Glossary           

Absolute Risk or Risk
Risk is the chance that something will happen to you during a certain period of time. It is the number of people who would have the event if 100 people were observed. It is written as a percent (%). For instance, your risk of getting a disease in the next 5 years might be 3%. If you have the disease, your risk of dying from it in the next 10 years might be 20%. Your risk is based on studies of people who are similar to you. See also Relative Risk.

Absolute Risk Reduction
Risk reduction means lowering the risk that something will happen to you, such as getting a disease, getting a disease for a second time, or dying from a disease. Certain treatments can reduce risk. Absolute risk reduction is the difference between your risk before and after you have a treatment. For example, if you had a 4% risk of having your breast cancer come back before you take drug X and a 3% risk of having your breast cancer come back after you take drug X, the absolute risk reduction would be 1% (4% - 3% = 1%). See also Relative Risk Reduction.

Activism
Activism is strong action in support of an issue.

Activists
Activists are people who take strong action in support of an issue.

Acupuncture (AK-yoo-punk-chur)
Acupuncture is a traditional Chinese way to relieve pain and help the body work better. Acupuncturists put thin needles into the skin along lines called "meridians."

Adenoid Cystic Carcinoma
See Breast Cancer.

Adjuvant (AD-joo-vant) Therapy
Adjuvant therapy is treatment breast cancer patients get after surgery. It may include chemotherapy, radiation therapy, or hormonal therapy.

Advance Directive
An advance directive is a written statement that tells doctors and your family how you want to be treated if you are too sick to talk for yourself. The directive is made when you are healthy so that you can tell people in advance what you would want done. Another kind of advance directive says who you would want to make health care decisions for you, if you couldn't do it yourself. This is called a "living will."

Advocacy
Advocacy is work done to promote a cause or idea. For example, breast cancer advocates work for more research and access to better health care. They also work to be more involved in government and research decisions.

Advocate
An advocate is someone who works to promote a cause or idea. For NBCCF, an advocate is 1) someone who has been personally affected by the disease (for example: a breast cancer survivor, family member, or friend) and 2) someone who represents and answers to the affected community.

Alternative Medicine, Treatments, or Therapies
Alternative medicine is treatment used in place of standard medical care. It is care that is outside of our country's mainstream medicine. It includes therapies known as "natural," "homeopathic," and others.

Anecdotal (an-neck-DOE-dul) Evidence
Anecdotal evidence comes from stories of what has happened with other patients. People sometimes think a certain treatment is good or bad based on these stories. But anecdotal evidence isn't worth much. It can only tell what happened to someone else. Your own illness and risk factors may be very different. And what happens to a few people may not reflect what will happen in general.

Anthracyclines (an-thruh-SIKE-leens)
Anthracyclines are chemotherapy drugs used to treat breast cancer. Some of them have serious side effects.

Aromatase Inhibitors (a-ROW-ma-tays in-HIB-it-ers)
Aromatase inhibitors are a category of drugs used to treat hormone-dependent (estrogen receptor-positive and/or progesterone receptor-positive) breast cancer. Currently they are only prescribed for post-menopausal women.See Hormonal Therapy

Axillary (AKS-uh-lar-ee) Lymph Node Dissection (di-SEK-shun)
Axillary lymph node dissection is a surgical procedure to determine whether an individual's cancer is node-positive or node-negative. There are three levels of axillary lymph nodes with Level I axillary lymph nodes being closest to the breast, and Level III axillary lymph nodes furthest away from the breast. Axillary lymph node dissection usually involves removal of Level I and II lymph nodes. About 10-20% of patients who have axillary lymph node dissection experience lymphedema. The risk of lymphedema increases with a greater number of removed lymph nodes. See Lymphedema

Behavioral Medicine
Behavioral medicine is a type of medicine that deals with human behavior. For example, behavioral medicine can help smokers quit smoking by teaching them healthier habits.

Benefits
Benefits are what your insurance pays. Health insurance benefits pay for health care. A life insurance policy pays benefits when you die. The word "benefits" also can mean the good results of a treatment or lifestyle change.

Benign (beh-NINE)
A benign tumor is not cancer. It will not spread to other parts of the body.

Biological Therapy
Biological therapy is a kind of treatment that works to build up the body's immune system to fight disease. It is also used to help the body fight side effects of other treatments.

Biomarker
See Tumor Marker.

Biopsy
A biopsy is when cells, fluids, and/or tissue are removed from the body and studied. The material is usually taken out with a needle. The following are different types of biopsies:

• Core Biopsy
  This type of biopsy involves removing samples of breast tissue with a needle. Often, the doctor uses imaging techniques such as ultrasound or mammography to help guide the needle to the area of concern. This type of biopsy does not require surgery in an operating room, but does enable a pathology review of the tissue.
• Fine Needle Aspiration (as-per-AY-shun) Biopsy
  Fine needle aspiration biopsy also involves a needle, but one that is much smaller than that used for core biopsy.
• Surgical Biopsy
  Surgical biopsy involves cutting the breast to remove a larger sample of the tissue. This type of biopsy is often done in an operating room, and requires stitches afterwards.

Biopsy Report See Pathology Report.

Blind Study See Masked Study.

Brachytherapy (BRA-kee-thayr-uh-pee)
Brachytherapy is a type of partial breast irradiation. The radiation is given internally by placing radioactive pellets directly in the breast tissue. This radiation treatment is given over a period of five days, instead of the six to eight weeks that standard external radiation therapy is given. However, brachytherapy is still an experimental treatment and not part of routine care. It should only be done as part of a clinical trial.

