This statistic applies to the male population, taking into account the identity of the tissues of this body in women and men, although cases of male breast cancer make up no more than one percent of the total number of illness.
Experts of the World Health Organization testify that about a million new cases of breast cancer are recorded in the world. In a number of deaths from female oncological diseases, breast cancer belongs to second place.
Classification of breast tumors
Tumor processes in the breast can wear a benign and malignant.
Benign species
All types of benign breast tumors are considered to belong to mastopathy.
The most common varieties (all of them over fifty) are presented:
- fatty cysts ();
Philloid (sheet)
A sheet tumor, which is a type of fibroadenoma, stands by a mansion in a number of benign breast neoplasms, since it is capable of reborn in a malignant tumor (sarcoma).
Philloid tumor is characterized by:
- the presence of clear boundaries separating it from nearby tissues;
- lack of capsule;
- insufficient mobility in the tissues of the mammary gland and the spyage with the skin;
- soreness when prescribed on the tissue affected by the type of breast;
- the presence of uneven polycyclic contours;
- a tendency to extremely rapid growth.
Considering the possibility of overcalling, the leafoid tumor is removed extremely surgically by exposing sectoral resection, not only the neoplasm itself, but also the fabric adjacent to it. With a large tumor, a radical mastectomy is performed - an operation to remove the affected breast.
For leafide breast tumors, a tendency to recurrent flow is characterized: the re-formation of benign fibrotane is noted in 8% of episodes, bordernote - in 25%, malignant - 20%. Dates of the occurrence of relapses: from several months to four years.
Malignant
Histological types of malignant tumors are represented by cancer:
- dolkov;
- dvokovy;
- metaplastic;
- medullar;
- inflammatory;
- colloid;
- undifferentiated;
- low-differentiated;
- infiltrating ductovy;
The same histological type includes malignant breast tumors, presented:
Stock Foto Raeded malignant breast tumor in woman
What malignant breast tumors are:
- invasive;
- hormone-dependent;
- estrogen-dependent.
Breast cancer can be primary and secondary.
Hormone-dependent
Hormone-dependent breast tumors are detected in 40% of patients. In the outer layers of tumor tissues there are receptors, endowed with the ability to contact with receptors of sex hormones of a female body. This contact stimulates the further growth of cancer cells.
To confirm or eliminate the presence of receptors sensitive to progesterone and estrogen, conduct a special test. Material for immunohistochemical study is taken during a biopsy. If the tenth of tumor cells also contains receptors, the neoplasm is considered to be hormone-dependent.
This not only makes it possible to begin hormonal treatment, but also allows us to make a forecast for the risk of recurrence. For hormone-dependent cancer breast tumors, a more calm flow and relatively rare metastasis are characterized.
Anti-estrogen therapy aimed at the oppression of the synthesis of estrogen and the destruction of cancer cells, although wears an auxiliary role, complementing chemotherapy, surgical treatment and radiation therapy, but in the case of impact on hormone-dependent tumor, it attaches particular importance to it.
Invasive
Invasive tumors of the dairy glands prefer to localize in connecting and fatty tissues. A distinctive feature of invasive tumors is the ability of cancer cells to leave the limits of the primary hearth, quickly penetrating the tissue and lymph nodes adjacent to it.
For launched stages of invasive breast cancer, it is characterized by metastasis in the tissue of the head and spinal cord, bones, lungs, liver and kidneys.
Invasive tumors of the dairy glands are presented:
- invasive ductocyan cancer, At first, affecting the milky ducts, gradually penetrating the fatty tissue, then through lymph nodes and blood flow - metastasis in other organs. The share of streaming cancer accounts for 80% of the malignant breast tumors.
- prein-proclaim cancer, developing and remaining exclusively in Milky Duchs. In the absence of diagnosis and proper treatment, this type of cancer is able to be reborn into the transduction form;
- invasive Dolkovo cancer, initially affecting the ducts and slices of the mammary glands, and then metastasive throughout the body. Invasive tumors of this type are found in 15% of patients.
Treatment of invasive tumors of the mammary glands includes a complete complex of anti-factor therapy: surgical treatment, radiation therapy, radio care, hormone and chemotherapy.
Causes of Education
Since the causes of breast cancer are still unknown, it is customary to talk only about the risk factors for this disease. These include:
- the presence of hereditary predisposition;
- early (up to 11 years) Menarche;
- conscious planning of pregnancy and childbirth at a fairly late age;
- rejection of prolonged breastfeeding;
- presence of bad habits ();
- later (after 55 years), the onset of menopause;
- lack of regular sex contacts;
- constant impact of severe stress and physical overwork;
- the presence of obesity, diabetes mellitus and hypertension;
- long (over 10 years) continuous reception of exogenous hormones;
- injury of the mammary glands;
- impact of increased radiation background.
Symptoms
Most of the neoplasms of the mammary glands (as benign and malignant) at the initial stage of their development does not cause painful sensations and does not exhibit themselves, therefore their regular and thorough inspection is so important. It is thanks to him that it is possible to identify the presence of a tumor at the earliest stage of development.
How to determine the breast tumor:
- the presence of swelling and seals in the tissues of the mammary glands;
- some changes in the consistency and the structure of the gland during palpactor examination;
- change configuration and general outlines of the gland;
- the presence of peeling, redness or wrinkling of the skin of the breast;
- the formation of the pits on the surface of the gland at the head of the hand for the head;
- the presence of a drawn nipple;
- discharge from the nipple (with benign neoplasms they are always watery, with malignant - bloody);
- availability of seals on the nipple itself;
- uncomfortable or pain;
- the presence of increased lymph nodes from the defeat.
Stages
Cancer tumors of the mammary glands in their development consistently pass through the following stages:
- 0: It is characterized by localization of cancer cells exclusively in the breast protocol and the absence of penetration into adjacent tissues;
- IA: At this stage, the size of the neoplasm does not exceed two centimeters, the tumor is localized in the tissues of the breast, pathological processes in the lymph nodes are absent;
- IB: For this stage, the presence of a tumor not exceeding two centimeters or small groups of tumor cells in a number of lymph nodes;
- IIa: The neoplasm not exceeding 2 cm is localized in the chest tissues and metasizes into the axillary lymph nodes (with a different version, the tumor can reach from two to five centimeters and not to give metastases);
- IIb: A tumor not exceeding five centimeters can be metastable in lymph nodes (second option: no metastases in the presence of a neoplasm exceeding five cm);
- Iiia: In the pathological process, not only the axillary, but also other lymph nodes are involved;
- IIIB: At this stage, the neoplasm of any size begins to affect the breast wall and the skin of the breast (the process of lesion of lymph nodes continues);
- IIC: In the pathological (with metastasis), the process is involved in the tissues of the axillary, thoracic and subclavian regions;
- IV: The tumor and metastases affect the entire female organism.
Diagnostics
To diagnose breast cancer, a number of instrumental and laboratory studies are carried out:
- (x-ray system method of the mammary glands);
- (under his control, they often carry out aspiration and puncture biopsy);
- NMR-visualization;
- , which gives the specialist not only about the anatomical structure of the tumor, but also on the nature of the metabolic processes occurring in the lesion focus;
- In suspected of breast cancer, it can be: aspiration, excision, stereotactic (puncture biopsy is performed with a thin needle, a trepan biopsy - with the use of trepan: needles with a wide lumen);
- laboratory test for hormonal receptors.
The video tells how to conduct self-examination of the mammary glands at home:
To identify the accompanying pathologies and remote metastases are carried out:
- x-ray organs of the chest cavity;
- ultrasound of adrenal glands, thyroid gland, ovaries;
- scan bone tissue.
Treatment
The leading method of therapy of benign tumors of the mammary glands is surgical treatment, and the scale of the intervention is determined exclusively with the size of the neoplasm. Fibroadomes of minor sizes are not removed, leaving the patient under dynamic observation.
In case of surgical treatment, a small tumor is subjected to:
With the help of hormone therapy, it seeks to reduce the content of estrogen in the female organism. A number of specialists recommend applying it prior to chemotherapy to confirm the sensitivity of the neoplasm to the action of hormonal drugs (, testolactone, testosterone, aminoglutortimide, Sustanon).
