is from the belly, but other sites can include the buttocks and the back. See also “DIEP flap” and “Latissimus dorsi flap.”
Axillary lymph node(s) Lymph nodes in the armpit that drain the arm and breast on that side. These are checked in the setting of invasive breast cancer and sometimes with DCIS to find out if cancer has spread.
Axillary lymph node dissection Operation performed to remove all the lymph nodes in the armpit. Done in some cases when cancer has been found to have spread there.
Baseline mammogram First-ever mammogram. Usually recommended at age forty, sometimes earlier if there is a family history of breast cancer diagnosed at a young age.
Benign Not cancer; normal finding on biopsy.
Bilateral Both sides, usually referring to both left and right breast. See also “Bilateral mastectomy” and “Double mastectomy.”
Bilateral mastectomy Synonymous with “Double mastectomy.” Removal of both breasts, can be done in the setting of prevention of breast cancer, when one breast has cancer and the other, normal breast is also electively removed, or in the rare setting of breast cancer diagnosed on both sides.
Biopsy Removal of a piece of tissue to look at it under the microscope, test it, and make a diagnosis. Can be a small piece (see also “Needle biopsy”) or a larger piece (see also “Surgical biopsy” and “Excision”).
Bone scan A test done to determine if breast cancer has spread or metastasized to bones.
BRCA-1 A gene that when mutated or abnormal is associated with an increased risk of developing breast cancer (approximately 80 percent), ovarian cancer (20 to 40 percent), and other cancers to a lesser degree. BRCA-1 cancers are frequently triple negative. See also “Genetic testing,” “Genetic counseling,” and “Triple negative.”
BRCA-2 A gene that when mutated or abnormal is associated with an increased risk of developing breast cancer (approximately 80 percent), ovarian cancer (10 to 20 percent), and other cancers to a lesser degree. Compared to BRCA-1, BRCA-2 cancers are more frequently ER-positive. See also “Genetic testing” and “Genetic counseling.”
Breast cancer The result when breast cell changes at the genetic level lead a cell to grow, divide, multiply, and spread without normal controls. See also “Tumor.”
Calcifications Deposits of calcium seen as clusters of tiny white spots on a mammogram. Can be the first sign of breast cancer (20 percent), but also can be related to normal findings (80 percent).
CAT or CT scan A scan that can be done of a particular part or region of the body to look for breast cancer spread. Often done of the chest, abdomen, and pelvis to look for breast cancer spread in the lungs and liver. Often done in combination with a bone scan. See also “PET scan” and “Bone scan.”
Chemo-brain Cognitive or neurologic changes, such as difficulties with memory, recall, or thinking process, attributed to chemotherapy.
Chemotherapy/systemic therapy Medicine, specifically chemical substances, aimed at killing cancer cells given to treat breast cancer or reduce its risk of recurrence. Usually given intravenously, occasionally orally.
Clinical trial A scientific, controlled test to determine the effectiveness of a new option for treatment before it can be made available to the general public and offered as a standard option for treatment.
Complementary medicine Treatments or therapies that are outside of standard proven medical modalities for treating disease, are often combined with standard treatments, and are aimed at alleviating symptoms related to standard treatments or disease.
Contralateral (prophylactic or risk-reducing) mastectomy Removal of the other, normal breast in addition to the one with cancer. Usually done with the intent of reducing the risk of getting breast cancer on the other side. Also done in some cases to eliminate the need for future imaging and possibly biopsy, and sometimes with the goal of achieving a more symmetrical cosmetic result. See also “Risk-reducing mastectomy.”
Core needle biopsy Procedure of choice to take small snippets of tissue of a suspicious area in order to make a diagnosis. Involves local anesthesia and taking small cores or pieces of tissue from a suspicious area. See also “Stereotactic biopsy,” “Mammotome biopsy,” “MRI-guided core biopsy,” and “Ultrasound-guided core biopsy.”
Cyst (simple cyst) A fluid-filled pocket in the breast that is a completely normal finding. One potential cause of a new mass that one feels in the breast.
DCIS (Ductal Carcinoma-in-situ) Noninvasive breast cancer, also referred to as stage 0 breast cancer.
Dense tissue Breast tissue that is thick and firm, and appears whiter on mammogram than its counterpart, fatty tissue. A new cancer can be obscured and difficult to identify against a background of dense tissue.
Density A descriptive word used to describe a mass or whiter area seen on a mammogram or other study, usually indicating the need for further follow-up studies. A density can prove to be normal or cancer. See also “Asymmetry,” “Mass,” and “Lump.”
