Breast Cancer Types | Symptoms and Treatments | MedStar Health
A team of physicians from MedStar Georgetown University Hospital's breast oncology program pose for a photo.

Our nationally-accredited breast cancer services combine the latest treatments with compassionate, personalized care.

One in eight women will have breast cancer in her lifetime. Although a diagnosis can be overwhelming, it doesn't have to be a life sentence. If you or someone you care about has been diagnosed with breast cancer, learning about the disease and your options is the best way to empower yourself to navigate treatment.

At MedStar Health, your breast cancer team involves experts with specialized training, experience, and recognition in breast oncology, radiation, surgery, radiology, pathology, genetics, rehabilitation, and more. From novel therapies and clinical trials to breast-conserving surgeries and sophisticated reconstructive procedures, we offer the latest breast cancer treatments available today. We're also leading the research and development of tomorrow's promising treatments through our partnership with the Georgetown Lombardi Comprehensive Cancer Center—one of only 51 National Cancer Institute-designated comprehensive cancer centers in the nation.

With multiple academic and community-based locations throughout the Washington, D.C., and Maryland region, we make it easy to get comprehensive breast cancer care. Whether you're at risk of developing breast cancer due to a family history or you've recently been diagnosed with breast cancer and are looking for a second opinion, we treat you like a person⁠—not just a disease.

Breast Cancer

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Breast Cancer is one of the most common causes of cancer fatality in women. Early detection through regular breast self-examination and mammography is key.

Symptoms and risk factors

No breasts are the same, and what's normal for you may be unusual for another woman.

It's possible to have breast cancer and not experience any signs of the disease. However, a change to your breast could be a warning sign, such as:

  • Pain in any part of the breast or nipple
  • A new lump in the breast or underarm
  • Redness or swelling in the breast
  • Grooved, dimpled, or uneven breast skin
  • A change to the nipples, like inversion or flattening
  • Crusting or flaking of the skin around the nipple area
  • Tingling, itching, or burning in the nipple area
  • Nipple discharge that is blood or rust-colored

If you notice anything new or unusual in your breasts, talk to a doctor. They can help you determine what's causing the change, whether cancer or another breast condition.

Seek care if you have a high risk of developing the disease.

Breast cancer can't always be prevented, but certain things, called risk factors, can increase your risk of developing the disease. For example, women have a greater risk of developing breast cancer than men, and this risk increases as you age. Other factors that may increase your risk of breast cancer include:

  • Family history of breast cancer, especially if it's a first-degree relative, such as a mother, sister, or daughter
  • Personal history of breast cancer in one or both breasts
  • Radiation exposure during childhood
  • BRCA genetic mutations
  • Early menstruation (12 or younger) or late menopause (55 or older)
  • Hormone (estrogen) replacement therapy

Some women who have risk factors never develop breast cancer, and most women who develop the disease have no known risk factors. But, if you are considered high risk for developing breast cancer, you may benefit from the resources available through our High-Risk Breast Clinic. Through a combination of breast imaging, genetic counseling, and oncology services, we’re proactive about managing and reducing your risk of disease. Your individualized risk management plan will take into account your personal preferences as well as the benefits and drawbacks of additional screening, risk-reducing surgeries, or medications.

Find out your breast cancer risk.

Our breast health risk assessment is a five-minute questionnaire that can help you learn about your personal risk of developing breast cancer. The information you provide allows our breast experts to predict your risk and offer suggestions to help you defend yourself against breast cancer, like:

  • Modifying your lifestyle
  • Enlisting the support of MedStar Health providers who can help you lower or manage your risk
  • Scheduling a breast cancer screening at a convenient location nearby, if you're eligible

Take the Free Breast Cancer Risk Assessment

Screening and prevention

The earlier breast cancer is found, the greater the chance for a cure.

Breast cancer is easily treatable when detected early, which is why it's important to stay on top of your annual mammogram. A breast cancer screening mammogram uses imaging technology to detect signs of the disease early when there is a greater chance for a cure.

Screenings are recommended for all women:

  • Women age 40 and older should have a mammogram every year and continue to do so for as long as they are in good health.
  • Women at high risk for breast cancer may benefit from an MRI and a mammogram every year, as recommended by their doctor.
  • Women in their 20s and 30s should have a clinical breast exam as part of a regular health exam by a health professional, preferably every three years. Starting at age 40, women should have a clinical breast exam by a health professional every year.
  • Starting in their 20s, women should conduct breast self-exams and report any breast changes to their health professional right away.

