Morphological diagnosis of invasive ductal breast cancer. Invasive cancer Invasive ductal carcinoma of the breast

Invasive ductal carcinoma of the breast is one that affects the mammary gland and develops from the glandular epithelium lining the milk ducts.

The neoplasm refers to tumors that can be asymptomatic for a certain time, which interferes with early diagnosis and timely treatment of this disease.

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Total information

This disease is the most common type of malignant breast lesion. In 80% of all clinical cases where a woman was diagnosed with malignant metaplasia of the breast, it turned out to be invasive ductal carcinoma.

The older the woman, the higher the risk of developing this malignant pathology. About 60% of all patients with this diagnosis are patients over the age of 55 years.

Invasive ductal carcinoma of the breast is treated jointly by oncologists and mammologists.

Causes, stages of invasive ductal carcinoma of the breast

The immediate causes of malignant degeneration of the cells that line the milk ducts have not yet been elucidated. Factors whose presence increases the risk of developing invasive ductal carcinoma of the breast have been identified. This:

• unfavorable heredity;
• history of other malignant tumors;
• chronic pathology of the mammary glands;
• some features of a woman’s gynecological status that fit into the concept of the norm;
• taking certain medications;
• unfavorable environmental situation;
• severe somatic diseases;
• failure in work endocrine system.

Unfavorable heredity is considered one of the factors against which the described disease most often develops.. If cases of invasive ductal carcinoma have been diagnosed in the family, then close relatives (representatives of neighboring generations) have a 2-3 times higher risk of developing this pathology than women whose relatives did not have this pathology.

It has been revealed that a woman’s chance of developing invasive ductal carcinoma of the breast increases if she has previously been diagnosed with other types of malignant lesions, in particular of the breast. Most often, the risk increases with a history of non-invasive ductal carcinoma. Moreover, the length of time after treatment cancerous tumor can vary greatly. Thus, cases of invasive ductal breast carcinoma were identified in women 20-25 years after they had non-invasive breast cancer.

Chronic (especially long-term) diseases of the mammary glands also occupy one of the first places among the factors contributing to the development of invasive ductal carcinoma of the mammary gland. Most often these are pathologies such as:

• – pathological hormone-dependent proliferation of glandular tissue of the mammary gland;
• fibroadenoma is a benign tumor that develops from the connective and glandular tissue mammary gland;
• – formations in the mammary gland in the form of cavities with liquid contents. Can be single or multiple.

note

Of all mastopathy, fibrocystic mastopathy, in which cysts form against the background of the proliferation of connective tissue of the mammary gland, most often leads to the occurrence of the described disease.

Some acceptable variants of the obstetric and gynecological norm have been identified, against which invasive ductal carcinoma of the breast could develop. This:

• earlier menarche (first menstrual bleeding) - before the age of 12-13 years;
• late start – timing fluctuates;
• late first pregnancy - on average after 35-40 years of age;
• absence of gestation (pregnancy), childbirth and breastfeeding in the obstetric and gynecological history. There is evidence that even if there was a history of an interrupted pregnancy (or an induced abortion), such women develop invasive ductal carcinoma of the breast less frequently than those who have not had a pregnancy.

Most often, the development of invasive ductal carcinoma of the breast is caused by taking medications such as:

• hormonal drugs aimed at correcting disrupted endocrine status - especially when used for a long time (for several years);
• (contraceptives taken by mouth);
• , used to eliminate or reduce menopausal symptoms.

Factors in an unfavorable environmental situation that significantly increase the risk of contracting the described pathology are, first of all:

• air and water pollution from industrial waste;
• high level of radiation.

In general any somatic disease can weaken a woman’s body and contribute to the development of malignant neoplasms. But most often, predisposing factors for the development of invasive ductal carcinoma of the breast are:

• (IHD);
• severe liver diseases.

Pathologies of the endocrine system that most often contribute to the development of the described pathology are:

• – impaired breakdown of carbohydrates due to deficiency of insulin production;
• – insufficient production of thyroid hormones;

The following stages of disease development are distinguished:

Symptoms of Invasive Ductal Carcinoma of the Breast

In the early stages of development, the disease is often asymptomatic.

Signs of invasive ductal carcinoma of the breast are:

• nipple discharge;
• local skin changes;
• change appearance mammary gland;
• with further progression of the disease - disturbances in the general condition of the body.

Characteristics of discharge:

• according to the degree of transparency/turbidity - transparent;
• color – yellowish-green;
• due to the presence of impurities – often bloody;
• The release time is periodic. The presence of such phase discharges menstrual cycle does not depend;
• by quantity - at first spotting, then as the disease progresses, the amount of discharge increases, they can be released from the nipple in drops.

As the discharge intensifies, it irritates the skin, resulting in:

• maceration of the skin - its corrosion;
• the appearance of single or multiple erosions and deeper ulcers in the areola area.

Changes in the appearance of the breast may include the following:

• the skin over the location of the tumor changes color - it turns pink, then turns red. Then peeling begins skin in this location;
• the so-called umbilification may develop above the tumor - retraction of the skin, similar in appearance to the navel;
• a platform symptom is observed - an area with reduced elasticity appears above the tumor, and if it is pinched for a short time, it does not straighten out;
• A characteristic symptom is lemon peel - the skin over the tumor becomes porous, similar to the peel of a lemon;
• over time, the external appearance of the mammary gland inevitably changes - it becomes larger than healthy, deformed (its regular rounded contours are disrupted, an uneven relief appears);
• the nipple may be drawn into the areola.

Disturbances in the general condition of the body appear with further progression of the disease. These are symptoms such as:

• general weakness;
• increased fatigue when performing a normal amount of work;
• persistent loss of appetite;
• pronounced aversion to meat products;
• gradual loss of body weight;
• hyperthermia (increased body temperature). It is insignificant, often up to 37.2-37.4 degrees Celsius.

