A
Adjuvant therapy – Treatment that is added to increase the effectiveness of a primary therapy. It usually refers to chemotherapy or radiation added after surgery to increase the chances of curing the disease or keeping it in check locally.
Advanced cancer – A stage of cancer in which the disease has spread from the primary site to other parts of the body, directly or by travelling through the network of lymph glands (lymphatic system) or in the bloodstream. When the cancer has spread only to the surrounding areas, it is called locally advanced.
Antibiotic – Antibiotics are chemical substances, produced by living organisms or synthesized (created) in laboratories, for the purpose of killing other organisms that cause disease. Some cancer therapies interfere with the body’s ability to fight off infection (they suppress the immune system), so antibiotics may be needed along with the cancer treatment to protect against or kill infectious diseases.
Anti-oestrogens – Any substance (for example, the drug tamoxifen) that blocks the effects of oestrogen on tumours. Anti-oestrogens are used to treat breast cancers that depend on oestrogen for growth.
Arimidex – Anastrozole is a drug used to treat advanced breast cancer in post-menopausal women. It works by lowering the amount of the hormone oestrogen in the body. It can be used in pre-menopausal women when using Zoladex as well.
B
Benign – Not cancer, not malignant. The main types of benign breast problems are fibro adenomas, fibrocystic changes and cysts.
Biopsy – A procedure in which tissue samples are removed from the body for examination of their appearance under a microscope to find out if cancer or other abnormal cells are present. The biopsy can be done with a needle or by surgery.
Bone marrow transplant – A complex treatment that may be used when breast cancer is advanced or has recurred. The bone marrow transplant, which was first proved successful in treating leukaemia, makes it possible to use exceedingly high doses of chemotherapy that would otherwise be impossible. Antilogous bone marrow transplant means that the patient’s own bone marrow is used. When this is not possible, it becomes necessary to find a donor whose biologic characteristics (such as blood type) match or very closely match the patient’s. A portion of the patient’s or donor’s bone marrow is withdrawn, cleansed, treated and stored. The patient is then given high doses of chemotherapy that kill the cancer cells but also destroy the remaining bone marrow, thus robbing the body of its natural ability to fight infection. The cleansed and stored marrow is given by transfusion (transplanted) to rescue the patient’s immune defences. Although this method has been widely reported by the media, and it has given good results in many people, it is not yet scientifically proven to be effective in breast cancer. It is a risky procedure that involves a lengthy and expensive hospital stay that may not be covered by the patient’s health insurance. The best place to have a bone marrow transplant is in a clinical trial at a comprehensive cancer centre or other facility that has the technical skill and experience to perform it safely.
Bone scan – An imaging method that gives important information about the growth and health of bones, including the location of cancer that may have spread to the bones. It can be done as an outpatient procedure and is painless, except for the needle stick when a low-dose radioactive dye is injected into a vein. Images are taken to see where the dye accumulates, indicating an abnormality.
Bone (skeletal) survey – X-rays of the entire skeleton.
Brain scan – An imaging method used to find abnormalities in the brain, including brain cancer and cancer that has spread to the brain from other places in the body. This procedure can be done in an outpatient clinic. It is painless, except for the needle stick when a radioactive dye is injected into a vein. The images taken will show the path of the dye and places where it accumulates, indicating an abnormality.
BRCA1 – A gene located on the short arm of chromosome 17. When this gene is damaged (mutated), it places a woman at greater risk of developing breast and / or ovarian cancer, compared with women who do not have the mutation. In a woman with a BRCA1 mutation, the risk of developing breast cancer by age 50 is 58%, compared with 2% in the general population. A person who has this mutated gene has a 50% chance of passing on the gene to each of her children. A genetic test is available at Action Cancer House but only for women over the age of 40. Scientists are working on a blood test that can be used to detect BRCA1 mutations in the general population, but this test is still several years away.
