Malignant neoplasm of overlapping sites of right female breast meaning

Breast cancers that have spread into surrounding breast tissue are known as invasive breast cancers.

Most breast cancers are invasive, but there are different types of invasive breast cancer. The two most common are invasive ductal carcinoma and invasive lobular carcinoma.

Inflammatory breast cancer is also a type of invasive breast cancer. 

Invasive (infiltrating) ductal carcinoma (IDC)

This is the most common type of breast cancer. About 8 in 10 invasive breast cancers are invasive (or infiltrating) ductal carcinomas (IDC).

IDC starts in the cells that line a milk duct in the breast. From there, the cancer breaks through the wall of the duct, and grows into the nearby breast tissues. At this point, it may be able to spread (metastasize) to other parts of the body through the lymph system and bloodstream.

Invasive lobular carcinoma (ILC)

About 1 in 10 invasive breast cancers is an invasive lobular carcinoma (ILC).

ILC starts in the breast glands that make milk (lobules). Like IDC, it can spread (metastasize) to other parts of the body. Invasive lobular carcinoma may be harder to detect on physical exam and imaging, like mammograms, than invasive ductal carcinoma. And compared to other kinds of invasive carcinoma, it is more likely to affect both breasts. About 1 in 5 women with ILC might have cancer in both breasts at the time they are diagnosed.

Less common types of invasive breast cancer

There are some special types of breast cancer that are sub-types of invasive carcinoma. They are less common than the breast cancers named above and each typically make up fewer than 5% of all breast cancers. These are often named after features of the cancer cells, like the ways the cells are arranged.

Some of these may have a better prognosis than the more common IDC. These include:

  • Adenoid cystic (or adenocystic) carcinoma
  • Low-grade adenosquamous carcinoma (this is a type of metaplastic carcinoma)
  • Medullary carcinoma
  • Mucinous (or colloid) carcinoma
  • Papillary carcinoma
  • Tubular carcinoma

Some sub-types have the same or maybe worse prognoses than IDC. These include:

  • Metaplastic carcinoma (most types, including spindle cell and squamous, except low grade adenosquamous carcinoma)
  • Micropapillary carcinoma
  • Mixed carcinoma (has features of both invasive ductal and invasive lobular)

In general, all of these sub-types are still treated like IDC.

Treating invasive breast cancer

Treatment of invasive breast cancer depends on how advanced the cancer is (the stage of the cancer) and other factors. Most women will have some type of surgery to remove the tumor. Depending on the type of breast cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both.

See Treating Breast Cancer for details on different types of treatment, as well as common treatment approaches based on the stage or other factors.

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Not all breast cancers are the same. Understand what type of breast cancer you have and how it differs from other types of breast cancer.

By Mayo Clinic Staff

Once you've been diagnosed with breast cancer, your doctor will review your pathology report and the results of any imaging tests to understand the specifics of your tumor.

Using a tissue sample from your breast biopsy or using your tumor if you've already undergone surgery, your medical team determines your breast cancer type. This information helps your doctor decide which treatment options are most appropriate for you.

Here's what's used to determine your breast cancer type.

In what part of the breast did your cancer begin?

The type of tissue where your breast cancer arises determines how the cancer behaves and what treatments are most effective. Parts of the breast where cancer begins include:

  • Milk ducts. Ductal carcinoma is the most common type of breast cancer. This type of cancer forms in the lining of a milk duct within your breast. The ducts carry breast milk from the lobules, where it's made, to the nipple.

    Ductal carcinoma can remain within the ducts as a noninvasive cancer (ductal carcinoma in situ), or it can break out of the ducts (invasive ductal carcinoma).

  • Milk-producing lobules. Lobular carcinoma starts in the lobules of the breast, where breast milk is produced. When it breaks out of the lobules, it's considered invasive lobular carcinoma. The lobules are connected to the ducts, which carry breast milk to the nipple.
  • Connective tissues. Rarely breast cancer can begin in the connective tissue that's made up of muscles, fat and blood vessels. Cancer that begins in the connective tissue is called sarcoma. Examples of sarcomas that can occur in the breast include phyllodes tumor and angiosarcoma.

How do your cancer cells appear under a microscope?

