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GLOSSARY

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Adenocarcinoma – cancer that starts in the glandular tissue, such as in the ducts or lobules of the breast.

Adjuvant therapy – treatment used in addition the main treatment. It usually refers to treatment after surgery to increase the chances of curing the disease or keeping it in check.

Alopecia – baldness. That’s what many chemo cocktails cause. To apply for wig reimbursement, you will need a prescription for the wig. This is one of the terms that will appear on the prescription.

Alternative therapy – an unproven treatment chosen instead of standard therapy.

Angiogenesis – the formation of new blood vessels. Some cancer treatments work by blocking angiogenesis, thus preventing blood from reaching the tumor.

Antiemetic – an anti-nausea or anti-vomiting drug, given before chemo and also usually kept at home as well.

Axillary dissection – taking out lymph nodes in the armpit (to check for cancer).

Benign – no evidence of cancer.

Bilateral – on both sides of the body.

Biopsy – removing a sample of tissue to see if cancer cells are present.

Breast conservation – preserving the breast by removing only the cancer and a small area of benign tissue surrounding the tumor (also known as a lumpectomy).

Brachytherapy – internal radiation treatment given by placing radioactive material directly into the tumor or close to it.

Breast prosthesis – a silicone- or five-filled object worn in a bra to replace a breast that was surgically removed.

Calcifications – small calcium deposits in the breast, typically discovered by mammography. Benign breast disease can cause calcifications; so can cancer. A biopsy may be required.

Cancer – develops when cells in the body begin to grow out of control. Cancer cells develop because of damage to DNA.

Carcinoma – a malignant tumor that begins in the lining layer (epithelial cells) of organs. At least 80 percent of all cancers are carcinomas.

Carcinoma in situ – a highly curable early stage of cancer in which the tumor is confined to the organ where it first developed.

Chemotherapy – treatment with drugs to destroy cancer cells. Chemotherapy is often used with surgery or radiation to treat cancer when the cancer has spread, when it has come back (recurred) or when there is a strong chance it could recur.

Clear margins – “margins” of tissue around the tumor that are free of cancer. In a lumpectomy, the surgeon removes margins of tissue that surround the tumor in all directions. If there’s no cancer, the margins are clear and there’s no need for further surgery to treat that particular cancer. If the margins aren’t clear, the doctor may feel that another surgery will remove the remaining cancer – or that a mastectomy is recommended.

Clinical trials – research studies that test new drugs or treatments and compare them to current, standard treatments. Before a new treatment is used on people, it is studied in the lab. If lab studies suggest the treatment works, it is tested with patients. These human studies are called clinical trials.

Complementary therapy- therapies used along with standard therapy, including acupuncture, herbal supplements, and more. Before trying any such therapy, even vitamins, a patient should ask her doctor if there is the possibility of a negative interaction with her standard treatment.

Cranial prosthesis – a wig (not a new head!). Will go on the doctor’s prescription to allow for medical reimbursement.

Cytokine – a product of cells of the immune system that may stimulate immunity and cause the regression of some cancers.

Cytotoxic – toxic to cells; cell-killing.

Differentiation – how the cells in a breast tumor stack up to normal breast cells in terms of maturity. Well-differentiated breast cancer cells resemble regular breast cells; they’re also slow growers. Poorly differentiated or undifferentiated cancer cells don’t look or act like regular cells. They’re rapid growers, and they tend to spread throughout the body.

DNA (deoxyribonucleic acid) – the genetic “blueprint” found in the nucleus of each cell. DNA holds genetic information on cell growth, division and function.

Duct – in a breast, the passage through which milk travels from the milk-making lobule to the nipple.

Enzyme – proteins that increase the rate of chemical reactions in living cells.

Epoetin (brand names: Epogen, Procrit, Eprex) – a drug that helps the body make more red blood cells. It is administered to chemo patients whose red blood count is low.

Estrogen – a female sex hormone produced primarily by the ovaries and in smaller amounts by the adrenal cortex. In breast cancer, estrogen may promote the growth of cancer cells.

Gene – a segment of DNA that contains information on hereditary characteristics, such as hair color, eye color and height, as well as susceptibility to certain diseases.