If the tumor compresses the venous and lymphatic vessels, the following additional clinical signs may be observed:

• swelling of the tissues of the upper limb on the affected side;
• pain on the same side, worsening when trying to raise the arm.

The severity of clinical symptoms of invasive ductal carcinoma depends on its stage:

• Stage I – in most cases there are no signs;
• Stage IIa - a positive sign of the platform is determined, wrinkling of the skin is detected when it is captured in a fold;
• Stage IIb - in addition to the previous symptoms, moderate umbilization is detected, unexpressed symptoms may appear in organs affected by metastases;
• Stage III - umbilization, swelling of the breast tissue and the “lemon peel symptom” are determined. Often at this stage, nipple retraction is observed. Symptoms from organs affected by metastases progress;
• Stage IV – severe deformation of the mammary gland is observed, general state the patient deteriorates significantly, manifesting severe symptoms from organs affected by metastases of this tumor.

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Diagnostics

In the early stages, diagnosis is difficult due to the absence of symptoms. Early diagnosis has great value in oncology, therefore, if the slightest suspicion arises, a full range of examination of the patient should be carried out. What is important is a careful collection of anamnesis (clarification of burdened heredity, the fact of various diseases, and so on), physical, instrumental and laboratory methods examinations.

Physical examination findings are as follows:

• upon examination - in the early stages it is not informative, since the shape of the mammary gland is not changed, the general condition of the patient does not suffer. As it progresses, an enlarged mammary gland, bulging tissue at the site of the tumor, and discharge from the nipple are visualized. In advanced cases, such patients are emaciated, emaciated, adynamic, their skin and visible mucous membranes are pale;
• upon palpation (palpation) of the mammary gland, a painful formation is determined in the form of a node that does not have clear boundaries, sometimes swelling of the gland is noted. When the nipple is squeezed, discharge may appear from it, often mixed with blood. Enlargement and tenderness of regional lymph nodes are noted.

Instrumental research methods that should be used in the diagnosis of invasive ductal carcinoma of the breast are:

To exclude or confirm the fact of metastasis, it is necessary to examine other organs where invasive breast carcinoma can most often metastasize. For this purpose, diagnostic methods such as:

• radiography of the spine and bones of the lower and upper extremities;
• radiography of the skull;
• liver and ovaries.

Laboratory diagnostic methods used to detect invasive ductal carcinoma of the breast are as follows:

Differential diagnosis

Differential diagnosis of this disease is often carried out with such pathologies as:

• non-invasive breast cancer;
• abscess - limited suppuration of breast tissue;
• fibroma is a benign connective tissue tumor;
• fibroids are a benign neoplasm that develops from connective and muscle tissue.

Complications

The most common complications of invasive ductal carcinoma of the breast are:

• germination into neighboring organs with disruption of their function - in particular, into the pectoral muscles and pleura;
• metastasis - the introduction of tumor cells through the blood or lymph into other organs and tissues with the subsequent formation of secondary malignant tumors in them;
• cancer intoxication - develops in the late stages of carcinoma development and consists in the fact that tumor cells disintegrate en masse, while intracellular toxins enter the bloodstream, and with it into almost all organs and tissues, provoking their toxic damage (poisoning).

Most often, invasive ductal carcinoma metastasizes to bone structures, lungs, skin, liver, ovaries and brain.

If metastases have reached the bones, they are mainly manifested by pain in the back, upper and lower extremities.

Metastases to the liver manifest as a cluster free liquid in the abdominal cavity.

Metastasis to the brain manifests itself quite clearly - intense and other neurological disorders.

Metastases of invasive ductal carcinoma to the lungs are one of the relatively mild forms of metastasis, since they are quite long time(longer than with metastasis to other organs and tissues) can occur without any symptoms. Later, persistent and hemoptysis may occur.

Metastasis to the skin is manifested by symptoms similar to the clinical picture erysipelas– infectious inflammation of the skin.

Treatment of invasive ductal carcinoma of the breast, surgery

Treatment strategy for invasive ductal carcinoma of the breast depends on factors such as:

• stage of tumor development;
• hormonal status (hormone-dependent or -independent);
• presence of metastases;
• presence of complications.

The basis of treatment is surgical intervention. The following operations are performed:

• at the initial stages of tumor development – radical resection of the mammary gland (removal of one third or half of the gland with fascia, muscles and fatty tissue) or subcutaneous mastectomy(removal of gland tissue while preserving the skin);
• with advanced carcinoma – radical mastectomy (removal of the gland along with the pectoral muscles) or mastectomy with simultaneous irradiation (radical removal of the gland with simultaneous irradiation of the surgical field).

After the operation, the patient is also prescribed radiation therapy, and after some time, breast reconstruction or prosthetics is performed.

If there are contraindications to surgery (old age, severe chronic diseases), then ablation is performed (exposure to radiofrequency radiation on tissues that are rejected) and removal of lymph nodes.

If a tumor of stages III and IV is detected, then therapeutic measures start with chemotherapy.

When a hormone-dependent tumor develops, hormonal therapy is used.

Psychological rehabilitation of patients who have lost a mammary gland is extremely important.

Prevention

There are currently no specific methods for preventing invasive ductal carcinoma of the breast, since the cause of the formation of this tumor is unknown.

Most important methods prevention are periodic self-examinations and preventive examinations. The frequency of the examination is as follows:

• all women of reproductive (childbearing) age need to visit a mammologist once a year and undergo an ultrasound of the breast;
• Women over 35 years of age should undergo a screening mammogram once every 2 years, and after the age of 50 years - once a year.

If tissue compactions or calcifications are detected in the mammary gland, a biopsy is necessary, followed by examination of the removed tissue under a microscope.

Screening for the presence of genetic mutations that increase the risk of developing invasive ductal carcinoma of the breast is also practiced.

