Invasive breast cancer: classification, prognosis, treatment methods. Invasive breast cancer: risk factors and causes, treatment methods, prognosis Non-invasive ductal breast carcinoma

Stage 2 breast cancer is a carcinoma that originates in the breast tissue and is about 2 cm in size. There are different characteristics of a breast tumor, which are interpreted differently depending on the type of tumor and its symptoms. A tumor of the second degree is classified according to its manifestations, and this is very convenient, since it becomes possible to expand the area of cognition.

If the cancer begins to hurt severely, this is the last stage of development. Cancer in earlier stages should not hurt. The disease is asymptomatic, pain does not appear.

Stage 2 breast cancer is early development tumors. This type of tumor is not considered dangerous to health and is treatable. But due to the factors that determine the recognition of the disease, breast cancer cannot always be diagnosed at the second stage. Therefore, this process means that developmental oncology leads to malignancy when ductal cancer affects the lymph nodes. In such cases, surgery and long-term treatment may be required.

Duration of illness

Type 2a cancer can affect women between 35 and 69 years of age. At the same time they are amazed The lymph nodes, connective fiber tissue, breast tissue. Grade 2 carcinoma can reach 2 to 5 cm, affecting adjacent areas. This means that ductal cancer progresses to the next stage quickly, affecting neighboring areas.
It spreads to other organs, and then the last stage of cancer is diagnosed - invasive. Moreover, it is much more dangerous than any other species.

During the time that stage 2 cancer is present in the body, it needs to be detected as soon as possible. Its form quickly spreads throughout the body, affecting all tissues from the inside. According to statistics, women with type 2a cancer can live 5 years or more. Regarding the percentage, this is expressed in 80% of cases. More than 15% of women do not survive stage 2 cancer. Therefore, it is impossible to say for sure that there is no threat to life.

Life expectancy in women diagnosed with stage 2 cancer early stages, is up to 7-8 years. If patients are already receiving treatment, then life expectancy increases to 20 years, but this prognosis cannot be confirmed. Let us consider the survival period for each tumor class separately, and also identify the optimal treatment and diagnostic methods.

Classification of stage 2 cancers

Carcinoma is her2 positive breast cancer that is confirmed medical research. You should not identify symptoms on your own, equating them to the table below. This is a summary of data from honey. statistics used by oncologists and surgeons.

Level 2 cancer form	Characteristic	Manifestation
dick2 initial	progesterone receptor (clone636)	cancer of one of the mammary glands up to 3 cm	Ki-67 marker and negative cell growth. Surgery may be required. Prognosis – survival rate 89%.	Treatment – chemotherapy, special nutrition, diet, examination three times a year
	estrogen receptor (clone 1D5)	cancer of the right breast from 2 to 4 cm	Invasive ductal cancer (carcinoma) of the breast with a high degree of nuclear polymorphism. Prognosis – survival rate 76%.	Treatment – chemotherapy, special nutrition, diet, examination three times a quarter
t4n2m0 + invasive risk g2	infiltrative release of nuclei	cancer of the right or left breast up to 5 cm	Prognosis – survival rate 34%.	Treatment – chemotherapy, special nutrition, diet, hormonal therapy, examination three times a month
Ductal invasive carcinoma	infiltrative release of nuclei into both gland cells	cancer of the right or left breast from 5 cm	Prognosis – survival rate 9%.	Chemotherapy, special nutrition, diet, examination three times a month

Unspecified or invasive breast cancer may show a negative result. That is, carcinoma found in the mammary gland, belonging to form 3, can be diagnosed as cancer of the previous form. Thus, oncology reveals only a fraction of the danger, since in fact cancer can be spread throughout the body.

Before making a diagnosis, it is necessary to undergo all possible examinations. Only after a thorough diagnosis is it possible to make a conclusion.

According to the World Health Organization, more than 67% of patients worldwide died from tumors this year. A third of them turned to medicine too late, the other part did not undergo examination. Only 4 people, starting from 20 years old, passed annual examination breasts

Formation of cancer cell forms

Breast carcinoma can be of different types:

Form 2 type a – T0 N1 M0.
Form 2 type a – T1* N1 M0.
Form 2 type a – T2 N0 M0.
Form 2 type b – T2 N1 M0.
Form 2 type b – T3 N0 M0.

In form 2 type a, carcinoma is detected using ultrasound, mammography and x-rays. Form 2 type B is detected using additional examination on an MRI machine - a tubular X-ray scans the shape of the tumor, producing a screening in the form of 270 photographs in 1 second. Thus, the device allows you to view breast cancer from all sides.

Doctors give the following prognosis:

According to form 2, survival rate reaches 50% of all patients who have undergone treatment.
In form 3, survival rate reaches only 4%, even if early examination is carried out.

The difficulty lies not in treatment, but in diagnosing cancer cells that could have spread to another area of the organ. WITH inside, from the external or lateral (when the lymph nodes are affected), invasive cancer may not be immediately detected. A three-time examination at a time makes it possible to establish the form of risk and the duration of treatment. An examination carried out three times in a month allows us to identify the form of the disease with the theory of the probability of detecting foci.

If the tests are carried out three or more times and do not give an accurate result, the focus has not been found. It is important to determine whether there are damaged side sections, then it is possible to establish a “source” that “gives birth” to new tumor cells.

As a treatment for all forms of cancer, carcinoma requires immediate hospitalization, otherwise the patient’s life is at risk. The prognosis is established at the time the tumor is detected. If the disease proceeds successfully, cancer cells can be diagnosed, then the prognosis is revised at the end of treatment. Also, patients must undergo drug therapy three times a day.

