Glossary
Ablation
Destruction of tissue
Adjuvant therapy
Treatment given in addition to surgery to improve outcome. This
may be radiotherapy, chemotherapy, hormonal therapy or treatment
with new biological agents such as Herceptin.
Atypical hyperplasia
Excess cell growth including some cells with unusual shapes and
sizes.
Augmentation
Increasing the size of the breast by inserting an implant
Axilla
The armpit
Benign
A change in the tissue that does not pose a danger as it does
not spread abnormal cells around the body
Bilateral
Both sides
Biopsy
A sample of tissue from the body taken for examination under the
microscope
Bone scan
See isotope scan
Ca 125
A tumour marker used to screen for ovarian cancer
Ca 153
A tumour marker.This substance is present in small quantities in
the blood. Cancer cells sometimes produce large ammounts and this
raised level can be measured with a blood test. It is not used as a
primary screening test but can be useful for monitoring response to
treatment or for detecting an early recurrence of a cancer after
treatment
Calcification
Deposits of calcium in the tissue.These show up as white spots
on a mammogram. Calcifications can be caused by benign conditions
such as previous surgery, aging and fibroadenomas. The radiologist
will try to classify them as benign, indeterminate (uncertain
origin) or obviously malignant. Any indeterminate or malignant
calcifications will require a biopsy.
Cancer
A growth of abnormal cells that can spread around the body
Carcinoma
A cancer arising from an epithelial surface - see cancer
Cell
The basic building blocks of the body. Each cell is a small sac
of specialised fluid contained in a cell membrane. In the centre is
the nucleus containing the genetic material.
Contracture
Hardening of scar tissue can occur around an implant or in other
breast tissue after surgery.
Core biopsy
A needle with a small groove is fired into the lump by a spring
loaded device after injecting local anaesthetic.A small cylinder of
tissue is remioved for examination.This method gives more tissue
than a fine needle aspiration biopsy and the pathologist can issue
a more detailed report.
CT Scan
Computerised axial tomography is an x-ray technique that takes
hundreds of cross sectional images through the tissue and uses a
fast computer to combine the data to produce a cross sectional view
of the area.You will need to lie in a narrow chamber for a few
minutes.THis method is useful in assessing possible spread of
breast cancer to other areas such as the liver and lungs. It may
also be useful in assessing the armpit and shoulder area looking
for enlarged lymph nodes.
Cyst
A fluid-filled lump
Cytology
Examination of individual cells under the microscope
DCIS
Ductal carcinoma in situ. Cancer cells are confined within the
lining of the duct and have not spread.
Duct
A small tube. In the breast small milk ducts connect the milk
sacs to the nipple.
Ductal cancer
A cancer arising in one of the breast ducts
Ectasia
Dilated ducts
Excision biopsy
Occasionally percutaneous needle biopsy will not provide enough
tissue to make a precise diagnosis. In these cases surgical removal
of the lump is recommended.
Fat necrosis
Fat necrosis is a process that can occur if the fatty tissue in
the breast is injured either as a result of surgery,radiotherapy or
trauma. The blood supply to the fat is damaged and the tissue dies.
This can cause a dramatic inflammatory reaction under the skin.
There is redness, swelling and pain and the features look very
similar to mastits. This condition does not respond to antibiotics.
With time the inflammation settles down. There may be a residual
hard lump and eventually the damaged tissue can break down to form
an oil cyst.
Fibroadenoma
A common benign breast lump
Fistula
An abnormal connection between two surfaces of the body. In the
breast this is usually a connection between a milk duct and the
skin. THis can result in milk or duct secretions oozing onto the
skin
FNA
Fine needle aspiration biopsy. A thin needle attached to a
syringe is passed through the lump with suction applied to the
syringe. Individual cells are sucked up into the syringe and then
sprayed onto a slide for examination under the microscope
Galactocoele
A cyst filled with milk. this appears as a lump in the breast.