Our breast imaging services are nationally accredited and recognized as Centers of Excellence by the American College of Radiology. Most of our breast radiologists are fellowship-trained and focus exclusively on detecting breast abnormalities, diagnosing breast cancer, and monitoring your body's response to treatment using imaging.

In addition to regular screening, you can help lower your risk by following healthy guidelines, such as: 

  • Exercising regularly
  • Maintaining a healthy weight
  • Eating a healthy diet
  • Limiting your intake of alcohol to no more than one drink per day
  • Avoiding smoking

Diagnosis

An accurate diagnosis leads to the best, most personalized treatment options.

When imaging detects an abnormality, the next step is a consultation with one of our breast surgeons, often followed by a breast biopsy to remove a sample of breast tissue and/or fluid for study. Whenever possible, our surgeons and radiologists take a minimally invasive approach, which offers:

  • Reduced infection risk
  • Quicker recovery
  • Less scarring
  • Faster results

Biopsies allow our team to look at tumor cells under a microscope to determine if you have cancer and identify the cancer type. If needed, your doctor may recommend additional diagnostic tests to learn information about your specific cancer, such as:

  • Where breast cancer began to develop
  • How far it has spread
  • How sensitive the tumor is to estrogen and progesterone hormones
  • The genetic makeup and protein levels associated with breast cancer growth
  • Unique tumor markers that predict how your cancer will respond to certain treatments

An accurate diagnosis is essential so our doctors can personalize treatments that will be most effective.

Types of cancer

There are five stages and many different types of breast cancer.

Breast cancer is categorized into five different stages based on cancer cell characteristics, such as the size of the tumor. The cancer’s stage also depends on whether it is:

  • Non-invasive: These cancers stay within the milk-producing glands (the lobules) or the milk ducts, such as the pre-cancer ductal carcinoma in situ (DCIS).
  • Invasive: These cancers spread into normal, healthy tissues.

Stage zero is the earliest and describes non-invasive breast cancers, like ductal carcinoma in situ, or DCIS. Stage four is considered metastatic cancer and the most advanced since cancer has spread to other parts of the body, such as the lungs or bones.

In addition to staging, all invasive cancer diagnoses note the cancer's hormone-receptor status and HER2 protein status, which affects your treatment options. This information helps form a personalized treatment plan, and your doctor might recommend additional tests for the most accurate classification.

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MedStar Health Breast Surgeon Atsuko Okabe, MD, discusses the different types of breast cancer.

Learn more about the types of breast cancer we treat below.

Getting a second opinion.

Getting a second opinion means asking a breast cancer expert, aside from your initial physician, to review your medical reports and test results and then provide a diagnosis and treatment recommendations. Our specialists may confirm your initial diagnosis and treatment recommendations, provide additional treatment options, or even give more details about your type and stage of cancer. Even if you’ve already had treatment, it’s not too late to get a second opinion.

Treatments

Infographic outlining the available treatment options for breast cancer.

Breast cancer treatments are becoming less invasive, more targeted, and more personalized, providing even more hope.

With new medical and surgical treatments, women (and men) who develop the disease are leading longer, fuller, and healthier lives than ever before. If you’ve been diagnosed with breast cancer, your care team will consider several factors before recommending the best treatment for you. These typically include:

  • The type of breast cancer you’ve been diagnosed with
  • What stage your breast cancer is in
  • Whether or not the tumor has metastasized (spread)
  • Whether or not your cancer has receptors for HER2, estrogen, progesterone, and others
  • Your personal preferences and goals
  • Age
  • Other health conditions

Many patients undergo multiple breast cancer treatment options, such as a combination of surgery, chemotherapy, and targeted therapy, to ensure that all cancer is removed—and that it doesn’t come back.

Surgery

Nearly every patient with breast cancer will undergo surgery as part of treatment. The goal of surgery is to remove the tumor and evaluate the lymph nodes to determine if cancer has spread. Deciding on surgery is often difficult and emotional. Our doctors take the time to help you make sense of all the considerations, including your physical health, appearance, and psychological and social concerns. When surgery is recommended, we consult the latest research findings to ensure the best care, including breast-conserving and nipple- and skin-sparing procedures.

Studies show that patients operated on by specialized surgeons get better results. At MedStar Health, all of our surgeons are board-certified, and many are fellowship-trained and recognized as "Top Docs" in the region by Baltimore magazine and the Washingtonian.