Every woman needs to develop the habit of doing it once a month.

It should be carried out on days 8-12 of the menstrual cycle. In this case it is necessary:

• carefully examine both mammary glands in the mirror to see if there is any asymmetry, changes in the shape and color of the skin of the glands;
• carefully palpate both mammary glands and axillary glands The lymph nodes;
• press on the nipple to identify discharge.

If at least one of the described signs of this pathology is detected, you must immediately contact a specialist for medical care.

Prognosis for invasive ductal carcinoma of the breast

The prognosis for invasive ductal carcinoma depends on:

• stages of the disease;
• prevalence of the pathological process;
• degree of malignancy of the tumor.

Compared to the prognosis for other malignant neoplasms (in particular, breast cancer), the prognosis for this pathology is more favorable. In stage I, survival rate during the first 5 years from the moment of diagnosis (a generally accepted criterion in oncology) is, according to various sources, from 85 to 95%. At stage II, the 5-year survival rate ranges from 66-80%, at stage III it is 41-60%.

Patients who have been diagnosed with stage IV invasive ductal carcinoma of the breast most often live about 2-3.5 years. Thanks to intensive, well-calibrated therapy, 25-35% of such women were able to live for more than 5 years, and 10% even for more than 10 years. Such facts indicate that with invasive ductal carcinoma of the mammary gland, one can successfully fight for the patient’s life.

Content

Breast cancer is considered one of the most common malignant processes. Invasive breast tumors can affect people of different age groups and genders. The disease quickly spreads to nearby tissues and organs, for this reason it is very important to diagnose a breast tumor at an early stage.

Invasive breast carcinoma manifests itself quite aggressively. In a short time, the neoplasm extends beyond the lobule or duct of the breast and begins to metastasize to the lungs, liver, and brain. Invasive cancer can proceed similarly to other malignant processes in stage 4. Advanced forms of pathology are difficult to treat. The prognosis for early detection is generally favorable.

Ductal carcinoma

This type of breast cancer in women is considered the most common. Infiltrative breast cancer of this type begins in the milk ducts and has a large number of variations in structural organization. Diagnosis of ductal cancer is complicated by the fact that the pathology does not manifest itself with any symptoms for a long time. Often, the compaction is detected when the process has already moved to the isola. In this case, deformation of the shape of the nipple and areola may be observed. The species classification of invasive ductal breast cancer includes:

1. Well-differentiated carcinoma - characterized by a high similarity of tumor cells to normal ones.
2. An intermediate degree of differentiation of neoplasms involves the formation of various structures by cancer cells and the presence of intraductal necrosis.
3. Poorly differentiated carcinoma - atypical cells completely line the surface of the duct mucosa. In this case, calcifications and necrotic masses are detected.

Pre-invasive ductal

Cancer mammary gland in women (in this form) it spreads to the external areas and does not extend beyond the milk duct. Preinvasive ductal carcinoma represents the initial stage of disease development. In the absence of adequate therapy, the tumor process can malignize and become invasive. However, in most cases, treatment gives good results, which has a positive effect on the course of the disease.

Invasive lobular

In most cases of this form of cancer, the tumor is located in the upper outer part of the breast. On palpation, small compactions with uneven contours are detected. A characteristic feature invasive lobular breast cancer is the presence of chains of 4-5 cells. Usually the capsule in this form of oncology is well developed, the presence of trabeculae in the form of strands is noted.

Unspecified cancer

Such a neoplasm is difficult to recognize during morphological examination. Invasive breast cancer with an unspecified pathogenesis has a poor prognosis. To determine the form of oncology, an immunohistochemical study is performed, which determines the lobular or ductal nature of the lesion. The main types of unspecified cancer are:

1. Medullary – has a weak invasive ability, the tumor can reach large sizes.
2. Inflammatory - the clinic of this type completely duplicates mastitis, which complicates early diagnosis oncological process.
3. Paget's breast cancer affects the nipples and areolas.

Causes of breast cancer

Breast adenocarcinoma can develop in anyone, regardless of gender or age. However, women constitute the main risk group for breast cancer. Anatomical features mammary glands cause the fair sex to be susceptible to the formation of neoplasms. Provoking factors for the development of glandular cancer in women are:

• absence of pregnancy;
• late onset of menstruation;
• pregnancy after 30 years;
• improperly adjusted lactation;
• heredity;
• long-term hormone therapy;
• chest injuries;
• postmenopause.

Diagnosis of breast diseases

Adenocarcinoma is one of the types of cancer lesions that can be detected by the patient himself. IN Lately specialists pay special attention to teaching women a simple self-examination technique, which makes it possible to diagnose breast cancer at an early stage, when the likelihood of negative consequences small. You can learn about the scheme for conducting such an inspection from numerous photos and videos available to the general public. The main diagnostic measures used to detect invasive cancer are:

1. mammography;
2. blood test for cancer markers;
3. biopsy;
4. ductography.

Treatment of breast cancer

Therapy for cancer of any location comes down to complex measures to remove atypical cells from the body. Treatment begins with diagnosis of the disease, without which it is impossible to determine the size of the formation, differentiate the tumor and the causes of its occurrence. When choosing one of the treatment methods, the following are taken into account: the patient’s age, a history of severe pathologies, and general health. Along with this, specialists are obliged to listen to the wishes of the patient himself, who for some reason does not want to undergo any course of treatment.

This type of therapy is used for large tumors. Chemotherapy is used in postoperative period to prevent metastasis and possible tumor relapses. However, this method can also be used to reduce the size of a tumor before surgery. Chemotherapy is carried out in 4-7 cycles. The advantage of this method can be considered a complex effect on the body. Special preparations destroy “buried” atypical cells that cannot be cured by other methods. During the course of chemotherapy the following are used:

1. alkylating agents;
2. antibiotics;
3. antimetabolites;
4. taxanes (interfering with the process of pathogen division).

