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By - Sandi Webster

Breast Cancer: Donations, DEI and Breast Cancer Types

On October 8, 2022, I will walk again for the American Cancer Society’s Making Strides for Breast Cancer research. Please give kindly to my New Birth Warriors team at http://main.acsevents.org/goto/newbirthwarriors.  In over 35 years of participating in the 5K walk for different organizations, I have always considered the disparity between men and women regarding breast cancer.

It’s been said that if men were the gender that was prevalent for having breast cancer, there would have been a cure a long time ago. I don’t disagree with that sentiment.

Is there a Diversity Issue?

I have never seen a man wearing a Survivor tag on the walks.  I have never seen a man with a Survivor license plate or decal on the street.  Is it the pink color? Women would wear it if it were blue!

Zazzle

Since diversity is present everywhere, I looked at three (3) areas for breast cancer: breast cancer studies, company leadership, and how listings of breast cancer.  My findings prove that the industry is no different from others:

  • The AstraZeneca breast cancer study site has 19 simultaneous studies in effect. Not one of those studies asked for men participants.
  • Why are the breast cancer listings on the Sloan Kettering site different for women (Breast Cancer) than for men (Male Breast Cancer)? It should just be a subset of Breast Cancer. No?
  • Anyway…I decided to look at random companies that support breast cancer research to see if they have a woman at the helm. Wouldn’t the female be focused on breast cancer research? The first randomly selected five companies, in the order I selected them, have all male CEOs.
    • Pfizer – $81 billion
    • AstraZenca – $37.5 billion
    • Merck -$48.7 billion
    • Eli Lilly – $28.3 billion
    • Bristol Myers Squibb – $46.8 billion

I resorted to Google to find a female leader of a drug company and found that only GSK (£25 billion, or appx. $28.7 billion, of the most known brands, has Dame Emma Walmsley as CEO.

That quickly, without intensive research, I was able to see that there are diversity issues prevalent in those three areas.

I also realized while doing the research that I don’t know the different types of breast cancer because, in my head, I just “lumped” them all together. I rarely ask a woman (never a man) what type of breast cancer she has and how it differs.

Breast Cancer Types

Thanks to Sloan Kettering, here are the different types of breast cancer. The information below is not the most comprehensive description so please look them up for additional information.

What is invasive breast cancer versus noninvasive breast cancer?

Noninvasive cancer means the abnormal cells are contained in the milk ducts of the breast and lack the ability to spread to surrounding tissue or elsewhere in the body. Invasive breast cancer means the cancer has grown beyond its original location into surrounding normal breast tissue and has the potential to spread to other parts of the body.

What is ductal carcinoma in situ?

Ductal carcinoma in situ (DCIS) is a very early form of breast cancer that’s confined to the milk ducts, which is why it’s called “ductal.” “Carcinoma” is the name for any cancer that begins in cells that line the inner or outer surfaces of tissues, such as the breast ducts. “In situ” is a Latin term meaning “in its original place.” DCIS is the most common form of noninvasive breast cancer.

 

DCIS is classified as low, intermediate, or high grade. Grades are based on what the cells look like under a microscope. The lower the grade, the more closely DCIS resembles normal breast cells. The higher the grade, the more different it is from normal cells. DCIS can sometimes involve the nipple, causing it to look red and scaly. This is a rare form of cancer known as Paget’s disease of the breast (named after the doctor who first described it).

What is invasive ductal carcinoma?

Invasive ductal carcinoma is a type of cancer that starts in the milk ducts and spreads to surrounding tissue. This is the most common form of breast cancer. Of the 245,000 American women diagnosed with invasive breast cancer each year, about 75% of them have invasive ductal carcinoma.

What is invasive lobular carcinoma?

Invasive lobular carcinoma (ILC) is a cancer that starts in the breast’s lobules and invades surrounding tissue. ILC is the second most common form of invasive breast cancer, accounting for 10 to 15% of breast cancer cases. ILC doesn’t always form a lump, but women who have it may notice a thick or full area that doesn’t feel like the rest of the breast.

What is inflammatory breast cancer?