When a sample of your breast cancer is examined under a microscope, here's what the pathologist looks for:

  • Cancer cells with unique appearances. Some subtypes of breast cancer are named for the way they appear under the microscope. Subtypes include tubular, mucinous, medullary and papillary. Your subtype gives your doctor some clues about your prognosis and how your cells may respond to treatment.
  • The degree of difference between the cancer cells and normal cells. How different your cancer cells look from normal cells is called your cancer's grade. Breast cancers are graded on a 1 to 3 scale, with grade 3 cancers being the most different looking and considered the most aggressive.

Are your cancer cells fueled by hormones?

Some breast cancers are sensitive to your body's naturally occurring female hormones — estrogen and progesterone. The breast cancer cells have receptors on the outside of their walls that can catch specific hormones that circulate through your body.

Knowing your breast cancer is sensitive to hormones gives your doctor a better idea of how best to treat the cancer or prevent cancer from recurring.

Hormone status of breast cancers includes:

  • Estrogen receptor (ER) positive. The cells of this type of breast cancer have receptors that allow them to use the hormone estrogen to grow. Treatment with anti-estrogen hormone (endocrine) therapy can block the growth of the cancer cells.
  • Progesterone receptor (PR) positive. This type of breast cancer is sensitive to progesterone, and the cells have receptors that allow them to use this hormone to grow. Treatment with endocrine therapy blocks the growth of the cancer cells.
  • Hormone receptor (HR) negative. This type of cancer doesn't have hormone receptors, so it won't be affected by endocrine treatments aimed at blocking hormones in the body.

What is the genetic makeup of your breast cancer cells?

Doctors are just beginning to understand how the individual DNA changes within cancer cells might one day be used to determine treatment options. By analyzing the genes of cancer cells, doctors hope to find ways to target specific aspects of the cancer cells to kill them.

A sample of your tumor tissue from a biopsy procedure may be tested in a laboratory to look for:

  • HER2 gene. Cancer cells that have too many copies of the HER2 gene (HER2-positive cancers) produce too much of the growth-promoting protein called HER2. Targeted therapy drugs are available to shut down the HER2 protein, thus slowing the growth and killing these cancer cells.
  • Other tumor markers. Researchers are studying ways to interpret the genetic makeup of tumor cells. Doctors hope this information can be used to predict which cancers will spread and which may need aggressive treatments. That way, women with relatively low-risk breast cancers may avoid aggressive treatments.

    Tests that analyze the genetic makeup of breast cancers are available but aren't recommended in all situations. Ask your doctor whether this type of test might be helpful in your case.

Doctors are increasingly using genetic information about breast cancer cells to categorize breast cancers. These groups help guide decisions about which treatments are best. Breast cancer groups include:

  • Group 1 (luminal A). This group includes tumors that are ER positive and PR positive, but negative for HER2. Luminal A breast cancers are likely to benefit from hormone therapy and may also benefit from chemotherapy.
  • Group 2 (luminal B). This type includes tumors that are ER positive, PR negative and HER2 positive. Luminal B breast cancers are likely to benefit from chemotherapy and may benefit from hormone therapy and treatment targeted to HER2.
  • Group 3 (HER2 positive). This type includes tumors that are ER negative and PR negative, but HER2 positive. HER2 breast cancers are likely to benefit from chemotherapy and treatment targeted to HER2.
  • Group 4 (basal-like). This type, which is also called triple-negative breast cancer, includes tumors that are ER negative, PR negative and HER2 negative. Basal-like breast cancers are likely to benefit from chemotherapy.

Understanding more about the chemical and genetic makeup of your cancer may help doctors choose the most effective treatment for your specific cancer.

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Feb. 24, 2022

  1. Bleiweiss IJ. Pathology of breast cancer. https://www.uptodate.com/contents/search. Accessed Feb. 7, 2018.
  2. Niederhuber JE, et al., eds. Cancer of the breast. In: Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. https://www.clinicalkey.com. Accessed Feb. 7, 2018.
  3. Breast cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Feb. 7, 2018.
  4. The Cancer Genome Atlas Network. Comprehensive molecular portraits of human breast tumours. Nature. 2012;490:61.

