What are the symptoms of breast cancer. Signs of a malignant neoplasm of the breast

Cancer - the word has become synonymous with death, and the first signs of breast cancer in women are perceived by some as a death sentence. But is it? Is there light at the end of the tunnel?

The first symptoms of breast cancer are very different and often resemble other, less dangerous diseases, so it is extremely important for a patient to contact a specialist.

Breast cancer as a global problem

A woman often herself, when examining and feeling the breast, reveals alarming signs. Sometimes she is alarmed by soreness or swelling, which can act as the first symptoms of breast cancer.

Breast cancer in women is a worldwide problem. More than a million new cases are recorded every year. But, at the same time, breast cancer is the most studied form of cancer. If the diagnosis is carried out in a timely manner and the therapy is chosen correctly, the patients recover and live a full life.

Elderly women are the most affected. But there are quite a few regions in the post-Soviet space where tumors are diagnosed in women of childbearing age. The provoking factor of this phenomenon is the consequences of the explosion at the Chernobyl nuclear power plant in 1986.

How to recognize the symptoms

The mammary glands are located on the chest in the area from 3 to 7 ribs. They include lobes, ducts, adipose and connective tissue, vessels for the flow of life-giving fluids. Blood and lymph are in charge of nutrition and purification from tissue decay products. The task of the lobules is to produce milk, which flows through the tubes into the milk ducts and then into the nipple. Consider how breast cancer manifests itself.

The vessels of the lymph flow flow into the lymph nodes under the arm. When single cancer cells reach the lymph nodes, they settle there and form a cancerous node. How to identify breast cancer?

Every woman should conduct a self-examination constantly in order to recognize the symptoms of breast cancer.

It is done like this:

1. We examine the glands in the mirror - is there an increase in one breast relative to the other.
2. With gentle movements in a circle, the iron is probed, if nodules, seals, changes of any nature are found, we examine it in more detail.

If you find a number of serious symptoms, you should immediately consult a doctor.

These include:

• we see wounds and various lesions on the nipple;
• there is pain when pressed;
• we see the allocation of lymph or ichorus;
• the shape is broken on palpation;
• the skin in some area is unnaturally retracted;
• irritation and peeling of the skin is noted on the nipples;
• the nipple is retracted, which was not previously noticed;
• we see an open wound or sore;
• the mammary gland is swollen and reddened;
• under the arm hurts when pressed or moved.

Similar signs are observed with various lesions of the breast tissue, but only a doctor can recognize the first symptoms of cancer and decide how to carry out further diagnosis.

When confirming the presence of a tumor, the doctor prescribes a series of studies to diagnose the type of formation and determine the ways of treatment.

Half of women over 30 years of age have changes and indurations in their breasts. If such a manifestation is noticed, there is no need to panic, but you should visit a gynecologist. The specialist will examine the glands and be able to determine the first signs of breast cancer in women and the type of neoplasm.

Reasons for the defeat

Every second woman who gets sick dies from breast cancer.

Doctors do not know what exactly provokes malignant breast cancer and transforms tissues into a pathological neoplasm. To date, it has only been found out that a certain type of hormones produced in a woman's body provokes the formation of tumors of the glands, but how this happens is unknown.

Physicians often wonder how certain flaws in the hereditary apparatus transform properly functioning cells into aggressive ones. The genetic mechanism of DNA transmits information about their purpose and work. Descendants share traits with their ancestors because they inherit their DNA.

There are genes that control cell division and development. As a result of their aging or shortening of telomerase, a pathological process is triggered and cancer occurs.

There are genes that promote cell division. They are called oncogenes. Others are responsible for slowing down the development of tumors. Some studies confirm that the appearance of neoplasms can be triggered by damage to the genes responsible for the development or inhibition of cells. Such genes are known under the label BRCA. When mutated, they cannot control this pathological process. There is evidence of inherited changes in DNA that can cause tumor growth.

Provoking factors

There are conditions that determine the risk of cancer. But the presence of such factors is not a sentence. The risk of getting sick may decrease or change over time depending on age and living conditions.

Permanent factors include:

• gender;
• age group;
• heredity;
• race;
• exposure;
• Lifestyle;
• the presence of children.

Belonging to the weaker sex is already considered a risk factor. This gland is larger in women and consists of more tissue than in men. Women's cells are attacked by hormones, so this type of cancer is usually female. There are manifestations of cancer in men, but this is rather an exception.

