Glossary

Common cancer-related terms

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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.

Breast conservation - See breast conserving surgery.

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.

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.

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.

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.

Toxicity - Side-effects which are due to treatment.

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.

Tumour type - The overall cell pattern of the tumour.

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.

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