It occurs during or shortly after a woman has been lactating. The
diagnsis is made with ultrasound. The fliud can be aspirated under
local anaesthetic if the lump is causing discomfort or
concern.Fluid may reaccumulate. Occaionally a galactocoele may need
to be excised if it does not resolve.
Galactorrhoea
Abnormal production of milk when not pregnant or breast-feeding.
May be due to a pituitary tumour producing the hormone prolactin.
Can also be caused by some drugs
HER2
Human epidermal growth factor receptor 2
Herceptin
A monoclonal antibody that can block the HER2 receptor.
Histology
Study of tissue under the microscope
Hormone
A chemical messenger
Hormone receptor
Chemical site located on some cells that can bind with a
particular hormone such as oestrogen allowing the hormone to
stimulate the cell
Hyperplasia
Excess cell growth
Impalpable
Cannot be felt
Implant
A silicone bag filled with saline or silicone jel - used to
increase size of breast or to replace breast after mastectomy.
Invasive cancer
A cancer in which malignant cells have spread from their normal
location into the surrounding tissue
Involution
Shrinking or dying back
Isotope scan
You are given an injection of a radioactive substance that is
selectively taken up by areas where cells are more active. A
scanner then shows up these areas as hot spots. This technique is
useful in looking for bone metastases.
Latissimus dorsi flap
A tissue flap based on this muscle used to reconstruct the
breast after mastectomy.
LCIS
Lobular carcinoma in situ. Cancer cells are confined within the
lining of the lobule and have not spread.
Liver scan
An imaging study to show the structure of the liver. May refre
to ultrasound liver scan, CT Scan or isotope scan. Usually refes to
ultrasound. Used to look for metastases.
Lobular cancer
A cancer arising from one of the breast lobules
Lymph nodes
Small filters connected to the lymph channels. They enlarge in
response to infection or cancer.
Lymphoedema
Swelling of tissue caused by a build-up of lymph fluid. After
breast cancer treatment this may be the result of damage to the
axillary lymph-nodes caused by surgery or radiotherapy. Cancer
cells can also obstruct the lymph vessels.
Malignant
A tumour that has the ability to spread around the body.
Mammogram
An x-ray of the breast. The breast is carefully positioned and
gently compressed between two plates to spread out the tissue
evenly. An x-ray beam passes through the tissue and creates an
image that is stored on a photographic plate. In conventional
mammography the images are stored on photographic film. New digital
machines can now store the images electronically. A mammogram
produces less radiation than a standard chest x-ray. Diagnostic
mammography is an important component of triple assessment - the
safe method that has evolved for investigating a breast problem.
Screening mammography is the use of routine mammograms in well
women to try to detect abnormal changes at an early stage.
Mastectomy
Operation to remove the breast
Mastitis
Infection of the breast tissue
Metastasis
A cancer that has spread from the original cancer and grown at a
distant site in the body
Microcalcification
Very small calcifications - see calcification
Milk sacs
The structures within the breast that produce milk
MRI scan
Nuclear magnetic imaging is not an x-ray. It is an imaging
technique that uses a strong magnetic field and radiofrequency
pulses to creare cross-sectional images of the body.The strong
magnet in the machine means that there are some situations where
MRI is not safe. These include people with cardiac pacemakers and
defibrillators, as well as those with ferromagnetic(metal) clips or
other introduced metallic foreign bodies in the brain or orbit. It
is useful for assessing problems with breast implants such as
possible rupture. It is also useful for looking for multifocal
cancer in the breast.
Neo-adjuvant chemotherapy
Chemotherapy given before surgery to shrink the cancer
Oestrogen receptor
See hormone receptor
Oncology
Study of cancer
Ovary
The female reproductive glands containing the eggs and also
producing oestrogen and progesterone
Paget's Disease
Paget's Disease of the nipple is an uncommon type of cancer that
develops around the nipple. It causes redness and scaling of the
nipple skin and can be mistaken for eczema. The diagnosis is made
by performing a biopsy of the abnormal area.