The treatment of each patient passes in strict accordance with the individual plan composed for it.
Palliative care
The breast cancer is resorted to cases where the chances of a complete healing of the patient with a launched disease are insignificant or when the methods of radical therapy cannot be applied.
If palliative care provides surgical intervention - only some tumor foci is removed if chemotherapy is carried out - a reduced dosage of drugs is prescribed.
The main goal of all therapeutic measures is the maximum extension of life and a significant improvement in its quality. If palliative care was rendered on time, it gives the patient a chance to live a few more years.
Observation after treatment
After the treatment is completed, the patient should stand on the dispensary accounting and undergo control examinations from the attending physician:
- in the first year - quarterly;
- next three years - every six months;
- five years after surgery Attending the doctor follows once a year.
The inspections are necessary to prevent the occurrence of relapses and to control the likely side effects.
After organizing operations, visits to the mammologist must be annual. If you suspect the doctor's recurrence, the doctor will appoint the necessary research. Upon confirmation of the relapse, a course of treatment is appointed, taking into account the localization of the tumor and therapy, applied before.
Oncology breasts in men
Men suffer from her a hundred times less often than women. Despite this, men's survival with breast cancer is significantly lower than women's. Similar to this is too late diagnosis of the ailment, unless manifests itself.
Male breast cancer is completely painless. The tumor is localized in the heart of the Nipple-Arelar zone. Mammography in this case is low-quality: it is possible to identify cancer only in the third and fourth stage. Much more effectively do ultrasound.
In this release, the video transmission "Live Great" says about the causes of breast cancer in men:
Methods for the treatment of male breast cancer are almost identical to methods used to treat women. During surgical treatment, a radical modified mastectomy is most often performed.
The breast cancer tumor in men is extremely sensitive to the effects of estrogen, therefore, in the occurrence of metastases and during the recurrence of tumor, patients are prescribed tamoxifen - a drug that has anti-estrogenic effects (akin to castration) is prescribed, so the need to remove the testicles in this case disappears.
The cancer of the first stage in men ends with 100% recovery. The five-year survival rate of the operated patients after radical mastectomy is more than 98%, ten-year-old - more than 94%.
Forecast for cancer
Five-year survival of patients with breast cancer:
- 1 stages - 70-96% ;
- 2 stages - 55-85% ;
- 3 stages - 15-50% ;
- 4 stages - no more than 10%.
Prevention
To reduce the risk of breast cancer or stop its development in the early stages, it is necessary:
- regularly carry out the self-sawing of the mammary glands;
- after reaching the forty-year age, visit the mammologist once every two years, after the fifty years - annually;
- in the presence of a family history, burdened by breast cancer, mammography make annually, starting from 35 years of age;
- in identifying suspicious symptoms, immediately access the doctor;
- do not give up long-term feeding of a child;
- control the weight, monitor the level of sugar;
- the choice of oral contraceptives to coordinate with the attending specialist (after the appropriate examination).
Why it is necessary to operate benign breast tumors, tells this video:
Breast Cancer (breast cancer) - Epithelial tumor emanating from the ducts or gland robes.
Daily 50 women in Ukraine is diagnosed with breast cancer. Every month about 750 women die from this disease. Breast cancer rarely occurs in women under the age of 20, and with increasing age, the number of cases increases. The peak of morbidity falls for the period of menopause and postmenopausal period. Unfortunately, in our country there is a high level of mortality from this disease, which is associated with the lack of screening programs for surveying the population and the late appeal of a woman to the doctor.
Historical Descriptions of breast cancer (chest)
Breast cancer is one of the most studied and studied forms of cancer. The oldest known descriptions of breast cancer (although the term "cancer" has not yet been known and was not used) was found in Egypt and dates back to about 1600 BC. The so-called "Papirus Edwit Smith" describes 8 cases of tumors or ulcerations of the breast, which were treated with flaming fire. Text says: "There is no treatment from this disease; She always leads to death. " At least one of the eight cases of breast cancer described in the papyrus appeared in a man.
For centuries, doctors described such cases in their practice with the same sad conclusion. No shifts in the treatment of breast cancer did not occur until in the XVII century, doctors did not achieve a better understanding of the work of blood and lymphatic systems of the body and could not understand that breast cancer spreads (metastasis) on the lymphatic paths and first Amming the nearest - axillary - lymphatic nodes. The French surgeon of Jean-Louis Petit (1674-1750) and shortly after it, the Scottish surgeon Benjamin Bell (1749-1806) was the first to have guessed to remove when breast cancer not only the milk gland itself, but also the nearest lymph nodes and the chest muscle to be chest. Their successful work was picked up by William Steuward Hood, who in 1882 introduced into broad medical practice a technically improved version of this operation, which he called "radical mastectomy". The operation has become so popular with breast cancer, which even got a name by the name of its inventor - "Mastectomy Holvlated" or "Mastectomy on Holvolstom".
Currently, the expression of various genes in the breast tumors has been studied and various molecular tumor types are highlighted. Clinically, they have a significantly different risk of development of metastases and require different therapy. The collection of data on expression of 17816 genes in breast tumors is available online and is used not only for medical and biological research, but also as a classic test example for visualization and cartography of data.
According to the US Cancer Institute, with timely discovery, breast cancer can be cured of 98.1% of women!
What provokes / causes breast cancer (breast cancer):
Risk factors for breast cancer (breast cancer)
age more than 40 years;
high level of estrogen in the blood;
The presence of relatives of the 1st line (mother, sister, aunt, grandmother), sick breast cancer;
reception of hormonal drugs in order to contraception or regulation of the menstrual cycle, replacement hormone therapy in menopause;
first pregnancy over the age of 30;
previously suffered cancer of the ovary or breast;
Contact with radiation sources;
Changes in the mammary gland, tracked by a doctor as the occurrence of atypical epithelial hyperplasia. Despite the fact that fibrous-cystic mastopathy is not a prejudition state, atypical changes in breast duct epithelium increase the risk of breast cancer;
lack of childbirth and pregnancies;
Endocrinological and exchange disorders (thyroid disease, obesity);
Early start of menstruation (up to 12 years) and / or later the beginning of menopause;
Increased consumption of oily food.
In the development of breast cancer, preceding pathological processes in its tissues play a significant role, mainly repeated dormsal hyperplasia with the formation of foci fibrous-cystic mastopathy (fibroadenomatosis). The causes of these changes in the tissue of the breast are a number of endocrine disorders, often due to the accompanying diseases of the ovaries, repeated abortions, the incorrect feeding of the child, etc. The risk increases with increasing the size of the gland. Some of the importance in the development of breast cancer can have anatomy-embryological deviations - the presence of additional robes of iron tissue, as well as preceding benign tumors - breast fibroadenomes. All these formations, regardless of their tendency to malignant transformation, are to be removed, for sometimes they are difficult to distinguish with sufficient confidence from the starting cancer.
Pathogenesis (what is happening?) During breast cancer (breast cancer):
According to the histological structure of the mammary cylinder glands, it is more common to adenocarcinoma or solid cancer with a multitude of transitional forms. Distinguished and lolk cancer presented by infiltrating and non-indemnitative forms.
It should be noted that, in addition to cancerous tumors, in lactic glands, it is extremely rare (in just 1% of cases), ne-absorious malignant tumors - sarcoma may occur, in the diagnosis and treatment of which there are no fundamental differences from cancer.
Breast cancers are classified by the presence or absence of ERC (the state of estrogen receptors). The state of the ERC can wholely change the course of the disease. Ertz-positive tumors are more often celebrated in postmenopausal (after the occurrence of Klimaks). About 60-70% of the primary breast cancers characterizes the presence of ERC. ERC-negative tumors are more often observed in patients in premenopause (before the onset of Klimaks). The state of estrogen receptors affects the choice of treatment tactics.
Metastasis
Lymph current, which is very developed in breast tissue, tumor cells are transferred to lymph nodes and give initial mstast. First of all, the axillary, subclavian and tumor groups of nodes are affected, and when the tumor is located in media quadrants, the chain of parasonal lymph nodes. The next stage, metastasis is in the necessary, cervical and mediastinal lymph nodes, as well as crosswise into the opposite axillary depression. There is an intersection metastasis in the second milk gland. In some cases, metastases in the axillary lymph nodes appear earlier than the tumor is found in the mammary gland, and then first of all it is necessary to exclude the cancer defeat.