Diagnostic test Any type of radiology test to further evaluate abnormal findings on either physical examination or prior imaging test. See also “Screening test.”
DIEP flap Type of reconstruction using one’s own tissue from the lower abdomen to rebuild the breast. The deep inferior epigastric perforator (DIEP) vessels of the abdomen are connected to vessels in the chest for blood supply.
Double mastectomy Synonymous with “Bilateral mastectomy.” Removing both breasts. Usually performed for cancer on one side with removal of the other, normal breast by choice. Can also be performed to reduce risk of developing breast cancer in high-risk situations, or in the rare situation of breast cancer diagnosed on both sides. See also “Unilateral mastectomy” and “Risk-reducing mastectomy.”
Duct lavage A test that involves injecting fluid into the nipple and duct system of the breast and aspirating the fluid along with cells lining the duct. The test was purported to determine the risk of developing breast cancer and even possibly diagnosing breast cancer. In practice, the test was never appropriately validated, and the significance of the results could not be definitively determined. As a result, duct lavage fell out of favor and is no longer routinely used or recommended.
Endocrine therapy Synonymous with “Anti-hormonal therapy.” Medical treatment, usually in pill form, that treats estrogen-receptor-positive breast cancer. Used in a variety of different settings: (1) for metastatic breast cancer to control disease, (2) to reduce the risk of breast cancer recurrence for cancers that are estrogen-receptor-positive, and (3) to prevent breast cancer in women at increased risk for developing the disease. See also “Aromatase inhibitors” and “Tamoxifen.”
Estrogen/progesterone-receptor-negative Terminology used to describe a tumor that does not have estrogen or progesterone receptors on the cells’ surfaces, and therefore does not respond to and cannot be treated with anti-hormonal or endocrine therapy. See also “Aromatase inhibitors,” “Tamoxifen,” “Endocrine therapy,” and “Anti-hormonal therapy.”
Estrogen/progesterone-receptor-positive Terminology used to describe a tumor that has a measurable number of estrogen or progesterone receptors on its cells’ surfaces, and therefore responds to and can be treated with anti-hormonal or endocrine therapy.
Excision Removal of tissue for the purpose of establishing a diagnosis or to completely remove a designated area via a surgical procedure.
Family history Having relatives who have had breast cancer. See also “First-degree relative” and “Second-degree relative.”
Fellowship Advanced training to specialize in a particular area of expertise. For example, breast surgery fellowship involves one to two years of additional training in breast surgery beyond the standard five-year general surgery training period.
Fibroadenoma One of the most common causes of a benign breast lump, especially in young women. Not associated with cancer or an increased risk of cancer.
Fibrocystic disease/fibrocystic changes A condition of benign breast tissue that can cause normal lumps, bumps, and cysts. Very common among premenopausal women.
Fine needle aspiration (FNA) A type of needle biopsy that aspirates cells from an area to get a preliminary determination of whether or not an area is abnormal. Limited by the small amount of cells that can be removed. Differs from a core biopsy, which can remove actual pieces of tissue and can give a definitive result. See also “Core needle biopsy.”
First-degree relative Parent, sibling, or child. See also “Second-degree relative.”
Gail model A mathematical model used to calculate approximate risk of an individual for developing breast cancer.
General anesthesia Anesthesia that affects the whole body and involves loss of consciousness. Can include intubation (placement of a breathing tube). See also “Local anesthesia.”
Genetic counseling Meeting with a trained, certified genetic counselor who evaluates one’s family history of cancer, the ages at which cancer developed, and the types of cancer to determine the likelihood of having an identifiable hereditary syndrome predisposing to cancer. Will also counsel regarding the risks and benefits of genetic testing.
Genetic testing Blood or saliva test (to obtain DNA) to determine the presence of a genetic mutation that predisposes one to an increased risk of a specific cancer or cancers.
Her2/neu A tumor gene that is amplified or overexpressed in approximately 15 to 20 percent of breast cancers. Herceptin and other medications specifically target these tumors and reduce their risk of recurrence in combination with chemotherapy. Her2/neu-positive tumors are often considered when giving chemotherapy before surgery. See also “Neoadjuvant chemotherapy” and “Herceptin.”
Herceptin Medicine given that specifically targets Her2/neu-positive tumors.
Hormone receptors Found on the cell surface of cancers that are hormone-receptor positive. Cancers with hormone receptors need circulating hormones to grow and spread. Medications such as tamoxifen function to block hormone receptors and prevent growth. See also “Tamoxifen” and “Aromatase inhibitors.”
Hospice care End-of-life care when death is imminent. Usually involves pain control, support for basic functions, and psychological, emotional, and spiritual support for patients and their families. See also “Palliative care.”
