Glossary

Adjuvant therapy: treatment prescribed after surgery in order to prevent any remaining cancer cells from spreading further or coming back. This includes chemotherapy and hormone or radiation therapy and surgical removal of the ovaries.

Aggressive: describes the likelihood that a cancer may spread to other sites. The higher the grade and stage of a tumour, the more aggressive it is.

Alternative (complementary, unconventional) therapies: therapies outside conventional medical treatments. These range from nutrients and herbal remedies to acupuncture and meditation. It is important to tell your oncologist of any such therapies you are using.

Anemia: decrease in the red blood cells necessary to carry oxygen to body tissues. Anemia may be a side effect of chemotherapy and radiation treatment.

Antiemetic: a drug used to control nausea or vomiting.

Axillary node dissection: removal of a sample of lymph nodes in the armpit to determine if cancer has spread to "regional lymph nodes" within the armpit.

Biopsy: removal of a small piece of tissue for examination under the microscope for presence of cancer or any other abnormality.

Cancer (carcinoma): a general term for more than 100 diseases characterized by uncontrolled, abnormal growth of cells that can invade and destroy healthy tissue.

Carcinoma in situ (CIS): pre-cancer that has not invaded surrounding tissue. Surgical removal is sometimes necessary to prevent a cancer from developing.

Chemotherapy: treatment with cancer-destroying (antineoplastic) drugs given by injection into a vein or orally or into a body cavity.

Clinical Trial: research studies to test new treatments or approaches, which might provide better results than current methods. Strict rules are followed to make sure patients are well informed about the purpose, risks and benefits of any study before they agree to join a clinical trial.

Combination chemotherapy: a term used when treatment consists of several anticancer drugs (antineoplastics) given at the same time. Examples of abbreviations for combinations used commonly in chemotherapy treatment plans for breast cancer are:

ACT (adriamycin, cyclophosphamide and Taxol)

CEF (cyclophosphamide, epirubicin, 5-fluorouracil)

Diagnosis (diagnose): identification of a disease from signs, symptoms, laboratory tests, x-rays and physical findings. People with cancer often speak simply of "being diagnosed," in a particular year, without further elaboration. "Newly diagnosed" means cancer discovered quite recently.

Ductal Carcinoma: cancer that arises in the milk ducts of the breasts. Ductal carcinoma in situ = DCIS.

Estrogen: a female hormone which influences breast development and the menstrual cycle.

Estrogen Receptor (ER) (also includes progesterone receptor): a protein present on some cancer cells which attaches to estrogen. Laboratory tests for this protein indicate when cells within breast tumours are sensitive to hormones. Tumours which are estrogen and progesterone receptor positive (ER+ve, PR+ve)) are likely to have a better prognosis.

Grade: a nine-point scale based on how much tumour cells still resemble and behave like normal cells. The higher the grade, the less "normal" cells look and the more likely a cancer is to spread. The cancer treatment plan is based partially on tumour grade.

Hormone: a chemical substance produced by the body to regulate specific body functions such as metabolism, growth and reproduction.

Hormone Therapy: use of hormones to treat breast cancer. The most common one is an anti-estrogen called Tamoxifen. Hormones are sometimes used in combination with other types of therapy to treat breast cancer.

Hyperplasia: increase in the number of normal cells in a tissue. Atypical hyperplasia is an overgrowth of cells where the cells are not normal. Atypical hyperplasia MAY become cancer.

Invasive Carcinoma: cancer that has invaded surrounding tissues, e.g., invasive ductal carcinoma. (Also called "infiltrating").

Leukopenia: decrease in white blood cells. Numbers are usually lowest 7-14 days after chemotherapy.

Lobular Carcinoma: cancer that arises in the lobules (milk-producing glands) of the breast.

Low blood count: this may refer to a decrease in red blood cells (anemia), white blood cells (leukopenia), or platelets (thrombocy-topenia). Decrease in blood cells is a common side effect of many chemotherapeutic drugs used to treat breast cancer.

Lumpectomy: surgical removal of a cancerous tumour and a surrounding area of healthy tissue. When the pathology report indicates tumour margins are "clear," it means there was no visible cancer extending to the edges of the tissue removed.

Lymph nodes: tiny structures scattered along the lymphatic vessel system. Nodes are more concentrated in such areas as the breast, underarm and groin. They filter foreign substances from the lymphatic fluid as it passes along the lymphatic system.

Lymphatic System: consists of a fluid called lymph, several organs and a system of vessels interspersed with nodes that carries the lymphatic fluid away from body tissues to the blood stream. Lymphatic tissue attacks invaders and abnormal cells, including cancer cells.

Lymphedema: swelling caused by blockage of lymphatic vessels or nodes to an extremity.

Mastectomy: removal of the entire breast, but not the muscle tissue underneath. Modified radical mastectomy is removal of the entire breast and the lymph nodes in the breast and underarm. Radical mastectomy, a procedure rarely done today, is removal of the breast, underlying muscle and lymph nodes in the breast and underarm.

Metastasis ("mets"): cancer cells that have spread from the primary site via the blood stream or the lymphatic system to other organs and have begun growing there, e.g., liver metastasis.

Neutropenia: decrease in the type of white blood cell necessary to protect the body from infection.

Oncologist: a doctor whose specialty is diagnosing and treating cancer. A radiation oncologist specializes in the use of radiation, a medical oncologist in the use of drugs for treatment of cancer.

Oophorectomy: surgical removal of the ovaries to eliminate a source of estrogen for an estrogen-dependent tumour and attempt to improve prognosis.

Pathology Report ("Path report"): report of the results of the microscopic examination of cells in tissue taken during a biopsy. This is the only way cancer can be definitely diagnosed. These reports are read by physicians with special training in pathology.

Platelets (thrombocytes): blood cells whose job it is to control bleeding and bruising by forming blood clots.

Portacath ("port"): a venous access device, with a small tube going into a vein placed under the skin for easy delivery of intravenous medications and taking of blood samples.

Primary site ("primary"): the tissue in which a cancer first developed, i.e., the breast.

Prognosis: a prediction of how cancer will respond to treatment. Prognosis is based on tumour stage and grade. These are determined by factors such as size, lymph node involvement, spread of the tumour, ER status, the number of tumour cells in the dividing phase, and the actual appearance of the cancer cells and the DNA in the cancer cells.

Radiation therapy: the use of high energy penetrating rays to treat disease. Radiation is recommended with lumpectomy and occasionally with mastectomy. It is usually given daily over a course of five to six weeks. Sources of radiation include x-ray, gamma rays, cobalt and isotopes. Linear accelerator is a type of machine to deliver radiation treatments.

Recurrence: the return of cancer after treatment. Local recurrence is cancer recurring at the original site treated, as a result of growth of microscopic cancer left behind after treatment. Metastasis or distant recurrence means the primary cancer has spread to other organs. The most common sites for breast cancer metastasis are bone, liver, lung and brain. Treatment depends on the site. Cancer rarely spreads from one breast to the other. Cancer occurring in the opposite breast is usually a new primary breast cancer.

Stage: a four-point scale that reflects the size of the tumour, its spread to lymph nodes or distant organs. The prognosis for cancer is determined by the stage and grade.

Thrombocytopenia: decrease in platelets, the cells in the blood necessary for blood clotting.

Tumour: a mass of abnormally growing cells that serve no useful body function. Tumours can be benign (non-cancerous) or malignant (cancerous). A malignant or cancerous tumour is harmful because it grows out of control, invading and destroying surrounding tissue, and can spread to other parts of the body.