Additionally, a diet and special nutrition are prescribed. It may differ radically from what was prescribed at the time of the examination. Special nutrition helps doctors not to “clog” the body with excess substances that negatively affect the development of cancer cells.

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Ductal invasive breast cancer

Statistics say that every eleventh woman gets cancer. But doctors are inclined to say that there are more patients. People may not be aware that they have a tumor. This is explained by the fact that the disease at the initial stage occurs without symptoms and is detected in most cases only during a diagnostic study. The appearance of the first signs, unfortunately, indicates the transition of cancer to another stage.

Among malignant breast tumors in women, the main percentage is carcinoma - a non-invasive neoplasm that appears inside the ducts. This form often develops into invasive cancer, which is difficult to treat.

Invasive cancer, what is it?

This is a tumor that extends beyond the boundaries of the membrane of the duct or lobule into the breast tissue, gradually moving to lymphatic system, lungs, liver, bones.

Types of disease

Pathology occurs in the milk ducts. After which the cancer cells move into the fatty layer of the breast. Neoplasm cells are able to enter the lymph or blood and form metastases in other organs of the body. This type of disease accounts for almost 80% of invasive cancers.

Tumor cells remain in the ducts without spreading to neighboring tissues. If left untreated, it quickly develops into other forms of cancer.

This type of disease accounts for about 14% of breast tumors. Patients with this form of cancer feel a tightness in the chest.

Breast cancer, symptoms

Pathology of the mammary gland initial stages development occurs most often without symptoms. However, there are a number of warning signs to pay attention to:

the appearance of a lump or lump that does not go away within menstrual cycle;
change in the contour, shape or size of the breast;
various types of nipple discharge;
modification of the skin of the nipple or breast. Emergence inflammatory processes, peeling, ripples;
redness of the skin;
a pronounced difference in the area on the gland;
marble-like area on the epithelium.

These changes are easy to notice if you perform independent breast monitoring.

Factors provoking the development of oncology

Age. After 44 years, every ninth woman develops cancer; after 55, two out of three.
Late pregnancy. New formation of the mammary gland ducts is encountered by women who have given up motherhood, as well as those who become pregnant for the first time in adulthood.
Menstrual period. Early menstruation and late menopause can become a factor in the development of cancer.
Estrogen-progestin hormone therapy.
Heredity. Doctors are increasingly calling this factor one of the fundamental ones. If there were people in the family with breast cancer, then the likelihood of the disease developing in their descendants increases significantly.

Diagnostics

Monthly self-examination, which allows you to notice minor changes in the breast;
Mammography is the most informative method that allows you to detect the disease at the beginning of its development;
ductography – a study that shows a tumor measuring 6 mm or more;
Ultrasound is necessary to visualize and determine the size of oncology, as well as determine the characteristics of the vascular bed;
MRI allows you to determine the characteristics of a malignant tumor;
biopsy – collection of material for subsequent histological examination. With its help, doctors determine the nature of the tumor.

Breast cancer, stages

Before removing the tumor, the specialist checks the breast tissue and determines the stage of the disease. Before the operation, the patient will be asked to take a test for hormone levels. The test will show whether progesterone and estrogen have an effect on cancer cells. If the test is positive, invasive ductal carcinoma can be treated with hormone therapy.
In some cases, other tests, such as a bone scan or CT scan, are also ordered. They make it possible to determine whether invasive breast cancer has spread to other organs.

Malignant breast formation is treated in several ways:

biological therapy;
surgery;
hormone therapy;
chemotherapy;
radiation therapy.

A specialist can use either a single method or a combination of several treatment methods.

The doctor selects therapy depending on a number of factors:

menopausal status;
patient preferences;
condition of the body and age of the patient;
stage of breast disease;
tumor location;
laboratory test results;
size of breast pathology.

Invasive cancer can be treated both systemically and locally. Systemic therapy includes biological, hormonal and chemotherapy. Local includes radiation and surgical treatment. It is used to remove a breast tumor and control or destroy remaining cancer cells.

Forecast

The peak likelihood of developing the disease occurs at age 65. IN last years invasive cancer became 35% more common. The prognosis for treating the disease is not good. That is why many countries have introduced screening programs that make it possible to find the disease in the initial stages of development. When a breast tumor is diagnosed in the early stages, a permanent cure occurs in 90% of cases. The prognosis worsens in cases where lymph nodes are damaged and metastases occur. Patients with breast pathology today can count on a favorable prognosis. For achievement best results You should completely trust the doctor.

Treatment of stage IIa breast cancer

Breast cancer, stage IIA (T2N0M0, T1N1M0).

At the diagnostic stage, patients with N0 are not shown a thorough radiological examination, including computed tomography lungs and liver, scintigraphy of skeletal bones.

Invasive lobular carcinoma (lobular cancer) at the preoperative stage of diagnosis requires an MRI examination, as it is a risk factor for the development of multifocal cancer of both mammary glands.

Treatment is planned with the participation of several specialists: a surgeon, a chemotherapy specialist and a radiologist. If necessary, a morphologist may be included in the commission.

Tactics surgical treatment should be determined with the participation of a plastic surgeon and should be directed to organ-preserving treatment (taking into account the wishes of the patient) with mandatory subsequent radiation therapy. Mastectomy should preferably be planned with the possibility of immediate or delayed breast reconstruction (taking into account the wishes of the patient). Repositioned flaps and silicone implants can be used for reconstruction.