Implant Silicone- or saline-filled capsule that is used to reconstruct the breast after mastectomy.
Indeterminate Results from a needle biopsy that are inconclusive and usually require removal of the area with surgery to obtain a definitive diagnosis.
Inflammatory breast cancer An aggressive form of breast cancer characterized by involvement of the breast and overlying skin. Treatment involves chemotherapy first, followed by surgery, and radiation.
Invasive/infiltrating ductal cancer The most common type of invasive breast cancer, accounting for approximately 80 percent of all cases. See also “Invasive/infiltrating lobular cancer” and “DCIS.”
Invasive/infiltrating lobular cancer The second most common type of invasive breast cancer, accounting for approximately 10 percent of all cases. Invasive lobular cancers can be more difficult to detect mammographically, and can thus be associated with larger tumor size.
Latissimus dorsi flap Type of reconstruction using one’s own tissue from the latissimus dorsi muscle in the back, overlying the shoulder blade. See also “Autologous tissue” and “DIEP flap.”
LCIS or lobular carcinoma in situ Cell changes that are not cancer but indicate a higher risk of developing a future breast cancer over one’s lifetime, approximately 20 percent.
Li-Fraumeni syndrome Rare genetic syndrome that predisposes to breast cancer, sarcoma, brain tumors, leukemia, and others.
Local anesthesia Anesthesia that affects only one isolated part of the body. Frequently used for breast biopsies and smaller breast procedures.
Local recurrence Breast cancer that comes back in the affected breast after previous lumpectomy.
Localization procedure Placement of a needle or seed in the breast prior to surgery to lead the surgeon to an area targeted for removal.
Lump A prominent area that can be felt on physical exam that stands out against the rest of the breast. See also “Mass.”
Lumpectomy One option for breast cancer surgery that removes a small part of the breast. Often coupled with radiation treatment to follow.
Lymph node Glands that are filled with immune system cells and to which cancer can spread. Can be found in groups and basins throughout the body, including in the neck, armpits, and groin.
Lymphatics Tiny threadlike vessels through which lymph fluid flows toward lymph nodes. One of the main pathways for cancer spread.
Lymphedema Swelling of the arm that can develop when axillary (armpit) lymph nodes are removed from that side.
Lynch syndrome A rare genetic mutation that predisposes to colon, uterine, and breast cancer.
Magnification views Additional specialized mammogram pictures that magnify an area of concern, done especially when concerned about or to get a better view of calcifications.
Malignant/malignancy Pertaining to cancer.
Mammogram A radiologic study done for breast cancer detection. The only test that has been shown to reduce the risk of mortality from breast cancer.
Mammotome biopsy A needle biopsy technique guided by findings seen on a mammogram.
Mantle radiation A type of radiation treatment given to the chest wall for Hodgkin’s disease (lymphoma). When given, especially in the teenage years, can significantly increase risk of developing a future breast cancer, and warrants high-risk screening.
Margin The rim of tissue around a tumor that is removed. A negative margin indicates there is normal tissue surrounding the cancer suggesting that the tumor was completely removed. A positive margin indicates that cancer cells came up to the edge of the tissue removed, thereby raising concern that there is residual cancer still left in the breast. Usually applies to lumpectomy surgery. See also “Re-excision.”
Mass A lump or bump in the breast tissue that can be either felt or seen on imaging studies. See also “Lump.”
Mastectomy One option for breast cancer surgery that removes all of the breast tissue and usually the nipple. Also can be done to prevent breast cancer in those at high risk.
Medullary cancer A subtype of breast cancer.
Metastasis/metastatic disease Spread of breast cancer outside the breast. Distant metastatic disease is spread to other parts of the body, most commonly lungs, liver, bone, and brain.
Microcalcifications Tiny white spots seen on a mammogram that are calcium deposits. May be a sign of breast cancer. If new or changed, usually require a biopsy. See also “Mammogram,” “Stereotactic biopsy,” and “Mammotome biopsy.”
Modified radical mastectomy Removal of all breast tissue, nipple, and areola, coupled with removal of axillary nodes. Done in cases where mastectomy is being performed and there is also spread to axillary lymph nodes thereby indicating the need for removal. Can be synonymous with “Skin-sparing mastectomy” when most of the skin envelope is also preserved. See also “Simple mastectomy.”
Mortality Death or risk of dying.
MRI A radiology examination used in screening for breast cancer in high-risk populations. Also used in determining extent of disease in the breast for selected women already diagnosed with breast cancer.
