Diagnosing Breast Cancer

The OSUCCC – James is home to world-renowned diagnostic experts in both the kind of breast cancer a patient has as well as the molecular and genetic make-up of that cancer.

These sub-specialists use the most accurate, advanced diagnostic testing and technology to analyze your cancer, enabling an entire team across multiple medical disciplines to determine the most targeted, leading-edge treatment specifically for you.

The team analyzes cancer cells by using:

Hormone Receptor Status

This test measures the amount of estrogen and progesterone (hormones) receptors in cancer tissue. These test results help determine if treatment to block estrogen and progesterone may stop the cancer from growing.

HER2/neu Status

This laboratory test measures how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab and lapatinib.

Triple-Negative Breast Cancer Studies

Triple-negative breast cancer (TNBC) is diagnosed based upon the lack of three cell receptors: estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2). TNBC is unresponsive to some of the most effective therapies available for breast cancer treatment, and this kind of breast cancer tends to grow more quickly, occur in younger women and are seen more often in African-American women.

OSUCCC – James research experts are scientific pioneers in studying triple-negative breast cancer, leading important national clinical trials and writing national clinical guidelines that have changed the way the disease is treated today. They continue to study the biology of the disease to discover more about how and why the cells behave the way they do, continually looking for innovative ways to treat TNBC.

Genomic Analysis

The breast cancer experts at the OSUCCC – James use the oncotype DX® breast cancer assay to evaluate the DNA, or genetic material, in a breast cancer. By using this test, for example, the OSUCCC – James experts can help predict how chemotherapy will benefit the patient and whether distant breast cancer will recur in women with a specific type of breast cancer.  

(Source: National Cancer Institute)

Breast Cancer Stages

Identifying breast cancer stages helps determine how much breast cancer is present in your body, whether or not it has spread, and if so, where it has spread. Staging is just one of many ways that the OSUCCC – James breast cancer experts plan the most targeted, accurate way to treat your specific cancer.

Stage 0 (Carcinoma In Situ)

There are two kinds of breast carcinoma in situ:

1. Ductal carcinoma in situ (DCIS) is a condition in which abnormal cells are found in the breast duct lining. These abnormal cells are noninvasive, which means they have not spread outside the duct to other breast tissues. In some cases, DCIS may become invasive and spread to other tissues.

Breast Ductal Carcinoma

2. Lobular carcinoma in situ (LCIS) is a condition in which abnormal cells are found in the breast lobules. LCIS rarely becomes an invasive (spreading) cancer. Having LCIS in one breast, however, does increase the risk of developing breast cancer in the other breast.

Breast Lobular Carcinoma

Stage I

Stage I is divided into stages IA and IB:

  • In stage IA, the tumor is 2 centimeters or smaller. Cancer has not spread outside the breast. 
  • In stage IB, small clusters of breast cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes, and either no tumor is found in the breast or the tumor is 2 centimeters or smaller.

Breast Cancer IA IB

Stage II

Stage II is divided into stages IIA and IIB.

  • In stage IIA, either no tumor is found in the breast or the tumor is 2 centimeters or smaller. Cancer larger than 2 millimeters is found in one to three axillary lymph nodes or in the lymph nodes near the breastbone (found during a sentinel lymph node biopsy); or the tumor is larger than 2 centimeters but not larger than 5 centimeters, but cancer has not spread to the lymph nodes.

Breast Cancer IIA

  • In stage IIB, the tumor is larger than 2 centimeters but not larger than 5 centimeters. Small clusters of breast cancer cells (larger than 0.2 millimeter but not larger than two millimeters) are found in the lymph nodes. Cancer has spread to one to three axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy). The tumor is larger than 5 centimeters, but cancer has not spread to the lymph nodes.

Breast Cancer IIB

Stage III

Stage III is divided into stages IIIA, IIIB and IIIC.

  • In stage IIIA, either no tumor is found in the breast or the tumor may be any size. Cancer is found in four to nine axillary lymph nodes or in the lymph nodes near the breastbone (found during imaging tests or a physical exam), or the tumor is larger than five centimeters. Small clusters of breast cancer cells (larger than 0.2 millimeter but not larger than 2 millimeters) are found in the lymph nodes, or the tumor is larger than 5 centimeters. Cancer has spread to one to three axillary lymph nodes or to the lymph nodes near the breastbone (found during a sentinel lymph node biopsy).

Breast Cancer IIIA

  • In stage IIIB, the tumor may be any size and cancer has spread to the chest wall and/or to the skin of the breast and has caused swelling or an ulcer. Cancer may have spread to up to nine axillary lymph nodes or to the lymph nodes near the breastbone. Cancer that has spread to the skin of the breast may be inflammatory breast cancer.

Breast Cancer IIIB

  • In Stage IIIC, either no tumor is found in the breast or the tumor may be any size. Cancer may have spread to the chest wall and/or to the skin of the breast and caused swelling or an ulcer. Also, cancer has spread to 10 or more axillary lymph nodes, or to lymph nodes above or below the collarbone, or to axillary lymph nodes and lymph nodes near the breastbone. Cancer that has spread to the skin of the breast may be inflammatory breast cancer. For treatment, stage IIIC breast cancer is divided into operable and inoperable stage IIIC.

Breast Cancer IIIC

Stage IV

The cancer has spread to other parts of the body, most often the bones, lungs, liver or brain.

Breast Cancer IV 

(Source: National Cancer Institute)

If you’ve been diagnosed with breast cancer, would like a second opinion or to speak with a breast cancer specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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Susan Tallentire

After the initial shock of her diagnosis, Susan Tallentire decided she was — and is — a breast cancer survivor. She credits the steady support of her family, students and The James team.

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Columbus, Ohio 43210

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