Biopsy of the sentinal lymph nodes, as well as their complete removal if clinically or according to ultrasound data there is a suspicion of their involvement, is a standard procedure. To identify nodes the following are used:

preoperative lymphoscintography (with this and the next method, the use of nanocolloidal radiopharmaceuticals 99mTc with d

intraoperative visualization of the sentinel node with a radioisotope probe,

peritumoral, periareolar, subcutaneous and intratumoral injection of dye.

The presence of metastases larger than 2 mm in the sentinal lymph nodes is an indication for axillary lymph node dissection.

Stage IIA invasive carcinoma is subject to:

Organ-conserving surgical intervention, subject to resection within healthy tissue in a minimal amount:

sectoral resection (lumpectomy - excision of the tumor to the fascia with at least 10 mm of surrounding tissue) for:

Invasive ductal carcinoma of Luminal subtype A up to 4 cm;

segmental resection (tilectotia - excision of the tumor with the skin above it to the fascia, with at least 10 mm of surrounding tissue) for:

Invasive ductal carcinoma Luminal subtype B with Ki67

Lobular carcinoma up to 2.5 cm in size;

quadrantectomy (excision of the tumor with removal of the skin above it, with the underlying fascia, within the unchanged surrounding tissues, usually at least 10 mm) for:

Invasive ductal carcinoma, Luminal subtype B

with Ki67 > 14% to 3.0 cm;

Lobular carcinoma up to 3 cm in size;

For Her2/neu-3+ breast cancer up to 2.5 cm in size;

Triple-negative breast cancer up to 2.5 cm in size;

with urgent cytological examination of smears of the bed of the remote sector and submamillary space;

with biopsy of the sentinal lymph nodes (for T2N0M0), followed by radiation therapy.

Organ-conserving surgery in patients with stage IIA invasive carcinoma is performed primarily through a peri- or para-areolar approach after separating the skin from the breast tissue using electrocoagulation. Access from the submammary fold or above the tumor is acceptable. If there are signs of umbilization of the skin over the tumor and with invasive lobular carcinoma, its excision is indicated. Stencial biopsy and lamphadenectomy can be performed through a separate approach in the axillary region. Surgery can be combined with reduction mammoplasty or various types mastopexy. It is permissible to perform corrective surgery on the contralateral breast at the same time. If necessary, a plastic surgeon is involved in the operation. For more accurate visualization of the tumor bed for subsequent radiation therapy, the tumor bed can be marked with clips.

When undergoing mastectomy in patients with stage IIA invasive carcinoma, preference is given to skin-preserving operations, possibly with excision of the skin area above the tumor and/or the nipple-areolar complex (to the extent subcutaneous mastectomy). The operation is planned with the participation of a plastic surgeon to determine the method and possibility of one-stage reconstructive surgery.

Indications for mastectomy for stage IIA invasive carcinoma:

Relatively big size tumor (> 4 cm), which does not allow radical breast-conserving surgery to be performed, with a relatively small size of the mammary gland, in order to achieve an acceptable aesthetic result

Central localization of the tumor with a small size of the mammary glands, which does not allow radical surgery to be performed and an acceptable aesthetic result to be achieved

Patients with multifocal or multicentric forms of carcinoma that do not allow radical surgery to be performed and an acceptable aesthetic result to be achieved

Diffuse microcalcification of breast tissue

Patients with contraindications to subsequent radiation therapy.

Mastectomies are performed according to Madden, Patey with biopsy of the sentinal lymph nodes; or according to Pirogov - in elderly patients with severe concomitant pathology when there is a high risk of complications due to an increase in the duration of the operation.

Axillary lymphadenectomy in patients with stage IIA invasive carcinoma is indicated:

only in the presence of micro and macrometastases in the sentinal lymph nodes (with T2N0M0) - more than 2 mm

if it is impossible to perform a stencil biopsy

When the tumor is localized in the internal quadrants of the mammary gland, it is permissible to simultaneously perform video-thoracoscopic parasternal lymph node dissection if lymph drainage into the parasternal area is reliably detected according to lymphoscintigraphy or if damage to the parasternal nodes is suspected on CT.

After surgery, it is mandatory to assess the risk of recurrence and death from cancer using the Nottingham Prognostic Index or the Adjuvant program (www.adjuvantonline.com).

Study of molecular genetic profile (Mammaprint™ or Oncotype DX test).

The Oncotype DX test is indicated for patients undergoing stage I and II surgery for invasive breast cancer (tumor size <5 cm) expressing estrogen receptors, without lymph node metastases (who are usually prescribed tamoxifen). The test results help make decisions about the appropriateness of use chemotherapy drugs to prevent relapse, in addition to hormonal treatment.

Combined treatment is carried out after organ-conserving surgery, with unfavorable prognosis factors (grade of malignancy G2-3, presence of peritumoral vascular invasion, lack of expression of estrogen receptors (ER) and progesterone receptors (PgR), overexpression or amplification of HER-2/neu, high level proliferation marker Ki-67 > 14%, triple-negative basal-like breast cancer (secreting cytokeratin 5/6), age up to 35 years).

Radiation therapy in patients with stage IIA invasive carcinoma is carried out after complete healing of the postoperative wound. It is aimed at reducing cases of local relapse in the surgical area and is indicated for all patients after organ-preserving surgery. Irradiation of the remaining part of the mammary gland ROD 1.8 – 2.5 Gy, SOD 50 Gy; 30 - 37 fractions (5 fractions per week). + Delivery of an additional dose to the tumor bed (boost) 10 – 16 Gy. The duration of the radiation course is 6 – 7.5 weeks (in the absence of local radiation reaction). Boost irradiation may not be performed if there are combinations of low risk factors for local recurrence in elderly patients (wide resection margins, N0, lack of vascular invasion).