Breast Cancer
The breast is made of fat and breast tissue. Breast tissue is like a bunch of grapes, where the stems are called ducts and the grapes are called lobules. Milk is made in the lobules and then goes out to the nipple through the ducts. Breast cancer is the abnormal growth of cells that line the ducts or the lobules of the breast. Classifying the types of breast cancer is based on:

• whether the cancer started in the ducts or the lobules and
• whether the cells have broken through the wall of the duct or lobule and "invaded" the tissue around it.

Doctors classify the cancer by looking at the breast tissue under a microscope. Following are different types of breast cancer:

• Adenoid Cystic Carcinoma (ADD-uh-noid SIS-tik kar-sin-O-muh)
  This type of cancer rarely develops in the breast. It is more often found in the salivary glands. Adenoid cystic carcinomas of the breast have a better prognosis than invasive lobular or ductal carcinoma.
• Carcinoma in Situ (kar-sin-O-muh in SYE-too)
  In situ means that the cancer is only in the ducts or lobules and has not spread to surrounding fatty tissues in the breast or spread to other organs in the body. There are two types of breast carcinoma in situ:
• Ductal Carcinoma in Situ (DCIS) (DUK-tal kar-sin-O-muh in SYE-too)
  DCIS is the most common type of noninvasive breast cancer. It begins in the ducts but does not spread through the walls of the ducts into the fatty tissue of the breast. There is active research on DCIS because it does not appear that all DCIS becomes invasive cancer. But the risk of invasion appears to be much higher than LCIS, so most doctors treat DCIS. But, because of the controversy, women may get conflicting treatment advice if DCIS alone is found in the breast tissue.
• Lobular Carcinoma in Situ (LCIS) (LOB-yoo-lar kar-sin-O-muh in SYE-too)
  Although often listed with breast cancers, LCIS is not actually breast cancer. It is a marker showing that a woman has an increased risk of getting invasive breast cancer in either breast. LCIS often affects both breasts. It begins in the lobules, but does not penetrate through the lobule walls. Most breast cancer specialists think that LCIS itself does not usually become an invasive cancer, but women with this condition do run a higher risk of developing an invasive cancer in either breast.
• Colloid Carcinoma (KOH-loid kar-sin-O-muh)
  This rare type of invasive ductal breast cancer is also called mucinous carcinoma. It's formed by mucus-producing cancer cells. Prognosis for colloid carcinoma is better than for invasive lobular or the usual invasive ductal cancer.
• Infiltrating (or Invasive) Ductal Carcinoma (IDC) (IN-fill-tray-ting DUK-tul kar-sin-O-muh)
  Starting in a milk passage, or duct, of the breast, the cancer cells break through the wall of the duct and invade the breast's fatty tissue. They can then invade into lymphatic channels or blood vessels of the breast and spread to other parts of the body. Infiltrating or invasive ductal carcinoma accounts for about 80 percent of all breast cancers.
• Infiltrating (or Invasive) Lobular Carcinoma (ILC) (IN-fill-tray-ting LOB-yoo-lar kar-sin-O-muh)
  This type of cancer starts in the milk-producing glands (lobules). Like IDC, this cancer can spread beyond the breast to other parts of the body. About 10 to 15 percent of invasive breast cancers are invasive lobular carcinomas.
• Inflammatory (in-FLAM-uh-tor-ee) Breast Cancer
  This disease accounts for about 1 percent of invasive breast cancers. The skin of the affected breast is red, feels warm, and may thicken to feel like an orange peel. The name for this type of breast cancer was chosen many years ago because the tissue appeared inflamed. Doctors now know that these changes are not due to inflammation but rather to spread of cancer cells within lymphatic channels of the skin.
• Medullary Carcinoma (MED-uh-lair-ee kar-sin-O-muh)
  This type of infiltrating ductal cancer has a distinct boundary between tumor tissue and normal breast tissue. It also has a number of other features, including the large size of the cancer cells and the presence of immune system cells at the edges of the tumor.
• Tubular Carcinoma (TOO-byu-lur kar-sin-O-muh)
  Accounting for about 2 percent of all breast cancers, tubular carcinoma is a special type of infiltrating ductal breast carcinoma. It has a better prognosis than the usual invasive ductal or lobular carcinomas.

Breast-Conserving Surgery
To "conserve" means to "save." Breast-conserving surgery is when a portion of the breast (but not the whole breast) is cut out in order to remove cancer cells. This is sometimes called "lumpectomy." It is different from a mastectomy, where the entire breast is removed.

Breast Prosthesis (prus-THEE-sis) or Breast Prostheses (prus-THEE-seez) (plural)
A prosthesis is something that takes the place of a missing body part. A prosthesis doesn't work like the real body part. But it can make your body look more normal. Breast prostheses can be made of foam, silicone, or something else. They are made to look and feel like breasts. They go outside your body. Some breast prostheses go inside a special bra. Others stick to your skin.

CAM
CAM is short for "complementary and alternative medicine." See Complementary Medicine and Alternative Medicine.

Cancer
Cancer is a disease where abnormal cells grow and reproduce uncontrollably. These cells can grow and kill the normal cells around them. A cluster of cancer cells is called a tumor. Cancer cells may also move into the lymph or blood system and travel to other parts of the body. There they grow into new tumors. This is called metastasis (muh-TASS-tuh-sis). See Metastasis.

Carcinoma in Situ (kar-sin-O-ma in SYE-too)
See Breast Cancer.