There is a directly proportional relationship between the risk of developing cancer and a woman's age. The older the fair sex, the higher her chances of becoming a patient of an oncologist. Approximate figures look like this: in 20% of cases, the first signs of illness in women are determined before the age of 50, in 80% - in the older age category.

Doctors are quite confident about the mutational cause of breast cancer. Approximately 1 in 10 affected women inherited the disease due to a breakdown of BRCA1 and BRCA2.

In a healthy body, these genes should be "soldiers" that do not allow uncontrolled cell division. The broken gene usually comes from one of the parents. Then the risk of getting breast cancer increases many times and three times increases the chances of becoming a patient of an oncology clinic. Such women also inherit the risk of getting cancer of the reproductive organs - ovaries and uterus.

Recent studies have confirmed the presence of additional gene factors that affect the possibility of developing breast cancer. This is the ATM gene, which is responsible for repairing a broken section of DNA. A study of biological material in families where symptoms of breast cancer often appear confirmed the failure of this gene. Another gene, CHEK-2, when mutated dramatically increases the risk of disease.

The medical literature describes cases of a very frequent incidence of oncology in families where such a pathology was repeatedly diagnosed in ancestors. If the mother or grandmother had cancer of the reproductive organs, then the woman has almost one hundred percent chance of getting this disease. The correlation of these factors is very high, every third patient has a relative with a cancer pathology, this is especially clearly seen in breast cancer.

If the cancer has already been, then the risk of recurrence is 75%. Carcinoma affects the same gland or another, healthy breast.

White women are affected by a tumor of the mammary glands more often than blacks and Asians. In women of African descent, the statistics are distorted due to late detection of cancer and the presence of forms that are not treatable. Perhaps the racial trait contributes to a more acute course of the tumor.

Asian women show the lowest percentage of this type of cancer on the planet.

The dependence of the risk of developing the disease on the hormonal cycles of the female body has also been proven. The most frequent cases of breast cancer occur in patients who entered childbearing age very early (from 11 years old) or left it too late (after 55 years).

An important factor experts call the absence of children or the birth of the first child over the age of 30 years. Some researchers consider it important whether a woman breastfed her children.

If the patient was treated for cancer earlier, several years before the onset of a secondary tumor, and the treatment was radiation, then the risk of recurrence of breast cancer increases several times. This is especially true for young women of childbearing age.

Common Complaints

Not always oncology in women can be manifested by formations in the breast. Very often, especially in Russia, women come to the doctor in the last stages of the disease, ignoring the initial symptom. The most common complaints are pain and discomfort.

There are the following examination methods for detecting breast cancer:

• determination of the properties of the formation, its size, sprouting into the muscle or chest;
• monitoring changes in the skin of the mammary glands for the presence of edema, nodes, seals;
• changes in the nipple to retraction, destruction, the presence of leakage, peeling;
• monitoring the shape and condition of the lymph nodes located near the tumor;
• changes in the structure of the skin, its color and appearance, the presence of rashes and ulcers.

If there are signs of an illness, it is necessary to use laboratory methods of examination.

Women who regularly see a gynecologist are screened for breast cancer. If unfavorable signs are detected, the patient is sent for an additional examination to a mammologist and laboratory tests.

These include:

1. Blood test for oncological markers and general blood counts. Often, a cancer marker is not detected, although the pathology is present, since in some types of cancer it is simply not produced by the body.
2. Breast scan - very often used in the diagnosis of cancer. If the mammogram is negative, cancer is ruled out, if it is positive, a biopsy is prescribed.
3. Biopsy - taking a piece of tumor tissue for histological examination.
4. Ultrasound examination of the mammary glands - helps to diagnose a benign formation (cyst) and distinguish it from a malignant one.

Biopsy and histological examination are the main procedures for determining malignancy.

Diagnostics is carried out in several ways:

• puncture of the formation with a thin biopsy needle to obtain fluid samples for analysis;
• cutting off part of the formation during surgery;
• puncture biopsy, puncture of the tumor with a thick needle to take a sample, anesthesia of the puncture site is performed before the procedure;
• excising biopsy, in which the size of the tumor and the structure of its tissues are visible;
• aspiration cytology in case of suspected cyst-like formation - fluid is removed from the cyst with a thin needle to analyze the presence of cancer cells;
• X-ray of the thoracic region - if you need to determine the growth of the tumor in the lung tissue;
• bone scan to determine bone damage;
• computer and magnetic resonance imaging - involves x-ray photography of the affected area from different angles to establish breast cancer in women.