Irradiation of the subclavian-axillary and supraclavicular zones in case of complete replacement of a lymph node with a tumor, germination of its capsule, tumor growth in fatty tissue ROD 1.8 - 2 Gy, up to SOD 44 Gy; 22 - 25 fractions (5 fractions per week). The duration of the radiation course is 4.5 – 5 weeks (in the absence of local radiation reaction).

Single-stage intraoperative irradiation of the tumor bed with an SOD of 20 Gy is acceptable instead of irradiation of the remaining part of the mammary gland after surgery in patients with negative nodes according to the results of their sentinal biopsy.

Mastectomy within healthy tissue is a sufficient procedure, and radiation therapy such patients are required if the tumor is located in the internal quadrants, as well as in the presence of unfavorable prognosis factors for T1N1M0 (grade of malignancy G2-3, presence of peritumoral vascular invasion, lack of expression of estrogen receptors (ER) and progesterone receptors (PgR), overexpression or amplification of HER-2 /neu, high level of proliferation marker Ki-67 > 14%, triple-negative basal-like breast cancer (secreting cytokeratin 5/6), age under 35 years, involvement of ≥ 4 lymph nodes).

Systemic adjuvant treatment is prescribed to patients taking into account the tumor subtype:

	Type of therapy	Note on therapy
"Luminal A"	One endocrine therapy	Very few patients require cytotoxic therapy (eg, those with multiple metastatic lymph nodes or other risk indicators)
“Luminal B (HER-2 – negative)”	Endocrine therapy +/- cytotoxic therapy	The administration and type of cytotoxic therapy may depend on the level of hormonal receptor expression, risk assessment, and patient preference.
“Luminal B (HER-2 – positive)”	Cytotoxic therapy + anti-HER-2 therapy + endocrine therapy)	There are no convincing data to withhold cytotoxic therapy in this group.
HER-2 – positive (not luminal)	Cytotoxic therapy + anti-HER-2 therapy	Very low risk patients (eg, (p)T1a and (p)N0) can be observed without systemic adjuvant therapy.
Triple negative (ductal)	Cytotoxic chemotherapy
Special histological type A: endocrine sensitive (cribriform, tubular and mucous);	Endocrine therapy
Special histological type B: Endocrine insensitive (apocrine, glandular and metaplastic carcinomas)	Cytotoxic chemotherapy	Medullary and glandular cystic carcinomas do not require adjuvant cytotoxic therapy (if (pN0) negative lymph nodes).

Chemotherapy in patients with stage IIA invasive carcinoma is prescribed in the presence of unfavorable prognostic factors for T1N1M0 (grade G2-3 malignancy, presence of peritumoral vascular invasion, lack of expression of estrogen receptors (ER) and progesterone receptors (PgR), overexpression or amplification of HER-2/neu, high level of proliferation marker Ki-67 > 14%, triple-negative basal-like breast cancer (secreting cytokeratin 5/6), age up to 35 years).

Treatment regimen

Drugs

Total cycle dose mg/sq.m

Single dose mg/sq.m

Administration mode

Cycle duration/days of administration (reception)

Invasive breast cancer (carcinoma) is a malignant process that is characterized by rapid division of atypical cells. Disease for a long time does not manifest itself with severe symptoms, which further complicates the possibility of selecting proper treatment. The disease code according to ICD 10 is C50. The prognosis for recovery is favorable only if early detection tumors.

Features of invasive breast cancer

The main characteristic of invasive breast cancer is its tendency to develop rapidly and spread metastases no less rapidly. At risk are the liver, pelvic and rib bones, regional lymph nodes, and lungs. At the first stage, the tumor process does not have severe symptoms. But as it develops, it takes on a rapid current. There is a high risk of loss of the affected organ.

Risk factors

There are several predisposing factors:

Hormonal instability. Occurs as a result of disruption of the functional activity of the adrenal cortex, thyroid or pancreas.
Presence of mastopathy (including its relapse).
Abrupt cessation of lactation or complete refusal to breastfeed.
Postponed mechanical damage chest(regardless of the type or statute of limitations of the injury).
Hereditary predisposition.

The lifestyle factor is of no small importance. If a woman perceives abortion as the preferred method of contraception, the likelihood of developing cancer problems increases. Regular alcohol intoxication, being in a stressful environment, working in harmful conditions - these factors increase the risk of developing breast carcinoma.

Forms of the disease

There are 3 forms - invasive ductal, pre-invasive ductal and invasive lobular cancer. Each of the listed types has characteristics - parameters, localization, clinical manifestations.

Invasive ductal carcinoma

The most common and dangerous type is detected in women over 55 years of age. Atypical cells appear in the ducts intended for feeding the child. They penetrate into the systemic circulation quite quickly. Invasive breast cancer is classified into several forms, each of which has specific symptoms:

Highly differentiated form. Characterized by slow development. Atypical cells are similar in structure to benign ones.
Ductal neoplasm of intermediate differentiation. Necrotic elements appear inside the ducts.
Low-grade ductal carcinoma. Reaches large sizes, atypical cells occupy almost the entire internal part of the duct and quickly overcome its limits.

The specific form can be determined through radiation diagnostic methods.

Preinvasive ductal carcinoma

It involves the replacement of milk duct tissue with atypical cells. For a short period of time, it does not spread to adjacent (healthy) tissues. If at this stage you perform diagnostics (in particular, mammography) and undergo treatment, the carcinoma with a high degree of probability will not progress to the next stage. Predisposing factors for aggravating the clinical picture are stress, decreased immunity, hormonal imbalance.