The hematogenic method of metastase occurs in the lungs, pleura, liver, bones and brain. For bone metastasis, the defeat of the spine, the plane bones of the pelvis, ribs, skulls, as well as the femoral and shoulder bones, which is first manifested by non-permanent noving pains in the bones, in the future taking persistent painful nature.
Symptoms of breast cancer (breast cancer):
Localization of cancer tumors in dairy glands is the most different. Equally often affected both the right and left gland; Approximately 2.5% are double-sided milk glands. A node in the second gland can be both metastasis and the second independent tumor.
In the breast itself, most often (approximately 1/2 patients) tumors occur in the upper-outer quadrant, sometimes at the very edge of it on the border with the armpit.
Unfortunately, the obvious manifestations of breast cancer appear, as a rule, already when the tumor forms are running. As a rule, these are dense painless formations in lactic glands. When germinated into the chest wall, the tumor and all iron becomes fixed. And when germinating a tumor on the skin - it is deformed, retracts, is ulcerated, the nipple is drawn. The manifestation of cancer can be the discharge from the nipple, as a rule, bloody. When the process is distributed into lymph nodes, they increase, which can cause discomfort in theoremp.
In addition to the usual clinical picture of breast cancer, its special shapes are distinguished: a mastic-like shape, a grid-like shape, carbon cancer and a peak cancer.
Mastito-like cancer It has a rapid flow with a sharp increase in the breast, its edema and soreness. The skin is tense, hot to the touch, reddish. The symptoms of this form of cancer are similar to the sharp mastitis that young women, especially on the background of transferred births, often entails heavy diagnostic errors.
Rozhist-like form Cancer is characterized by the appearance of a sharp redness on the skin of the gland, sometimes spreading out of its limits, with uneven gear edges, sometimes with a high rise temperature. This form can be accepted for conventional silent inflammation with the appropriate appointment of various physiotherapy procedures and medicines, which leads to a delay in proper treatment.
Third form - pancar cancer It arises due to cancer infiltration on the lymphatic vessels and skin slots, which leads to a bug-sized thickening of the skin. It is formed as if a dense shell, covering half, and sometimes all the chest. The flow of this form is extremely malignant.
A special form of a plane lesion of a nipple and areal represents cancer Padzta. In the initial stages appear peeling and the moisture of the nipple, which is often taken for the Ekla. In the future, the cancer tumor is propagated by the ridges into the tissue, forming its typical cancer node in the tissue with a metastatic lesion of lymphatic nodes. Padpet cancer proceeds relatively slowly, sometimes for several years, limited only by the damage to the nipple.
In general, the course of breast cancer depends on many factors and primarily from the hormonal status and age of a woman. In young, especially against the background of pregnancy and feeding, it proceeds very quickly, early giving remote metastases. At the same time, the old women may exist for 8-10 years without tendency to metastasis.
When you need to consult a doctor:
You discovered a seal in the chest;
There are allocations from nipples;
Breast leather changed ("citric crust", retraction, redness, swelling);
The nipple has changed (the bleeding wound appeared).
In the early stages, the main manifestation of breast cancer is the presence of volumetric education in the breast, detected during mammography, ultrasound or other research methods, or the woman itself (much less often, and, mostly in women with a small breast). But it is necessary to understand that to detect a tumor characterized by diffuse growth (not having a dense part), it is impossible without special instrumental methods. Regular prophylactic surveys 1 time per year in most cases sufficient to identify the RMW in the early stages.
Diagnosis of breast cancer (breast cancer):
Modern diagnostic methods used all over the world are the key to successful treatment. As a result of a comprehensive diagnosis, the doctor becomes clear how common is the process. Then he can choose the optimal treatment tactics for each patient. Diagnostic methods can be divided into 3 groups:
Methods Visualization of breast cancer (breast cancer):
X-ray (mammography);
ultrasonic;
Magnetic tomography method (MRI).
Mammography is the most informative diagnostic method.
Diagnostic biopsy
To form an accurate diagnosis, it is necessary to carry out a biopsy. Biopsy is a minimally invasive method - allows you to take a plot of suspicious fabric for histological examination before the start of treatment. Pathological research determines the type of tumor, and immunohistochemical tests allow you to determine the hormone-dependence of the tumor (i.e. the presence of estrogen and progesterone receptors, as well as the presence of receptors to Her2neu), because Hormonal status affects the prognosis and selection of treatment. All necessary types of biopsies are held in our hospital, including a high-tech stereotactic biopsy for Ukraine. Special installation allows you to very accurately and practically painlessly take a study, and sometimes remove completely, the formation of 1 mm size. Procedures are performed with anesthesia in outpatient conditions, no special preparation before carrying out such manipulations is required.
Additional studies for breast cancer
ultrasound examination of the abdominal organs;
lung radiography;
Computed tomography of the abdominal and chest organs;
scintigraphy (radioisotope study) skeleton ;;
generalization analyzes and surveys;
The study of lymph nodes before the start of treatment.
These studies are carried out to assess the prevalence of the tumor process in the body, the presence or absence of metastases in lymph nodes or other organs. They also characterize the overall condition of the body, concomitant pathology, which can also affect the choice of treatment.
Treatment of breast cancer (breast cancer):
In the last decade, world cancer has been achieved in the treatment of breast cancer. The basis of successful treatment is an integrated approach - the optimal combination
surgical;
chemotherapeutic;
radiotherapy steps.
Tactics of treatment is chosen jointly by clinical oncologists, surgeons, radiotherapists. If necessary, the plastic surgeon is attracted to this, in advancely participating in the planning of the optimal operation or in the execution of its plastic stage.
The choice of the treatment method is influenced by the type of tumor, its size, the presence of metastases, individual characteristics of each patient. The earlier the tumor was found than the smaller distribution of the disease - the easier, in short, cheaper and more efficient treatment.
Until recently, the classic approach was considered to be the surgical removal of the tumor together with all the breasts and paths of lymphottock - regional lymph nodes (mastectomy) with subsequent possible conduct of chemotherapy or hormone therapy. However, modern approaches to surgical treatment have changed significantly. Many studies have been proved by the possibility of more "conservative" treatment. It is not always necessary to remove all the milk gland and all lymph nodes. If the tumor is small, it is enough to remove it only, retreating within the limits of healthy tissues about 1 cm (so-called lamectomy), and carry out postoperative irradiation of the breast. Such tactic gives results, absolutely similar mastectomy, but allows you to preserve the milk gland.
Full lymphodissection, i.e. The removal of all lymph nodes from the breast lymphottock zone is necessary only if they are involved in the tumor process. If, according to surveys, the lymph nodes are not increased, and the likelihood of their lesion is maintained, then it is possible to study the so-called. "Watchtime" lymphatic node. This node first gets lymph from the tumor zone and is the first in which metastases develop. If the metastase node is not detected in the "watchdog", the probability of their propagation into other nodes does not exceed 2-3%. Thus, exploring the state of the watchdog lymph node, we can judge the state of all other lymph nodes, and save many patients from the traumatic operation and the possible complications associated with it.
The procedure for identifying a guard lymph node is actively used throughout the world and is a standard in determining the prevalence of the tumor process with good remote results. Unfortunately, for Ukraine, this method is unique.
After removal of the breast or part of it, reconstruction is possible, i.e. Restoration of its shape and volume. This performs a plastic surgeon during the primary operation (simultaneous reconstruction) or after the end of the entire course of treatment (deferred reconstruction). Recovery is possible by three basic methods:
Plastic with own fabrics taken from other parts of the body (as a rule, is the stomach, less often - back). In this case, the correction of the figure is possible;
plastic artificial implant;
The combination of both methods.