Case Series
Case series is a type of study where a small number of people or patients are observed. This is the weakest form of study design because it does not include a comparison (or control) group.

Cell
Cells are tiny spheres that make up all the organs and tissues in your body. Cells also make up cancer tumors. Cells are too small to see with your eyes.

Cervical Cancer
Cervical cancer is the name for cancer of the cervix. (The cervix is the lower end of a woman's uterus.)

Chemotherapy (KEE-moh-THAIR-uh-pee)
Chemotherapy is when chemicals are used to treat an infection or other disease. Nowadays, chemotherapy usually means using chemicals to destroy or stop the spread of cancer cells. Chemotherapy drugs are given in one of two ways:

• They can be put into your body through a needle inserted into your blood stream.
• You can swallow them. Then they are carried to your bloodstream through your stomach and intestine.

Chemotherapy is usually designed to kill quickly growing cells. Since cancer cells grow quickly, the chemotherapy can kill the cancer cells. Unfortunately, other quickly growing cells may also be killed. These include hair, new blood cells, or cells lining your stomach and intestine. These side effects can cause diarrhea, vomiting, and hair loss. But how much these side effects occur varies with each person and the dose of the chemotherapy.

Citation
A citation gives information on where to find a published article. It tells the title and date of the magazine or journal where the article was published. It gives the authors' names, the title of the article, and page number where the article can be found.

Clinical Trial
A clinical trial is a research study where a new treatment or other health intervention is tried out on people. Clinical trials test how well and/or how safely a new treatment works. Some clinical trials use control groups and randomization. See also Randomized Controlled Clinical Trial.

Colloid Carcinoma
See Breast Cancer.

Complementary Medicine, Treatments, or Therapies
Complementary medicine is treatment used along with standard medical care. It is care that is outside of our country's mainstream medicine. It includes therapies known as "natural," "homeopathic," and others. Some complementary treatments may help relieve cancer symptoms. Some may help with side effects of standard treatment. Some may improve your sense of well-being.

Complications
Complications are illnesses or side effects you get while being treated for something. Complications can change your chances of getting well or delay the time it takes you to get well.

Computed Tomography (tuh-MAH-gra-fee) Scan (also called "CT scan")
A CT scan is a series of detailed pictures of areas inside the body taken from different angles. The pictures are created by a computer linked to an X ray.

Control or Control Group
You may see the word "control" in phrases like "randomized controlled trial." In these studies, the control is a group of patients who do not get the new treatment or health intervention. Instead they get the standard treatment for the same disease. The researchers then compare results for the patients getting the new treatment (investigational group) to the control group's results. Another name for the control group is the "comparison group."

Controlled Clinical Trial
A controlled clinical trial has one or more test treatments and at least one control treatment.

Coordination of Care (also called "coordinated care")
Coordinated care means that someone keeps track of the care you are getting. This is important when you have more than one caregiver. See Multi-disciplinary.

Copayment
A copayment is a fixed amount that you pay for medical services. Copayments are a part of many health insurance plans. For example, your health insurance plan may require that you pay $10 each time you visit a doctor or $10 for a particular prescription drug.
See also Health Plan and Coverage.

Cosmetic Surgeon
See Plastic Surgeon.

Coverage (also called "health coverage" or "health insurance")
Your coverage is what your health care plan will pay for. See also Health Plan and Benefits.

Diagnosis (die-ug-NO-sis)
Diagnosis is the name of a disease or condition. Doctors use many tools to find your diagnosis. They look at physical signs, symptoms, history, lab test results, and other types of tests.

Diagnostic Services
A place that offers diagnostic services for breast cancer will examine you to see if you have breast cancer. Diagnostic services may include tests such as mammograms.

Disease Characteristics
See Specific Disease Characteristics.

Double-Masked Study
"Double-masked" is a way of giving treatment in a clinical trial. Neither the people doing the study nor the person getting the treatment know what therapy is being given to which patient. That way neither the patients nor the researchers know who is getting which treatment. The goal is to keep people from changing what they do because of which treatment they are getting (or giving). It helps keep patients and researchers from changing the results based on what they think should happen. "Double" refers to both parties -- that is, the researchers and the patients. Double-masked can also mean any time that information is kept from two groups of people to keep that information from affecting some measurement, observation, or process. Double-masked studies are also called "double-blind" studies. See also Masked Study.

Duct
Ducts are thin, tube-like structures in your breast. When a woman breast-feeds, milk goes through her breast ducts to her nipples. Breast cancer often starts in the ducts.

Ductal carcinoma in situ (DCIS) (DUK-tal kar-sin-O-muh in SYE-too)
See Breast Cancer.

End-Stage Breast Cancer
End-stage breast cancer usually refers to when a breast cancer patient is nearing the end of her life. At this point, treatments have stopped working to control the cancer growth.

Estrogen (ES-truh-jin)
Estrogen is a normal hormone in women's bodies.

Estrogen Receptor-Negative (ES-truh-jin ree-SEP-tur NEG-uh-tiv)
Some breast cancers have a place in the cells (a receptor) where estrogen can sit and affect how the cancer grows. These cancers are called "estrogen receptor-positive." Cancers that don't have a place for estrogen are called "estrogen receptor-negative."

Estrogen Receptor-Positive (ES-truh-jin ree-SEP-tur PAHS-uh-tiv)
Some breast cancers need estrogen to grow. They are called "estrogen receptor-positive." Doctors usually prescribe the drug tamoxifen to patients with estrogen receptor-positive breast cancer. Tamoxifen blocks estrogen from being used by the cancer.