Surgical treatment of malignant tumors

Early stage invasive cancer can be successfully treated with surgery. Recently, with this kind of intervention, the method of oncological radicalism has prevailed. This approach is accompanied by significant functional damage to the patient. It is worth saying that today new methods of surgical treatment of cancer with immediate reconstruction of the lost organ are being developed. The duration of rehabilitation depends on the volume of intervention performed.

Radiation therapy course

This method is based on the use ionizing radiation. It is important to say that not all diagnoses of the oncological spectrum are amenable to radiation therapy. The procedure is carried out using iridium, cobalt, cesium. Radiation therapy is prescribed if the doctor has sufficient grounds to carry it out. Treatment of this type has many contraindications and side effects. Radiation therapy can reduce mortality from breast cancer or extend survival in hopeless cases to 5-10 years.

Hormone therapy

ERC-positive hormone-dependent tumors often appear in postmenopausal women. Most neoplasms have estrogen receptors. ERC-negative cancer affects the fair sex during perimenopause. If breast adenocarcinoma is suspected, an immunohistochemical study is prescribed, during which the hormonal status of the tumor is determined. If it is positive, the following types of therapy are used:

1. Adjuvant – carried out to prevent relapses.
2. Neoadjuvant – used to reduce the size of large tumors before surgery.
3. Therapeutic – aimed at eliminating the tumor.

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Invasive breast carcinoma is a pathology that can affect absolutely any person - at any age, both men and women. However, most often the disease is found in women of reproductive age.

Unfortunately, patients with carcinoma can live for a long time without knowing that they have a dangerous pathology.

But for successful treatment, it is very important to seek medical help as early as possible: for this it is necessary to understand and distinguish the typical signs of carcinoma.

ICD 10 code

• D 00-D 09 – tumors in situ;
• D 05 – non-invasive breast carcinoma;
• D 05.0 – non-invasive lobular carcinoma;
• D 05.1 – non-invasive intraductal carcinoma;
• D 05.7 – non-invasive breast carcinoma of other localization;
• D 05.9 – non-invasive breast carcinoma, unspecified;
• C 50 – malignant breast tumor.

ICD-10 code

C50 Malignant neoplasm of the breast

Causes of Invasive Breast Carcinoma

The reasons for the appearance of an invasive neoplasm in the mammary gland have not yet been fully established. Experts identify only risk factors that can serve as an impetus for the development of malignant pathology.

• Hereditary predisposition. If immediate relatives have had cancer, the likelihood that other family members will also become ill increases.
• Malignant tumor on one breast. If a patient has a cancerous tumor in one gland, the risk of developing cancer in another gland increases.
• Features of sexual development and reproduction of the patient. The risk of carcinoma increases if a woman experiences premature pregnancy. puberty, late menopause, late first pregnancy or primary infertility, etc.
• Benign neoplasm in the mammary gland. A benign process (cysts, fibroadenomas) can sometimes degenerate or serve as a trigger for the development of a malignant neoplasm.
• Exposure to radiation. Radiation like environmental factor, or used in medicinal purposes, significantly increases the risk of cancer.
• Endocrine disorders, disorders metabolic processes. Diseases such as diabetes, thyroid dysfunction, hypertension, and obesity contribute to the growth of atypical cells.
• Hormonal therapy, oral contraceptives. Hormone imbalance can also be an indirect cause of the appearance of tumors in the mammary gland.

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Pathogenesis

The stages of carcinoma progression, such as initiation, promotion and progression, are not fully understood. It is known that pathogenesis is provoked by mutational processes of proto-oncogenes, which are transformed into oncogenes and activate cell growth. Proto-oncogenes also increase the synthesis of mutational growth factors or affect external cellular receptors.

When the integrity of the cell is violated by estrogen hormones, the replication of the destroyed cell is activated even before the process of its regeneration. Estrogen interference is one of the mandatory conditions for the development of breast cancer. In this way, a stage such as promotion is launched. Distant metastasis occurs during the latent period ( clinical symptoms not yet expressed) - this usually occurs when the stage of angiogenesis begins in the lesion.

Symptoms of Invasive Breast Carcinoma

Carcinoma can be hidden for a long period without revealing any symptoms. The first signs of pathology often appear at later stages:

• the appearance of a dense area in the chest, independent of phase monthly cycle;
• visible changes in the outline, volume or shape of one of the glands;
• the appearance of liquid discharge from the milk ducts (usually light or bloody);
• external changes in the skin on the gland (wrinkles, peeling, redness, marbling, etc.);
• the appearance of compactions in the armpits (enlarged lymph nodes).

Later, signs of disease progression can be observed:

• the nipple becomes flat or inverted, the areola swells;
• some areas of the gland take on the appearance of a “lemon peel”;
• the gland is noticeably deformed;
• the skin over the source of pathology retracts (falls in);
• distant metastases are detected.

Pain is not typical for breast carcinoma.

Classifications of invasive breast carcinomas

Invasive breast carcinoma is a cancerous tumor that forms outside the lobular membrane or duct, directly in the breast tissue. Gradually, the process affects the lymph nodes in the armpit, as well as the skeletal system, brain, respiratory organs and liver.

If cancer cells are found in other organs, then we are talking about metastasis (that is, the spread of metastases).

There are several variations in the course of carcinoma:

• invasive ductal carcinoma of the breast - originates from the milk ducts (ducts), after which they degenerate cellular structures spread through tissue into the fatty tissue of the breast. Atypical cellular structures penetrate the lymph flow and circulatory system and disperse throughout the body. Invasive ductal carcinoma is considered the most common form of breast cancer;
• preinvasive ductal carcinoma is a condition that precedes the spread of a cancerous tumor deep into the tissue;
• invasive lobular breast carcinoma - occurs in approximately 15% of all cancer cases mammary glands. Invasive lobular carcinoma develops in the lobular structure of the breast, spreading further according to the principle of the previous two options.