In the absence of timely, competent treatment, cells changed by mutation do not remain inside the duct, but cover nearby tissues. This means that the tumor process takes on an aggressive form of development. The main symptom accompanying the condition is intense pain and heaviness in the mammary gland.

Invasive lobular breast cancer

It is characterized by damage predominantly to the upper lobes of the mammary glands. Occurs in middle and old age. Often the tumor process takes on bilateral localization. Atypical cells spread simultaneously from two or more lesions. Difficult to diagnose long time does not attract attention. There is no palpable lump or secretion from the nipples.

Unspecified form

Invasive breast cancer of a nonspecific type is a rare disease. Its peculiarity is the uncharacteristic structure of atypical cells. Sometimes, based on histological examination, it is not possible to determine whether the patient has a ductal or lobular form of cancer. In this case, they talk about the development of unspecified carcinoma. It is classified into the following types:

Medullary type. A large compaction forms. Covers organs slowly, not immediately. But it grows quickly within its own structure.
Infiltrating ductal type. Quickly covers nearby structures, causing the development of metastases in 99% of cases.
Inflammatory type. The manifestations resemble the course of mastitis, but there is no increase in body temperature.
Paget's disease. Affects the nipple and areola. Initially it appears in the form of bubbles and crusts, then unites into a common conglomerate.

60-70% of all these tumors contain estrogen receptors, which makes it possible to suppress the progression of cancer hormonal drugs. The absence of these structures indicates the appearance of carcinoma in the period before menopause.

Symptoms

As the tumor develops, it manifests itself with quite varied symptoms. The patient explains some of the symptoms by overwork, heavy lifting, osteochondrosis, and uncomfortable body position during sleep.

The presence of only a small number of atypical (cancerous) cells hardly attracts attention. Clinical manifestations malignant process becomes noticeable only as it develops. This is one of the reasons why women see a doctor only at stage 2 of the disease. When atypical cells more actively occupy the physiological structure of the mammary glands, the following symptoms occur:

Chest pain. Localization unpleasant sensation– glandular part of the organ with transition to the armpit. With stage 2 invasive breast cancer, it is painful for a woman to even lie on her stomach, which involves adopting a forced body position.
Increased sensitivity of the nipples (even to the point of pain). Discomfort reaches a high degree of severity. Sometimes, due to pain, the patient refuses to wear a bra.
The appearance of secretion from the nipples. The discharge is characterized by the presence of pus and blood; at advanced stages of the tumor process they are abundant.
Changes in the contours of the areola, breast deformation.

Additional signs are the presence of a palpable conglomerate in the form of a lump or node. Its size is maintained in any phase of the menstrual cycle. The skin of the affected area loses tone and elasticity - it wrinkles.

The difference between the clinical picture and signs of mastitis (breast inflammation) is the absence elevated temperature bodies. Hyperthermia is a rare occurrence in breast cancer.

Stages of the disease

There are 4 stages of development of invasive breast carcinoma:

Initial. The size of the conglomerate is no more than 1-2 cm, but the tumor does not involve other organs.
Moderate weight. The tumor process progresses, metastases occur (mainly in the axillary lymph nodes). Atypical cells are not fused.
Difficult stage. Due to its ability to quickly penetrate other structures, it is difficult to differentiate. Distant metastases do not occur.
An extremely difficult stage. Cancer covers almost the entire mammary gland. Metastases are directed to bones and internal organs.

It is impossible to establish the specific stage of the malignant process without the use of diagnostic methods. The doctor takes into account the patient’s medical history, but this information is not paramount in making a diagnosis. Survey responses are of decisive importance.

Diagnostics

To identify a tumor, determine its size and type, a woman will have to undergo an ultrasound examination of the mammary glands. If these types of diagnostics confirm the presence of carcinoma, the specialist prescribes:

Ductography – x-ray examination breasts The method involves the use of a contrast agent. This solution fills the milk ducts, after which it is possible to visualize the characteristics of the compaction in detail.
Puncture of the affected breast followed by biopsy. The tissue sample is sent to histological examination– to determine the form of cancer.

Immunohistochemical tests. Aimed at determining the sensitivity of the neoplasm to female sex hormones. Thanks to the results of this study, it becomes clear whether the malignant process can be eliminated with hormone therapy.

To determine the stage of the oncological process, a woman will undergo a CT scan of organs and structures that are susceptible to metastases. If there is a suspicion of the presence of tumor foci in the listed areas, a histological examination is indicated. The method also involves a preliminary biopsy to take a sample of the material.

In oncology, a system for determining tumor growth is used. To understand how quickly the tumor will spread to other structures, the Gleason classification is used. In order to determine these parameters, the patient undergoes a biopsy of the tumor, then examines the tissue sample under a microscope. Counting undifferentiated chains of cells allows you to obtain a result (marked with the mark G for the word “Gleason”), which is interpreted as follows:

G1 – well-differentiated carcinoma.
G2 – moderately differentiated carcinoma.
G3 – malignant tumor is poorly differentiated.
G4 is an extremely malignant tumor.
Gx analysis does not allow establishing the degree of differentiation.

The lower the degree of differentiation, the more difficult it is to overcome the oncological problem. It is possible that a combination of treatment approaches will be required.

