Breast cancer is a common malignant tumor disease.According to medical statistics, it is diagnosed in about 10% of female representatives, with the highest prevalence of pathology in Europe.Most cases of illness occur at the age of over forty-five years.It should be noted that in developed countries there is a tendency to reduce the incidence rate due to early screening of the disease.
As a rule, malignant neoplasms of the breast have a heterogeneous structure and consist of different types of cells with different growth rates and response to therapy.Therefore, it is not always possible to accurately predict how pathology will develop.In a number of cases, tumor growth is very slow and almost asymptomatic for a long time, in other situations, deterioration of the condition occurs rapidly.The success of breast cancer treatment depends on qualitative early diagnosis.Table of Contents: Causes of Breast Cancer Development Breast Cancer: Varieties and Signs Early Diagnosis of Breast Cancer Breast Cancer Treatment Methods Breast Cancer Surgery Breast Therapy for Breast Cancer Treatment in Women Hormonal Therapy for Breast Cancer Prognosis Survival Data
Causes of developing breast cancer
There are many factors that can somehow contribute to the occurrence of breast cancer.The underlying causes of the development of a dangerous ailment are associated with genetic or hormonal changes.In the latter case, the effect on the formation of a malignant tumor is exacerbated by the activity of estrogens.
The risk factors for malignant breast processes include:
- weighed down family history, when breast cancer was detected in relatives;
- earlier onset of menstruation( up to twelve years) or late menopause( later than fifty-five years old) - this indicates a high activity of estrogens;
- malignant neoplasms of another site;
- various genetic disorders;
- , the risk of developing breast cancer is higher in nulliparous women, as well as those female representatives whose first pregnancy occurred at the age of over thirty-five years;
- exposure to radiation, such as radiation therapy, adverse environmental conditions, hazardous working conditions, frequent X-ray examinations, etc.;
- exposure to carcinogens;
- is a sedentary lifestyle;
- bad habits, such as smoking and alcohol abuse;
- uncontrolled intake of hormonal contraceptives or long-term hormone therapy.
Attention ! Numerous studies show that the risk of developing breast cancer increases in women of high growth, as well as overweight women in the postmenopausal period.
All of the above factors do not cause cancer directly, but create a favorable background for the development of malignant processes.Of course, overweight and high growth does not mean that the woman will necessarily have cancer, but such circumstances may increase the risk of its appearance.As a rule, the formation of a tumor occurs under the influence of several provoking factors.
Breast cancer: varieties and signs
In clinical practice, several types of breast cancers are distinguished:
- nodal form - nodular compaction in thoracic tissues of round or irregular shape, painless to the touch.When you raise your hands at the site of the localization of the tumor, you can see the cavity, the skin is wrinkled.At later stages, ulcers on the skin, deformity of the mammary gland, an increase in lymph nodes in the subclavian and axillary region may occur;
- edematous-infiltrative form of breast cancer - is more common in young patients.The tumor can cause a slight soreness, while it takes up almost the entire volume of the gland.Skin covers in the affected area begin to resemble an orange peel, there is swelling, which is especially pronounced near the nipple, also an increase in lymph nodes in the axillary region;
- is a rosy-like form - a type of cancer resembling erysipelas, accompanied by unevenness and redness of the skin, a tightening of the breast.At palpation the nodal formations are not probed;
- mastitis-like form of breast cancer - occurs in women of any age group, more often - in young patients.When the disease develops edema, as a result of which the breast increases in volume, the temperature of the body and skin rises.In the thickness of the chest, one can grope for a major painful compaction;
- armored form - tumor germination occurs through the entire thickness of fat and glandular tissue, the pathological process can spread to the second breast.The main symptoms of this type of cancer include reducing the volume of the breast, multiple seals, uneven skin in the pathological area, limiting the mobility of the breast;
- Paget's cancer is a rare form of a malignant disease that occurs in no more than 5% of patients.It is characterized by the formation of a crust near the nipple, the presence of erosive foci and ulcers on the skin of the breast, itching, deformity of the nipple.In later stages, the tumor metastasizes to the lymph nodes, so with a timely begun treatment, the prognosis is usually favorable.
Like most malignant diseases, breast cancer is very difficult to detect in the early stages, since for a long time it may not have clinical manifestations.Severe soreness, swelling, a feeling of discomfort, retraction of the nipples, pathological discharge from them and any other symptoms require an urgent appeal to a specialist.
Please note! If you have found a seal in your chest, even if you have no other symptoms, it is better to consult a doctor immediately to find out the nature of the lesion.
To determine the extent of the disease, a special table is used: the letter T denotes the condition of the primary tumor, M indicates the presence of metastases in other organs, and N the tumor metastasizes to regional lymph nodes.
Malignant neoplasm can be localized in various parts of the breast: in the area of the skin, areola and nipple, in the area of the upper or lower inner square of the gland, the upper or lower outer square, in the back axillary part, etc.
Early diagnosis of breast cancer
Early diagnosis of breast tumors should include regular self-examination, visit to a mammalian doctor.After forty years, it is recommended to undergo a mammogram routine every year for preventive purposes.
It is advisable to perform a self-examination of the breast every month on the fifth-seventh day of the menstrual cycle.On examination, special attention should be paid to the symmetry of the mammary glands, the condition of the skin and nipples, and also whether the size of one breast has changed.Palpation can be performed in a prone or standing position.In turn, it is necessary to feel the two glands with fingertips, starting from the nipple towards the outer part.Disturbing signals will be any seals in the tissues of the breast or in the nipple.Also, attention should be paid to the condition of the lymph nodes in the subclavian and axillary regions.
If you see any suspicious symptoms, you should contact a specialist.