Breast cancer – Cancer that starts in the breast. How rapidly it grows, whether it will spread (metastasise) or not, and what the outcome will be varies, depending on many factors, including the type of cancer, where it begins, how soon it was detected, whether it is oestrogen-receptor positive or negative, and whether it responds to the type of treatment chosen. Some of the factors that contribute to the course of breast cancer are still unknown, but one area that is under study is the effect of diet. The main types of breast cancer are ductal carcinoma in situ, infiltrating ductal carcinoma, invasive lobular carcinoma, lobular carcinoma in situ, medullary carcinoma, and Paget’s disease of the nipple (see definitions under these headings).
Breast implant – A manufactured sack that is filled with silicone gel (a synthetic material containing silicon) or saline (sterile saltwater). The sack is surgically inserted to increase breast size or restore the appearance of a breast after mastectomy.
Breast reconstruction – Surgery that rebuilds the breast contour after mastectomy. A breast implant or the woman’s own tissue provides the contour. If desired, the nipple and areola may also be re-created. Reconstruction can be done at the time of mastectomy or any time later.
Breast self-exam (BSE) – A technique of checking one’s own breasts for lumps or suspicious changes. The method is recommended for all women over age 20, to be done once a month, usually at a time other than the days before, during, or immediately after her menstrual period.
C
Cancer – A general term for more than 100 diseases in which abnormal or malignant cells develop. Some exist quietly within the body for years without causing a problem (this happens frequently with prostate cancer). Others are aggressive, rapidly forming tumours that may invade and destroy surrounding tissue. If cancer spreads, it usually travels through the lymph system or bloodstream to distant areas of the body.
Cancer care team – The group of health professionals who co-operate in the diagnosis, planning, treatment, after-care, and counselling of people with cancer. The team may include any or all of the following and others: primary care physician and / or gynaecologist, nurse, pathologist, oncology specialists (medical oncologist, radiation oncologist, and haematologist), surgeon, oncology nurse specialist, oncology social worker.
Cancer cell – A cell that divides and reproduces abnormally and can spread throughout the body.
Cancer-related check-up – A routine health examination for cancer in persons without obvious signs or symptoms of cancer. The goal of the cancer-related check-up is to find the disease, if it exists, at an early stage, when chances for cure are greatest. Clinical breast examination, pap smears and skin examinations are examples of methods used in cancer-related check-ups.
Carcinoma – A malignant tumour that begins in the lining (epithelial) cells of organs. Carcinomas can occur in almost any part of the body. At least 80% of all cancers are carcinomas, and almost all breast cancers are carcinomas.
Carcinoma in situ – An early stage of cancer, in which the tumour is still only in the structures of the organ where it first developed, and the disease has not invaded other parts of the organ or spread (metastasized). Most in situ carcinomas are highly curable.
Cell – The basic unit of which all living things are made. Cells carry out basic life processes. Organs are clusters of cells that have developed specialised tasks. In scientific language, cytecell, and therefore cytology is the study of cells, cytotoxic means “toxic to cells,” an erythrocyte is a red blood cell, and so on. Cells replace themselves by splitting and forming new cells (mitosis), and it is this process that is disrupted in cancer.
Chemotherapy – Treatment with drugs to destroy cancer cells. Chemotherapy is often used in addition to surgery or radiation or to treat cancer that has come back (recurred).
Cyst – A fluid-filled mass that is usually harmless (benign). The fluid can be removed fro analysis.
D
Detection – Finding disease. Early detection means that the disease is found at an early stage, before it has grown large or spread to other sites. (Note: Many forms of cancer can develop to an advanced stage without presenting symptoms. Ovarian and pancreatic cancers are very difficult to detect.) Mammography is the principal way to detect breast cancer early. A mammogram can show a developing breast tumour before it can be felt by the woman herself or even by a highly skilled health professional
Diagnosis – Identifying a disease by its signs, symptoms, and laboratory findings. The earlier a diagnosis of cancer is made, the better the chance for cure.
Dimpling – A pucker or indentation of the skin; on the breast, it may be a sign of cancer.
Dissection – Surgery to divide, separate, or remove tissues.
DNA – Abbreviation for deoxyribonucleic acid. One of two acids (the other is RNA) found in the nucleus of all cells. DNA holds genetic information on cell growth, division, and function.