Evidence
Evidence is information that is collected in an orderly way to help us understand what to do. This information can come from medical research.

Evidence-Based Medicine or Health Care
Evidence-based medicine is advice and treatment based on the best available medical research. Doctors who practice evidence-based medicine have a system for reviewing medical research and judging the evidence. Some evidence is better than others. There rarely is enough evidence to know what to do for sure. Knowing how doctors judge evidence and come to conclusions can help you understand the quality of their advice.

False Negative
A false negative test result is when a test incorrectly gives a negative result when the patient does have the disease.

False Positive
A false positive test result is when a test incorrectly gives a positive result when the patient does not have the disease.

FISH Test
A fluorescence in situ hybridization (FISH) test is a diagnostic test used to determine whether breast cancer cells carry too many copies of the HER2/neu gene, in which case a woman is considered HER2/neu-positive and treatment with Herceptin may be effective.

Gene Expression Profiles
Gene expression profiles are a way to measure the activity in tumor cells of specific genes associated with breast cancer. Gene expression profiles are also known as "gene panels" or "molecular profiles." They give information about a woman's breast cancer, such as how aggressive it may be, how it may respond to a particular treatment, or how likely it is to spread. Gene expression profiles are still being studied and evaluated, and are still considered investigational. See also NBCCF for our fact sheet on Gene-Expression Profile Testing.

Genetic Tests
There are several genetic tests that can be used to identify women who may have a higher risk of developing breast cancer. These tests look at genes that have been strongly associated with breast cancer risk, such as the BRCA1 and BRCA2 genes. These genes are called "breast cancer susceptibility genes." The genetic tests cannot predict exactly who will develop breast cancer. See also NBCCF for our position statement on Genetic Testing.

Health Coverage
See Coverage and Health Insurance.

Health Insurance
Your health insurance helps protect you from paying health care costs when you are sick or injured. It also usually pays for preventive care. See also Health Plan and Benefits.

Health Outcomes
Your health outcome is how you are at the end of your treatment or your disease. It includes how well you are and how well your needs for more care, medicine, support, counseling, or education have been met. Clinical trials measure the health outcomes of groups of patients. Some common health outcomes in clinical trials include illness, survival, and improved quality of life.

Health Plan
Health plan is another name for health insurance. It is how you get and pay for health care. Your health plan may cover visits to private doctors. Or you may belong to a health maintenance organization (HMO) that has its own doctors. Plans differ in how much you have to pay. And they differ in how easy it is to get the services you need. Plans generally don't pay for all the costs of your medical care. But some plans cover more than others.

HER2/neu
HER2/neu is a protein. Normal breast cells have a very small amount of this protein. About 25%-30% of breast cancers have too much of this protein. These breast cancers are called "HER2/neu positive." HER2/neu positive breast cancers tend to grow faster than other cancers.

Herceptin®
Herceptin® is a targeted drug used to treat women with HER2/neu-positive, metastatic breast cancer. It has been shown to extend survival for these women by 24% when added to chemotherapy drugs. There is mounting evidence that Herceptin® may also be effective among patients with early stages of HER2/neu-positive breast cancer. These findings have prompted the makers of Herceptin® to seek FDA approval in extending its use to these patients. However, the data given to the FDA for evaluation comes from two clinical trials that were stopped before being completed due to better-than-expected results among the women given Herceptin®. Herceptin® is the drug's brand name, and it is also known by its generic drug name trastuzumab. See Targeted Treatments.

Hormonal Therapy
Hormonal therapy treats diseases by removing, blocking, or adding hormones to a person's body. It is also called endocrine therapy. Tamoxifen is an example of hormonal therapy for breast cancer. It sits on the wall of a cell and blocks the effects of estrogen. Aromatase inhibitors are another example of hormonal therapy.

Hospice (HAHS-piss) Care
Hospice care is a special service available to people who are terminally ill. It is usually family-centered care designed to help patients and their families. It helps the sick person be comfortable. It also helps them lead a decent life through the phases of dying.

IHC Test
An immunohistochemistry (IHC) test is a diagnostic test used to determine the level of HER2/neu protein overexpression in breast cancer cells. This test can indicate whether treatment with Herceptin may be effective.

Implant
An implant is an object placed in the breast area that can create a shape like a breast. Some breast cancer patients have implant surgery after a mastectomy.

Infiltrating Ductal Carcinoma (IDC)
See Breast Cancer.

Infiltrating Lobular Carcinoma (ILC)
See Breast Cancer.

Inflammatory Breast Cancer
See Breast Cancer.

Informed Consent
Informed consent is when you say it is OK to do a certain test or procedure after you fully understand the risks of that test or procedure. You sign a paper to give your informed consent. Your informed consent is needed before most invasive procedures. (An invasive procedure is any time the doctor or surgeon goes inside your body with a tool.) Your consent is also needed before you can be part of a clinical trial.

In Situ Breast Cancer
Under Breast Cancer, See Ductal Carcinoma In Situ and Lobular Carcinoma In Situ.

Institutional Review Board
An institutional review board (IRB) is a group of scientists, doctors, consumers, and others. There is an IRB at each health care center that takes part in a clinical trial. They review and must approve the plan for every clinical trial at their health care center. They check to see that the trial is well designed, does not pose undue risks to patients, and includes safeguards for patients.

Insurance Premium
Your insurance premium is the cost of your insurance. Your employer may pay part of your premium if you get your insurance through work.

Internet (also called the "World Wide Web")
The Internet is a network of information run on computers. Information is given through web sites. Most often, you access the Internet through a computer.