The task of chemotherapy is the destruction of tumor cells not only in the main focus, but in the whole body. Tumor disease is initially considered as systemic, i.e. The trend towards distribution is metastasis - immediately in all systems and organs. In the early stages, the probability of distribution is not high, and if it happens, then at the level of individual cells. They cannot be found in modern methods of surveys, but it is possible to destroy chemotherapeutic means. The smaller the tumor cells in the body, the easier and more effectively achieve a positive result. Therefore, local treatment - directly on the tumor - surgical or radiation, is almost always complemented by systemic - chemotherapy. This greatly improves the results and, most importantly, the survival rate of the patients.
Chemotherapy It can be assigned both before and after the operation. The purpose of chemotherapy before the operation is to reduce the size of the primary tumor. In this case, conditions are created for radical removal of the tumor while preserving the breast - Limpectomy.
Adjuvant chemotherapy begin 2-3 weeks after surgery. The most commonly used MDC regime (cyclophosphane -100 mg / m2 orally, 1-14th days in combination with methotrexate - 40 mg / m2 V / v, 1-and 8th days and 5-fluororation-scrap - 500 mg / m2 in / in, 1st and 8th days; intervals between courses - 2-3 weeks, the number of courses is 6). With a high content of RE and / or RP during menopause, there is additionally given tamoxifen (20 mg daily for 2 years), and with a stored menstrual cycle, an ovariectomy is produced, then tamorsifens (20 mg) or prednisone (10 mg) are long. With menopause more than 10 years and high levels of RE, adjuvant therapy can be carried out only by tamoxifen.
In the development of remote metastases at various stages of the disease, the main therapeutic meaning is of drug therapy. Chemotherapy modes should include adriamycin:
1) Adriamycin (20 mg / m2 V / in, 1 -th, 8th and 15th days) in combination with methotrexate (20 mg / m2 V / in, 1st day), 5-fluorouracyl (500 mg / m2 V / in, 8th day) and cyclophospham (400 mg / m2 V / in the 15th day); 2) adreamicine (40 mg / m2 V / in, 1st day) in combination with cyclophosphane (600 mg / m2 V / in, 1st day); 3) Adriamycin (30 mg / m2 V / in, 1st and 8th days) in combination with 5-fluorouracil (500 mg / m2. 1st and 8th days) and cyclophosphane (100 mg / m2 orally , 1-14th days); 4) Adriamycin (60 mg / m2, in / in, 1st day) and vincristine (1.2 mg / m2,1st and 8th days). Treatment courses are carried out every 4 weeks. There are no clear evidence of differences in the effectiveness of these modes.
In resistance to the CMF and adriamycin, partial regression can be obtained using mitomycin C, cisplatin, vinblastine. An independent value is to use thiophosphamide (20 mg / m 3 times a week for 3 weeks), however, such treatment significantly reduces hemopoiesis reserves. More often thiophosphamide is injected into the cavity of the pleural (30-50 mg) after removal of the exudate.
Tamoxicon occupies a leading place in the endocrine therapy of breast cancer. Prescribed it with positive or unknown receptors orally, 20 mg / day long. With an insufficient Effect of Tamoxifen, it is advisable to use Aminogluthemid (Orimet) - 500 mg / day from a cortisone acetate - 50 mg / day daily for a long time. Keep the therapeutic importance of androgens (testosterone or a medotertron Propionate-100 mg per / m daily or every other day; Omnadren, prolotone - 3 times a month). With a high level of RE, drug therapy can be started with endocrine drugs, and in the future is supplemented with cytostatic drugs.
Radiotherapy or radiation therapy for breast cancer It is used mainly in three cases:
To reduce the probability of recurrence after the excision of the tumor in the breast and after removal of the affected lymph nodes;
For symptomatic (palliative) treatment of unsaluble tumors, in the case of the development of complications - ulceration, bleeding;
For palliative treatment of remote metastases, if they cause severe complications - compression of the head or spinal cord, expressed by pain syndrome, etc.
Forecast for breast cancer The prediction depends on the process stage, the speed of its flow and age of patients. In the running stages, life expectancy is 2-3 years. Early diagnosis of breast cancer ensures successful treatment of most patients. Five-year survival in the treatment of localized form I-II stage is 90%, with a local prostinal cancer - 60%. The results of treatment are much worse in the presence of remote metastae.
Prevention of breast cancer (breast cancer):
Breast cancer prevention It is primarily in timely deliverance of patients from precancerous seals in lactic glands, as well as in compliance with the normal physiological rhythm of the life of a woman (pregnancy, feeding) with a reduction to a minimum of the number of abortions. In the diagnosis of breast cancer, systematic independent surveys are important (see the Machine Self-Excidation Station) and annual preventive medical examinations of women over the age of 40. Mammography is recommended 1 time in 2 years aged after 40 years, 1 time per year - after 50 years. Women relating to risk groups recommended annual mammography since possible early age.
Earlier Detection of breast cancer
The simplest and most affordable method of prevention, however, is the least effective, is self-examination - inspection of the host of the dairy gland itself. This procedure allows you to reveal a tumor at an early stage. Self-examination is carried out once a month. First, inspection in front of the mirror. The following signs should be a mandatory reason to appeal to the doctor:
skin retraction
visually defined education
Changes resembling "Lemon Cork".
Then take feeling. When the seals are detected or the heterogeneity of the structure of the gland, the discharge from the nipple - should contact an oncologist.
The most effective method of breast cancer prevention is screening.
Breast Cancer Screening
Screening is a planned survey of a healthy population in order to identify the earliest forms of the tumor. Breast cancer screening procedures are very simple and painless. So, women are recommended, depending on age, carry out:
In 20 - 39 years - self-examination of the breast monthly, annually ultrasound (ultrasound research), especially if a woman is included in the risk group;
once aged 35-39 years old to perform mammography;
From 40 years - self-examination monthly, every year - mammography.
When choosing a hospital to pass the screening, it is important to remember that in the early stages, cancer is very weak or does not show itself, so it is very important to:
1. Screening conducted a high-class specialist who knows how to detect even the most minor signs of the disease;
2. Equipment that is used for screening was highly accurate and complied with modern standards of world oncology;
3. The hospital provided comprehensive and efficient oncological assistance.
What doctors should contact if you have breast cancer (breast cancer):
Does something bothers you? You want to learn more detailed information about breast cancer (breast cancer), its causes, symptoms, methods of treatment and prevention, course during the course of the disease and observance of the diet after it? Or do you need an inspection? You can make an appointment to the doctor - Clinic Euro.lab always at your service! The best doctors will examine you, learn external signs and will help determine the disease in symptoms, you will advise you and provide the necessary assistance and make a diagnosis. you also can call a doctor. Clinic Euro.lab Opened for you around the clock.
How to contact the clinic:
Phone of our clinic in Kiev: (+38 044) 206-20-00 (multichannel). The secretary of the clinic will select you a convenient day and an hour of visiting to the doctor. Our coordinates and travel scheme are indicated. Look more detailed about all clinic services on it.
(+38 044) 206-20-00
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Other diseases from the group oncological diseases:
| Adenoma pituitary gland |
| Adenoma Parasitovoid (Porish-shaped) glands |
| Adenoma of the thyroid gland |
| Aldosteroma |
| Angome Glotka |
| Angiosarcoma liver |
| Astrocitoma brain |
| Basal cell cancer (basaloma) |
| Bovenoid Papulse Semi |
| Bowen's disease |
| Pedge's disease (breast nipple cancer) |
| Hodgkin's disease (lymphogranulomatosis, malignant granuloma) |
| Intrapral Tooth Hemispheres Brain |
| Hairy PC Polyp |
| Ganglia (ganglionevrom) |
| Ganglionever |
| Hemangioblastoma |
| Hepatoblastoma |
| Herminoma |
| Giant Kondyloma Bushke-Levenshtein |
| Gyoblastoma |
| Glywa brain |
| Glioma optic nerve |
| Gliwa Hiazma |
| Glomes tumors (paragalioma) |
| Hormonian-inactive adrenal tumors (incidental) |
| Mushroom-shaped micaosis |
| Benign Tumors of Glotka |
| Benign tumors of optic nerve |
| Benign tumors of pleura |
| Benign oral tumors |
| Benign tumors of language |
| Malignant front media formation |
| Malignant neoplasms of the mucous membrane of the nasal cavity and the apparent sinuses |
| Malignant tumors of pleura (Cancer Plevra) |
| Carcinoid syndrome |
| Cysts mediastia |
| Seat horn penis |
| Corticosteroma |
| Kosya-forming malignant tumors |
| Bone marrow malignant tumors |
| Cranephorgioma |
| Leukoplakia penis |
| Lymphoma |
| Lymphoma Berkitta |
| Thyroid lymphoma |
| Lymphosarcoma |
| Macroglobulinemia Valdenstrema |
| Medulovoblastoma brain |
| Mesothelioma peritoneum |
| Mesothelioma malignasy |
| Mesothelioma Pericarda |
| Mesothelioma pleura |
| Melanoma |
| Melanoma conjunctiva |
| Meningoma |
| Meningioma optic nerve |
| Multiple myeloma (plasmocyte, myeloma disease) |
| Nevnoma Gotka |
| Nevnoma of auditory nerve |
| Neuroblastoma |
| Non-Hodgkin Lymphoma |
| Registering xerotic balanitis (sclerosing Lichn) |
| Tumor-like lesions |
| Tumors |
| Tumors of the vegetative nervous system |
| Pituitary tumors |
| Tumors of bones |
| Tumors of the frontal stuff |
| Cerebellum tumors |
| Tumors of the cerebellum and IV ventricle |
Breast cancer is malignant rebirth and uncontrolled growth of breast epithelium cells, one of the most dangerous and common diseases of women is rarely detected in men.