Duct – A pathway. In the breast, a passage through which milk passes from the lobule (which makes the milk) to the nipple.
G
Genes – A segment or unit of DNA that contains information on hereditary characteristics such as hair colour, eye colour, and height. Women who have the BRCA1 gene have an inherited (genetic) tendency to develop breast cancer.
Genetic – Related to the genes.
Glands – Organs that produce and release chemicals used locally or elsewhere in the body. This term is often used incorrectly to mean lymph nodes.
H
Haematoma – A collection of blood outside a blood vessel caused by a leak or injury; for example, the bruise that may appear after blood is drawn for lab work. Haematomas that occur in the breast after injury may feel like a lump. As with other breast lumps, it’s important to have this checked to be sure that it is indeed a haematoma and not a more serious problem.
Hereditary cancer syndrome – One or several types of conditions associated with cancers that occur within multiple family members, because of an inherited, mutated gene.
High risk – Having a higher risk of developing cancer, compared with the general population. Some of the factors that can place a person at higher risk are heredity (a family history of breast cancer increases risk of breast cancer), lifestyle choices (smoking increases risk of lung cancer), and the environment (exposure to sunlight increases risk of skin cancer).
Hormone – A chemical substance that is released into the body by the endocrine glands, such as the thyroid or ovaries. The substance travels through the bloodstream and sets in motion various body functions. For example, prolactin, which is produced in the pituitary gland, begins and sustains the production of milk in the breast after childbirth.
Hormone receptor test – A test to see whether a breast tumour is affected by hormones or if it can be treated with hormones.
Hysterectomy – An operation to remove the uterus, via the abdomen or the vagina. Total hysterectomy means that the ovaries were also removed.
I
Imaging – Any method used to produce an image of internal body structures. Some imaging methods used to detect cancer or metastasis of cancer are x-rays (a breast x-ray is called a mammogram), magnetic resonance imaging (MRI), bone scans and (CT) scans
Immune system – The complex system by which the body resists invasion by a foreign substance such as bacterial infection or a transplanted organ.
Intravenous (IV) – A method of supplying fluids and medications, using a needle inserted in a vein.
Invasive cancer – Cancer that has invaded surrounding tissue and spread to distant parts of the body.
L
Leukaemia – Cancer of the organs that form the blood, such as lymph nodes and bone marrow. People with leukaemia often have a noticeable increase in leukocytes (white blood cells). Leukaemia can develop as a consequence of some types of breast cancer therapy.
Limited breast surgery – Also called lumpectomy, segmental excision, and tylectomy. It removes the breast cancer and a small amount of tissue around the cancer, but preserves most of the breast. It is almost always combined with axillary lymph node removal and is followed by radiation therapy
Local excision – Removal of a lesion or tumour that is confined to one area.
Localised breast cancer – A cancer that arose in the breast and is confined to the breast.
Lump – Any kind of mass that can be felt in the breast or elsewhere in the body.
Lumpectomy – Surgery to remove the tumour and a small amount of surrounding normal tissue
Lymph – Clear fluid that passes within the lymphatic system and contains cells known as lymphocytes. These cells fight infections. They have a lesser role in fighting cancer.
Lymph nodes – Small masses of bean-shaped tissue, located along the lymphatic vessels, which remove waste and fluids from lymph and act as filters of impurities in the body.
Lymphatic system – The tissues and organs (including bone marrow, spleen, thymus, and lymph nodes) that produce and store lymphocytes (cells that fight infection) and the channels that carry the lymph fluid. The entire lymphatic system is an important part of the body’s immune system.
Lymphedema – Swelling in the arm caused by excess fluid that collects after lymph nodes and vessels are removed by surgery or treated by radiation. This condition is usually painful and can be persistent.
Lymphoma – Tumour made up of lymph node tissue, from an abnormal production of immature lymphocytes (a form of white blood cells). About 5% of all cancers are lymphomas. One form is Hodgkin’s disease. Lymphoma can occur as a result of some types of cancer therapies.