Stages of invasive breast carcinoma:

• 0 – the process does not affect nearby tissues;
• I – the malignant lesion is less than 20 mm in size, lymphatic system not affected;
• II – tumor size is less than 50 mm, metastases are detected in the axillary lymph nodes on the affected side;
• III – the size of the tumor may be more or less than 50 mm, with adherent metastases in the lymph nodes, or in the lungs or skin;
• IV – there are distant metastases.

Until stage II, carcinoma is considered early. In stage III they speak of local spread of the process. Stage IV is called widespread or metastatic.

The degree of differentiation of the neoplasm (g) is assessed microscopically and can be determined by values ​​from 1 to 3. How more value g, the less degree of differentiation the tumor has, and the more unfavorable the prognosis.

• g1 – high degree of differentiation.
• g2 – average degree differentiation.
• g3 – low degree of differentiation.
• gx – it is not possible to establish the degree of differentiation.
• g4 – undifferentiated tumor (invasive breast carcinoma of a nonspecific type).

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Consequences and complications of invasive breast carcinoma

Invasive carcinoma is a very common pathology, and complications from this disease can occur with or without treatment. A malignant tumor grows directly in the breast tissue or milk ducts. It damages and presses on nearby tissues, nerve endings and blood vessels. The consequences of this situation can be bleeding and pain. An inflammatory reaction may occur if external damage to the skin occurs.

Mastitis can significantly worsen the course of carcinoma and accelerate the malignant process.

With distant metastasis in the affected organs, complications can also occur. The function of the respiratory or skeletal system, liver, and brain is impaired (depending on the spread of metastases). Often there is a constant headache, disturbance of consciousness, problems with bowel movements and urination.

Difficulties may also arise after surgery. Eg, complete removal glands often provokes the appearance psychological problems, and surgical resection of the axillary lymph nodes can cause swelling and a decrease in the range of motion in the upper limb.

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Diagnosis of invasive breast carcinoma

External examination and palpation of the breast is the first and main examination when invasive carcinoma is suspected. It is advisable to palpate the gland in the first half of the monthly cycle - this will provide an opportunity to obtain sufficient information about the condition of the breast. Palpation helps to suspect carcinoma, however, in the early stages of development with a small tumor size, this method may be ineffective.

Laboratory tests include tests for cancer markers - this is an understudied diagnostic method that demonstrates the body's tendency to develop cancerous tumors.

Instrumental diagnostics includes:

• mammography;
• ductography;
• pneumocystography;
• ultrasonography mammary glands;
• magnetic resonance and x-ray computed tomography.

Given the unpredictability of the malignant process, most specialists insist on a comprehensive examination of patients. It should include not only instrumental and laboratory diagnostic methods, but also an assessment of the function of the respiratory organs, liver, etc. This may require consultation with specialized specialists such as a pulmonologist, orthopedist, gastroenterologist, gynecologist and surgeon.

Differential diagnosis is carried out with a nodular form of mastopathy, with adenoma, mastitis and erysipelas in the mammary gland.

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Treatment of invasive breast carcinoma

Treatment of carcinoma involves an integrated approach, using chemotherapy, hormone therapy, radiation and, in most cases, surgery.

• Radiation therapy It is always used in combination with other medical procedures, and never on its own. Radiation is prescribed after a course of medication, after surgery, etc. It affects not only the area of ​​the affected breast, but also sites of possible metastasis (for example, the area of ​​the axillary lymph nodes). Sessions are carried out either immediately after resection, or against the background of drug therapy, but no later than six months after surgical treatment.

• Chemotherapy for the treatment of breast carcinoma is prescribed in the vast majority of cases, especially in the presence of metastases or in the late stages of the disease. Choice medicines for this treatment method is very wide. With pronounced tumor progression, medications such as cyclophosphamide, adriamycin, and 5-fluorouracil are usually used, which help prolong the life of patients even in the most advanced cases.

Chemotherapy is often used in the preoperative period to reduce the volume of the tumor, which significantly improves the prognosis of the operation. And the simultaneous use of drugs such as trastuzumab or bevacizumab makes the treatment as effective as possible.

• Hormone therapy it is also rarely used independently - this is allowed only in old age to ensure long-term remission. Hormonal drugs are successfully used in combination with other treatment methods. In this case, medications with estrogen-like effects that control tumor growth or drugs that reduce estrogen synthesis are prescribed. The first drugs include tamoxifen, and the second group includes anastrozole or letrozole. The listed medications are considered the first choice drugs for invasive carcinoma. The regimen for using these medications is strictly individual.

Surgical treatment can be done in several ways:

• the standard method of radical mastectomy involves removal of the mammary gland (while preserving the pectoral muscles for the possibility of mammoplasty);
• partial mastectomy, with the possibility of mammoplasty.

Subsequently, the shape and volume of the gland is restored using endoprosthetics or reconstruction with autogenous tissue.

In particularly severe advanced cases, operations are performed, the purpose of which is to alleviate the patient’s condition and prolong his life. Such surgical interventions are called palliative.

Homeopathy for the treatment of invasive carcinoma- This is enough controversial issue in medical circles. Most specialists traditional medicine admit admission homeopathic remedies for the prevention, but not for the treatment of malignant tumors. Of course, each patient decides for himself whether to trust homeopathy or not. The main thing is not to waste time and not to bring the disease to an advanced inoperable stage, when there can no longer be any talk of successful treatment.

The most common homeopathic remedies for gland carcinoma include Conium, Thuja, Sulfuris, Kreosotum.

Traditional treatment can only be used simultaneously with the traditional one, but not instead of it. Here are a few most popular recipes, which help inhibit tumor growth.