MRI-guided core biopsy A needle biopsy performed with MRI guidance to sample an abnormality seen on MRI.
Mucinous cancer Subtype of breast cancer, usually associated with good prognosis.
Neoadjuvant chemotherapy Chemotherapy that is given before surgery to shrink a breast cancer. Usually given with the goal of making subsequent surgery more likely to be successful in advanced cases, or with the goal of increasing the chance of successful lumpectomy for a larger tumor. Also commonly given in cases of triple negative or Her2/neu-positive breast cancer. See also “Triple negative” and “Her2/neu.”
Neuropathy Potential side effect of some chemotherapy drugs that involves pain, numbness, or weakness in the limbs or extremities.
Nipple inversion Nipple that is pulled inward instead of projecting outward. Can be normal and long-standing, or can be a symptom of breast cancer, particularly when new or changed, due to a tumor behind the nipple pulling it in.
Nipple-sparing mastectomy A variation of mastectomy that involves sparing the nipple and surrounding areola. Eliminates the need for nipple reconstruction.
Nodule Descriptive word usually used to describe a small mass or lump that is more likely to be benign.
Obesity Extreme of being overweight. Associated with increased risk of breast cancer and an increased risk of breast cancer recurrence for those already diagnosed.
Occult breast cancer Approximately 1 percent of all breast cancer cases, where the first sign of breast cancer is a cancerous node under the arm, with no identifiable source of cancer in the breast based on examination or mammogram.
Oncofertility Subspecialty of fertility medicine focused on reproductive options and fertility preservation and safety in cancer survivors.
Oncologist: medical, surgical, radiation Physician who specializes in the care and treatment of patients with cancer using medicine, surgery, or radiation, depending on specialty.
Oncotype DX A genetic profile of a tumor stratifying it at high, intermediate, or low risk of recurrence. Used in selected patients to help determine need for chemotherapy.
Overdiagnosis Diagnosing a disease or condition that would never become a health issue if left alone.
Paget’s disease A subtype of breast cancer that involves the nipple.
Palliative care An approach that focuses on pain and symptom control for patients with severe and life-threatening disease.
Pathologist/pathology Specialist or specialty that examines tissue to determine diagnosis.
Peau d’orange Literally “skin of an orange.” Breast skin changes including thickening and pitting that are signs of inflammatory breast cancer.
Perjeta A new drug targeting Her2/neu-positive breast cancer, frequently given in combination with Herceptin. See also “Her2/neu” and “Herceptin.”
PET scan/PET-CT A total body scan (frequently coupled with CT scan) that is performed to look for metastatic disease or spread of cancer in the body. Can also be used in patients with known metastatic disease to assess response to treatment.
Placebo A substance, pill, or treatment that has no therapeutic effect. Frequently used in one arm of a trial to compare effects and side effects of an actual treatment in the other arm.
Post-mastectomy radiation Radiation given after mastectomy, usually in cases of large or locally advanced tumors or extensive lymph node involvement.
Prognosis The likely or expected course or outcome of a disease.
Prophylactic mastectomy Removal of a breast to prevent breast cancer. See also “Risk-reducing mastectomy.”
Prosthesis A breast-shaped piece of material, usually made of silicone or fabric, that can be placed in the bra to fill it out after a mastectomy in lieu of reconstruction.
Radiation/radiation oncologist A treatment for breast cancer and the physician who plans and administers the treatment, usually after lumpectomy, occasionally after mastectomy.
Radical mastectomy An operation performed for breast cancer, rarely done and needed in the current era, which involves removing the breast, lymph nodes, and the underlying pectoralis muscle.
Radiologist A physician who reads and interprets imaging studies such as mammograms, ultrasounds, MRIs, X-rays, and CAT scans.
Randomization The process of assigning people or patients to different groups of a study without bias so that study groups will be even in terms of patient population and characteristics.
Reconstruction The process of rebuilding and re-forming the breast after mastectomy. See also “DIEP flap,” “Implant,” and “Latissimus dorsi flap.”
Recurrence When breast cancer returns after treatment and a disease-free interval. See also “Local recurrence” and “Systemic recurrence.”
Re-excision The procedure of removing additional tissue after lumpectomy when margins are not clear of cancer. See also “Margin.”
Risk-reducing mastectomy Removing the breast or breasts when no cancer is present to reduce the risk of developing a future cancer in that breast. See also “Contralateral mastectomy” and “Prophylactic mastectomy.”
Screening test A test done in people with no symptoms with the goal of detecting a disease. See also “Mammogram” and “Diagnostic test.”
Second-degree relative Grandparent, aunt/uncle, grandchild, niece/nephew.