Learn More About Breast Cancer Surgery

Breast reconstruction

From the very beginning, all patients have the option to meet with one of our renowned plastic surgeons to discuss the vast array of reconstruction options. At MedStar Health, our surgeons are leaders in breast reconstruction, performing new and complex procedures that lead to better outcomes, including nerve restoration, lymphedema prevention, and minimized breast scarring. We use the latest procedures available to restore what cancer has taken away, including surgeries that are hard to find elsewhere in the Mid-Atlantic region, like lymph node transfer and microsurgical techniques in breast reconstruction.

Learn More About Breast Reconstructive Surgery

Chemotherapy

Chemotherapy drugs can control or stop the growth of cancer cells in your breast and kill any cancer cells that could have spread beyond the breast. These drugs may be used:

  • Before surgery to shrink tumors and make it easier to operate or conserve your breast
  • After surgery to reduce the risk of breast cancer coming back

Medication may be administered orally, intravenously (into the veins), or via injections alone or in combination with other drugs. Each medication comes with its own risks, benefits, and side effects, and our team of experts will help navigate you through each of your treatment options.

Learn More About Chemotherapy for Breast Cancer

Immunotherapy and targeted therapy

Also known as immunotherapy or biological therapy, targeted therapy is transforming breast cancer treatment by offering more powerful, less toxic approaches to eradicating the disease. Targeted therapy starts with identifying a breast cancer’s characteristics then uses drugs or other substances to trigger the body’s immune response to interfere with the way cancer cells operate. Many of our clinical trials are working to advance the standard of care for breast cancer treatment using targeted therapies.

Learn More About Targeted Therapy

Hormone therapy

About two out of every three breast cancers are hormone receptor-positive—meaning they contain receptors for the hormones estrogen (ER-positive) and/or progesterone (PR-positive) and are fueled by these natural chemicals. We offer the latest options in hormone therapy to lower hormone levels or stop them from acting on breast cancer cells. Also called endocrine therapy, this approach is often used with other treatments. We also are investigating new drugs in clinical trials to overcome resistance in certain breast cancers.

Learn More About Hormone Therapy

Chemoprevention can reduce the risk of breast cancer by 50 percent in women considered high-risk.

For patients who are considered high-risk for developing breast cancer because of their family history, genetic makeup, or personal health history, we may offer chemoprevention. Chemoprevention is medication to prevent breast cancer—or a need for chemotherapy like the name suggests. Our research shows that drugs like tamoxifen, raloxifene, and aromatase inhibitors can reduce the risk of developing breast cancer by about 50 percent for women considered high risk. These drugs are in a family of medications that manipulate hormone levels. Before reaching any decision, our experts will discuss the risks, benefits, and drawbacks with you and your family so you can choose what’s right for you.

Radiation therapy

Radiation therapy plays a vital role in preventing breast cancer from coming back after surgery. At MedStar Health, our radiation oncologists are experienced and specially-trained to use new and advanced radiation techniques:

  • After breast-conserving lumpectomy (i.e., partial mastectomy) to reduce the chance cancer will return to the breast or the lymph nodes
  • Following a mastectomy when the tumor is larger or cancer has spread to lymph nodes
  • When cancer has spread to other areas of the body

We offer all radiation therapies you'd expect and others that may be hard to find elsewhere. If radiation is part of your treatment plan, the type of radiation your radiation oncologist recommends will take into account your tumor's size, location, and other factors and may include:

  • External beam radiation, a standard type of radiation therapy given over six weeks using intensity-modulated radiation therapy or 3D conformal radiation therapy technology
  • High-dose rate brachytherapy, delivers a high dose of radiation in and around the tumor. It spares much of the surrounding healthy tissue.
  • Intraoperative radiation therapy (IORT), a faster, more convenient radiation therapy that offers a single dose in one visit immediately after a lumpectomy
  • Proton therapy, targeted therapy with precision accuracy and less radiation dose than conventional radiation therapies

Learn More About Radiation Therapy

Looking for expert cancer care?

With multiple locations throughout the region, patients have access to many of the nation’s renowned cancer specialists offering high quality care, second opinions and a chance for better outcomes close to where they live and work. Georgetown Lombardi Comprehensive Cancer Center, one of the nation’s comprehensive cancer centers designated by the National Cancer Institute (NCI), serves as the research engine allowing patients access to clinical trials that often lead to breakthroughs in cancer care.