• Approximately 150 g of cherry pits are poured with 2 liters of goat milk and placed in the oven on low heat for 6 hours. The resulting medicine is drunk 100 ml three times a day in between meals. The duration of treatment is at least two months.
• Pure propolis is consumed 4-5 times a day, 6 g, in between meals.
• The color of the potatoes is collected, dried in the shade and an infusion is prepared: 1 tsp. raw materials - 0.5 liters of boiling water. Infuse for 3 hours. Take 100 ml three times a day 30 minutes before meals. Duration of treatment is one month.
• Birch mushroom is grated and infused for 2 days in warm boiled water at a rate of one to five. Next, the infusion is filtered and drunk at least three times a day 30 minutes before meals. Store the medicine in the refrigerator for no more than 4 days.

In addition, you can use the gifts of nature - herbs, leaves, berries or plant fruits. Herbal treatment involves the use of plants that have the following properties:

• stimulate the immune system in the fight against malignant cells (euphorbia, astragalus, duckweed, red brush, etc.);
• damage tumor cells (natural cytostatics - periwinkle, colchicum, comfrey, meadowsweet, burdock, etc.);
• stabilize the hormonal balance, compensate for the deficiency or excess of one or another hormone, for example, estrogens or prolactin (sparrow, black cohosh, comfrey, black root, etc.);
• accelerate elimination toxic substances and breakdown products from the body (milk thistle, dandelion, chicory, yarrow, etc.);
• eliminate pain (larkspur, peony, willow, black root).

Prevention of invasive breast carcinoma

The danger of developing a cancerous tumor haunts almost every woman, especially over 45 years of age. However, do not be alarmed, because there are preventive recommendations that will often help avoid the disease.

Of course, the existing hereditary predisposition cannot be eliminated. If there is one, then the only way out is regular visits to a gynecologist and mammologist, who can monitor the health of the reproductive system in general and the mammary gland in particular.

• do not smoke, do not abuse alcohol;
• treat in a timely manner infectious diseases, inflammatory processes in the genital area;
• avoid stress and excessive loads that can negatively affect hormonal levels;
Forecast

The prognosis for patients with invasive carcinoma depends on a number of conditions:

• from the presence of metastases;
• on the size of the tumor;
• on the degree of penetration into surrounding tissues;
• on the rate of tumor growth.

Unfortunately, for last years The incidence of carcinoma in the world has increased by more than 30%. For this reason, preventive programs have become mandatory in many countries to help recognize the disease at an early stage of development.

Invasive breast carcinoma, diagnosed at the first or second stage, ends in recovery in more than 90% of cases. If the malignant pathology was discovered much later, when the process of spreading metastases had already begun, then the prognosis becomes much more unfavorable.

Recently, the incidence of breast cancer in women has increased significantly. If the disease is detected in time and treatment is started, the likelihood of a successful outcome increases significantly. Therefore, you need to regularly visit a qualified mammologist. However, if you believe the statistics, in most cases doctors are able to detect stage 3 breast cancer, at which life expectancy is relatively short. Therefore, any woman must take her health very seriously and have a detailed understanding of this terrible disease.

general information

Breast cancer, or carcinoma, is a malignant tumor of an advanced form, in which the disease has entered an aggressive stage and has begun to affect soft fabrics and cells of neighboring organs. Stage 3 breast cancer, in which life expectancy in most cases does not exceed ten years, most often occurs in women closer to 65 years of age. At timely diagnosis and the beginning of treatment, there is a high probability that the patient will undergo surgery normally and will also live for a fairly long time. However, everything here depends on many nuances.

What factors influence the life expectancy of patients?

The survival rate for this cancer depends not only on individual characteristics body, but also from the following factors:

• cancer stage;
• histological structure of the tumor;
• hormonal receptor levels;
• accompanying illnesses;
• the patient's condition, etc.

It is also worth noting that life expectancy for any malignant tumor depends on what lifestyle a person adheres to. Therefore, it is very important to get rid of all bad habits.

Types of disease

The severity of the disease of a person who has been diagnosed with stage 3 breast cancer, life expectancy may depend on many factors. The disease is divided into three types:

1. 3A. The size of the tumor does not exceed five centimeters, and its localization extends to a maximum of 3 lymph nodes.
2. 3B. The cancer has begun to strike muscle tissue, and the size of the formation does not exceed 8 cm. At this stage of the disease, there is a great threat to the patient’s life, and in the absence of treatment, the likelihood fatal outcome increases very strongly.
3. 3C. The size of the tumor exceeds eight centimeters, and the affected area reaches 10 lymph nodes. In this case, there is practically no hope for a cure.

Each stage manifests itself differently and is accompanied by different symptoms.

Classification of the disease

There is no specific classification of breast cancer, however, it can be divided into two types: invasive and non-invasive. The first type is more aggressive and implies that the tumor has begun to affect healthy tissue outside the organ in which it first appeared. A tumor of this form spreads very quickly and, in addition to the lymph nodes, affects fatty and soft tissues, and is also transported along with the blood throughout the body. Non-invasive carcinoma develops very slowly and does not spread beyond one organ.

Forms of invasive carcinoma

Invasive unspecified breast cancer stage 3 is divided into the following forms:

• Invasive ductal carcinoma is one of the most popular forms of the disease, which is accompanied by painful sensations, nonspecific discharge, as well as changes in the shape and size of the breast.
• Lobular cancer - accompanied by the formation of compactions that appear outside the organ.
• Medullary form - most often diagnosed in younger women. It develops very quickly, but has no clinical manifestations of a malignant tumor.
• Adenoid cystic carcinoma is very rare. The tumor measures no more than three centimeters, does not pose a serious threat to the patient’s life and responds well to treatment.
• Secretory tumor is a very insidious form of cancer that affects both women and men of any age.
• Cystic breast cancer, metastases in which can spread throughout the body, occurs in medical practice very rare and affects women of middle and older age categories. The size of the formation can reach ten centimeters.
• Apocrine carcinoma is a very rare form of benign tumor, with which the patient can live throughout his life.
• Crib cancer is one of the mildest forms of the disease, which is highly treatable in the early stages. Very often accompanied concomitant diseases which may complicate treatment.