If breast cancer is detected at the stage of manifestation of primary signs, you should immediately contact the clinic and undergo the necessary examinations. If the first symptoms of cancer are detected in a timely manner, this gives a woman a chance to undergo the necessary treatment and live for many more years.

Video

From our video you will learn by what signs you can independently determine pathological formations in the chest.

Breast cancer (BC, breast cancer) is one of the most common malignant neoplasms in women. According to WHO, about one million new cases of cancer are registered every year in the world. Most often, patients have crossed the 40-year mark, however, in young women this disease can also be diagnosed. Rarely, but still, the occurrence of cancer of this localization is also possible in men, especially those who have signs of gynecomastia (enlargement of the mammary glands) against the background of any hormonal disorders.

Almost every woman, one way or another, faced with certain changes in the mammary gland. At a young age, dyshormonal processes and benign tumors are most common, and cancer accounts for no more than 5% of cases. During menopause and after its onset, the risk of developing cancer increases significantly, so the age category of patients with a tumor is 50-70 years.

The mammary gland, in addition to its main function - lactation during breastfeeding - is also important from the standpoint of the aesthetics and appearance of a woman, so any problems, and especially surgical interventions, accompanied by removal of the organ, bring considerable psychological discomfort. There are frequent cases of severe depression after radical breast surgery. To avoid such consequences, you need a reverent and attentive attitude to your health, and regular medical examinations are extremely important for the timely detection of the disease.

Breast cancer is one of the most studied types of human tumors. and research on the mechanisms of its occurrence and ways to combat the disease continues to this day.

The first information about this insidious disease was found in ancient Egyptian papyri. Then the tumor was cauterized, and no one knew about metastasis, so the disease always ended in death. With the development of medicine came the realization of the possibility of tumor spread through the lymphatic and circulatory system, which was reflected in numerous observations. Removal of the regional lymphatic collectors along with the tumor was a real breakthrough on the way to a truly effective cancer treatment.

Today, science has invaluable knowledge in the field of causes, diagnosis and effective treatment of malignant tumors. However, despite the positive results of modern medicine, the frequency of launched forms remains high (up to 40%). Such sad statistics are due to the low awareness of the population about the first symptoms of the disease and methods of self-examination. Often, women themselves ignore visiting a antenatal clinic or a mammologist, referring to employment, postponing the visit indefinitely, etc.

In many countries, including those in the post-Soviet space, there are no adopted mandatory screening programs aimed at mass examination of a large number of people at risk (women over 40). A wide coverage of such a study as mammography would allow diagnosing much more early forms of a breast tumor, and, accordingly, achieve better treatment results.

It is known that with early detection of a malignant neoplasm of the mammary gland, it is possible to achieve a complete cure in more than 95% of cases, and mortality is reduced by at least a third.

Why does cancer appear?

Any woman who is faced with the problem of breast cancer asks herself the question: why did the tumor develop in her? What were the reasons for this and could the disease have been avoided?

Today known and studied risk factors that greatly contribute to the development of cancer:

• Genetic predisposition, unfavorable family history;
• Early onset of menstruation and late onset of menopause;
• Absence or late first birth;
• Benign lesions of the parenchyma of the mammary gland;
• Changes in metabolism and pathology of the endocrine system;
• Long-term use of hormone-containing drugs;
• The presence of mutations in the BRCA1 and BRCA2 genes.

It has long been observed that women whose mothers or grandmothers suffered from malignant tumors of the breast are much more likely to develop cancer, which led to conclusions about availability family predisposition to the disease.

Since the mammary gland is a hormone-dependent organ, that is, it has receptors for female sex hormones, any endocrine disorders, in general, and genitals, in particular, contribute to pathology. Early onset and late end of menstrual function, disturbances in the work of the hypothalamic-pituitary-ovarian system, abortions, early and multiple births or their absence, ovarian diseases contribute to hormonal changes that cause disruption of cell reproduction processes and hyperplasia of the glandular tissue, which becomes the basis for the development of mastopathy .