The high level of incidence of women is associated with the role of estrogen, progesterone, other hormones on the stages from Menarche to menopause, pregnancy periods ,. The risk of development of oncology does not depend on the size of the chest
Symptoms of breast cancer
Non-specific signs of breast cancer, when identifying which it is advisable not to delay in the treatment institution for consultations:
Progressive body weight loss. How to determine? Reducing the mass of the preserved, in a row more than three months (attention! The dynamics of the mass decline is individual for each person), on the background of familiar physical exertion, without the use of low-calorie diets.
Persistent and stable rash, peeling on the chest.
dynamic rash development;
different stages of rash (starting, ripening, healing);
by reducing or on the contrary, an increase in their quantity.
Change the shape of a nipple. Norm only during lactation, with breast feeding.
Increasing births in the chest area. It should be alerted when growing moles, combined with the discharge of nipples.
Pain in the axillary region. One of the reasons for the inflammation of the lymph node, it is advisable to exclude the cause.
Almost always breast cancer associates with the development of nodule seals, neoplasms. Indeed, this is so. However, some forms accompanied by seals in the chest are not oncology, although part is capable of malignancy (malignant reincarnation). There are forms, for a long time that are not manifested by neoplasms.
Previously, mastitis, nodules, diffuse mastopathy, fibrotomans for which focal or spilled chest tissues are being formed.
There are other pathologies, with iron damage, also diagnosed in different stages and periods:
Galactocele or dairy cyst. It is formed after the blockage of the dairy duct, as a consequence of acute. In the cyst, stagnant milk accumulates, conmenced (fluctuating) swelling is formed.
Chest injury. This is meant, scratching or similar. It is manifested with improper application of a baby, an infection. Accompanied by the formation of hematoma (bruise).
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Suspicions of the preclinical and the results of clinical examination are confirmed by the methods of instrumental and laboratory diagnostics.
Previously described in more detail about the symptoms detected by instrumental methods, their diagnostic value (), including:
radiation (mammography, CT);
ultrasound and magnetic radiation (ultrasound, MRI).
The main disadvantage is subjectivism, evaluating the results of X-ray mammography and ultrasound, depending on the qualifications of doctors. Much higher quality of the results on the CT is the type of X-ray study, and the MRI is the type of magnetic radiation.
In recent years, high efficiency of the diagnosis of early stages, methods:
contrast MSCT (multispiral computed tomography) - 3D image, topographic tumor binding to anatomical formations, examination of the entire body, which allows the doctor to choose a treatment program.
PET-CT (positron emission tomography and computed tomography) - combines the advantages of X-ray study with topographic binding and identifying the nature of pathophysiological processes in the tumor and around.
Infrared mammography - the method is based on the increased sensitivity of cancer cells, in comparison with healthy tissues, to penetrating heat rays, construction, on this basis, three-dimensional image of the chest with foci of oncoclecks. It is reported on the high sensitivity of the method, up to 90% of the correct diagnosis of the first stage of breast cancer.
Methods have elevated, compared with other methods, diagnostic value. Are not painful procedures, minimally affect the body, the results of objective analysis are presented in the form of a three-dimensional image, the results are carried out and are executed for a short time, fixed on any media including computer.
The disadvantage is the relatively high cost of surveys, including abroad, queues for quotas for free examination.
Differentiation of breast cancer forms in a cellular and fabric level. Methods are used:
cytological (tumor cells) research;
histological (ultra-thin sections of tumor tissue) research.
Samples are obtained as a result of biopsy - a lifetime excision of pieces of breast tissues.
Definition, microscopic characteristics of the tumor, is necessary to establish:
forms of pathology (breast cancer forms differ in growth aggressiveness);
tactics (Programs) of therapeutic measures (differ in sensitivity to the effects of drugs);
the forecast of the likely outcome of the disease (differ in the probability of relapses).
Definition of symptoms on monackers
Early symptoms can be defined long before the clinical manifestations of the disease using immunological methods.
The definition of oncomarcresses using PCR (polymerase chain reaction) is in vitro (in the tube) technology of help finding complementary to each other:
antibodies - (standardized DNA fragment of the breast tumor molecule - oncomarker, its commercial designation Ca 15-3);
antigens - (native breast cancer oncocletes circulate in the patient's blood, have capture receptors to Ca 15-3).
As a result of the PC technology, when mixed, in the wells of the tablets of the device containing samples (Ca15-3 + human blood), the following results confirming or excluding the disease are possible:
Confirmation of oncology. The complex is formed by the type "" antibody-antigen ".
Execution of oncology. The immune complex "" Antibody-antigen "is not formed.
The results are easily read by detectors built into the hardware complex of the device.
Using PCR also distinguish tumor growth tumor growths:
ER - estrogen receptor;
PR-progesterone receptor;
Her 1 or Her 2 - receptors to the growth factors of the oncoclettas.
The problem is that not all forms of cancer want to obey the simplified laws of immunology - the complimentaryness of receptors of specific antigens and antibodies. There are information about false positive and falsely negative results. Cancer cells are successfully fighting with the immune system of a sick person, suppressing it, directing the answer to the false track. This is the cunning of most forms of cancer.
Breast cancer is classified according to various principles. In this text, we will not specify the forms of cancer.
Previously described the main forms of pathology:
primary registration of the patient, collecting anamnesis of life and illness, traditional methods of examination (inspection, palpation, percussion, auscultation, thermometry);
x-ray study (mammography and radiography of the organs of the chest);
Ultrasound of the mammary glands in various modifications with an additional examination (liver);
SCINCigraphy - the method of radioisotope visual diagnosis of metastases in bone tissue, it is known to apply the methodology for other medical purposes;
hormone-dependent;
three times negative;
luminal cancer;
In addition, we will list the methods of standard research used in the clinical practice of diagnosing breast cancer, namely:
Other diagnostic techniques are appointed according to the testimony, taking into account the technical capabilities of the medical institution. Laboratory studies of biological fluids (solid, stabilized blood, serum, other) for morphological, biochemical, other indicators are auxiliary, mainly to clarify the state of the patient's body.
Education: He graduated from the redemption in the "Russian scientific oncological center them. N. N. Blokhin "and received a diploma in the specialty" Oncologist "
In the lactation period:
At any stage of life, more often in the older age group:
Breast cancer (carcinoma) - the most common malignant tumor of the mammary glands.
The disease is characterized by high prevalence. In developed countries, it occurs in 10% of women. European countries leading. The smallest prevalence of breast cancer is marked in Japan.
Some epidemiological data about breast cancer:
- most of the cases of the disease are registered at the age of 45;
- after 65 years, the risk of breast carcinoma increases 5.8 times, and compared with young age (up to 30 years) increases 150 times;
- most often, the lesion is localized in the upper outer part of the breast, closer to the axillary depression;
- 99% of all patients with carcinoma of the breast - women, 1% - men;
- describes single cases of disease in children;
- mortality for this neoplasm is 19 - 25% of all other malignant tumors;
- today, breast cancer is one of the most common tumors in women.