See more In-depth

See also

  1. 3D mammogram
  2. Accelerated partial breast irradiation (ABPI)
  3. Axillary dissection
  4. Biopsy procedures
  5. Blood Basics
  6. Bone scan
  7. Brachytherapy
  8. BRCA gene test
  9. Breast cancer
  10. Breast Cancer
  11. Breast cancer chemoprevention
  12. Breast Cancer Education Tool
  13. Common questions about breast cancer treatment
  14. Breast cancer prevention
  15. Breast cancer radiation: Can it cause dry skin?
  16. Infographic: Breast Cancer Risk
  17. Breast cancer risk assessment
  18. Breast cancer staging
  19. Breast cancer supportive therapy and survivorship
  20. Breast cancer surgery
  21. Breast implants and cancer
  22. Evaluating breast lumps
  23. Breast lumps
  24. Breast MRI
  25. Infographic: Breast Reconstruction Options
  26. Breast self-exam for breast awareness
  27. Cancer blood tests
  28. Chemo Targets
  29. Chemotherapy
  30. Chemotherapy and hair loss: What to expect during treatment
  31. Chemotherapy and sex: Is sexual activity OK during treatment?
  32. Chemotherapy for breast cancer
  33. Chemotherapy nausea and vomiting: Prevention is best defense
  34. Chest X-rays
  35. Complete blood count (CBC)
  36. Contrast-enhanced mammography
  37. Coping with pain after breast surgery
  38. COVID-19 vaccine: Should I reschedule my mammogram?
  39. CT scan
  40. Dense breast tissue
  41. Does soy really affect breast cancer risk?
  42. Dragon Boats and Breast Cancer
  43. Genetic Testing for Breast Cancer
  44. Genetic testing for breast cancer: Psychological and social impact
  45. Hormone therapy for breast cancer
  46. Intralesional injection therapy
  47. Lower your risk of breast cancer
  48. Lumpectomy
  49. Magic mouthwash
  50. Mammogram
  51. Mammogram guidelines: What are they?
  52. Mastectomy
  53. What is breast cancer? An expert explains
  54. Minimally invasive inguinal lymphadenectomy (MILND)
  55. Modified radical mastectomy
  56. Molecular breast imaging
  57. Infographic: Molecular Breast Imaging
  58. MRI
  59. MRI-guided breast biopsy
  60. Nipple discharge
  61. Nipple-sparing mastectomy
  62. Oncoplastic breast-conserving surgery
  63. PALS (Pets Are Loving Support)
  64. Paulas story A team approach to battling breast cancer
  65. Pink Sisters
  66. Positron emission mammography (PEM)
  67. Positron emission tomography scan
  68. Precision medicine for breast cancer
  69. Preventive (prophylactic) mastectomy
  70. Prophylactic mastectomy
  71. Radiation therapy
  72. Radiation therapy for breast cancer
  73. Infographic: Scalp Cooling Therapy for Cancer
  74. Seeing inside the heart with MRI
  75. Sentinel node biopsy
  76. Skin-sparing mastectomy
  77. Stereotactic breast biopsy
  78. Support groups
  79. Tai chi
  80. The Long Race Beating Cancer
  81. Thyroid guard: Do I need one during a mammogram?
  82. Tomosynthesis-guided breast biopsy
  83. Ultrasound
  84. Sentinel node biopsy for melanoma
  85. Mammogram for breast cancer — What to expect
  86. MRI
  87. Tai chi
  88. Weight Loss After Breast Cancer
  89. X-ray

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What does malignant neoplasm of overlapping sites mean?

"Overlapping" implies that the sites involved are contiguous (next to each other). While numerically consecutive subcategories are frequently anatomically contiguous, this is not invariably so (for example bladder, C67). The coder may wish to consult anatomical texts to determine the topographic relationships.

How serious is malignant neoplasm of breast?

Other tumors are "malignant" and are cancer. Breast cancer often starts out too small to be felt. As it grows, it can spread throughout the breast or to other parts of the body. This causes serious health problems and can cause death.

What does neoplasm mean of the breast?

Malignant neoplasms are cancerous tumors. They develop when cells grow and divide more than they should. Malignant neoplasms can spread to nearby tissues and to distant parts of your body. Treatment options may include surgery, chemotherapy or radiation therapy.

What is primary malignant neoplasm of female breast?

Breast cancer starts when cells in the breast begin to divide and grow in an unusual and uncontrolled way. Primary breast cancer is breast cancer that hasn't spread beyond the breast or the lymph nodes (glands) under the arm.