Adjuvant chemotherapy/hormone
therapy
The use of either chemotherapy or hormone therapy after initial
treatment either by surgery or radiotherapy. The aim of adjuvant
therapy is to destroy any cancer that has spread.
Alopecia
Hair loss. It is usually partial, although it can be complete. Full
recovery usually occurs fairly quickly.
Anti-oncogene
See tumour suppressor gene.
ANZBCTG
Australian and New Zealand Breast Cancer Trials Group. It is a trans-Tasman
clinical trials group which conducts research on new treatments
for breast cancer.
Atypia
Abnormal changes in cells. See also dysplasia.
Axilla
The armpit.
Axillary dissection
Surgery to remove fat and lymph nodes from the armpit. It can be
done either at the same time as a mastectomy or as a separate operation.
It can be partial or complete.
Benign
Not malignant, not cancer. A benign tumour is not capable of spreading.
Biopsy
Removal of a sample of tissue or cells from the body to assist in
diagnosis of a disease.
Body image
A person's conception of and feelings about his or her body - its
form, size, shape and the way it fits society's norms. Self-esteem
and sexuality are linked with body image.
Bone scan
A test to see whether the cancer has spread to any bones.
Boost
An extra dose of radiation given to a smaller area, usually the
site where the tumour was removed, after the rest of the breast
has been irradiated.
BRCA1
Breast cancer gene 1. A gene which is defective in about 2% of women
with breast cancer. See also familial breast
cancer.
BRCA2
Breast cancer gene 2. Another gene implicated in familial breast
cancer.
Bone scan
A test to see whether the cancer has spread to any bones.
Breast conservation
See breast conserving surgery (below).
Breast conserving
surgery
Surgery where the cancer is removed, together with a margin of normal
breast tissue. The whole breast is not removed.
Breast reconstruction
The formation of a breast shape after a total mastectomy.
Breast sharing
A method of reconstruction in which some of the opposite breast
is used to reconstruct the missing breast.
Calcification
The deposition of calcium salts in body tissues. In the breast,
it can be associated with either normal or cancerous tissue.
Carcinoma
A malignant tumour arising from epithelial cells, which are cells
lining the external or internal surfaces of the body. Carcinomas
spread to nearby tissues. They may also spread to distant sites
such as lung, liver, lymph nodes and bone. See also metastasis
Carcinoma
in situ
A malignant tumour which has not yet become invasive but is confined
to the layer of cells from which it arose. A form of pre-invasive
cancer.
Carcinoma NOS
Invasive ductal carcinoma not otherwise specified. Comprises 70
per cent of all breast cancers
Cathepsin D
A protein secreted by breast cancer cells. It may be a marker of
poor prognosis.
Centigray
A measure of radiation. 1 centigray = 1 rad.
Chemotherapy
The use of medications (drugs) that are toxic to cancer cells. These
drugs kills the cells, or prevent or slow their growth.
Chromosome
A body in the cell nucleus carrying genes. See gene.
CLE
See complete local excision.
Clinical trial
Research conducted with the patient's permission which usually involves
a comparison of two or more treatments or diagnostic methods. The
aim is to gain better understanding of the underlying disease process
and/or methods to treat it.
Combined modality
treatment
The integration of two or more forms of treatment to combat the
cancer. For example: radiation and surgery; radiation and chemotherapy;
surgery, radiation and chemotherapy.
Comedo carcinoma in situ
An aggressive type of breast carcinoma.
Complete
local excision
The complete removal of a tumour with a surrounding margin of normal
breast tissue. Also known as CLE and breast conserving surgery.
Conservative
surgery
Surgery in which the breast is not removed. Also known as breast
conserving surgery.
Coping strategies
Strategies or behaviours used to reduce psychological stress. Coping
strategies may be influenced by personality style and the specific
situation, and may change over time.
Core biopsy
The sampling of breast tissue with a needle to give a tiny cylinder
of tissue for examination by a pathologist.
Cosmesis
The appearance of the breast following treatment.
Cribriform
See Non-comedo carcinoma.
Cycle
Chemotherapy is usually administered at regular intervals. A cycle
is a course of chemotherapy followed by a period in which the body
recovers.
Cytology
An examination by a pathologist of the cellular structure of a tissue.
DCIS
Ductal carcinoma in situ. A form of breast cancer which requires
special consideration. It spreads along the ducts of the breast,
rather than forming a lump.
Denial
Inability to acknowledge something apparent to others. It can be
an involuntary coping strategy.
Depression
A pervasive and sustained lowering of mood. Other features include
tearfulness, guilt, irritability, loss of interest in life, loss
of energy, poor concentration, poor sleep and loss of appetite.