Currently there is an increase in incidence worldwide. At the same time, in a number of developed countries there are trends to decline due to well-organized screening (mass examination of women) and early detection.
Causes of breast cancer
There are a large number of factors contributing to the development of carcinoma of the mammary glands. But almost all of them are associated with two types of disorders: amplification of the activity of female sex hormones (estrogen) or genetic disorders.Factors raising the risk of breast cancer:
- female;
- unfavorable heredity (the presence of cases of disease in close relatives);
- the beginning of the monthly earlier than 12 years or their ending after 55 years, their presence for more than 40 years (this indicates an increased activity of estrogen);
- lack of pregnancy or its offensive for the first time after 35 years;
- malignant tumors in other organs (in the uterus, ovaries, salivary glands);
- various mutations in genes;
- the effect of ionizing radiation (radiation): radiation therapy for various diseases, accommodation in the area with an increased radiation background, frequent fluorography with tuberculosis, professional harm, etc.;
- other diseases of the mammary glands: benign tumors, nodal forms of mastopathy;
- the action of carcinogens (chemicals that are capable of provoking malignant tumors), some viruses (as long as these moments are weakly studied);
- high growth of women;
- low physical activity;
- alcohol abuse, smoking;
- hormonal therapy in large doses and for a long time;
- constant use of hormonal drugs for contraception;
Usually, malignant tumors of the mammary glands are characterized by inhomogeneity. They consist of different types of cells that multiply in different rates react differently to treatment. In this regard, it is often difficult to predict how the disease will develop. Sometimes all the symptoms grow rapidly, and sometimes the tumor grows slowly, without leading to noticeable disorders for a long time.
The first signs of breast cancer
Like other malignant tumors, breast cancer at an early stage is very difficult to detect. For a long time, the disease is not accompanied by any symptoms. His signs are often discovering by chance. Symptoms in which you need to immediately consult a doctor:
- pain in the mammary gland, which does not have visible reasons and is preserved for a long time;
- feeling of discomfort for a long time;
- seals in the mammary gland;
- change in shape and sizes of breast, swelling, deformation, appearance of asymmetry;
- pacific deformation: most often it becomes drawn;
- selection of nipple: bloody or yellow;
- skin changes in a certain place: it becomes drawn, it starts to peel or shriven, its color changes;
- sneakers, wpadin, which appears on the breast, if you raise your hand up;
- an increase in lymph nodes in the axillary depression, above or under the clavicle;
- punching in the shoulder, in the field of breast.
- Regular self-examination. A woman should be able to correctly inspect her chest and identify the first signs of malignant neoplasm.
- Regular visit to the doctor. It is necessary to inspect the mammologist (specialist in the field of diseases of the mammary glands) at least once a year.
- Women after 40 years is recommended to regularly pass by mammography - X-ray examination directed to the early detection of breast cancer.
How to inspect the chest yourself?
An independent inspection of the dairy glands takes about 30 minutes. It needs to be done 1 - 2 times a month. Sometimes pathological changes are not felt immediately, so it is advisable to keep a diary and celebrate data in it, their feelings on the results of each self-image.The inspection of the mammary glands should be carried out by 5 - 7 days of the menstrual cycle, preferably in the same days.
Visual inspection
It is necessary to do in a warm bright room, in which there is a mirror. Undress to the belt and stand exactly opposite the mirror, so as to see the chest well. Relax and align your breath. Pay attention to the following points:- is it symmetrically located right and left dairy glands?
- does one milk iron not increased compared to the other (it is worth remembering that the size of the right and left milk glands may vary slightly)?
- is the skin look normally, did not suspicious areas appear with the changed appearance?
- are nipples normally?
- is nothing more suspicious noticed?
Feeling
Turning the chest can be carried out in the standing position or lying as more convenient. If there is an opportunity, it is better to do this in two positions. The examination is carried out by the tips of the fingers. The pressure on the chest should not be too strong: it should be sufficient to feel changes in the contestation of the mammary glands. First, they feel one milk gland, then the second. Start from the nipple, then move the fingers of the bed. For convenience, it is possible to sweep in front of the mirror, conventionally dividing the milk gland to 4 parts.
Moments to pay attention to:
Total contestation of the mammary glands - did it be more dense from the past inspection?
- the presence of seals, nodes in the tissue of the gland;
- the presence of changes, seals in the nipple;
If changes are detected, it is necessary to contact one of the specialists:
With the help of self-image, it is possible to reveal not only breast cancer, but also benign neoplasms, mastopathy. If you discovered something suspicious, then it still does not speak about the presence of a malignant tumor. Accurate diagnosis can be installed only after the survey. For the purpose of early diagnosis of breast cancer, women older than 40 years are encouraged by three studies annually:
- Mammography - X-ray breast photographs. Reveal the available seals in the tissue. The modern method is digital mammography.
- Determining the level of female genital hormones - estrogen. If he is high - there is an increased risk of breast cancer.
- Oncomarker Ca 15-3 is a substance that is produced by chest carcinoma cells.
Symptoms and appearance of various forms of breast cancer
| Nodal form of breast cancer | In the thickness of the breast, a painless dense education is tested. It can be rounded or have an irregular shape, growing evenly in different directions. The tumor is fasting with surrounding fabrics, so when a woman raises his hands, in the breast in the appropriate place is formed. The skin in the tumor area is wrinkled. In the later stages, its surface begins to resemble a lemon crust, ulcers appear on it. Over time, the tumor leads to an increase in the breast in size. What does the knot form of breast cancer look like? |
| Father-infiltrative form | This breast cancer form is most often found in young women. Painful sensations are most often missing or weakly expressed. There is a seal that occupies almost the entire volume of the breast. Symptoms:
 |
| Pancar cancer | The tumor germinates through all the glandular tissue and fat fiber. Sometimes the process goes to the opposite direction, on the second milk gland. Symptoms:
|
| Cancer Pedge | The special form of breast cancer is found at 3 - 5% of cases. Symptoms:
|
Chest cancer degrees
The degrees of cancer of the mammary glands are determined by the generally accepted TNM system, in which each letter has the designation:- T - the state of the primary tumor;
- M - metastasis to other organs;
- N - metastases in regional lymph nodes.
| Degree of tumor process | Main characteristics |
| T X. | The doctor does not have enough data to estimate the tumor state. |
| T 0. | The tumor in the breast is not detected. |
| T 1. | A tumor having a diameter of no more than 2 cm in the largest dimension. |
| T 2. | Tumor having a diameter from 2 to 5 cm in the largest dimension |
| T 3. | Tumor size more than 5 cm. |
| T 4. | The tumor germinating into the wall of the chest or skin. |
| N. |
|
| N X. | The doctor does not have a sufficient number of information in order to assess the condition of lymph nodes. |
| N 0 | There are no signs indicating the distribution of the process into lymph nodes. |
| N 1. | Metastasis B. middle Lymph nodes, in one or more. In this case, the lymph nodes are not laughing with skin, easily shifted. |
| N 2. | Metastases in the axillary lymph nodes. At the same time, the nodes are fasting among themselves or with the surrounding tissues, they are disappeared with difficulty. |
| N 3. | Metastasis B. occonditional lymphatic nodes On the side of the defeat. |
| M. |
|
| M X. | The doctor has no data that would help judge the tumor metastasis in other organs. |
| M 0. | Signs of metastases in other organs are absent. |
| M 1. | The presence of remote metastases. |
Of course, only a doctor may receive a tumor to some other stage by the TNM classification after the survey. From this will depend on the further tactics of treatment.
Classification depending on the location of the tumor:
- breast skin;
- nipple and arole (skin around the nipple);
- the upper inner quadrant of the breast;
- the lower inner quadrant of the breast;
- upper outer quadrant of breasts;
- lower outer quadrant of breasts;
- rear axillary part of the breast;
- the location of the tumor cannot be clarified.