It is worth noting that stage 3 breast cancer, the life expectancy of which can vary, has many other forms, but those listed above are the most common.

Forms of non-invasive carcinoma

Non-invasive malignant tumors are divided into two types:

• ductal - a very insidious form of the disease, which often makes itself felt after complete recovery;
• lobular - does not metastasize, but can affect two breasts at the same time.

It is worth noting that in medical practice there is another type of this oncological disease, which does not have a scientific term. Its clinical manifestations are very similar to mastitis or some other diseases caused by various infections.

Reasons for the development of the disease

Breast cancer, the prognosis of which is not always grim, can develop for the following reasons:

• Unhealthy Lifestyle;
• improper diet;
• mammary gland injuries;
• hormonal disbalance;
• infertility;
• late birth;
• irregular sex life;
• state of ecology;
• overweight;
• heredity;
• consequences of inflammatory diseases;
• irradiation;
• failure in the stable activity of the endocrine system.

The most common reasons why invasive breast cancer develops are hormonal imbalance and lack of sexual activity.

Clinical manifestations of carcinoma

The disease can make itself felt in completely different ways, and the symptoms depend on the stage and shape of the tumor. The most common signs accompanying stage 3 breast cancer (life expectancy may vary, for example, the five-year survival rate is 55-80%) are:

• severe pain in the area of ​​tumor formation;
• red rashes on the skin;
• discharge of various contents and consistency;
• change in normal breast shape and size;
• the presence of formations that are easily palpable;
• swelling and inflammation of the chest and surrounding areas;
• ulcers;
• poor appetite and sudden weight loss;
• anemia;
• poor health, accompanied by constant weakness.

All these symptoms appear when invasive breast cancer has already begun to progress and developed into an aggressive form. The disease can be recognized in the initial stages by the shape of the nipple. If he wrinkles or retracts, then this is a serious reason to think about it and go to the hospital for examination.

Modern examination methods

Modern diagnostics of breast cancer allows doctors not only to identify the disease itself, but also to obtain comprehensive information about it, allowing them to create the most effective treatment program. This is very important because the clinical manifestations of breast cancer have many similarities with some other diseases.

When visiting a medical facility, the patient is prescribed:

• mammography and consultation with a specialized specialist;
• cellular analysis;
• blood and urine tests;
• computer and magnetic resonance tomography.

Professional diagnosis of breast cancer allows you to detect the disease at the earliest stage, at which it is best treated. Therefore, you should not put off visiting a doctor.

Treatment of carcinoma

Treatment of cancer can be carried out using different stages, however, the likelihood of a complete recovery and the patient’s future life largely depends on how timely it was started. Breast cancer, the metastases of which have already begun to grow, can also be treated, however, treatment methods and complete disposal of the tumor depend on the form and severity of the disease.

Chemotherapy and hormone therapy

These treatments are used as a supplement because they are not effective on their own. The thing is that even a small tumor can give metastases, which can lead to tumor growth throughout the body and damage to other organs. The use of chemotherapy and hormonal therapy makes it possible to localize the disease and slow down or completely stop its development.

Surgical treatment

Surgery to remove the mammary glands is considered one of the most popular methods of treatment in cases where other measures are completely useless. During the operation, surgeons completely remove the affected areas of soft tissue and organs. To restore the normal shape of the breast, plastic correction is performed, but this is possible after complete completion of treatment and the patient’s completion of a rehabilitation program.

Surgeries for breast cancer are the most radical method, so doctors perform them only in in some cases. It is important to understand that surgical intervention is not possible in the later stages of the disease.

Radiation exposure

This method is an alternative to chemotherapy and is used in conjunction with other treatments. Radiation therapy has a detrimental effect on malignant tumor, killing it and preventing further progression of the disease. The full course of therapy takes about six weeks, but the doctor may make adjustments to it depending on the clinical picture patient. It is worth noting that during the irradiation process, healthy cells also die, but during the rehabilitation period the body gradually restores them. If we compare radiation exposure with other modern types therapy, then it is one of the safest.

To avoid this terrible disease, women should regularly visit a qualified doctor. You can also do a breast self-examination at home. Take care of your health, and then you will not be afraid of any diseases.

Oncology is under study. Recently, among scientists there have been more supporters of antipathogenic cancer therapy. Invasiveness (in Latin invasio) is an attack by viruses, protozoa, and bacteria. Invasive (sometimes called "infiltration") cancer that originates from a duct or lobule. It is sometimes called "adenocarcinoma."

In a short time, the tumor leaves the breast duct and begins to metastasize to the liver, lungs, and brain. The prognosis when detected at the initial stage is more favorable. Invasive - of a nonspecific type, the origin of which is difficult to identify.

Kinds

Invasive unspecified breast cancer has a variety:

• Paget's cancer - affects the nipple and ariola of the breast, symptoms resemble eczema (an allergic disease).
• Erts - tumors occur in premenopause and postmenopause - hormone-dependent, in 65% of cases they have estrogen receptors.
• Medullary breast cancer - characterized by large formations, has low invasiveness - according to statistics, 8% of cases.
• Inflammatory breast cancer - similar to mastitis - according to statistics, 8% of cases. Symptoms: Swelling or redness that affects a third or more of the breasts. The skin may have ridges or pits appear, and the skin color is orange.

These symptoms develop because cancer cells block lymphatic vessels in the skin, preventing normal course lymph through the inflammatory tissue of breast cancer (BC), progresses quickly. When diagnosing stage III (tumor spreads to nearby lymph nodes), stage IV (tumor spreads to parts of the body).