An accurate diagnosis can be made only after a comprehensive examination including the following diagnostic methods:
- examination by a mammologist;
- ultrasound examination;
- tissue biopsy of the neoplasm;
- laboratory studies of discharge from the nipple;
- blood test for hormones and oncomarkers.
Important! For the purpose of early diagnosis of breast cancer, all women who have crossed the forty-year line are recommended to undergo three screening tests per year: mammography, hormonal blood analysis and research on CA 15-3 oncomarkers.
With the diagnosis of "breast cancer", the extent of the spread of the malignant tumor is determined by the results of additional diagnostic methods:
- chest X-ray,
- bone examination,
- ultrasound abdominal examination and others.
Methods of treatment of breast cancer
Modern methods of treatment of breast cancer include surgery, chemotherapy and radiation therapy, as well as hormonal and immunotherapy.Therapeutic tactics for breast cancer are always chosen individually and most often consists of a combination of several techniques.
Surgical treatment of breast cancer
The main method of treatment of malignant breast tumors is surgery.The development of modern medicine makes it possible to produce gentle interventions with the preservation of the maximum possible volume of the gland tissues.After the operation, radiation and chemotherapy are usually prescribed.
There are several operational techniques by which surgeons-oncologists remove tumors:
- radical resection - excision of the breast with lymph nodes and subcutaneous fat;
- radical mastectomy - removal of the whole breast with lymph nodes and subcutaneous fat.To date, in medical practice, such intervention is extremely rare;
- quadrantectomy is the treatment of breast cancer by excising directly neoplasm with adjacent tissues within a radius of several centimeters.The method is effective in the early stages of the disease;
- Lumpectomy is the minimal surgical intervention for breast cancer, involving excision of the neoplasm and lymph nodes.
Radiation therapy for the treatment of breast cancer in women
As for the radiation therapy used in the treatment, it can be preoperative, intraoperative, postoperative and independent in case of malignant lesion of the breast.The main goal of radiotherapy before surgical intervention is to destroy the maximum number of cancer cells, which makes it possible to translate the tumor into an operable state.In the postoperative period, radiation therapy is necessary to reduce the risk of relapse.
In a number of cases, radiation exposure is used directly in the course of surgery, when the surgeon tries to keep as many of the gland tissues as possible.If surgery is not possible, radiation therapy is used as an independent therapeutic method.In addition to remote radiation therapy, interstitial can also be used, in which the source of radiation is fed directly to the neoplasm.Radiation is also affected by lymph nodes.
To medicamental methods of treatment of the considered pathology the chemotherapy assuming reception of cytostatics - the medical products destroying malignant cells concerns.Such therapy has a mass of side effects, therefore its appointment is performed only in accordance with the regulations and taking into account the patient's condition.
Hormonal therapy for breast cancer
Since breast cancer is provoked by increased activity of estrogens, an appropriate hormonal correction can be prescribed.It is effective when a woman diagnoses a cancer that has hormonal sensitivity.The methods of hormonal therapy include surgery to remove the ovaries, as well as taking medications that are selected by the doctor in a strictly individual order.
When preparing a treatment plan, the doctor must take into account the type and size of the tumor, the presence of regional and distant metastases, the results of laboratory and instrumental studies, the general condition of the patient.
Special place in the treatment of breast cancer is given to competent rehabilitation.Therapy of such a serious disease is always associated with psychological and social difficulties, so special attention should be paid to the adaptation of patients.Reconstructive plastic surgery can be used to restore the appearance of the mammary glands.They can be performed immediately after an intervention to remove the tumor.
To date, breast cancer is the most studied of all cancers, and identified at an early stage, it is very successfully treated.When composing an individual prognosis, it is necessary to take into account the anatomical form of growth, size, localization, rates of tumor development and other criteria.
The most favorable prognosis is observed with hormone-dependent tumors, since the disease in this case has a long pre-tumoral period.There are also tumors of the so-called favorable histological type.They are easier to treat than, for example, invasive ductal neoplasms, even if the latter have very small dimensions.
The prognosis of the disease under consideration is also largely determined by the degree of metastasis.Studies prove that breast cancer can be treated worse, in which more than four lymph nodes are affected.The most favorable is regional metastasis in breast cancer, in contrast to hematogenous metastasis.The last form can indicate the lack of metastases in the lymph nodes with a tumor size of more than two centimeters.The worst prognosis is noted in the presence of distant metastases.No less important is the indicator of oncomarkers.If their level is elevated, there is a high probability of tumor metastasis or recurrence.
An indicator of the success of treatment of breast cancer is the five-year survival rate, which in the present case is about 55%.In the absence of adequate therapy, this indicator is reduced to 10%.The prognosis of survival in breast cancer is influenced by many factors.If we consider survival statistics by stages, then in the first stages with a tumor size of less than two centimeters, the five-year survival rate is up to 95%.In the second stage of breast cancer with a tumor size of up to five centimeters in the presence of malignant cells in several lymph nodes, this figure is about 55-80%.
With the involvement of lymph nodes and the germination of malignant cells of a large tumor into the skin of the breast in the third stage of cancer, the five-year survival rate among patients is less than 50%.At the fourth stage in the presence of distant metastasis - up to 10%.
However, if you follow your own health, undergo a regular screening test and immediately start a combined treatment when a tumor is detected, the prognosis of the disease can be more comforting.As practice shows, the most effective in breast cancer is the combination of surgical treatment with chemotherapy and radiation therapy.Observance of the doctor's recommendations, as well as a healthy lifestyle and diet, will help to prolong life and maintain health.
Viktorova Julia, obstetrician-gynecologist doctor