Diagnosis of breast cancer
Inspection
The diagnosis of malignant breast tumors begins with an inspection of an oncologist or mammologist. During inspection, the doctor:
- in detail asking a woman, it will try to get the most complete information about the course of the disease, factors that could contribute to its occurrence;
- it will inspect and palpation (feeling) of the mammary glands in the lying position, standing with lowered and raised hands.
Instrumental diagnostic methods
| Diagnostic method | Description | How is it held? | |
| Mammography - Diagnostic section that is engaged non-invasive (without cuts and punctures) study of the internal structure of the breast. | |||
| X-ray mammography | The X-ray study of the breast is carried out using devices generating low intensity radiation. Today, mammography is considered the main method of early diagnosis of malignant breast neoplasms. It has an accuracy of 92%. In Europe, X-ray mammography is compulsory regularly held in all women over the age of 45. In Russia, it is obligatory for women over 40 years old, but in practice it is not carried out. With the help of X-ray mammography, the tumors of 2 - 5 cm are best detected. An indirect sign of malignant neoplasm is a large number of calcinates - calcium salts clusters that are well contrasting in the pictures. If more than 15 are detected on cm 2, this is a reason for further survey.  | The study is carried out in the same way as ordinary radiography. A woman is exposed to the belt, leans to a special table, puts on it the dairy gland, after which they take a picture. The devices for X-ray mammography must comply with the requirements established by WHO. Types of X-ray mammography:
 |
|
| MRImmmography | MRImmmography - the study of the mammary glands using magnetic resonance tomography. Advantages of MRI mammography in front of x-ray tomography:
 | Before studying, it is necessary to remove all metallic items. It is impossible to take any electronics, since the magnetic field that generates the device can output it. If the patient has some metal implants (pacemaker, joint prostheses, etc.), you need to warn your doctor - this is a contraindication to the study. The patient is placed in the apparatus in a horizontal position. It must be in a fixed position during the entire study. Time is determined by the doctor. |
|
| Uzi -Mammography | Ultrasound examination is currently an additional method for diagnosing malignant neoplasms of the mammary glands, although it has several advantages over radiography. For example, it allows you to get pictures in different projections, does not adversely affect the organism. The main indications for the use of ultrasound diagnostics during breast cancer:
 | The methodology for carrying out no different from the usual ultrasound. The doctor uses a special sensor that applies to the breast. The image is broadcast on the monitor, can be recorded or printed. During the ultrasonic study of the mammary glands, Doppler and duplex scanning can be performed. |
|
| Computer volumemmography | The study is a computed tomography of the mammary glands. Advantages of computer volumemmography in front of x-ray mammography:
The study is worse than X-ray mammography, identifies small structures and calcinates.  | The study is carried out in the same way as the usual computed tomography. The patient is placed on a special table inside the apparatus. It must be stationary during the entire study.  |
|
| Biopsy - excision fragment of breast tissue, followed by studying under a microscope. |
|||
| Puncture biopsy | The accuracy of the technique - 80 - 85%. In 20 - 25% of cases receive a false result. | The fragment of the breast tissue for the study is obtained using a syringe or a special aspiration pistol. The procedure is carried out under local anesthesia. Depending on the thickness of the needle, two types of puncture biopsy are distinguished:
 |
|
| Trepanobiopia | The trunkobiopsy of the mammary glands is carried out in cases where it is necessary to obtain more material for the study. The doctor gets a fragment of the fabric of the breast in the form of a column. | Tpardobiopia is carried out using a special tool consisting of cannula with Mandren, which inserted a rod with a cutter. Intervention is carried out under local anesthesia. The surgeon makes an incision on the skin and enters through it a tool for trepalobiopsy. When the edge of the cutter reaches the tumor, it is pulled out of the cannula. With the help of the cannula, the tissue columns are cut, extract it. After receiving the material, the wound thoroughly coagulates to prevent the propagation of cancer cells. During research in the laboratory, it is possible to determine the sensitivity of tumor cells to steroid hormones (including estrogens including estrogens). It helps with the further selection of treatment tactics.  |
|
| Excision biopsy | Excius - complete tumor removal with surrounding tissues. All the mass is entirely sent to the laboratory for research. This makes it possible to detect tumor cells on the cutting boundary, study the tumor sensitivity to the sex hormones. | The surgeon removes the tumor with the surrounding tissues during the operation. Thus, the excision biopsy is both therapeutic, and diagnostic procedure. |
|
| Stereotactic biopsy | During stereotactic biopsy through one needle, samples are taken from several different places. | The procedure resembles the usual puncture biopsy. It is always carried out under the control of X-ray mammography. The needle is introduced into a certain place, get a sample, then they are squeezed, they change the angle of inclination and again introduced, now elsewhere. Get several samples, which makes the diagnosis more accurate. |
|
Laboratory breast cancer diagnostics methods
| Study | Description | Methodology |
| Definition in the Blood Overcomarcker Sa 15-3 (Sin: Carbohydrate Antigen 15-3, Carbohydrate Antigen 15-3, Cancer Antigen 15-3) | Oncomarkers are various substances that are determined in the blood with malignant neoplasms. For various tumors, their own oncomarkers are characteristic. CA 15-3 - antigen, located on the surface of the ducts of the mammary glands and secreting cells. Its content in the blood is increased in 10% of women with early stages of breast cancer and in 70% - with tumors accompanied by metastases. Testimony:
| For research, blood is carried out from Vienna. For half an hour before surrender, it is impossible to smoke. |
| Cytological study of the selection from the nipple | If a woman has a discharge from a nipple, then they can be sent to a laboratory study. When inspection under the microscope, tumor cells can be detected. You can also make a fingerprint of crusts formed on the nipple
| When studying the discharge from the nipple under the microscope, cells are detected characteristic of malignant tumor. |
Treatment of breast cancer
Methods for treating breast cancer:- surgical;
- chemotherapy;
- hormonal therapy;
- immunotherapy;
- radiation therapy.
Combined treatment is usually carried out using two or more methods.
Surgery
Surgical intervention is the main method of treating breast cancer. Currently, the oncologists are currently trying to perform less volumetric interventions, maximize the tissue of the breast, complementing the surgical methods of radiation and drug therapy. Types of surgical interventions for breast cancer:
- Radical mastectomy: Complete breast removal together with fatty tissue and nearby lymphatic nodes. This version of the operation is the most radical.
- Radical resection: Removal of the breast sector together with subcutaneous fatty tissue and lymph nodes. Currently, surgeons are increasingly preferred by this version of surgery, since radical mastectomy practically does not prolong the life of patients compared to resection. Intervention must complement radiation therapy and chemotherapy.
- Quadrantctomy - removal of the tumor itself and surrounding tissues within a radius of 2 - 3 cm, as well as a number of lymph nodes. This surgical intervention can be carried out only in the early stages of the tumor. The excised tumor is mandatory sent to the biopsy.
- Lampectomy - The smallest operation in terms of volume, during which the tumor and lymph nodes are separately removed separately. Surgical examination was developed during the studies of the National Project Supplement of Operations at Breast (NSABBP, USA). The conditions for conducting intervention - as for quadrantctomy.
Radiation therapy
Types of radiation therapy depending on the timing of the:| Name | Description |
| Preoperative | Intensive short-term irradiation courses are carried out. Objectives of preoperative radiation therapy during breast cancer:
|
| Postoperative | The main goal of radiation therapy in the postoperative period is to prevent tumor relapses. Places that irradiate during postoperative radiation therapy:
|
| Intraoperative | Radiation therapy can be applied right during the operation if the surgeon is trying to preserve the breast tissues as much as possible. This is advisable at the stage of the tumor:
|
| Self | Indications for the use of gamma therapy without surgical intervention:
|
| Intraknevaya | The radiation source is supplied directly to the tumor. Urban radiation therapy is used in combination with remote (when the source is at a distance) mainly in the nodal forms of cancer. The purpose of the method: To bring to the tumor as much as possible radiation dose to make it maximize it. |
Areas that may be irradiated:
- directly tumor itself;
- lymph nodes located in the axillary region;
- lymphatic nodes located above and under the clavicle;
- lymphatic nodes located in the field of sternum.