M
Magnetic resonance imaging (MRI) – A method of obtaining cross-sectional images of the interior structures of the body. Whereas x-rays are obtained by beaming radiation through the body and onto a film, MRI uses a powerful magnet and transmits radio waves through the body, and the images appear on a computer screen as well as on film. Like x-rays, the procedure is physically painless, but some people find it psychologically uncomfortable to be in the small core of the MRI machine. Sedatives may be prescribed if this is a problem.
Malignant tumour – A mass of cancer cells that may invade surrounding tissues or spread (metastasis) to distant areas of the body.
Mammogram, mammography – An x-ray of the breast; the principal method of detection of breast cancer in women over 40. Mammography is performed on a special type of x-ray machine that is used only for this purpose. It has two plates. The lower plate is metal and has a drawer for the film cassette. The bare breast is placed on this plate. The upper plate, which is clear plastic, is lowered onto the breast. Thus compressed, it is possible to obtain a clear image of the interior structures of the breast (mammogram). The compression is maintained for only a few seconds – long enough for the technician to go to the control panel and snap the image. The procedure is then repeated with the other breast. A mammogram can show a developing breast tumour before it is large enough to be felt by a woman or even by a highly skilled health professional.
N
Needle aspiration – Removal of fluid from a cyst, or cells from a tumour. In this procedure, a needle and syringe (like those used to give injections) is used to pierce the skin, reach the cyst or tumour, and with suction, draw up (aspirate) specimens for biopsy analysis. If the needle is thin, the procedure is called fine needle aspiration or “FNA.” If a needle with a large bore (or core) is used, the procedure is called a core biopsy.
Neoplasm – Any abnormal growth; neoplasms may be benign or malignant. Cancer is a malignant neoplasm.
Nipple – The tip of the breast; the pigmented projection in the middle of the areola. The nipple contains the opening of milk ducts from the breast.
Nipple discharge – Any fluid coming from the nipple. It may be clear, milky, bloody, tan, gray, or green.
Node – Lymph glands.
Nodule – A small, solid lump that can be located by touch.
Nolvadex – Trade name for tamoxifen, an anti-oestrogen drug commonly used in breast cancer therapy.
Non cancerous – Benign; not malignant; no cancer is present.
Normal hormonal changes – Changes in breast and other tissues that are caused by fluctuations in levels of female hormones during the menstrual cycle.
O
Oestrogen – A female sex hormone produced primarily in the ovaries, possibly in the adrenal cortex, and produced in men in the testis (in much smaller amounts than in women). In women, levels of oestrogen fluctuate on nature’s carefully orchestrated schedule, regulating the development of secondary sex characteristics, including breasts; regulating the monthly cycle of menstruation; and preparing the body for fertilization and reproduction. In breast cancer, oestrogen may feed the growth of cancer cells.
Oestrogen replacement therapy – The use of oestrogen (exogenous oestrogen, i.e., oestrogen not produced by the body; oestrogen from other sources) to replace oestrogen that the body would normally produce, but has ceased to produce because of natural or induced menopause. This type of hormone therapy is often prescribed to alleviate discomforts of menopause and has been shown to provide protective effects against heart disease and osteoporosis in women. Since oestrogen nourishes some types of breast cancer, scientists are working on the question of whether oestrogen replacement therapy increases breast cancer risk
Oncologist – A doctor who is specially trained in the diagnosis and treatment of cancer. Medical oncologists specialize in the use of drugs and chemotherapy to treat cancer. Radiation oncologists specialize in the use of x-rays (radiation) to kill tumours. Medical and radiation oncologists often cooperate in giving complicated treatments.
Oncology nurse specialist – A nurse who has taken highly specialized training in the field of cancer, after completing the RN (registered nurse) degree. Oncology nurse specialists may mix and administer treatments, monitor patients, prescribe and provide aftercare, and teach and counsel patients and their families. Many oncology nurse specialists are also certified nurse practitioners.
Oncology social worker – The oncology social worker provides counselling and assistance to people with cancer and their families, especially in dealing with the crisis that can result from cancer but are not medical, such as financial problems, housing when treatments must be taken at a facility far away from home, and child care.
One-step procedure – Surgery in which a breast treatment (such as mastectomy, if the diagnosis is indeed breast cancer) is performed in a single operation. The patient is given general anaesthesia and does not know until awakened if the diagnosis was cancer or surgery was performed. Once the only option in breast cancer, the one-step procedure is now rarely used.
Osteoporosis – Break-down or disintegration of bone, resulting in diminished and porous bone mass. Osteoporosis can result from cancer (including breast cancer) that has spread to the bones), some cancer therapies, and oestrogen deficiency (oestrogen is an important participant in maintaining bone). Osteoporosis can cause pain, deformity (especially of the spine), pathologic fractures (fractures caused by weakened bone), or traumatic fractures (for example, wrist or hip fracture from a fall).
Ovary – Reproductive organ in the female pelvic region. Normally a woman has two ovaries. They contain the eggs (ova) that joined with sperm, result in pregnancy. Ovaries are also the primary site of production of oestrogen.
P
Palliative treatment – Therapy that relieves symptoms, such as pain, but does not cure the disease. Its main purpose is to improve the quality of life.
Palpation – Using the hands to examine. A palpable mass in the breast is one that can be felt.
Pathologist – A physician who specialises in the identification of abnormalities and disease by examining body tissue under a microscope and organs. The pathologist determines whether a lump is benign or cancerous.
Pathology – The study of disease. Examination of body tissues and organs under a microscope for evidence of disease. Any tumour thought to be cancer must be diagnosed by examination under a microscope.
Prevention – Avoiding the occurrence of an event, such as development of cancer, by avoiding things known to cause cancer and participating in activities that can or might prevent cancer. For example, avoiding smoking can prevent lung cancer, and taking tamoxifen may prevent breast cancer in women who are at high risk for the disease.
Primary cancer – The site where cancer begins. Primary cancer is usually named after the organ in which it starts (for example, breast cancer).
Progesterone – A female sex hormone released by the ovaries to prepare the uterus for pregnancy and the breasts for milk production (lactation).
Progesterone receptor test – A test that shows whether a breast cancer depends on progesterone for growth. Progesterone receptors are tested along with oestrogen receptors for more complete information on the hormone sensitivity of a cancer, and how best to treat it.
Prognosis – A prediction of the course of disease; the prospects for the cure of the patient. For example, women with breast cancer that was detected early and received prompt treatment have a good prognosis.
Prosthesis – An artificial formed breast for use after a mastectomy.
R
Radiologist – A physician who has taken additional years of training to produce and read x-rays and other types of images (for example, ultrasound or magnetic resonance imaging; for the purpose of diagnosing abnormalities.
Radiotherapy – Treatment with radiation to destroy cancer cells. Methods used include linear accelerators, x-rays, cobalt and betatrons. This type of treatment may be used to reduce the size of a cancer before surgery, or to destroy any remaining cancer cells after surgery. Also called irradiation and radiation therapy.
Rectus abdominus flap procedure – A method of breast reconstruction in which tissue from the lower abdominal wall which receives its blood supply from the rectus abdominus muscle, is used. The tissue from this area is moved up to the chest to create a breast mound and usually does not require an implant. Moving muscle and tissue from the lower abdomen to the chest results in flattening of the lower abdomen (a ‘tummy tuck’). Also called a TRAM flap.
Recurrence – Cancer that has re-occurred, or reappeared after treatment. Local recurrence is at the same site as the original cancer. Metastasis means that the disease has recurred at a distant site. Regional recurrence is in the lymph nodes near the site.
Regional involvement – The spread of cancer from its original site to nearby areas such as muscles or lymph nodes, but not to distant sites such as other organs.
Rehabilitation – Activities to adjust, heal and return to a full, productive life after injury or illness. This may involve physical restoration (such as the use of prostheses, exercises, and physical therapy), counselling, and emotional support.
Relapse – Reappearance of cancer after a disease-free period.
Remission – Complete or partial disappearance of the signs and symptoms of advanced cancer in response to treatment; the period during which a disease is under control. A remission may not be a cure.
Risk factor – Anything that increases a person’s chance of getting a disease, such as cancer. The known risk factors for breast cancer are: family history of the disease, especially in one’s mother or sister; beginning menstrual periods at a young age (before age 12); obesity, never having completed a pregnancy; first pregnancy after age 30.
S
Sarcoma – A malignant tumour growing from connective tissues, such as cartilage, fat, muscle, or bone. Breast sarcoma is sarcoma occurring in the breast, but this happens only rarely. Sarcoma is often highly malignant when occurring outside the breast, but it has a better outlook when it occurs in the breast.
Scan – A study using either x-rays or radioactive isotopes to produce images of internal body organs.
Screening – The search for disease, such as cancer, in people without symptoms. Screening may refer to coordinated programs in large populations. The principal screening measure for breast cancer is mammography.
Secondary tumour – A tumour that forms as a result of spread (metastasis) of cancer from its site of origin.
Side effects – After-effects or secondary effects of treatment, such as hair loss caused by chemotherapy and fatigue caused by radiation therapy.
Silicone gel – Synthetic gel compound used in breast implants because of its flexibility, strength, and texture, which is similar to the texture of the natural breast. Silicone gel breast implants are available for women who have had breast cancer surgery, but only under the auspices of a clinical trial
Staging – A method of determining and describing the extent of cancer, based on the size of the tumour, whether regional axillary lymph nodes are involved, and whether distant spread (metastasis) has occurrence. Knowing the stage at diagnosis helps decide the best treatment and the prognosis.
T
Tamoxifen (brand name: Nolvadex) – A drug that blocks oestrogen; an anti oestrogen drug. Blocking oestrogen is desirable in some cases of breast cancer because oestrogen feeds the growth of certain types of tumours.
Therapy – Any of the measures taken to treat a disease. Alternative therapy is any therapy that has not been scientifically tested and approved. Some alternative therapies are used along with standard therapy. Some are harmless, some may be helpful, and others can be dangerous, especially if they divert a person with cancer from receiving standard therapy. Also called questionable methods or unproven methods. Some people use alternative therapies along with standard therapy; in this approach, the health care team should be informed of the alternative method used.
Tissue – A collection of similar cells, united to perform a particular function. There are four basic types of tissue in the body: epithelial, connective, muscle and nerve.
TRAM flap – This is a type of breast reconstruction.
Tumour – Tissue growth in which the cells multiply uncontrollably; also called neoplasm. Can be either benign or malignant.
U
Ultrasound – An imaging method in which high-frequency sound waves are used to outline a part of the body. High-frequency sound waves are transmitted through the area of the body being studied. The sound wave echoes are picked up and displayed on a television screen. This painless method is used mainly to find out if a structure is solid or liquid. It is useful in detecting breasts cysts in young women with firm, fibrous breasts. No radiation exposure occurs.
V
Vaccine – A procedure in which a small quantity of inactivated or killed disease-causing organisms (for example, smallpox) are injected into the body. The body’s immune system responds to the presence of the organisms by forming antibodies that are specifically targeted to those particular organisms. The result is that the body is then resistant (immune) to the disease for a specific period of time; in some cases, the immunity lasts forever. Development of a cancer vaccine is a subject of intense research.
W
White blood cells – A name for several types of cells in blood that remain after red cells have been removed. Their purpose is to help defend against infection. T-cell lymphocytes and B-cell lymphocytes are two types of white blood cells that play a role in the immune system against cancer.
X
X-rays – One form of radiation that can, at low levels, produce an image of cancer on film, and at high levels, can destroy cancer cells.
Z
Zoladex – (goserelin acetate) is an injectable luteinising hormone-releasing hormone analogue (LHRHa). It stops the production of sex hormones (testosterone and oestrogen) and is used to treat hormone-sensitive cancers of the prostate and breast (in pre-/perimenopausal women) and some benign gynaecological disorders (endometriosis, uterine fibroids and endometrial thinning). In addition, Zoladex is used in assisted reproduction.