Differentiation
The degree to which a tumour resembles normal tissue. In general,
the closer the resemblance, the better the prognosis. Well differentiated
tumours closely resemble normal tissue.
Disease-free
survival
The time from the primary treatment of the breast cancer to the
first evidence of cancer recurrence.
Ducts
Passages along which milk passes during breastfeeding.
Ductal carcinoma
in situ
See DCIS.
Dry desquamation
A reaction to radiotherapy involving the shedding of dry skin
Dysplasia
An abnormal growth of cells which look something like cancer cells,
but do not have all the features of cancer. See also atypia.
ECOG
Eastern Cooperative Oncology Group. A group of American oncologists
which conducts trials on cancer treatments.
ECOG performance
status
A five point scale developed by the Eastern Cooperative Oncology
Group.
0 - No symptoms of cancer
1 - Presence of cancer-related symptoms
2 - Spends less than 50% of daylight hours in bed
3 - Spends more than 50%, but less than 100% of daylight hours in
bed
4 - Totally confined to bed
EGF-R
Epidermal growth factor receptor. A protein on some cancer cells.
Cancers with plenty of EGF-R are likely to be aggressive. See also
erbB-2.
Electron
The smallest particle of negative electricity.
EORTC
European Organisation for Research and Treatment of Cancer. A group
which carries out clinical trials on cancer therapies.
EORTC
core quality of life questionnaire (QLQ)
A questionnaire designed to determine the impact on quality of life
of different treatments.
Epidermal growth
factor receptor
See EGF-R.
ER
Oestrogen receptor. A protein on breast cancer cells that binds
oestrogens. It indicates that the tumour may respond to hormonal
therapies. Tumours with plenty of ER have a better prognosis that
those which do not.
erbB-2
Also known as HER2/neu. A protein similar to EGF-R. Tumours with
plenty of erbB-2 are usually aggressive.
Erythema
Redness of the skin, which is the earliest sign of radiation reaction.
Familial
breast cancer
Breast cancer affecting two or more close relatives, especially
in premenopausal women. It implies an inherited disposition.
Fine needle aspiration
biopsy (FNA or FNAB)
See fine needle biopsy (below).
Fine needle biopsy
(FNB)
The sampling of cells from breast tissue for examination by a pathologist.
Fraction
Radiotherapy is usually given over several weeks. The dose delivered
each day is known as a fraction.
Free flap reconstruction
Breast reconstruction using microsurgery.
Frozen section
A rapid method of obtaining a pathological examination of tissue
during an operation. This is not routinely used in breast cancer.
G-CSF
Granulocyte cell stimulating factor. A natural substance which promotes
the growth of white cells. It can be used after chemotherapy.
Gene
The functional unit of heredity. Each gene sits on a chromosome
within the cell nucleus.
Grade
The degree of similarity of the cancer cells to normal cells. This
is assessed by a pathologist. A grade 1 carcinoma is well differentiated
and is associated with a good prognosis. A grade 2 carcinoma is
moderately differentiated and is associated with an intermediate
prognosis. A grade 3 carcinoma is poorly differentiated and is associated
with a poor prognosis. Grade is assessed by a pathologist.
Gray
The modern unit of radiation dosage. Doses used in treatment for
early breast cancer range from 45 and 65 Gray. See also rad.
Halsted mastectomy
See radical mastectomy.
HER2/neu
See erbB-2.
Histology
An examination of the structure of a cell by a pathologist.
Hormone receptors
Proteins in a cell which bind to specific hormones. This binding
stimulates the cell to act in a certain way.
These receptors are present in about 50% of all women with breast cancer. Women with plenty of hormone receptors are likely to respond to hormone treatments, and are more likely to do well than women without hormone receptors.
Hormone replacement
therapy
The use of hormones as a substitute for natural hormones in women.
Hormone therapy
The use of drugs or hormones which specifically inhibit the growth
of hormone responsive cancer cells.
Hyperplasia
Increased numbers of epithelial cells. If excessive, there is a
slightly increased risk of developing subsequent breast carcinoma.
Immediate reconstruction
The reconstruction of the breast at the time of mastectomy.
In situ carcinoma
See carcinoma in situ.
Increment
See fraction.
International
Breast Cancer Study Group
An international cooperative group which includes many Australian
clinical researchers. The group is carrying out multicentre trials,
especially in the area of chemotherapy.
Iridium (wire)
A radioactive wire often used to deliver the boost to the operative
site in breast conserving techniques.
Large cell in situ carcinoma
See comedo carcinoma.
Latissimus dorsi
flap
A method of reconstruction using skin from the back, which is carried
on the latissimus dorsi muscle.