Chemotherapy
Chemotherapy - Medical treatment of breast cancer, in which cytostatics are used. These drugs destroy cancer cells and suppress their reproduction. Cyticostatics - preparations with numerous side effects. Therefore, they are always prescribed strictly in accordance with the established regulations and taking into account the characteristics of the disease.
The main cytostatics used in malignant tumors of the mammary glands:
- adribute;
- methotrexate;
- 5-fluorouracil;
- paklitaxel;
- cyclophosphane;
- docetaxel;
- kseloda.
- Cmf (cyclophosphane, fluorouracil, methotrexate);
- CAF (cyclophosphane, fluorouracil, adriablastine);
- FAC (fluoruracyl, cyclophosphane, adriablastine).
Hormonal therapy
The main goal of hormonal therapy is to eliminate the influence of female sex hormones (estrogen) on the tumor. The techniques are applied only in the case of tumors with sensitivity to hormones.Methods of hormone therapy:
| Method | Description |
| Removal of ovarian | After removal of ovaries in the body, the level of estrogen drops sharply. The method is effective in a third of the patients. Used aged 15 - 55 years. |
"Dosage Castra" drugs:
| Medicinal preparations suppress the release of the hypophysome of the follicularity immuling hormone (FSH), which activates the production of estrogen ovaries. The method is effective in a third of women aged from 32 to 45 years. |
Anti-estrogenic drugs:
| Anti-estrogen - drugs, overwhelming estrogen functions. Effective in 30% - 60% of women aged from 16 to 45 years. |
Medicinal preparations, overwhelming enzyme aromatase:
| The Aromatase enzyme takes part in the formation of steroid hormones, including the female sex hormones of estrone and estradiol. Suppressing the activity of aromatase, these drugs reduce estrogenic effects. |
Progestins (Gestagens):
| Progestins are a group of female sex hormones that interact not only with their own receptors on the cell surface, but also with receptors intended for estrogen, thereby partially blocking their action. Medicinal preparations containing progestins are prescribed between the ages of 9 and 67, have an effectiveness of 30%. |
| Androgens are drugs of men's genital hormones. | Androgens suppress the formation of a follicularity hormone (FSH), which activates the production of estrogen in the ovaries. The method is effective in 20% of girls and women aged 10 to 38 years. |
How does the doctor choose the tactics of breast cancer treatment?
The treatment plan for breast cancer is compiled individually. Features to take into account the doctor:
- the size of the neoplasm;
- the presence of metastases in lymph nodes;
- germination in neighboring organs, the presence of remote metastases;
- laboratory data characterizing cellular composition, tumor malignancy.
What folk treatment methods can be used when breast cancer?
Modern treatments provide good predictions in most women with malignant tumors of the mammary glands. So, at the beginning of treatment at the I stage, about 95% of patients live longer than 5 years. Many have complete recovery.Folk methods are not able to ensure an effective fight against the tumor process. Self-treatment is delaying a visit to the doctor. Often, such patients turn to a specialist when there are already remote metastases in lymph nodes. At the same time, 70% of patients do not survive for 3 years.
The only correct solution for the patient with a suspicion of breast cancer is as early as possible appeal to the doctor, diagnostics and, if necessary, the beginning of treatment in the oncological clinic.
When developing such a disease, like breast cancer in women, signs, photos will help to reveal the entire area of \u200b\u200bdefeat and identify the causes of the disease.
Breast structure scheme.
Causes of breast cancer
Unfortunately, the exact reasons leading to the development of the tumor in the field of breasts in women, with all the details, doctors cannot be allocated.
However, a number of factors contributing to the occurrence of cancer were found:
- Belonging to the female floor is considered a factor that increases the risk of disease. This is explained by the fact that in the female body there is a greater number of breast cells. They give up a female growth hormone, have a property to be reborn into cancer.
- Alcohol and smoking abuse significantly increases the likelihood of the disease. In particular, when harmful habits were acquired at an early age, during the formation of the sternum and the development of the body as a whole.
- Special attention should be paid to your health if someone from blood relatives had a similar problem, since the genetic predisposition is a significant factor that increases the risks of the development of the disease.
- The probability of the appearance of the disease is significantly higher in women after 50 years. Statistics revealed that most cases are diagnosed with this age category.
- Hazardous influence of radiation waves. It is dangerous for people working with a x-ray or at a chemical enterprise.
- It is harmful for a long time in the outdoor sun, as it emits ultraviolet.
- Incorrect nutrition (excessive use of fast food and smoked), subsequently - obesity (excess weight).
- Some chronic diseases. These include diseases such as diabetes, hepatitis, hypothyroidism, immunodeficiency.
But it is worth noting that the presence of one or even several factors does not mean that you will definitely comprehend the disease.
Screenshots include: tumors of light and breast, tumor of the bone system. In the complex, these diseases form the concept of sternum cancer. The separation in the stage depends on the occurrence of the disease and its form of launching.
The most common cancer pathology is the disease affecting the dairy glands. An example is presented in photo 1.
Stage oncology
Several stages of the oncology of the mammary glands are distinguished:
Photo 1. Breast cancer scheme.- The 1st stage is the defeat of the nodes and the closely adjacent area of \u200b\u200bthe skin are not observed. The diameter of the lesion does not exceed 2 cm.
- 2 stage is divided into two. The first: deep folds begin to form deeply folds, there is a gradual decrease in elasticity. The sizes of the tumor reach 3-5 cm. The second: the formation of metastatic nodes, which are localized on the damaged side.
- 3 Stage - Novo formation begins to spread to fatty tissues, increasing in diameter, and reaches 5 cm sizes and more. The epidermis in the nipple area begins to draw inside. At this stage, the presence of 1-2 tumor foci.
- 4 Stage - there is a noticeable deformation involving all the chest. There are many metastases.
Stages of the tumor of the lungs in women:
Scheme of cancer development stages.- Blood and lymphoid systems are not involved in the process. Such a stage is characterized by a minor volume of mutations, this structure of the tumor eliminates the likelihood of metastases. The size of the neoplasia is about 3-5 cm.
- The respiratory tract tumor begins to increase and reaches about 7 cm. At this stage, cough bouts appear, blood wet.
- The neoplasm exceeds the diameter of 7 cm, the walls and lymph nodes are easily involved in the process, appears pain syndrome.
- Terminal phase. Under this concept, the last stage is meant, it is uncontrollable, there is a large growing of tumor cells, which is irreparable.
Bone tumors in the field of sternum
Scheme of the structure of the sternum.With this damage, the deformation of solid tissues occurs. Directly from the stage of the disease depends on the clinical picture and the severity of cancer pain.
The first degree is characterized by the surface location of the pathological focus. The further phase is accompanied by the involvement of the central part of the sternum.
The third stage is the beginning of the spread of mutated cells from the bone area. In the terminal phase, the bone transformation into nearby structures occurs.
Symptoms of oncology breasts
Cancer breasts are very cunning, as the symptoms actually do not make themselves felt. In the early stages, the disease occurs without special clinical manifestations and signs, patients do not even suspect the existence of the problem. This often leads to death, since the symptoms of cancer appear on the last time.
The patient has much more chances to recover if you determine the disease on early. Therefore, if the inspection was found that a woman has many risk factors, one should be regularly examined.
The first symptoms will let yourself know after the tumor increases in size.
General signs of breast cancer:
- a sharp decline in body weight without cause and deterioration of appetite;
- increased body temperature, which is not shot throughout the time;
- inxication, manifested in the form of increased fatigue, malaise, headaches.
The pain syndrome is primarily connected with the location of the neoplasm localization. The first notable visual manifestations occur in the form of swelling or "bumps". Around the tumor zone, the skin becomes a blue shade, possibly with subteps.
From this video you will learn how to cure breast cancer.
Symptoms of cancer, which are manifested with joint damage to the sternum and lungs:
- pain, localized in the field of the back;
- the appearance of shortness of breath;
- chronic cough, which is not amenable to treatment;
- blood wet.
The sooner the diagnosis is carried out, the greater the likelihood of full cure.
This video tells about signs of breast cancer, which will help to recognize the disease at the initial stage.
An oncologist will inspect and, if necessary, prescribe the necessary surveys that will help identify cancer pathology.