Treatment methods

The method of eliminating a breast tumor depends on the location, size of the carcinoma, and sensitivity to hormones. There is local and systemic removal of the tumor. In the first case, the malignant process is suppressed by radiation therapy or surgical excision of the affected tissue. Systemic removal involves chemotherapy, biological or hormonal treatment. To determine the optimal type of treatment, the doctor takes into account the woman’s age and whether she has reached menopause.

Standard treatment regimen:

First stage. The patient's condition is corrected with hormonal drugs. This action allows you to reduce the volume of the tumor and its fusion with nearby structures.
Second phase. The affected mammary gland is removed completely or only the tumor is excised, but along with it - part of the breast and axillary lymph nodes.
Third stage. The patient is referred for chemotherapy or radiation. This minimizes the risk of breast carcinoma reoccurring.

The patient’s opinion is taken into account, but in determining the optimal treatment method, it is advisable to listen to the recommendation of the attending physician. It is also contraindicated to stop the prescribed therapeutic course.

Prognosis and survival

If the diameter of the tumor does not exceed 2 cm, the probability of survival for 5 years is 94%. If cancer is detected at stage 1, complete recovery occurs in 90% of cases. Survival increases with the presence of estrogen and progesterone receptors within the tumor. Paget's disease, ductal and lobular types of carcinoma cause an unfavorable prognosis.

Conclusion

Invasive breast cancer is a serious disease that involves long-term treatment. The severity of symptoms of the tumor process depends on its stage. Upon reaching 20 years of age, you need to undergo screening tests as planned (once a year). Then it will be possible to detect a malignant neoplasm in a timely manner.

With invasive carcinoma, which is the most dangerous type of breast tissue pathology, there are metastases to nearby internal organs. Breast cancer is the most common cancer in women. During the development of invasive cancer, tumor cells grow into all nearby areas. In addition, a woman with this disease is found to have altered cells in the lungs, lymph nodes, armpit, liver, bones, brain.

Unlike non-invasive cancer, which has borders and is characterized by the absence of metastases, the appearance of invasive carcinoma is very dangerous. This diagnosis often causes the patient to panic. Since the pathology is very dangerous, it is necessary to diagnose it as soon as possible and begin treatment. In some cases, it is possible to save the patient’s life and prolong it as much as possible.

What is invasive breast cancer

There are also four degrees of malignancy of the oncological process:

G1 – well-differentiated carcinoma. In this case, breast cancer does not germinate, but develops very quickly.
G2 - second degree of malignancy of invasive cancer with little germination, but rapid growth tumors.
G3 – new cells appear that differ from each other and differ from healthy tissues.
G4 – the highest degree of neoplasm infiltration.

Knowledge of the stage of development and degree of malignancy of the oncological process helps to select optimal treatment methods.

Classification

Breast carcinoma has several types depending on the location of the tumor. In order to understand the classification, you need to know the structure of the female mammary gland. IN female breast there are about twenty segments, similar to orange ones, of which it consists. Between the lobules and on top of them there is adipose and fibrous (connective) tissue. Inside the lobes there are ducts through which milk flows during lactation. According to histological characteristics, breast cancer is:

Invasive ductal;
Invasive lobular;
Pre-invasive ductal;
Unspecified.

These varieties can be divided into other subtypes of invasive cancer.

Pre-invasive ductal

This form of tumor arises from the milk ducts, but does not grow into neighboring structures. This type of carcinoma can only be detected by chance during preventive mammography. If you skip this stage of tumor development, then with a high degree of probability it will develop into invasive ductal carcinoma.

Invasive ductal

A tumor forms in the ducts (or one of them) for the outflow of milk during lactation. The cells quickly penetrate the lymph flow and bloodstream, spreading throughout the body. Often the pathology is diagnosed after the age of fifty-five. For invasive ductal carcinoma of the breast pathological cells diverge towards the nipple, changing its shape and size. With this disease, discharge may be observed from the nipple.

The degree of differentiation of such a tumor is:

High – cancer cells are nuclear-free and have the same structure;
Intermediate – similar to non-invasive low-grade cancer;
Low - the structure of the cells differs from each other, they have a high degree of infiltration into neighboring tissues.

This type of breast cancer is the most common and, at the same time, the most dangerous.

Invasive lobular

A tumor arising in the lobules of the gland is diagnosed in ten to fifteen percent of breast cancer cases.

When several nodules occur, we are talking about multiple carcinoma. Often neoplasms affect both breasts at once. This pathology is poorly diagnosed and is often detected too late, since at the initial stages of development there are no signs such as “bumps” in the breast or discharge from the nipples.

Unspecified

If the doctor, after a biopsy, conducts a histological examination and cannot determine whether the tumor is ductal or lobular, then we are talking about invasive carcinoma of a nonspecific type. Based on the cell structure, invasive nonspecific breast cancer can be of the following types:

Inflammatory cancer. The signs of this nonspecific type of breast cancer are the same as with mastitis. A round lump appears in the chest, over which hyperemia occurs skin. This type of cancer is diagnosed in ten percent of cases.
Medullary carcinoma is the least invasive. It grows into neighboring structures very slowly, but in the area of its appearance it quickly increases in size. Occurs with the same frequency as the previous type.
An infiltrating ductal neoplasm that quickly grows and metastasizes. It is found in seventy percent of patients with breast cancer.
. The lesion occurs in the nipple-areolar region. In appearance, it resembles eczema with its symptoms (itching, weeping surface, blisters).

More than half of all neoplasms, regardless of their structure, have estrogen receptors, which indicates the possibility of using hormonal therapy. When invasive breast carcinoma of a nonspecific type occurs in the period before menopause, such receptors are absent. Nonspecific carcinoma of the medullary type is the most favorable. Depending on which breast cells the tumor originated from (basal or luminal), a basal or luminal type of cancer is possible.