LCIS
Lobular carcinoma in situ. It is a misnomer which describes a benign
process in the breast. It is not a carcinoma. It is usually detected
by chance in the course of a breast biopsy for another lesion.
Local recurrence
Return of the cancer in the affected breast.
Limited axillary
dissection
Surgery to the armpit in which not all lymph nodes are removed.
Linear accelerator
Modern radiation equipment capable of delivering x-rays at very
high energies
Lumpectomy
Surgical removal of a lump from the breast. See complete local excision.
Lymphatic system
A system of vessels which drains fluid out of the head, neck and
limbs and returns it to the general circulation.
Lymph node
A small collection of tissue along the lymphatic system which acts
as a filter. White cells and cancer cells, in particular, collect
in lymph nodes. They are found in the neck, the armpit, the groin
and many other places. Lymph nodes are also known as glands.
Lymphoedema
Swelling in the arm or breast because of a collection of lymphatic
fluid.
Malignant
A tumour having the capacity to destroy tissue locally, spread and
cause death.
Mammogram
A soft tissue x-ray of the breast which may be used to evaluate
a lump or which may be used as a screening test in women with no
signs or symptoms of breast cancer.
Mammography
The process of taking a mammogram
Margins of resection
The edge of the tissue removed. See complete local excision
Mastectomy
Surgical removal of the breast. May be total (all of the breast)
or partial. See also radical (Halsted) mastectomy.
Medical oncologist
A doctor who specialises in the use of chemotherapy and hormone
therapy.
Megavoltage
High energy X-rays.
Meta-analysis
A statistical technique used to examine all research on a particular
issue.
Metastasis
The spread of a cancer from the primary site to somewhere else via
the bloodstream or the lymphatic system.
Metastasise
See metastasis (above).
Metastatic cancer
Cancer which has spread to a site distant from the original site.
Micrometastases
Small undetectable deposits of cancer which grow later.
Micropapillary
See non-comedo carcinoma.
Mitosis
The process of cell division.
Modified radical mastectomy
Total mastectomy with removal of lymph nodes in the armpit, but
without removal of the muscles of the chest.
Moist desquamation
A response to radiotherapy in which skin peels off. It is made worse
by friction and sweat.
Nadir
The lowest measured value. In cancer treatments, it usually refers
to the lowest white blood cell and platelet count.
Nausea
Feeling sick or wanting to be sick. If it is caused by chemotherapy,
it can last for anywhere between a few hours and a week.
NBOCC
National Breast and Ovarian Cancer Centre (formerly known as The National Breast Cancer Centre (NBCC).
Necrosis
The death of an individual cell or groups of cells in living tissue.
Sometimes seen in carcinomas.
Neutropenia (febrile)
A decreased number of white cells in the blood, which greatly increases
the risk of infection. It usually occurs as a result of chemotherapy.
Nodal status
The presence or absence of cancer in the lymph nodes of the armpit.
A woman with cancer in one or more nodes is node positive, or node
+ve. A woman with no cancer in her nodes is node negative, or node-ve.
Non-comedo
carcinoma in situ
A low grade type of carcinoma.
Occult metastasis
A metastasis that has not yet shown up.
Oestrogen receptor
See ER.
Oncogene
A gene which, functioning abnormally, encourages normal cells to
turn cancerous.
Oncologist
A doctor who specialises in treating cancer.
Oncology
The study of the biology and physical and chemical features of cancers.
Also the study of the cause and treatment of cancers.
Oncology nurse
A registered nurse who is educated in the care of people with cancer.
Oophorectomy
Surgery to remove the ovaries. It is sometimes used as a treatment
for breast cancer.
Open biopsy
Surgery performed under local or general anaesthetic in which a
sample of breast tissue is removed so it can be examined by a pathologist.
Orthovoltage
X-rays delivered from generators operating at less than 500,000
volts.
Overall survival
The time from the primary treatment of the breast cancer to death.
p53
A protein which, when the gene for it is damaged, leads to an increased
risk of breast cancer.
Palliation
The alleviation of symptoms due to the underlying cancer, without
prospect of cure.
Partial mastectomy
Removal of part of the breast.
Patey's operation
An operation in which the breast and lymph nodes of the armpit are
removed, but not the pectoralis major muscle. See also modified
radical mastectomy.
PR
Progesterone receptor. A receptor inside the cell which binds progesterone.
Tumours with plenty of PR are less aggressive and more responsive
to hormone therapy than those without.
Predictive factor
Something which helps predict what may happen. For example, the
oestrogen receptor is a predictive factor for a good response to
hormone therapy.
Premenopausal
Before menopause
Postmenopausal
After menopause.
Primary breast
tumour
Tumour arising in the breast.