Intervention
A health intervention is anything that may improve or protect a person's health, or make a person live longer. It can also be something done to help a patient's mind, body, or feelings. Some common health interventions include medicine, surgeries, acupuncture, exercise, and eating healthier foods.

Invasive Breast Cancer
Under Breast Cancer, see Infiltrating (or Invasive) Ductal Carcinoma and Infiltrating (or Invasive) Lobular Carcinoma.

Invasive Ductal Carcinoma (IDC)
Under Breast Cancer, see Infiltrating (or Invasive) Ductal Carcinoma.

Invasive Lobular Carcinoma (ILC) (ILC)
Under Breast Cancer, see Infiltrating (or Invasive) Lobular Carcinoma.

Investigational Group (also called "new treatment group")
The group receiving the study agent that is being tested in a clinical trial or clinical study.

Investigational Treatment or Therapy
An investigational therapy is a treatment that has not been shown to work yet. No one knows yet if the treatment works and is safe. It is still being tested on patients.

Leukemia (loo-KEE-mee-yuh)
Leukemia is a type of cancer. There are many different kinds of leukemia. In most leukemias, the body starts making large numbers of abnormal white blood cells. These cells do not work the way they should. And they invade the lymph nodes, spleen, and liver.

Lobular Carcinoma in Situ (LCIS)
See Breast Cancer.

Local Recurrence
A local recurrence is when cancer comes back in the same spot where it was removed.

Lumpectomy (lum-PEK-tuh-mee)
Lumpectomy is when doctors cut out a tumor without taking away a lot of tissue around it. If you have a breast lumpectomy, most of your breast will still be there afterwards. See also Breast-Conserving Surgery.

Lymph (limf) Nodes
Lymph nodes are small oval glands that help your body fight infection. They also filter the liquid called lymph and help carry fluid throughout the body. Most lymph nodes are in the mouth, neck, armpit, and groin. Breast cancer can move from the breast to the lymph nodes under the arm. It is common for doctors to remove some of these lymph nodes to help diagnose breast cancer.

Lymphedema (LIMF-uh-DEE-muh)
Lymphedema is swelling caused by a build-up of fluid (lymph) in the tissue of your body. There are a few different ways to get lymphedema. You can get it after your lymph nodes are removed. You can get it if you have cancerous tumors in your lymph system. Or you can be born with it. (This is called "Milroy's disease.") Some teenage girls can get it. (This is called "lymphedema praecox" [PREE-cocks].) Or you can get it if you have parasites in your lymph system.

Magnetic Resonance Imaging (MRI) (mag-NET-ik REZ-o-nans Im-a-jing)
An MRI is a scan that creates detailed pictures of areas inside the body. The pictures are created by a magnet that is linked to a computer. Malignant (muh-LIG-nent)
A malignant tumor is made up of cancer cells. It may grow quickly and spread to other organs in the body. (When cancer spreads to other parts of the body, it is called "metastasis" [muh-TASS-tuh-sis].)

Mammography and Mammogram
A mammogram is an X ray picture of the breast. The X ray shows spots where the breast tissue is more dense. Tumors are denser than other tissues. That's why they show up on a mammogram. These days, mammograms can spot a tumor that is only 1-2 millimeters long. It is very hard to tell if a spot on a mammogram is cancer. If there is a spot on your mammogram, doctors usually take a sample of the spot for testing. This is called a "biopsy" (BY-ahp-see).

Masked Study
A masked study is one where the people in it don't know what group they are in. For example, let's say the study is testing a new drug. Some people will get an already approved drug, and others will get a new drug. But none of them will know which drug they are getting until the study is over. Masked studies are done so that people will record what they really feel and see, not just what they think they feel and see. Sometimes these studies are referred to as "blind studies" instead.

A "double-masked" study is when the person doing the study doesn't know who is getting the drug either. Masked and double-masked studies are a very important way to test whether a therapy works. Advances in our ability to treat breast cancer depend on people agreeing to take part in studies. See also Double-Masked Study.

Mastectomy (mass-TEK-tuh-mee)
Mastectomy is when surgeons remove one or both breasts. They usually do this to take away a malignant tumor. There are three types of mastectomy:

Simple Mastectomy (mass-TEK-tu-mee)
In a simple mastectomy, only breast tissue is removed from the breast area.

Modified Radical Mastectomy (MAHD-uh-fide RAD-uh-kul mass-TEK-tuh-mee)
A modified radical mastectomy is when surgeons remove the breast, some small chest muscles, and some lymph nodes in the armpit. They do not remove the large chest muscles that move the arm.

Radical Mastectomy (RAD-uh-kul mass-TEK-tuh-mee)
A radical mastectomy is surgery to remove the whole breast, most chest muscles, and all the lymph nodes in the armpit.

Medicaid
Medicaid is health insurance for lower-income families and the disabled. It is paid for partly by the federal government and partly by the state where you live. The rules for getting Medicaid depend on your state.

Medical Errors
A medical error is when the right care is not carried out as planned or when the wrong care is used. Errors can happen in all stages of the care process, from diagnosis, to treatment, to preventive care.

Medical Practice
A medical practice is a business that gives health care.

Medical Oncologist
See Oncologist.

Medicare
Medicare is a national health insurance program for people age 65 or older. It is paid for by the U. S. federal government. The program has four parts. Part A helps cover the basic costs of medical care, surgery, and mental hospital care. Part B is extra insurance. The government pays for part of it. But people in the program pay insurance premiums, too. Part C is a choice to get Parts A and B through a private insurance plan. And Part D helps cover prescription drug costs.