Genetic testing – tests performed to see if a person has certain gene changes known to increase cancer risk. Such testing is recommended for t hose with specific types of family history. Genetic counseling should be part of the process.

Grade – reflects how abnormal the cancer looks under the microscope. There are several grading systems for different types of cancer. As in golf, a low score is better. The higher the grade, the greater the degree of abnormality and the greater the risk of the cancer’s rapid growth and spread.

Graft-versus-host disease (GVHD) – the condition that results when the immune cells of a transplant (usually of grafted stem cells) from a donor attack the tissues of the person receiving the transplant.

Growth factors – a naturally occurring protein that causes cells to grow and divide. Too much growth factor production by some cancer cells helps them grow quickly. Other growth factors help normal cells recover from side effects of chemotherapy.

HER2 – this oncoprotein is present in very small amounts on the outer surface of normal breast cells. About 25 to 30 percent of breast cancers have too much of this protein, which stimulates cell growth. A monoclonal antibody that attaches to the HER2 protein slows the growth of breast cancer cells and may stimulate the immune system to more effectively attack the cancer. Other types of cancer also have too much HER2.

Hereditary cancer syndrome – conditions associated with cancers that occur in several family members because of an inherited, mutated gene, such as BRCA1 and BRCA2 for breast and ovarian cancer. Examples of syndromes include hereditary nonpolyposis colon cancer and familial adenomatous polyposis for colorectal cancer and von Hippel-Lindau disease for kidney cancer.

Hormone therapy – treatment with drugs that interfere with hormone production or hormone action, or the surgical removal of hormone-producing glands. Hormone therapy may kill cancer cells or slow their growth.

Immunotherapy – treatments that promote or support the body’s immune system response to a disease such as cancer.

In situ – cancer confined to its point of origin – the breast ducts in the case of breast cancer.

Invasive breast cancer – cancer that has spread from the milk glands (lobules) or milk passages (ducts) where it began to nearby fatty breast tissue. Also called infiltrating cancer.

Lesion – an area of abnormal tissue change – and a less emotionally charged synonym for tumor.

Lobules – the glands in a woman’s breast that produce milk.

Lump – a mass in the breast or elsewhere in the body.

Lumpectomy – surgery to remove the tumor in the breast and a small amount of normal tissue around it (see breast conservation).

Lymph nodes – small bean-shaped collections of immune system tissue, such as lymphocytes, found along lymphatic vessels. Lymphocytes remove cell waste, germs and other harmful substances from lymph. They help fight infections and also have a role in fighting cancer, although cancers sometimes spread through them.

Lymphedema – swelling caused by excess fluid in the arms or legs. The removal of lymph nodes and radiation can put a breast cancer patient at lifelong risk of lymphedema in the arm on the side of the affected breast.

Malignant – cancerous.

Marker – an indicator from a blood test of possible cancer activity in the body. The test for “markers” may help in diagnosing metastatic disease, but they have limitations.

Mastectomy – surgical removal of the breast.

Medical oncologist – a doctor who is trained to diagnose and treat cancer with chemotherapy and other drugs. In patient lingo, this doc is usually referred to as the oncologist.

Metastasis – cancer cells that have spread to one or more sites elsewhere in the body, often by way of the lymph system or bloodstream. Regional metastasis is cancer that has spread to the lymph nodes, tissues or organs close to the primary site. Distant metastasis is cancer that has spread to organs or tissues that are farther away (such as when prostate cancer spreads to the bones, lungs or liver).

Monoclonal antibodies – antibodies made in the lab to lock onto specific antigens. Antigens are substances that can be recognized by the immune system. Monoclonal antibodies are used in chemotherapy and radioactive substances to deliver cancer treatment directly to cancer cells, not healthy cells. Monoclonal antibodies are also used to help classify and detect cancer cells under a microscope.

Mutation – a change in the DNA of a cell. All types of cancer are thought to be due to mutations that damage a cell’s DNA. Most mutations happen after the person is born and are not genetically passed on to offspring.

Needle biopsy – removal of fluid, cells, or tissue with a needle for examination under a microscope to check for cancer.

Negative – there’s no cancer found in the tumor, lymph nodes, or organs tested.

Neoadjuvant therapy – treatment given before the main treatment.