In addition to dyshormonal disorders, obesity, diabetes mellitus, arterial hypertension, thyroid and liver pathology contribute to the appearance of a malignant tumor of the mammary gland.

Among the external causes that increase the risk of developing a malignant tumor of the breast, a special role is given to smoking, exposure to carcinogens, contained in food and household chemicals, dietary errors with a predominance of fatty foods, as well as ionizing radiation.

Long taking hormonal drugs, prescribed for the regulation of the menstrual cycle, the treatment of infertility, as well as in postmenopausal women with endometrial pathology, can also increase the likelihood of a tumor to some extent. However, in recent years this issue has been debated, and new data regarding modern drugs deny the existence of such a risk.

A special place among the causes of cancer of various localizations is given to genetic disorders. The successes of modern molecular genetics have made it possible to identify a number of genes whose mutations are most often found in certain neoplasms. Such mechanisms of carcinogenesis have been very convincingly demonstrated in relation to breast tumors. It has been proven that carriers of mutant BRCA1 and BRCA2 genes have a high probability of developing a tumor, while the BRCA1 gene is also associated with the risk of ovarian cancer. Thus, the breast cancer gene is known, and its detection is available in large clinics using modern equipment.

the ratio of the number of cases of breast cancer and identified hereditary factors

Examination of women at risk is the basis of oncogenetic counseling aimed at identifying a hereditary predisposition to malignant neoplasms of the breast among close relatives of sick women, as well as among those whose mothers or grandmothers had a tumor. There are cases when women who had the described mutations were found to have resorted to the removal of the mammary glands in advance, without waiting for the development of cancer.

Precancerous processes in the mammary gland

The main place among precancerous changes in breast tissue is given to hyperplastic processes, united in the group of mastopathy. Often this pathology is considered as a precancerous process.

signs of potentially precancerous breast changes

Mastopathy represents hyperplastic changes, accompanied by proliferation and an increase in the proportion of the glandular component in relation to the stromal. In other words, the mass of glandular tissue in the form of lobules increases. At the same time, the phenomena of epithelial dysplasia, accompanied by a violation of cell differentiation with the appearance of signs characteristic of malignant tumors, are not uncommon. Mastopathy, or fibrocystic disease, is classified as a dishormonal disease that occurs when endocrine function is disturbed, pathology of the female genital organs. Frequent abortions, taking hormonal drugs, metabolic factors, in particular obesity, greatly contribute to this kind of change. Women of young age are most susceptible to mastopathy, and according to various sources, its signs can be found in more than half of the female population of the globe.

fibrocystic disease characterized by soreness, an increase in the volume of the mammary gland, uneven tissue compaction. The process can be both diffuse and focal with the formation of nodes and cysts in limited areas of the organ. In all cases, morphological examination reveals areas of excessive proliferation of the epithelial component, an increase in the number of lobules and interlobular connective tissue, as well as dysplasia. Although mastopathy is a benign process, the presence of epithelial dysplasia makes it a dangerous condition in terms of the prospect of malignancy of its foci.

Timely diagnosis and treatment of hormonal changes preceding fibrocystic disease can significantly reduce the likelihood of cancer in the future.

In addition to mastopathy, it is also possible to detect a benign tumor of the mammary gland - papillomas or adenomas, consisting of the epithelium lining the ducts or forming its lobules, as well as fibroadenoma, which has a mixed epithelial-connective tissue structure. Fibroadenoma often occurs in young girls in the form of a single dense node; in itself, it does not pose a danger with timely diagnosis and removal.

Types of malignant breast tumors

There are various approaches to the classification of malignant tumors of the breast, and the localization, size, degree of differentiation and histological type of cancer, growth characteristics and the presence of receptors for female sex hormones estrogen are of decisive importance in determining treatment tactics and prognosis.

According to the nature of tumor growth in the parenchyma, cancer is:

1. Nodal - in the form of a limited node in the thickness of the gland;
2. Diffuse - the tissue of the organ germinates, does not have clear boundaries.

Atypical forms of growth are possible - Paget's cancer, primary metastatic cancer.

The size of a primary cancerous node often reflects its degree of malignancy. The larger the tumor, the more aggressive and prognostically unfavorable it is.

distribution of tumor locations

Localization determines the stages of metastasis along the paths of lymphatic drainage. The location of the tumor is characterized by the corresponding quadrant - a tissue fragment obtained by schematically dividing the gland into four equal parts.