As its name suggests, inflammatory breast cancer (IBC) often causes the breast to become red, swollen, and inflamed. Some women with IBC also notice thickened or discolored breast skin with tiny dimples, puckers, or ridges that make it look like an orange peel. While the symptoms may sound like an infection, the real culprit is cancer that is blocking lymphatic vessels in the skin and breast tissue, causing a buildup of fluid (lymph) and, in some cases, pain, discoloration, and sudden swelling of the breast. Also called inflammatory breast carcinoma or locally advanced breast cancer, IBC can spread quickly, making prompt diagnosis and treatment essential.

What is breast sarcoma?

Breast sarcoma is a very rare form of breast cancer. Instead of cancer forming in the lobes or ducts, a tumor may form in the connective or fibrous tissue surrounding them. Sarcomas account for only 1% of all breast cancers.

What is metaplastic carcinoma?

Also known as metaplastic breast cancer, metaplastic carcinoma is a rare type of invasive breast cancer with a unique characteristic: It contains a mix of two or more types of breast cancer cells, usually carcinoma combined with sarcoma. “Metaplastic” means that one form is turning into another. Various leading-edge techniques are used to analyze the exact genetics and biology of these confused cancers to find out if the tumor is more similar to carcinoma or sarcoma, since these two types of cancer have very different treatments.

What are estrogen receptor–positive breast cancer and progesterone receptor–positive breast cancer?

Cells from your breast cancer can be tested for receptors on two hormones that can fuel cancer growth: estrogen and progesterone. Receptors are special proteins on cells that attach to certain substances, such as estrogen and progesterone, much like a key entering a lock. Breast cancer can contain receptors for one of these hormones, both, or neither.

  • Breast cancer with receptors for estrogen is called estrogen receptor positive, or ER positive.
  • Breast cancer with no receptors for estrogen is called estrogen receptor negative, or ER negative.
  • Breast cancer with receptors for progesterone is called progesterone receptor positive, or PR positive.
  • Breast cancer with no receptors for progesterone is called progesterone receptor negative, or PR negative.

If your cancer is ER positive, PR positive, or positive for both estrogen and progesterone receptors, your treatment may include a hormone therapy — a drug or drugs that keep these hormones from plugging into their receptors. The idea is to cut off cancer’s access to the fuel that would otherwise power its growth, much like putting a child safety cap on an electrical outlet.

 

What is HER2-positive breast cancer?

HER2/neu is a gene in cells that acts like an on/off switch to produce a protein called HER2. This protein normally helps control how healthy breast cells grow and divide. However, about one in five breast cancers either has extra copies of the HER2/neu gene or produces an oversupply of this protein. This type of cancer is called HER2 positive and makes cells grow in an uncontrolled way. If your cancer is HER2 positive, it can be treated with targeted therapy drugs that block HER2 receptors.

What is triple-negative breast cancer?

About 10 to 15% of breast cancers are classified as triple negative because they lack receptors for estrogen, progesterone, and HER2. They can be harder to treat because they don’t respond to drugs that target estrogen, progesterone, or HER2 receptors. Women with triple-negative breast cancer are mainly treated with chemotherapy or take part in clinical trials.

Studies show that genetic mutations are more common in women with triple-negative breast cancer, even if they don’t have any family history of breast cancer. If you have triple-negative breast cancer, talk to your doctor about genetic counseling and testing for hereditary forms of breast cancer, such as those linked to the BRCA1 and BRCA2 genes and other genetic mutations. Knowing if you have a genetic mutation helps your doctors determine the best treatment plan and may have implications for cancer risk for your relatives.

What is breast papilloma, and is it cancer?

Also called intraductal papilloma, a breast papilloma is a small, wartlike growth in the breast’s milk ducts. This benign (noncancerous) condition may cause a clear or bloody discharge from the nipple, or you may feel a small lump behind or next to the nipple. Having one papilloma does not raise your breast cancer risk, though having several of these growths has been linked to higher risk.

 

Now that you know the issues with breast cancer, you now also know that there are different types and how they differ.  Please take time to speak to someone whom you know is suffering with breast cancer, join a breast cancer walk in October – just Google – and lobby for more research on breast cancer.

Thank you.

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