Clinical picture

With mammary cancer, the symptoms are specific, depending on the type of tumor, and common to any type of cancer process. Specific signs:

Invasive ductal carcinoma - the nipple is deformed, pathological fluid oozes from it.
Lobular cancer - occurs painful lump with a bumpy surface. The breast shrinks and the nipple retracts.
Inflammatory carcinoma – has signs of mastitis, which can make diagnosis difficult.
Paget's carcinoma - chronic eczema occurs in the nipple area.

Common symptoms and signs of the disease include pyrexia, loss of appetite and weight, and anemia. Mammary glands become asymmetrical, they may have different size and shape. Symptoms also appear on the skin, it changes color and becomes reddish, yellow, with a blue tint. It is worth remembering that on initial stages During the development of carcinoma, it can proceed secretly, without any pain or visual signs, so the pathology is often diagnosed in an advanced form.

Diagnosis of the disease

In order to begin treatment for invasive carcinoma, it is necessary to make an accurate diagnosis, which is impossible without a full examination of the patient. First, the doctor palpates the woman’s mammary gland, listens to complaints and collects anamnesis. Next, instrumental and laboratory examinations are carried out:

mammography;
ultrasound examination of the breast;
breast ductography;
computed tomography or magnetic resonance imaging;
biopsy followed by histological examination;
general clinical blood and urine tests;
blood chemistry;
blood test for tumor markers.

After diagnosis, the doctor prescribes a regimen therapeutic measures. Therapy is selected individually for each patient and depends on the degree of aggressiveness of the tumor, the stage of its development, the presence or absence of metastases and general condition women.

Treatment tactics

Invasive ductal carcinoma and other types of breast cancer are best treated with surgery. The extent of surgical intervention depends on the size of the tumor and the degree of damage to surrounding tissues. The operation can take place according to one of the following schemes:

Removal of the tumor and adjacent tissues;
Excision of the tumor and nearby lymph nodes;
Partial removal of the mammary gland and lymph nodes;
Complete amputation of the affected breast.

If the breast has been completely removed, then after the patient is completely cured, she can resort to plastic surgery for placement of a silicone implant. For invasive carcinoma that has reached the third or fourth stage, radiation therapy or a course of chemotherapy is given before surgery. This stops the development of the tumor and kills some of the malignant cells. After surgery, chemical and radiation therapy is also performed, which reduces the risk of relapse.

Prognosis and prevention

The prognosis for breast cancer depends on the stage at which therapy was started.

For stage 1 carcinoma, five-year survival is guaranteed for ninety women out of a hundred;
If stage 2 breast cancer is detected, the five-year survival rate drops to sixty-six;
In the third stage, survival rate is no more than forty-one percent;
After stage 4 treatment, only ten percent of women can expect a five-year survival rate.

For malignancy only up to grade G2, the prognosis is relatively favorable. Prevention of recurrence from cancer infiltrating the second breast is only possible by removing both breasts. Prevention is about avoiding risk factors.

Invasive breast cancer is a disease characterized by the progressive spread of tumor formation to the lymph nodes, as well as other tissues and organs. According to statistics, 80% of women diagnosed with breast cancer, which is not detected at the first stage, have invasive carcinoma mammary gland.

Features of the pathology

An invasive neoplasm begins to form from epithelial cells and gradually grows without clear boundaries. When each type of pathology occurs, a pathological process occurs in certain groups of cells. For example, invasive ductal breast cancer develops in the tissues of the milk duct, starting with altered cells.

Important! The disease is dangerous because it is malignant and affects healthy tissue. The affected cells are transported by the bloodstream throughout the body, so the pathological process can spread to any organ.

Factors contributing to the development of the disease are:

The main cause of the disease is an imbalance of hormones. The pathology begins to progress under the influence of diseases related to precancerous ones. Diseases that can cause cancer include:

The pathology also progresses against the background of termination of pregnancy (abortion) and lactation (breastfeeding). With all of the listed conditions of the body, there is a risk of formation of lumps in the female breast, which, in the absence of treatment or under the influence of provoking factors, develop into malignant neoplasms (cancer).

Forms

Arises oncological tumor most often it is not in the gland itself, but in the canals connecting the nipples with the lobules. Invasive breast cancer is divided into two types:

The first type is found in most cases. The unspecified type is diagnosed less frequently and is more difficult to treat.

In medicine, there are three main forms of the disease:

The form of the disease can only be determined using medical diagnostics, since the main symptoms are very similar. At the first stages of development, an accurate diagnostic examination is necessary to exclude an incorrect diagnosis (mastitis, fibroadenoma, etc.).

Symptoms

Signs of invasive breast cancer can manifest in different ways, depending on the characteristics of the body and the extent of the damage. In the first stage, some patients are completely free of any symptoms.

At the same time, others, even with a slight degree of tissue damage, show signs of pathological process(pain and discomfort in the mammary glands).

There are no exact symptoms that can characterize the clinical picture. However, experts identify a number of signs that can help patients determine the presence of pathology:

Such signs should be alarming when they first appear. It should be taken into account that the disease can progress at any age. However, the risk group is represented by women over 45 years of age. According to statistics, cancer is diagnosed in every third woman over 55 years of age.

Diagnosis and treatment

The treatment process begins with a diagnostic examination to determine all the features of the clinical picture. Based on the results that the doctor receives, a further treatment regimen is established.