Progesterone
receptor
See PR.
Prognosis
An estimate of what is likely to happen in the future.
Prognostic factors
Factors which are associated with a better or worse outcome of the
disease. They are not the same as causes.
Progression
The continuing growth of the cancer.
Prosthesis
An artificial part designed and fitted to overcome a defect in the
body.
Prosthetic breast
reconstruction
Creation of a breast shape using an artificial breast.
Protocol
A detailed program of treatment.
pS2
A protein which may reflect ER status. People with plenty of pS2
usually have a good prognosis.
Quadrantectomy
Removal of quarter of the breast.
Quality of life
The individual's overall appraisal of their situation and subjective
sense of well-being.
Quality of life encompasses symptoms of disease, side- effects of treatment, relationships, how well you get on at work and play and how you cope with daily life.
QLQ
See EORTC Core Quality of Life Questionnaire (QLQ).
Rad
An old unit of radiation dose now superseded by the Gray. 1 Gray
= 100 rads.
Radiation oncologist
A doctor who specialises in treating cancer with radiation. Also
known as a radiotherapist.
Radical (Halsted) mastectomy
Total mastectomy with removal of all lymph nodes from the armpit
and removal of muscles of the chest. This operation is obsolete
and should be performed rarely.
Radiographer
A technician who gives radiotherapy prescribed by a radiation oncologist.
Radiotherapy
The use of radiation, usually x-rays or gamma rays, to kill tumour
cells.
Rectus flap reconstruction
Breast reconstruction using skin and fat from the abdomen carried
on the rectus abdominis muscle, which runs down the middle of your
abdomen. Also known as TRAM - transverse rectus abdominis myocutaneous
flap.
Relapse
Recurrence of disease after an initial response to treatment.
Remission
A reduction or disappearance of the symptoms of cancer. It can be
partial or complete.
Response to therapy
- complete response
The disappearance of all detectable cancer for a minimum of one
month. Also known as remission.
Response to therapy
- disease progression
Continued growth of the cancer.
Response to therapy
- partial response (partial remission)
A reduction in size of the cancer of 50% or more.
Response to therapy - stable disease.
No change in the cancer.
Scleroderma
A disease involving tightening of the skin and of the lining of
the oesophagus.
Secondary reconstruction
Reconstruction of the breast carried out some time after the original
mastectomy.
Secondary tumour
A deposit of breast cancer away from the breast (such as in the
lung, bone or lymph node). See metastasis.
Segmentectomy
The excision of an entire segment of the breast.
Simulator
A machine which allows a radiation oncologist to calculate the correct
dose and position of the radiotherapy.
Small cell carcinoma
See non-comedo carcinoma.
Soft tissue reconstruction
A method of breast reconstruction using the patient's own tissue,
transfered from another part of the body.
Sonographer
A technician trained in performing ultrasounds.
Specimen X-ray
An X-ray of a surgically removed specimen to confirm that a mammographically
detected cancer has been removed.
Staging
Refers to the allocation of categories (0, I, II, III, IV) to groupings
of tumours defined by internationally-agreed criteria. Staging helps
determine treatment and prognosis.
Subcutaneous
mastectomy
An operation in which the tissue of the breast is removed but the
skin and nipple are not.
Support group
A group of people you can turn to for emotional support. The group
may also provide practical help, information, guidance and feedback
about your stressful experiences and ways of coping.
Surgical oncologist
A surgeon who specialises in the care of people with cancer.
Telangiectasia
Small dilated blood vessels which appear in areas which have been
heavily irradiated.
Tissue expansion
Creation of a breast shape using an inflatable envelope placed under
the skin and muscle. It is gradually expanded over several weeks
by repeated injections of salt water.
Total mastectomy
Surgery to remove the entire breast, including the nipple and areola.
Transverse rectus
abdominis myocutaneous flap (TRAM)
See rectus flap reconstruction.
Treatment failure
The inability of the treatment to halt the growth or spread of the
cancer.
Tubular carcinoma
A very well differentiated carcinoma seen increasingly as a result
of mammographic screening.
Tumour
An abnormal growth of tissue. It may be localised (benign) or invade
nearby tissues (malignant) or distant tissues (metastatic).
Tumour suppressor gene
A gene which usually prevents cancers growing. When it is not functioning
normally, tumours can grow. Examples include p53 in breast cancer,
RB protein in retinoblastoma and possibly BRCA1 in breast cancer.
Also known as an anti- oncogene.
Toxicity
Side-effects which are due to treatment.
Ultrasound
The use of sound waves to form a picture of internal tissues.
Vascular infiltration
Invasion by cancer cells of lymphatics or veins. It is a sign that
the tumour is likely to spread.