Our locations

Distance from Enter your location

MedStar Health: Betty Lou Ourisman Breast Health Center at MedStar Georgetown University Hospital

3800 Reservoir Rd., NW
Georgetown Lombardi Comprehensive Cancer Center
Ground Floor
Washington, DC 20007

MedStar Health: Breast Health Program at Lafayette Centre

1133 21st St., NW
Bldg. 2
Ste. 800
Washington, DC 20036

MedStar Health: Breast Health Program at MedStar Washington Hospital Center

110 Irving St. NW
Washington Cancer Institute
1st Floor
Washington, DC 20010

MedStar Health: Breast Center at Bel Air

12 MedStar Blvd.
Ste. 180
Bel Air, MD 21015

MedStar Health: Breast Center at MedStar Good Samaritan Hospital

5601 Loch Raven Blvd.
Smyth Building
Suite 403B
Baltimore, MD 21239

Why choose us

Doctors Fritz and Wehner stand together with a nurse navigator in a hospital hallway.

Clinical trials and research

Clinical trials

Clinical trials test new and innovative ways to treat breast cancer using various treatment modalities, offering hope to patients dealing with all stages of breast cancer. We currently offer over 30 different breast clinical trials in conjunction with the National Cancer Institute and world pharmaceutical companies.

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Research

Georgetown Lombardi Comprehensive Cancer Center is the research engine driving evidence-based cancer care throughout MedStar Health. Through this partnership, our breast team investigates innovative ways to improve the standard of breast care or define new standards of care.

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Awards and recognition

Full accreditation from the National Accreditation program for Breast Centers (NAPBC)

Accredited and designated as a Breast Imaging Center of Excellence by the American College of Radiology (ACR)

Recipient of an Accreditation with Commendation, the highest level of approval, from the American College of Surgeons’ Commission on Cancer (CoC)

Consistent winners of the Women's Choice Awards for "Comprehensive Breast Centers" and "Best Mammogram Imaging Center"

Numerous breast surgeons, reconstructive surgeons, and surgical oncologists recognized as "Top Doctors" by both Baltimore Magazine and the Washingtonian

Magnet® designation from the American Nurses Credentialing Center (ANCC)

Support services

You are more than just a cancer diagnosis, and that's why we offer a full spectrum of support services to promote healing, comfort, and education. Aside from your medical providers, your care team involves social workers, psychologists, and nurse navigators—nurses who guide you and your family through the coordination of care, the delivery of services, and the tough decision-making. Services also include:

  • Nutritional counseling
  • Spiritual care
  • Support groups and peer-to-peer counseling
  • Complementary care

Learn More About Cancer Support Services

Genetic counseling

Does cancer run in your family? Were you diagnosed with cancer at a young age? Does someone in your family carry the BRCA gene mutation? If you answered yes to any of these questions, genetic counseling—and possibly genetic testing—can provide you and your family with valuable information about risk management for hereditary cancers. Although only five to ten percent of cancers are due to inherited genes, genetic counseling can help you:

  • Understand any cancer risks associated with your family history
  • Identify inherited mutations that can cause cancer
  • Make decisions about treatment after a diagnosis
  • Help the next generation of your family manage their risks for developing breast cancer

Through our partnership with the Georgetown Lombardi Fisher Center for Hereditary Cancer and Clinical Genomics Research, we are leaders in local, national, and international genetics research that is finding better ways to detect, treat, and prevent hereditary cancers.

Learn More About Genetic Counseling

Personalized rehabilitation

Rehabilitation can help you deal with any challenges associated with breast cancer treatment and recovery, from lingering pain to proactive lymphedema management. Our specially-trained doctors, nutritionists, and physical and occupational therapists at MedStar National Rehabilitation Network help you fully recuperate and regain strength as you heal.

Learn More About Breast Cancer Rehabilitation

Survivorship

Once you beat cancer, it's common to feel a mix of feelings, from relief to uncertainty about your new normal. Through our survivorship program, we help you transition to life after cancer treatment by offering compassionate and coordinated post-cancer care that involves:

  • Follow-up medical care to address any late side effects from treatment
  • Personalized plans to minimize the risk of cancer recurrence
  • Support and coping strategies for emotional needs
  • Guidance for transitions in your family life
  • Encouragement and resources for healthy lifestyle changes

Learn More About the Cancer Survivorship Program