The first stage of diagnosis is chest palpation. If, as a result of palpation, the doctor reveals the presence of seals, and other symptoms of pathology are observed during examination, then the patient is sent to undergo a series of laboratory and hardware tests:

The diagnostic results determine the stage of cancer and the location of pathological formations, as well as their structure. The choice of treatment regimen is made by a specialist.

There are two ways to influence the disease:

conservative;
surgical.

Depending on the stage at which the pathology was identified, one of the treatment methods is used. It is also the stage of the disease that influences the further prognosis of recovery.

Therapy methods

In cases where therapeutic intervention is permissible, an integrated approach is used. However, in most cases of invasive breast cancer, surgery is preferred. This is due to the high risk of relapse and the spread of metastases, to which this form of the disease is prone. During therapy the following are used:

For invasive breast cancer (g1, g2 and g4), treatment is carried out using a combination of all three methods of treatment, since these three types of malignant neoplasms are characterized by rapid growth. The prognosis for type G4 pathology is negative. If type g3 disease is detected, it may be used conservative methods(the prognosis is positive).

Traditional treatment

Invasive breast cancer – dangerous disease that needs to be treated by medicinal method. You cannot self-medicate. Such an attitude towards health can lead to the fact that late surgery will have an unfavorable prognosis.

Attention! At malignant neoplasms Can be used in the chest folk remedies in the form of additional exposure, which significantly improves the prognosis of the disease, however, using methods traditional medicine only with the permission of the attending physician.

During the period of medicinal influence on pathology, it is recommended to drink infusions from plants that have properties that prevent the spread of cancer cells and have a general strengthening effect. Such plants include:

You can also take an infusion of birch leaves, licorice and plantain mixed in equal quantities. You can make lotions and compresses from the infusions. They have a general anti-inflammatory, analgesic and immune-strengthening effect.

A huge number of women and girls around the world find themselves alarming symptoms such a dangerous pathology as breast cancer. Flabbiness of the skin, compactions in the tissues, so-called nodules, redness and many other changes - all this, if not directly indicated, should make you think: is it time for an examination?

For decades, scientists and doctors from all over the planet have been struggling to create a cancer treatment that can save millions of lives. Behind Lately, after long and, of course, fruitful research, oncology has made significant progress towards a panacea for cancer.

Ten years ago, there were no such modern and effective methods of examining a patient as the fish test, immunohistochemical and cytological studies, and much more. All this now, in our days, helps to reliably and accurately study cancerous tumor, its benignity or malignancy, size, reactions, speed of spread and other important details.

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Breast pathology

The most common type of this pathology, which is diagnosed annually in hundreds and thousands of women, is breast or mammary gland cancer. There are several stages of cancer, from less to more dangerous:

Zero stage.

Non-invasive cancer – does not spread to other tissues or lymph nodes. There is no presence of metastases. Also, this stage is the earliest and is treated most successfully by doctors - in most cases the patient makes a full recovery.

Also refers to the early stages, but is already called invasive. The size of a grade 1 tumor is within 2 cm.

Second stage.

The tumor grows up to 5 cm, however, metastases and germination into other tissues are not observed. This stage is accompanied by a variety of symptoms (wrinkling, sagging). Stage 2 breast cancer is also divided into two stages, 2a and 2b; with the latter, no more than two metastases can form.

Third stage.

You can note an increase in the diameter of the tumor (more than 5 cm) and the appearance of symptoms such as swelling, nipple retraction or the “lemon peel” symptom, redness of the skin, in which the pores become very noticeable. At this stage, the number of metastases does not exceed two.

Like, 4 is a late stage, the most severe of all, in which the tumor spreads throughout the entire breast tissue and gives numerous and extensive metastases (to internal organs, fatty tissues, skin and even bones).

Other types

There are different forms of breast cancer. They differ from each other in the location of the affected areas, the presence, and therefore the degree of severity for the human body.

One of the forms of pathology is, which differs from other types in its higher aggressiveness. The spread of malignant cells to lymph nodes, bones, internal organs and joints is extremely high in infiltrative cancer, and metastases can be unnoticed in the human body and make themselves known only decades later.

Remember: It is necessary to undergo not only examinations, but also preventive tests for breast cancer.

So, this form of cancer also has several subtypes:

Ductal breast cancer - or carcinoma, which is one of the most common types of cancer among women and spreads inside the ducts of the breast; the presence of metastases and spread to other tissues.
Lobular cancer is the so-called lobular carcinoma, which is accompanied by a tumor in the glandular part of the breast, where breast milk is formed. This form is a consequence of the patient’s advanced disease, since it is not always easy to notice on early stage upon inspection.
Non-specific type - a rare case of breast cancer, for example, colloid cancer, squamous metaplasia, the treatment of which is significantly different from the treatment of other forms. The unspecified form of cancer also differs when predicting its development and effect on the body.

When examining and studying the first and second subtypes of infiltrating cancer, doctors, based on the biopsy performed, evaluate the tumor according to the degree of aggressiveness (sprouting into other tissues), which includes several categories:

GX – changes are difficult to determine;
G1 – high degree;
G2 – moderate degree;
G3 – low degree;
G4 is an undifferentiated process.

Thus, invasive breast cancer at grades G1 and G2 germinates the least, and at G3 and G4, respectively, more. Breast cancer is a very serious and difficult disease to treat.

Doctor's advice: do not forget to undergo annual routine and preventive examinations with a mammologist. Such examinations are mandatory for every girl or woman in order to avoid serious illnesses and prevent cancer at first, when it is still easily treatable.

Be healthy and take care of yourself!

For complete information about breast cancer, watch the following video: