There are several types of breast cancer, but some of them are quite
rare. In some cases a single breast tumor can have a combination of
these types or have a mixture of invasive and in situ cancer.
Ductal carcinoma in situ
Ductal carcinoma in situ (DCIS; also known as intraductal carcinoma)
is the most common type of non-invasive breast cancer. DCIS means that
the cancer cells are inside the ducts but have not spread through the
walls of the ducts into the surrounding breast tissue.
About 1 in 5 new breast cancer cases will be DCIS. Nearly all women
diagnosed at this early stage of breast cancer can be cured. A mammogram
is often the best way to find DCIS early.
When DCIS is diagnosed, the pathologist (a doctor specializing in
diagnosing disease from tissue samples) will look for areas of dead or
dying cancer cells, called tumor necrosis, within the tissue sample. If necrosis is present, the tumor is likely to be more aggressive. The term comedocarcinoma is often used to describe DCIS with necrosis.
Lobular carcinoma in situ
Although it is not a true cancer, lobular carcinoma in situ (LCIS; also called lobular neoplasia)
is sometimes classified as a type of non-invasive breast cancer, which
is why it is included here. It begins in the milk-producing glands but
does not grow through the wall of the lobules.
Most breast cancer specialists think that LCIS itself does not become
an invasive cancer very often, but women with this condition do have a
higher risk of developing an invasive breast cancer in the same breast
or in the opposite breast. For this reason, women with LCIS should make
sure they have regular mammograms and doctor visits.
Invasive (or infiltrating) ductal carcinoma
This is the most common type of breast cancer. Invasive (or
infiltrating) ductal carcinoma (IDC) starts in a milk passage (duct) of
the breast, breaks through the wall of the duct, and grows into the
fatty tissue of the breast. At this point, it may be able to spread
(metastasize) to other parts of the body through the lymphatic system
and bloodstream. About 8 of 10 invasive breast cancers are infiltrating
Invasive (or infiltrating) lobular carcinoma
Invasive lobular carcinoma (ILC) starts in the milk-producing glands
(lobules). Like IDC, it can spread (metastasize) to other parts of the
body. About 1 out of 10 invasive breast cancers is an ILC. Invasive
lobular carcinoma may be harder to detect by a mammogram than invasive
Less common types of breast cancer
Inflammatory breast cancer: This uncommon type of invasive
breast cancer accounts for about 1% to 3% of all breast cancers. Usually
there is no single lump or tumor. Instead, inflammatory breast cancer
(IBC) makes the skin of the breast look red and feel warm. It also gives
the breast skin a thick, pitted appearance that looks a lot like an
orange peel. Doctors now know that these changes are not caused by
inflammation or infection, but by cancer cells blocking lymph vessels in
the skin. The affected breast may become larger or firmer, tender, or
itchy. In its early stages, inflammatory breast cancer is often mistaken
for an infection in the breast (called mastitis). Often this
cancer is first treated as an infection with antibiotics. If the
symptoms are caused by cancer, they will not improve, and the skin may
be biopsied to look for cancer cells. Because there is no actual lump,
it may not show up on a mammogram, which may make it even harder to find
it early. This type of breast cancer tends to have a higher chance of
spreading and a worse outlook than typical invasive ductal or lobular
cancer. For more details about this condition, see our document, Inflammatory Breast Cancer.
Triple-negative breast cancer: This term is used to describe
breast cancers (usually invasive ductal carcinomas) whose cells lack
estrogen receptors and progesterone receptors, and do not have an excess
of the HER2 protein on their surfaces. (See the section, "How is breast cancer diagnosed?"
for more detail on these receptors.) Breast cancers with these
characteristics tend to occur more often in younger women and in
African-American women. Triple-negative breast cancers tend to grow and
spread more quickly than most other types of breast cancer. Because the
tumor cells lack these certain receptors, neither hormone therapy nor
drugs that target HER2 are effective against these cancers (but
chemotherapy can still be useful if needed).
Mixed tumors: Mixed tumors contain a variety of cell types,
such as invasive ductal cancer combined with invasive lobular breast
cancer. In this situation, the tumor is treated as if it were an
invasive ductal cancer.