Histological types of breast cancer are distinguished depending on the source of growth:

• Ductal cancer arising from the epithelium of the lactiferous passages;
• Lobular cancer, the source of which is the glandular cells of the lobules.

Invasive breast cancer can be both lobular and ductal, and involves the penetration of the tumor through the basement membrane, on which epithelial cells are located. This type of growth makes it more aggressive and prone to metastasis.

ductal carcinoma (left) and lobular carcinoma (right) - types of breast cancer in terms of histology

Among the histological variants of malignant tumors of the breast the most common are adenocarcinoma (glandular cancer), solid cancer (undifferentiated variant), and transitional forms. Such a classification is complex and necessary for oncologists-mammologists.

Early cancer is the initial stage of tumor development, when cells spread beyond the basement membrane, but no deeper than 3 mm. As a rule, metastasis is not characteristic of this stage, since there are no vessels, and the prognosis is almost always quite favorable.

As for other malignant neoplasms, a classification of breast cancer has been developed according to the TNM system, which characterizes the features of the primary tumor and metastases. Given the possible combinations of manifestations for TNM There are four stages of breast cancer:

• Stage I - a tumor no more than two centimeters in diameter, there is no germination into the surrounding tissue and no metastases;
• II stage (a, b) - tumor 2-5 cm, possibly growing into the surrounding tissue and damage to regional lymph nodes;
• IIIa, IIIb - a tumor of more than five centimeters, germinating the surrounding tissues, the presence of lymphogenous metastases in the axillary lymph nodes and beyond;
• Stage IV - distant metastases were detected, regardless of the size of the primary tumor and the involvement of the lymph nodes.

Metastasis

Metastasis is considered an integral component of almost all malignant tumors. Breast cancer is no exception. Lymphogenic metastases are detected in almost all cases, and this way of spreading the tumor is realized quite early. In later stages, it is possible to detect the spread of the tumor through the blood vessels.

The nature of the lesion of specific groups of lymph nodes determines the stage of the disease, and also significantly affects the volume of the operation during subsequent surgical treatment. In this regard, regional (in the axillary, subscapular, sub- and supraclavicular, as well as parasternal lymph nodes located along the sternum) and distant metastasis (in the axillary and supraclavicular from the opposite side of the tumor, mediastinal and lymph nodes of the abdominal cavity) are distinguished.

Localization of metastases also depends on the location of the malignant neoplasm in the parenchyma of the gland. So, when it is in the upper outer quadrant, the axillary lymph nodes are among the first to be affected. Sometimes such metastases are detected earlier than the primary tumor itself, with its small size and the absence of clinical manifestations.

The hematogenous pathway of cancer spread is typical for later stages, when a malignant tumor grows into blood vessels. Cancer cells are carried in the bloodstream to various organs. brain, bones, liver, opposite gland etc.

In some cases, metastases can manifest themselves many years after radical surgery. Thus, cases are known when brain damage by secondary tumor nodes occurred 10-15 years after effective treatment. In such a situation, imaginary well-being can end fatally in a fairly short time.

Manifestations of breast cancer

The manifestations of malignant tumors of the breast do not differ in variety, however, for a long time the disease may go unnoticed by a woman. In the case when the tumor has not reached 2-3 cm, and the mammary gland contains a significant amount of adipose tissue, self-detection of cancer can be difficult.

As a rule, patients themselves turn to a specialist when they find a seal or other breast changes. Often, neoplasms are detected during medical examinations and even accidentally during consultations in connection with other diseases.

The most common symptoms of breast cancer are:

1. Palpable nodular formation or diffuse enlargement of the gland, change in its shape and consistency;
2. The appearance of ulcers on the skin, in the areola or nipple;
3. Discharge from the nipple, often bloody;
4. Discomfort in the armpit due to enlarged lymph nodes.

The clinical features of the course make it possible to distinguish the following forms of cancer:

• nodal;
• Diffuse (mastitis-like, shell cancer, etc.);
• Atypical variants (Paget's cancer).

The nodular variant is characterized by the growth of education in the form of a limited node, often of a dense consistency and painless to the touch. As the size of the tumor increases, skin changes appear - wrinkling, thickening, possibly retraction of the nipple, and breast deformity. Germination of the skin is accompanied by ulceration and the addition of secondary inflammation.

With an increase in the size of the neoplasm, the mobility of the mammary gland is also disturbed. In advanced stages, when the cancer grows into the chest wall, the tumor becomes immobile.

To determine the localization of cancer, as well as its relationship with the skin, nipple, chest wall, a thorough palpation examination of the breast in different positions is necessary.

The diffuse form of breast cancer is represented by four main varieties:

1. Edema-infiltrative cancer;
2. Mastitis-like;
3. erysipelatous;
4. Shell cancer.

Edema-infiltrative variant The course of breast cancer is more common among young women, during pregnancy and lactation. This form is characterized by a significant increase in volume, swelling of the tissue, thickening of the gland, discoloration of the skin, the appearance of a symptom of "lemon peel" due to damage to the lymphatic vessels by cancer cells. As a rule, early metastasis is observed.

Mastitis-like cancer also more common among younger women. Its manifestations in the initial stage are similar to the inflammatory process in the mammary gland - mastitis, so cases of belated diagnosis are not uncommon. The clinical picture consists of an increase in body temperature, the appearance of signs of general intoxication against the background of changes in the organ in the form of an increase in size, the appearance of diffuse or focal compaction, swelling, pain, redness of the skin at the site of growth of the neoplasm. A malignant tumor progresses rapidly, the appearance of metastases can be detected quite early. With this form of cancer, it is important to suspect the possibility of malignant growth in time, especially in women who are breastfeeding and prone to mastitis.

some types of breast cancer

Erysipelatous cancer, in addition to compaction of the breast tissue, it manifests itself with peculiar skin changes similar to erysipelas. The skin over the affected area becomes hot to the touch, redness appears with uneven outlines, which can spread over a large area, going beyond the gland. Perhaps an increase in body temperature, ulceration of hyperemic areas, the addition of a secondary infection. Very characteristic is the defeat of cancer cells in the lymphatic vessels and metastasis to regional lymph nodes. An erroneous diagnosis with the appointment of anti-inflammatory and physiotherapeutic treatment for this form of cancer can lead not only to loss of time, but also to provoke faster tumor growth.

shell cancer got its name due to the appearance of the mammary gland characteristic of this form. A neoplasm growing from glandular tissue affects the skin and fatty tissue, and the mammary gland decreases in size and deforms, the skin above it becomes dense and resembles a shell. The pathological process can spread to the chest wall or the second gland. The course of shell cancer is very unfavorable.

Paget's cancer is considered an atypical variant of breast cancer. affecting the nipple and areola. The source of the neoplasm is the epithelium of the ducts, from where the neoplasia grows into the skin and spreads into the dermis. In the early stages, the tumor node is not detected, and the defeat of the nipple and areola comes to the fore. Characteristic signs are hyperkeratosis (excessive formation of horny masses) with the appearance of scales and peeling, redness and ulceration of the skin of the nipple and areola, itching is possible. As the tumor grows, the nipple deforms and undergoes destruction. The clinical manifestations of this form of cancer are similar to eczema or psoriasis, which may be the reason for incorrect and delayed diagnosis.

Any changes in the mammary gland, even the smallest, should be a reason to see a doctor, because the sooner the correct diagnosis is made, the more effective the subsequent treatment will be.

Particular attention should be paid to young women and nursing mothers, in which malignant tumors grow very rapidly and are prone to early metastasis. In elderly patients, cancer can develop for years, without showing signs of spreading even to regional lymph nodes. Thus, the course of the disease depends on the age of the woman, the form of cancer, hereditary factors and the timeliness of the correct diagnosis.

Video: signs of breast cancer in the program “Live healthy!”

Diagnostics

The possibilities of effective control of the disease entirely depend on the stage at which the neoplasm is detected. Early diagnosis of breast cancer can be difficult, especially if a woman does not have regular self-examinations. However, it can be effective to examine at least women from the risk group who have an unfavorable family history, hormonal imbalances, certain forms of precancerous processes in the breast, pathological changes in the uterus and ovaries. Also The risk group includes women over 35 years of age.

When contacting a doctor, a palpation examination of the breast will be carried out to determine the presence or absence of seals or tumor nodes, the displacement of the gland in different positions of the patient, the presence of deformation, changes in the nipples, etc.

After the examination, in addition to general clinical studies (general and biochemical blood tests, urine, etc.), special diagnostic procedures will be prescribed to detect the tumor.