Medullary Carcinoma
See Breast Cancer.

Menopause (MEN-uh-paws)
Menopause is when a woman's menstrual periods stop. It can take months or years to go through menopause. Women naturally go through menopause when they are between 35 and 60 years old. But your periods may stop earlier if you get sick. They will also stop if your uterus or both ovaries are removed. Menopause begins when your body starts making less of the hormone estrogen (ESS-truh-jin). It makes less of other chemicals, too. The result is that you have fewer periods. After a while, your periods stop. Your hormone levels can go up and down during menopause. You may get hot flashes. You may get some heavy bleeding.

Metastasis (muh-TASS-tuh-sis) or Metastases (muh-TASS-tuh-seez) (plural)
Metastasis is the spread of cancer to another organ, usually through the bloodstream. See Metastatic Breast Cancer.

Metastatic (MEH-tuh-STAT-ik) Breast Cancer
Metastatic breast cancer is breast cancer that has traveled to other parts of the body. Breast cancer most often spreads to the bones, lungs, or liver. The cancer creates more tumors at the new sites. Metastatic breast cancer is also known as stage IV breast cancer.

Modified Radical Mastectomy
See Mastectomy.

Multi-disciplinary
A multi-disciplinary team is one that involves experts from different fields (i.e. surgery, oncology, radiation) working together. The advantage of a multi-disciplinary team is better coordinated care, and potentially fewer medical appointments because multiple medical consultations can be done during the same appointment.

Node-Negative Breast Cancer
Node-negative breast cancer is breast cancer that has not spread to the lymph nodes.

Node-Positive Breast Cancer
Node-positive breast cancer is breast cancer that has spread to the lymph nodes.

Observational Study
Observational studies include case-control and cohort studies. In an observational study, the researcher observes and collects data on populations of people. Groups of people with different exposures are compared to see if these exposures are associated with disease. An observational study is different from a clinical trial in that people in the observational study choose their own exposures and are not randomized.

Occupational Therapy
Occupational therapy uses activities to help people build and regain skills they need for their health and well-being. For example, occupational therapy can help people learn how to bathe and cook again after being injured.

Oncologist (ahn-KAH-luh-jist)
An oncologist is a doctor who specializes in studying and treating cancer. Breast cancer patients often get care from three types of oncologists:

• Medical Oncologist
  A medical oncologist is a doctor trained to treat cancer with medicines. Medical oncologists use chemotherapy, hormonal therapy, and biological therapy. One of the doctors who manages a cancer patient's care is often a medical oncologist.
• Radiation (RAY-dee-YAY-shun) Oncologist
  A radiation oncologist is a doctor who has gotten special training to use ionizing radiation to treat cancer. See Radiation.
• Surgical Oncologist
  A surgical oncologist is a doctor who specializes in removing cancerous tumors.

Oncology Nurse
Oncology nurses are specially trained nurses who help care for individuals during their cancer treatment and follow-up. They can advocate for patients and their families, and help make sure everyone's questions are answered during all phases of cancer treatment and follow-up.

Oncology Social Worker
Oncology social workers help patients and their families with their physical, emotional, social, psychological, spiritual, informational and practical needs. Oncology social workers are specially trained to provide counseling and assistance to patients with the numerous psychosocial issues associated with a cancer diagnosis.

Outcomes Research
Outcomes research studies the "end results" of health care. These results include how long people live, what illnesses they get, and how well they feel. Outcomes research links the care people get to how it affects their lives. This research is one key to developing better care.

Out-Of-Pocket Costs
Your out-of-pocket costs are health care costs that you have to pay. They can include co-payments, deductibles, and costs over and above your health plan's limits. They can also be costs for treatment that your health plan does not cover.

Outpatient
There are two kinds of hospital patients: inpatients and outpatients. People admitted to the hospital to stay for at least one night are inpatients. People who are seen at the hospital but do not spend the night are outpatients.

Pain Control
Pain control means using drugs, hypnosis, or other methods to lessen pain. It can help make life easier for people who have pain all the time. Pain control is one type of palliative care.

Palliative (PAL-yuh-tiv) Care
Palliative care can relieve symptoms caused by advanced cancer. It doesn't try to cure the disease. But it can make the patient feel better. For example, pain medicine is a type of palliative care.

Partial Breast Irradiation (ih-ray-dee-AY-shun)
Partial breast irradiation is a new way of giving patients radiation therapy over a much shorter period of time, and only to the part of the breast with cancer. This method is still experimental, and should only be done as part of a clinical trial. One type of partial breast irradiation is brachytherapy.
See Brachytherapy.

Pathologist (path-AHL-uh-jist)
A pathologist is a doctor who studies diseases and diagnosis.

Pathology (path-AHL-uh-jee) Report (also called "biopsy report")
Your pathology report has information about your cancer. It helps the oncologist understand what type of cancer you have. It also helps him or her predict what the cancer tumor will do. The pathology report is a bit like a snapshot of an animal. The doctor looks at the snapshot and tries to guess how the animal will act.

Patient Navigator
Patient navigators help guide individuals through the health care system. For example, a patient navigator may assist an individual with an abnormal screening mammogram result obtain appropriate follow-up care such as diagnosis and treatment. Patient navigators may also provide information to patients on relevant clinical trials. Navigators can be a professional provider of health care services, a cancer survivor, or a patient advocate.