Self-examination Examining oneself for signs of an illness. With breast self-examination, focuses especially on lumps, skin, or nipple changes.
Sentinel lymph node (biopsy) Standard procedure for examining lymph nodes under the arm for spread of cancer. See also “Axillary lymph node dissection.”
Side effect Consequence of a treatment or intervention that is usually undesirable.
Simple mastectomy Removal of all breast tissue, nipple, and areola. Can be synonymous with “Skin-sparing mastectomy” when most of the skin envelope is also preserved. Synonymous with “Total mastectomy.” See also “Skin-sparing mastectomy” and “Modified radical mastectomy.”
Simulation The planning phase of radiation.
Skin dimpling Visible indentation of the skin, raising the concern for the presence of a cancer underneath pulling the skin inward.
Skin-sparing mastectomy Removal of all the breast tissue, nipple, and areola while preserving most of the surrounding skin envelope for improved cosmetic result. See also “Simple mastectomy” and “Modified radical mastectomy.”
Sonogram (synonymous with “Ultrasound”) A medical imaging test using high-frequency sound waves to delineate structures in the body. Particularly useful for differentiating fluid (as in a cyst) from solid (as with a mass).
Specialization Additional training to develop expertise in a particular field. See also “Fellowship.”
Stage/staging A system that is used to estimate cancer prognosis. For breast cancer, TNM staging is used, which involves tumor size, lymph node status, and presence or absence of distant metastatic disease.
Stage 0 DCIS (noninvasive cancer) only.
Stage 1 Invasive cancer with tumor size 2 centimeters or less and no lymph node involvement.
Stage 2 Invasive cancer with tumor size greater than 2 centimeters and/or lymph node involvement.
Stage 3 Larger tumor size, more extensive lymph node involvement, or tumor that is more locally advanced, including overlying skin involvement or underlying pectoralis muscle invasion. Also includes inflammatory breast cancer (categorized as stage 3B) and breast cancer involving lymph nodes above the collar bone (categorized as stage 3C).
Stage 4 Breast cancer that has spread (metastasized) to distant sites in the body, most commonly lung, liver, bone, and brain.
Stereotactic biopsy Needle biopsy guided by findings on a mammogram. Synonymous with “Mammotome biopsy.”
Surgical biopsy Removal of tissue to establish a diagnosis via a surgical procedure.
Survivorship Transition period after treatment when there is no evidence of recurrence and focus shifts toward maintenance of overall general and continued surveillance for recurrence.
Systemic recurrence Breast cancer return to the body. Synonymous with Stage 4.
Tamoxifen Medication given for hormone-receptor-positive disease to reduce the risk of recurrence.
Thermography An experimental test with the goal of differentiating malignancy from normal findings by analyzing heat distribution.
Tissue expander Temporary device inserted at the time of mastectomy as part of the initial stage of the reconstruction process.
Total mastectomy Removal of all breast tissue, nipple and areola. Can be synonymous with “Skin-sparing mastectomy” when most of the skin envelope is also preserved. Synonymous with “Simple mastectomy.” See also “Skin-sparing mastectomy” and “Modified radical mastectomy.”
Triple negative Breast cancer that does not express estrogen, progesterone, or Her2/neu receptor.
Tubular cancer Subtype of breast cancer typically associated with lower likelihood of spread and better prognosis.
Tumor An abnormal growth of tissue, usually associated with malignancy, but can also be benign.
Tumor grade Description of cancer cells that indicates how abnormal the cells look compared to normal cells. Often, but not always, an indicator of cell growth, spread, and aggressiveness.
Tumor marker A substance found in the blood or urine that can be an indicator of the presence of cancer or recurrence.
Ultrasound A medical imaging test using high-frequency sound waves to delineate structures in the body. Particularly useful for differentiating fluid (as in a cyst) from solid (as with a mass). Synonymous with “Sonogram.”
Ultrasound-guided core biopsy Needle biopsy guided by an ultrasound or sonogram finding.
Underdiagnosis Failure of a test to detect a disease that is clinically significant and will affect overall health. See also “Overdiagnosis.”
Unilateral One side or one breast. See also “Bilateral” and “Contralateral mastectomy.”
Unilateral mastectomy Removal of one breast. See also “bilateral” and “bilateral mastectomy.”
Z-11 trial Landmark trial in breast cancer showing that for most women who have had a lumpectomy and have one or two positive nodes, removing the rest of the nodes (axillary dissection) is not necessary due to the low risk of residual disease, and the likelihood that additional treatments including chemotherapy, anti-hormonal therapy, and radiation will eradicate any residual disease.