Neupogen/Nulasta – if chemotherapy wipes out too many white blood cells, these drugs can be injected to stimulate the bone marrow to make more of them.

Oncologist – a doctor trained to diagnose and treat cancer (surgical, medical, and radiation).

Palliative treatment – treatment that relieves symptoms, such as pain, but is not expected to cure the disease. Its main purpose is to improve the patient’s quality of life.

Pathologist – a doctor who specializes in diagnosis and classification of diseases by lab tests such as examining cells under a microscope. The pathologist determines the specifics of a cancer diagnosis, such as its cell type and grade.

Port – also called a port-a-cath. A small device placed under the skin. It empties into a blood vessel and makes it easier to give chemo and to take blood for tests.

Positive – yes, there is cancer in the tumor or lymph node or organ in question.

Primary site – the place where the cancer begins.

Prophylactic mastectomy – removing one or both breasts to reduce the risk of developing breast cancer.

Radiation oncologist – a doctor who treats the patient with radiation to wipe out any lingering cancer cells and prevent a recurrence in the breast.

Radiation therapy – treatment with high-energy rays (such as X-rays) to kill or shrink cancer cells. The radiation may come from outside of the body (external radiation) or from radioactive materials placed directly in the tumor (brachytherapy or internal radiation).

Radiologist – a doctor who reads mammograms and can perform breast biopsies using a needle.

Reconstruction – building a new breast with implants or tissue from the patient’s body after a mastectomy.

Recurrence – the return of cancer after treatment,. Local recurrence means that the cancer has come back at the same place as the original cancer. Regional recurrence means that the cancer has come back after treatment in the lymph nodes near the primary site. Distant recurrence is when cancer metastasizes after treatment to distant organs or tissues (such as the lungs, liver, bone marrow or brain)

Regional involvement – cancer that has spread to nearby areas like the lymph nodes of the armpit, but not to organs or to the bones.

Remission – complete or partial disappearance of the signs and symptoms of cancer in response to treatment. A remission may not be a cure.

Sarcoma – a malignant tumor growing from connective tissues, such as cartilage, fat, muscle or bone.

Sentinel node biopsy – guided by blue dye or a radioactive tracer, the surgeon removes the first node or nodes that breast cancer would probably reach in the armpit area. At some hospitals, the pathologist checks the sentinel node or nodes for cancer while the lumpectomy or mastectomy is going on. (At other hospitals, the patient must wait 5 to 7 days for results.) Word comes back to the operating room: cancer (which means more modes will be removed to see the extent of the spread) or no cancer (which means no additional nodes will be removed.).

Side effects – unwanted effects of treatment that can include hair loss, anemia (low red blood cell count), fatigue, thrombocytopenia (low platelet count) and neuropathy (nerve damage).

Stage – designation that indicates if and how far the cancer has spread. There is more than one system for staging different types of cancer. The most commonly uses is the TNM system.

Stem cell transplant – procedure used to restock stem cells in the bone marrow when they have been destroyed by chemotherapy, radiation or disease. Stem cells may be the patient’s own (autologous), or may come from someone else (allogeneic).

Surgical biopsy – the doctor cuts into the breast and takes a sample of the lesion to determine if it is cancerous or not. Also known as excisional biopsy.

Surgical oncologist – a surgeon who specializes in cutting out cancer.

Survival rate – the number of people who survive a certain period of time after diagnosis (the typical time period use in survival rates is 5 years). If the survival rate is 85 percent, then after 5 years, 85 out of 100 breast cancer patients with a similar prognosis are alive and well.

Systemic disease – breast cancer that affects the whole body.

Systemic treatment – therapies that affect cells throughout the body. For example, chemo is systemic, while surgery and radiation are targeted to the site of the cancer.

Tamoxifen – the most common hormonal therapy, administered for 5 years to patients who might benefit. It blocks the ability of estrogen to reach a cancer cell that would be stimulated to grow from the estrogen.

Targeted therapy – treatment to attack the part of cancer cells that make them different from normal cells. Targeted agents tend to have fewer side effects than conventional chemotherapy drugs.

Tumor – an abnormal lump or mass of tissue; it can be cancerous or not cancerous.

White blood cells – cells that help fight infection and disease. Chemotherapy can reduce the number of white blood cells.
 

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