Peer Review
Your "peer" is someone at the same professional level as you. Peer-reviewed medical research has been judged by other doctors or scientists working in the same field. Nurses and other health care workers sometimes get peer reviews of how they work, teach, or do research.

Physical Therapy (FIZZ-uh-kul THAIR-uh-pee)
Physical therapy is a kind of health treatment. It does not use medicine. It uses things like massage, exercises, cold, heat, baths, small electric charges, and light. It can help after illness or injury. It can help you feel better. It can also help you do things you used to do before you got sick or hurt.

Plastic Surgeon (also called a "cosmetic surgeon")
A plastic surgeon is a doctor who changes or rebuilds parts of the body during surgery to make them look better. During surgery, the surgeon may use tissue from the patient, tissue from another person, or other materials. Some breast cancer patients need to have their breast removed as part of their treatment. A plastic surgeon can help those patients rebuild their breast through breast reconstructive surgery.

Positron Emmision Tomography (tuh-MAH-gra-fee) Scan (also called "PET scan")
A PET scan involves three-dimensional colored images that capture the activity of the substances in the body. The images are created by giving the patient a small amount of a radioactive sugar substance (about the same amount of radiation exposure as two chest X rays), and a computer linked to a scanner shows where the sugar is used in the body. Tumor cells tend to be more active than normal cells, and will use more sugar. PET scans can show where active tumor tissue is in the body, but cannot measure the size of the tumor.

Preinvasive
A preinvasive condition or disease is when a person's body shows signs of abnormal changes that often lead to cancer. An example is cells that are growing much faster than usual.

Primary Breast Cancer
Primary breast cancer refers to the first time a person is diagnosed with breast cancer.

Primary Care Doctor
A primary care doctor is a doctor who looks after your general health. The primary care doctor may refer you to specialists. Specialists have training in specific types of medicine.

Primary Tumor
A primary tumor is the first place where cancer began to grow.

Progesterone
Progesterone is a normal hormone in women's bodies. Progesterone receptor-negative and receptor-positive breast cells have some receptors for progesterone. When progesterone comes in contact with these receptors, the breast cells grow and reproduce. In some breast cancers, the cancer cells have many more progesterone receptors than normal. These breast cancers are called progesterone receptor-positive. Breast cancers with low amounts of progesterone receptors or no receptors at all are called progesterone receptor-negative.

Prognosis
A prognosis tells whether doctors think you will survive a disease, how long it will take you to recover, and what your recovery will be like. A prognosis is based on the usual course of the disease and the patient's situation.

Qualified Alien
The federal government defines a qualified alien to include: legal permanent residents, asylees, refugees, aliens paroled into the U. S. for at least one year, aliens whose deportations are being withheld, aliens granted conditional entry (prior to April 1, 1980), battered alien spouses, battered alien children, the alien parents of battered children, and alien children of battered parents who meet some requirements, and Cuban/Haitian entrants. Many qualified aliens who arrived in the United States after August 21, 1996, can't get Medicaid benefits for 5 years after entering the country. But the 5-year bar does not apply to certain refugees, asylees, and certain other groups. And, you may still be able to get Medicaid even if you do not meet the immigration rules. That's because the federal law allows states to give health care through Medicaid when an otherwise eligible person has an "emergency medical condition."

Quality of Life
Your quality of life includes how well you feel, physically and mentally. It includes how well you can do everyday activities such as eating, bathing, and dressing. It also includes how content you feel and how rewarding your relationships with family and friends are. A cancer diagnosis may affect all of these things, so they are an important part of health care.

Radiation (RAY-dee-YAY-shun)
Radiation (or radiotherapy) is a treatment for breast cancer. It uses X rays to kill cells as they divide. (Cells divide to make more of themselves. That is how cancer tumors grow.) The X rays kill any cells that are dividing. But cancer cells divide more often than normal cells. So the X rays kill more cancer cells. Usually, radiation is used after a surgery like lumpectomy or mastectomy. The breast or chest wall gets radiation to kill any cancer cells that the surgery missed. Radiation is also used in the palliative care of breast cancer. In this case, radiation can treat secondary effects of metastatic breast cancer, like tumors in organs or bones.

Radiation Oncologist
See Oncologist.

Radical Mastectomy
See Mastectomy.

Radiologist
A radiologist is a doctor who specializes in creating and interpreting pictures of areas inside the body. The pictures are created with X rays, sound waves, or other types of energy.

Random Assignment
See Randomization.

Randomized Controlled Clinical Trial
A randomized controlled trial (RCT) is a kind of clinical trial. People in the study are put in the investigational or control group by chance. People in the investigational group get the new treatment. People in the control group get the standard treatment. The results for both groups are compared very carefully. Researchers compare rates of disease, death, recovery, or other health outcomes for both groups. Most scientists think that RCTs are the most reliable studies.

Randomization (also called "random assignment")
Randomization is when people in a clinical trial are assigned to a group by chance. That is, the investigational group and control group are picked at random, like flipping a coin. This means the people running the study do not decide who gets which treatment.

Receptors
Receptors are molecules in cells that bind other molecules. Different kinds of receptors can affect the growth of breast cancer cells. See Estrogen Receptor-Negative and Estrogen Receptor-Positive.

Reconstructive Surgery (also called "reconstruction")
Reconstructive surgery rebuilds the breast after a mastectomy. It is a kind of plastic surgery. You can have it while you are still under anesthetic for the mastectomy. Or you can wait months or years to have reconstruction.

Recurrence
A recurrence takes place when breast cancer comes back after treatment.