Palliative
Treatment to control symptoms of cancer rather than to cure
it.
Partial mastectomy
Operation to remove part of the breast including the cancerous
area
Peau d' orange
Characteristic dimpling of the skin caused when there is
swelling of the breast. The small Coopers ligaments thether the
skin. Can be a sign of large cancer but also seen after
radiotherpay or infection of the breast
PET Scan
Positron emission tomography is one of the newest imaging
techniques. You are injected with a small ammount of radioactive
material that is taken up by active cells. A scan of the body then
shows areas of increased activity. These may show areas of cancer
growth. PET scanning is most useful in assessing whether cancer has
spread to the lymph-nodes or beyond. IT is also useful in assesslng
response to chemotherapy. It is not very good at detecting small
cancer changes within the breast. PET scanning may be combined with
other imaging methods such as CTscan to evaluate areas of increased
uptake more precisely. PET scanning is only available in a few
centres and is expensive. It is currently used selectively to sort
out complex diagnostic problems.
Primary
A cancer that has developed in the breast
Progesterone receptor
See hormone receptor
Prosthesis
An artificial breast worn in the bra
Radiologist
Specialist in breast imaging
Receptor
A site on the surface or interior of the cell that can bind a
specific molecule such as oestrogen, progesterone or HER2. Binding
activates the receptor and signals the cell to perform an
activity.
Recurrence
When a cancer comes back after treatment. In breast cancer this
may be a local recurrence within the breast, a regional recurrence
involving the draining lymph-nodes or a distant recurrence if
cancer cells have spread to another site such as the liver, lungs
or bones
Secondary
A cancer that has spread to another site such as the bone or
liver.
Sentinel node
The first lymph-node to which cancer cells have spread
Sestimibi imaging
You are given an injection of a radioactive substance called
Technetium 99 which circulates around the body and is picked up by
active cells including cancer cells. A scanner can then detect
areas of increased activity. It is not a good method for picking up
small tumours. This technique is not widely used in breast cancer
diagnosis and treatment in New Zealand at present.
Stereotactic biopsy
Screening results in the detection of many small abnormalities
that cannot be felt. Biopsy of these small areas requires image
guidance. This may be ultrasound or x-ray guided. Steretactic
biopsy is a technique that uses the mammogram machine to position a
core biopsy needle correctly so that samples can be taken. This is
done under local anaesthetic.
Thermography
Is an imaging technique that records temperature differences in
the breast. It has been promoted as a screening method for early
detection of breast cancer. The problem is that this investigation
is neithwer sensitive or specific. This means that some cancers
will not be detected and on the other hand many non-cancer changes
such as inflammation may show up. Any abnormal area seen on
thermography requires standard assessment with clincial exam,
ultrasound, mammography and biopsy. The Cancer Society of New
Zealand issued a position statement on Thermography in January
2005.
TRAM
Transverse rectus abdominus myocutaneous flap
Triple assessment
Complete breast assessment may include: 1.Clinical examination
2.Ultrasound and mammography 3.Biopsy This combination of tests is
called Triple Assessment and provides a high level of accuracy
Tumour
"A swelling" - term usually refers to an abnormal growth of
cells. Benign tumours increase in size but do not spread. Malignant
tumours can spread around the body.
Ultrasound
Ultrasound uses sound waves to produce an image of the breast.
It is quick, painless and does not involve any radiation. Warm
jelly is applied to the skin to provide a good contact for the
probe. The probe is then moved over the breast tissue producing an
image on the screen. We can very quickly identify most lumps and
get a good idea as to whether it is a fluid-filled cyst or a solid
lump. We can also obtain an impression of as to whether the lump
looks benign or malignant. Needle biopsy is required to confirm the
diagnosis and can be performed with ultrasound guidance to improve
accuracy and minimise discomfort.