Invasive ductal breast cancer, according to statistics in 70% of cases, occurs in the milk ducts mainly in older women. Depending on the composition of cells, it is divided into different types. The degree of cell classification is very important. Poorly identified by touch.

As the disease spreads, the shape or areola changes, and discharge from the nipple varies in consistency and color. Cancer cells start from the milk duct, break through the walls, and invade the breast tissue. It may be localized, close to where the tumor started.

If cancer cells spread throughout the body, pathological process in this case, they develop quickly and metastasize. Invasive begins in the ducts of the breast or glands, grows in the breast tissue. It can then spread to nearby lymph nodes and beyond. Lobular, ductal and Paget's cancers have an unfavorable prognosis. Treatment depends on the stage and extent of the lesion.

Causes

Menopausal women and older women are at high risk of the disease. Women who are obese, have lumps in the breast, women with a late first pregnancy (after 35 years of age) and women who have not had children are at high risk.

The main causes of breast cancer:

• mastopathy;
• fibroadenomas;
• abortion;
• cessation of lactation.

Symptoms

Invasive breast cancer may not have any symptoms, especially in the early stages. As the tumor grows, you may notice the following symptoms:

• A thickening in or near the breast or armpit area that continues after your monthly menstrual cycle.
• A mass or small lump the size of a pea.
• Changes in the shape, size, or contour of the breast.
• Blood or clear fluid from the nipples.
• Change in skin color on the breast or nipple.
• The skin on the breast and nipple is dimpled, wrinkled, scaly, or inflamed.
• Changing the shape or position of the nipple.
• Lump in the chest area.
• Pain between the shoulder blades.
• Breast asymmetry.
• Itching, redness, skin dying.
• Hardened areas under the skin.

You may notice changes if you do a monthly checkup. If you suddenly find signs of cancer, immediately see a doctor. He can be treated well if doctors come to the rescue in time.

Degree

After surgery, the stage and extent of the tumor is determined. It depends on how different cancer cells are from normal cells when viewed under a microscope. The higher the degree of difference, the more aggressive the disease behaves. To determine this, classification G (from the word Gleason) is used.

Gleason classification.

The doctor also checks the sample for estrogen and progesterone receptors. This test shows how female hormones– estrogen and progesterone – affects malignant cells. If the test is positive, this means that hormones cause the growth of cancer cells.

In these cases, treatments are used that suppress and block hormones that cause cancer cells to grow. The cancer will also be tested for a gene called HER2. The dominant oncogene that gives the command to grow. If one is found, additional drugs such as trastuzumab (Herceptin) can be used. If it spreads to other parts of the body, additional tests are performed.

Stage

The TNM system is used to determine the stage of cancer:

Stage I – small tumor.

Stage II - neoplasm 2 - 5 centimeters with or (without) metastases to the lymph nodes.

Stage III is a large tumor with metastases to the lymph nodes, which may have spread to the chest wall.

Stage IV is a tumor that has spread to other organs in the body (metastasis).

Diagnostics

Diagnosis begins with an independent examination, which is carried out in a lying position, standing with a raised hand behind the head, in a tilted position. The surface of the entire palm must be palpated (palpated) for the presence of swelling or lumps in the chest and under the arms. If a change in the color and structure of the skin of the breast or nipples is detected, the nipple is pulled inward or asymmetry appears, this is a reason to do a mammogram.

Basic diagnostic methods:

• Mammography – detects cancer at any stage.
• Blood test for cancer markers.
• Ultrasound – determines the location and size.
• MRI – establishes the characteristics of the tumor.
• Ductography reveals a tumor measuring 5 mm.
• Biopsy – allows you to take material for laboratory testing to determine the stage and type of tumor.

Invasive breast cancer is life-threatening, but it can be stopped.

Biomarkers

At first, scientists thought there was only one type of breast cancer. Now they know that this is not true. There are different subtypes of breast cancer, and a pathologist determines which subtype a patient has by looking for specific molecular markers and cancer cells. Markers are divided into three categories:

• Those that are used to help determine the prognosis of a particular cancer and how life-threatening they pose.
• Those that are used to predict how a cancer will respond to a certain treatment.
• Those that do both studies.

By classifying a patient's tumor with a molecular marker, the pathologist provides the patient and physician with information that will be used to determine the best treatment options.

Treatment

Invasive breast cancer uses the following treatment methods:

1. A lumpectomy is a surgical procedure in which the surgeon removes the tumor and a small area of ​​healthy tissue around it.
2. A mastectomy, a procedure in which the entire breast is removed, may be performed after chemotherapy.
3. - This drug treatment may be done before surgery to reduce swelling. Sometimes done after surgery to try to stop the cancer.
4. Radiation therapy is very often given after chemotherapy and surgery to prevent cancer from returning.
5. Hormone therapy is carried out if tumor cells have hormone receptors.
6. Targeted therapy is a drug treatment carried out if cancer cells have the HER2 gene.

During treatment, the doctor uses one or a combination of therapies to achieve a favorable result. The specific procedures and treatment order depend largely on the stage and characteristics of the tumor. The following factors influence the treatment of the disease:

• results laboratory research on cancer cells.
• General health.
• Location of the tumor.
• Stage and grade of cancer.
• Age.
• Reproductive age or menopause.
• Heredity.
• Test results for gene mutation.

Prevention

No one is immune from cancer, but there are things that can increase your chances of living. Basic preventive measures:

• self-examination – once a month;
• medical examination – once a year;
• limit the use of contraceptives;
• do not stop breast lactation;
• control body weight;
• prevention of diabetes mellitus;
• eliminate alcohol and nicotine;
• active lifestyle.

Taking preventative measures is much easier than spending money on long-term treatment.

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