Medullary carcinoma: This special type of infiltrating breast
cancer has a rather well-defined boundary between tumor tissue and
normal tissue. It also has some other special features, including the
large size of the cancer cells and the presence of immune system cells
at the edges of the tumor. Medullary carcinoma accounts for about 3% to
5% of breast cancers. The outlook (prognosis) for this kind of breast
cancer is generally better than for the more common types of invasive
breast cancer. Most cancer specialists think that true medullary cancer
is very rare, and that cancers that are called medullary cancer should
be treated as the usual invasive ductal breast cancer.
Metaplastic carcinoma: Metaplastic carcinoma (also known as
carcinoma with metaplasia) is a very rare type of invasive ductal
cancer. These tumors include cells that are normally not found in the
breast, such as cells that look like skin cells (squamous cells) or
cells that make bone. These tumors are treated like invasive ductal
Mucinous carcinoma: Also known as colloid carcinoma, this rare
type of invasive breast cancer is formed by mucus-producing cancer
cells. The prognosis for mucinous carcinoma is usually better than for
the more common types of invasive breast cancer. Still, it is treated
like invasive ductal carcinoma.
Paget disease of the nipple: This type of breast cancer starts
in the breast ducts and spreads to the skin of the nipple and then to
the areola, the dark circle around the nipple. It is rare, accounting
for only about 1% of all cases of breast cancer. The skin of the nipple
and areola often appears crusted, scaly, and red, with areas of bleeding
or oozing. The woman may notice burning or itching.
Paget disease is almost always associated with either ductal
carcinoma in situ (DCIS) or, more often, with infiltrating ductal
carcinoma. Treatment often requires mastectomy. If only DCIS is found
(with no invasive cancer) when the breast is removed, the outlook is
Tubular carcinoma: Tubular carcinomas are another special type
of invasive ductal breast carcinoma. They are called tubular because of
the way the cells are arranged when seen under the microscope. Tubular
carcinomas account for about 2% of all breast cancers. They are treated
like invasive ductal carcinomas, but tend to have a better prognosis
than most breast cancers.
Papillary carcinoma: The cells of these cancers tend to be
arranged in small, finger-like projections when viewed under the
microscope. These tumors can be separated into non-invasive and invasive
types. Intraductal papillary carcinoma or papillary carcinoma in situ
is non-invasive. It is often considered a subtype of ductal carcinoma in
situ (DCIS), and is treated as such. In rare cases, the tumor is
invasive, in which case it is treated like invasive ductal carcinoma,
although the outlook is likely to be better. These cancers tend to be
diagnosed in older women, and they make up no more than 1% or 2% of all
Adenoid cystic carcinoma (adenocystic carcinoma): These
cancers have both glandular (adenoid) and cylinder-like (cystic)
features when seen under the microscope. They make up less than 1% of
breast cancers. They rarely spread to the lymph nodes or distant areas,
and they tend to have a very good prognosis.
Phyllodes tumor: This very rare breast tumor develops in the
stroma (connective tissue) of the breast, in contrast to carcinomas,
which develop in the ducts or lobules. Other names for these tumors
include phylloides tumor and cystosarcoma phyllodes. These tumors are usually benign but on rare occasions may be malignant.
Benign phyllodes tumors are treated by removing the tumor along with a
margin of normal breast tissue. A malignant phyllodes tumor is treated
by removing it along with a wider margin of normal tissue, or by
mastectomy. Surgery is often all that is needed, but these cancers may
not respond as well to the other treatments used for more common breast
cancers. When a malignant phyllodes tumor has spread, it may be treated
with the chemotherapy given for soft-tissue sarcomas (this is discussed
in detail in our document, Soft-tissue Sarcomas.
Angiosarcoma: This is a form of cancer that starts from cells
that line blood vessels or lymph vessels. It rarely occurs in the
breasts. When it does, it usually develops as a complication of previous
radiation treatments. This is an extremely rare complication of breast
radiation therapy that can develop about 5 to 10 years after radiation.
Angiosarcoma can also occur in the arm of women who develop lymphedema
as a result of lymph node surgery or radiation therapy to treat breast
cancer. (For information on lymphedema, see the section, "How is breast cancer treated?") These cancers tend to grow and spread quickly. Treatment is generally the same as for other sarcomas. See our document, Sarcoma - Adult Soft Tissue Cancer.