Relative Risk and Relative Risk Reduction
Your relative risk is your risk compared to the risk of other people. Relative risk is a proportion. For example, suppose 4% of breast cancer patients have their breast cancer come back if they do not take drug X. And, 3% of breast cancer patients have their breast cancer come back if they do take drug X. The relative risk of people who take drug X compared to the people who do not take drug X is 75% (3%/4% = 75%). Risk reduction means lowering the risk that something will happen to you. Examples are getting a disease, getting a disease for a second time, and dying from a disease. Your relative risk reduction is 100% minus (-) your relative risk. So, in relative terms, taking drug X reduces your risk by 25% (100% - 75% = 25%).

Reliability
Reliability is the degree to which similar results from a measurement can be found again and again.

Remission
A remission is when signs and symptoms of cancer decrease or go away. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms have disappeared, although there still may be cancer in the body.

Second Opinion
A second opinion is when you go to another doctor. You do this to see both if doctors agree about what your disease is and how to treat it. This can help you make choices about what to do. Every breast cancer patient has the right to a second opinion.

Sentinel Lymph Node Procedure (SEN-tuh-nul LIMF nohd pro-SEE-juhr)
Breast cancer cells often spread to the lymph nodes. The "sentinel lymph node" is the first lymph node that a tumor is likely to spread to. During a sentinel lymph node procedure, the doctor usually injects a dye and something radioactive near the cancer tumor. The dye flows to the sentinel lymph node, showing the surgeon where it is. The surgeon removes the sentinel lymph node and checks it for signs of cancer. If cancer has not spread to the sentinel lymph node, it is unlikely that it has spread to any other lymph nodes. But, a cancer-free sentinel lymph node does not rule out the possibility of cancer somewhere else. More research is needed to know if sentinel lymph node procedures are an effective way to judge whether breast cancer has spread to lymph nodes.

Settlement
A settlement is when people agree to something before a court decides for them.

Slides
Breast tissue samples are stored on glass plates called "slides."

Specialist
A specialist is a doctor who has training in a specific type of medicine.

Specific Disease Characteristics
Your specific disease characteristics tell what type of breast cancer you have. The disease characteristics help you doctors decide what treatment to recommend. Disease characteristics include things like lymph node status, estrogen receptor status and HER2/neu status.

Standard of Care
The standard of care is a yardstick for measuring the level of health care. You can use the standard of care to compare what your health plan offers with the generally accepted level of care. The standard of care may be developed by a group of specialists or by advocates for people with special needs. Good standards of care are based on medical evidence.

Statistical Significance
A study's results are statistically significant when the results most likely did not occur simply by chance. Researchers apply a mathematical formula to the data from the study to find its statistical significance.

Statistical Techniques or Methods
A statistical technique or method is a way of collecting and looking at numbers. Researchers use statistical techniques to help make sense out of numbers they collect in a study.

Surgical Oncologist (ahn-KAH-luh-jist)
See Oncologist.

Systemic Treatments
Systemic treatments are treatments that affect the entire body. Two main types of systemic treatments for breast cancer are chemotherapy and hormonal therapy.

Tamoxifen (tam-OX-uh-fin)
Tamoxifen is a drug that blocks estrogen (ES-truh-jin) from being used by breast cancer cells. (Estrogen helps some breast cancers grow.) It is given to women who have estrogen receptor-positive breast cancer.

Targeted Treatments
Targeted treatments target cancer cells without harming many healthy cells. One type of targeted treatment for metastatic breast cancer is the drug Herceptin®. Scientists hope to find more targeted treatments for breast cancer.

Tissue Flap Surgery
Tissue Flap Surgery is a kind of surgery used to rebuild breast tissue. It uses a piece of tissue from another part of the body, such as the back, belly, or buttocks.

Trastuzumab (traz-TWO-zuh-mab)
Trastuzumab is the generic drug name for the targeted treatment, Herceptin®.
See Herceptin®.

Tubular Carcinoma
See Breast Cancer.

Tumor Grade
Tumor grade refers to what the breast cancer cells look like. Grade 1 (low grade) tumors have breast cancer cells that look very similar to normal breast cells, and are considered to be less aggressive in behavior than tumors with higher grades. Tumors with higher grades have cells that look less like normal breast cells, and tend to grow more rapidly and spread faster than tumors with lower grades.

Tumor Margins
Tumor margins are the cells on the edges of removed tissue. When the pathologist reviews the tissue that was removed, the margins are considered clear if there are no cancer cells found at the edges. Clear tumor margins after either lumpectomy or mastectomy indicate that the breast cancer has been completely removed. If the tumor margins are not clear, further surgery may be necessary.

Tumor Marker (also called "Biomarker")
A tumor marker is a substance found in a person's blood, urine, or tissue. A high level of a particular tumor marker in the blood or urine may indicate the presence of a particular type of cancer. There are different tumor markers for different cancers. For example, one tumor marker for breast cancer is called CA 15-3. A tumor marker cannot be used alone to diagnose cancer, and is generally not accurate enough to be used to screen for cancer.

Uncontrolled Studies
See Case Series.

Validity
Validity is the degree to which a measurement actually measures what it tries to measure.

Web Site
A web site is an address on the Internet that is run by a person or a group. When you visit this address, you see information put together by the site's owner. Web sites have many purposes. Some are meant to sell things. Others are for education. There are very few rules about what information you can put on the Internet, or how the Internet can be used. So it is important to make sure that information you find on the Internet is trustworthy and up-to-date.

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© 2001, 2002, 2006 National Breast Cancer Coalition Fund
Last reviewed: March 2006