The Who, What, Where, When and Sometimes, Why.

Types of Tumors

Although breast cancer is often referred to as one disease, there are many different types of breast cancer.

While all breast cancers start in the breast, they differ in other ways. They can be non-invasive or invasive. Tumor cells can vary in location (milk ducts or lobules) and how they look under a microscope. These differences often affect prognosis.

Tumor characteristics, such as hormone receptor status and HER2 status, also affect prognosis.

Learn more about factors that affect prognosis.

Non-invasive and invasive breast cancers

A pathologist looks at the tissue removed during a biopsy under a microscope to check whether a tumor is non-invasive (ductal carcinoma in situ) or invasive breast cancer.

Ductal carcinoma in situ (DCIS)

Ductal carcinoma in situ (DCIS) is a non-invasive breast cancer. In situ means “in place.” With DCIS, the abnormal cells are contained in the milk ducts of the breast and have not spread to nearby breast tissue.

Although DCIS is non-invasive, without treatment, the abnormal cells could progress to invasive breast cancer over time. You may also hear the terms “pre-invasive” or “pre-cancerous” to describe DCIS.

With treatment, prognosis (chance of survival) for DCIS is usually excellent.

Learn about breast anatomy.

Invasive breast cancer

Invasive breast cancer has spread from the original site (either the milk ducts or the lobules) into the nearby breast tissue, and possibly to the lymph nodes and other parts of the body.

For this reason, invasive breast cancers have a poorer prognosis than DCIS.

Learn about breast anatomy.

Types of invasive breast cancer

Figure 4.6 lists types of invasive breast cancer.

Invasive ductal carcinoma is the most common type of breast cancer (70-80 percent of all breast cancers) [17-18]. It may also be called infiltrating ductal carcinoma, invasive carcinoma of no special type or invasive carcinoma not otherwise specified.

Invasive lobular carcinoma is the next most common type (about 5-10 percent of breast cancers) [18-19].

Figure 4.6: Prevalence and Tumor Characteristics of Different Types of Invasive Breast Cancer

Type of invasive breast cancer

Proportion of all invasive breast cancers

Tumor characteristics

Prognosis

Invasive ductal carcinoma (IDC)

70-80%

  • Hard tumor texture
  • Tumor is irregular, star-shaped
  • Cell features vary
  • DCIS often present

  • Prognosis varies with stage and grade of tumor

Invasive lobular carcinoma (ILC)

5-10%

  • Normal, slightly firm or hard tumor texture
  • Cells most often appear in single file order
  • Tumors are most often ER-positive and HER2-negative

  • Prognosis varies with stage and grade of tumor
  • For any given stage or grade, prognosis is similar to that of IDC
  • Pattern of metastases may be slightly different from IDC (for example, ILC may metastasize to the gastrointestinal tract or the ovaries)

Tubular carcinoma

1-2%

  • Tumors are most often small
  • Often no palpable tumor
  • Cells form tube-like structures
  • Tumors are almost always ER-positive and HER2-negative

  • Prognosis is usually better than for IDC
  • Rare for cancer to spread to lymph nodes or other parts of the body

Mucinous (colloid) carcinoma

2%

  • Soft tumor
  • Often no palpable tumor
  • Cells are surrounded by excess mucous (mucin)
  • Tumors are most often ER-positive and HER2-negative

  • More common among older women
  • Tends to have a good prognosis
  • Less common for cancer to spread to lymph nodes

Carcinomas with medullary features

1%

  • Soft tumor
  • Cells have a sheet-like appearance
  • Tumors tend to be triple negative (ER-negative, PR-negative and HER2-negative)

Invasive papillary carcinoma

1%

  • Soft tumor
  • Cells appear as fingerlike branches

  • More common in women after menopause
  • Tends to have a good prognosis
  • <

* Percentage is higher in cancers found through mammography screening.

ER-positive = estrogen receptor-positive

ER-negative = estrogen receptor-negative

PR-negative = progesterone receptor-negative

HER2-negative = HER2 receptor-negative

Adapted from select sources [17-19].

Special invasive breast cancers and carcinoma in situ

Inflammatory breast cancer (IBC) is an aggressive locally advanced breast cancer.

The main symptoms of IBC are swelling and redness in the breast. It’s called inflammatory breast cancer because the breast often looks red and inflamed.

About 1-5 percent of breast cancers are IBC [20-21].

Learn more about IBC

Paget disease of the breast (Paget disease of the nipple) is a rare carcinoma in situ in the skin of the nipple or in the skin closely surrounding the nipple. It’s usually found with an underlying breast cancer.

About 1-4 percent of breast cancers also involve Paget disease of the breast [22-24].

Learn more about Paget disease of the breast.

Metaplastic breast cancer is rare, accounting for less than one percent of all invasive breast cancers [25].

Compared to more common breast cancers, metaplastic tumors tend to:

  • Be larger
  • Have a higher tumor grade

They are also more likely to be triple negative [17,25-28]. Triple negative breast cancers are:

  • Estrogen receptor-negative
  • Progesterone receptor-negative
  • HER2 receptor-negative

Diagnosis

Under a microscope, metaplastic tumor cells can look very different from the tumor cells of more common breast cancers. So, these cancers can be hard to diagnose and are often confused with other uncommon breast tumors or tumors that began in other parts of the body.

It’s best to have the pathology slides reviewed by another pathologist to confirm the diagnosis. You can request your health care provider send the slides out for review, or you may wish to get a second opinion with another pathologist for confirmation. You may need to sign a release giving your current health care provider permission to send the slides out for review.

Learn more about getting a second opinion.

 

Susan G. Komen® Support Resources

  • If you or a loved one needs more information about breast health or breast cancer, contact the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) or helpline@komen.org. All calls are answered by a trained specialist or oncology social worker, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. Se habla español.
  • Komen Patient Navigators can help guide you through the health care system as you go through a breast cancer diagnosis. They can help to remove barriers to high-quality breast care. For example, they can help you with insurance, local resources, communication with health care providers and more. Call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636) or email helpline@komen.org to learn more about our Patient Navigator program, including eligibility.
  • Komen Facebook groups provide a place where those with a connection to breast cancer can share their experiences and build strong relationships with each other. Visit Facebook and search for “Komen Breast Cancer group” or “Komen Metastatic Breast Cancer group” to request to join one of our closed groups.
  • Our fact sheets, booklets and other education materials offer additional information. 

Other types of cancer that occur in the breast

Most cancers that occur in the breast are breast cancers (breast carcinomas).

In rare cases:

  • Other types of cancer, such as lymphomas (cancer of the lymph system) and sarcomas (cancer of the soft tissues), can occur in the breast.
  • Cancers from other sites can metastasize (spread) to the breast and mimic breast cancers.

Some of these cancers are not carcinomas. Others are carcinomas, but they don’t start in the breast. So, they are treated differently and have different risk factors than breast cancer.

For more information on other cancers that can occur in the breast, such as lymphomas, sarcomas and malignant phyllodes tumors, visit the National Cancer Institute’s website.

Updated 03/24/22