The main ways to detect breast cancer are:

• Mammography (X-ray method);
• Ultrasound procedure;
• Needle biopsy.

For further clarification of the diagnosis can be used CT, MRI, X-ray of the lungs, bone scintigraphy, ultrasound of the abdominal organs, allowing also to reveal the presence and localization of metastases.

Mammography refers to X-ray research methods and in a number of countries is screening for women over 40 years old. This method is rightfully considered the "gold standard" in the diagnosis of breast cancer, and the reliability of the data obtained reaches 95%. Mammography is carried out using special devices - mammographs, which make it possible to detect a fairly small tumor with minimal radiation exposure.

mammography

On mammograms, it is possible to detect a tumor-like formation in the gland tissue, changes in the skin, lymphatic and blood vessels, as well as areas of calcium salt deposits that occur early enough in the presence of a cancerous tumor. Calcifications can be considered one of the reliable indicators of the malignancy of the pathological process.

If necessary, mammography can be supplemented ductography with the introduction of a radiopaque substance into the lumens of the ducts.

ultrasonic the study is also highly informative, especially in young women who are pregnant or breastfeeding. Since young people have more fluid in the breast tissue and the breast has a greater density, ultrasound sometimes provides more information than mammography. In addition, this method is harmless, so it can be carried out, including for pregnant women, and the information content in some forms of cancer reaches 100%.

In all cases, the presence of a tumor-like formation in the breast tissue is necessarily carried out needle biopsy, and subsequently - cytological and histological examination of the resulting tissue. Sampling of tumor fragments under the control of ultrasound or mammography allows the material to be taken strictly from the affected area, thus eliminating possible diagnostic errors.

In large medical centers equipped with modern X-ray digital equipment, stereotaxic biopsy is possible, which makes it possible to take material with almost 100% accuracy.

Histological examination Fragments of tumor tissue allows not only to determine the specific type of cancer, but also the presence of receptors for sex hormones, which is very important in choosing further treatment tactics.

Research is becoming increasingly popular - specific proteins, enzymes, hormones, the number of which increases with certain malignant tumors. This method allows you to suspect cancer even before it can be detected by other available methods.

In order to diagnose breast cancer, an analysis is carried out for the oncomarker CA 15-3, a protein whose content in the blood increases when a tumor appears. It is also important to monitor changes in its level over time, since an increase in concentration may be the result of not only an increase in the size of a malignant tumor, but also a sign of incipient metastasis.

The development of molecular genetics also makes available genetic studies of predisposition to cancer, in particular, the determination of the carriage of mutations in the BRCA1 and BRCA2 genes. Some women, having received a positive result, resort to the removal of both mammary glands, without waiting for the development of cancer, which can be a very effective tumor prevention in such cases.

Video: self-examination and palpation by a doctor for breast cancer

Features of breast cancer therapy

Treatment of breast cancer consists of a combination of surgical, chemotherapeutic methods of exposure, as well as radiation. The choice of a specific tactic is always determined by the stage of the disease, the size of the tumor and the presence or absence of metastases. The best results are obtained by treating early forms of cancer.

Surgical method still remains the main one in the case of malignant tumors of the breast. The most common types of surgery are Halsted radical mastectomy, lumpectomy, resection of the quadrant of the breast.

The most radical and at the same time the most traumatic is Mastectomy according to Halsted implying the removal of the gland itself with a tumor, pectoral muscles, fiber and lymph nodes. This type of treatment is used in advanced severe cases, and a serious cosmetic defect requires subsequent correction with the help of various plastic surgeries.

Lumpectomy is a modern and sparing method of treatment applicable for tumors of the first and second stages. In this case, the tumor and surrounding tissue are removed within two centimeters, and the axillary lymph nodes are removed through a separate incision. This operation gives a good cosmetic result, allowing you to save at least partially the tissue of the gland. Lumpectomy requires high qualification and precision of surgical technique on the part of the surgeon.

Resection of the breast quadrant involves the removal of a quarter of the organ in which a small tumor is located, and through a separate incision of the lymph nodes. Such an operation is supplemented with chemoradiotherapy due to the possibility of tumor recurrence and gives a fairly good result, sometimes not inferior in efficiency to more radical and traumatic interventions.

Since the removal of breast cancer is accompanied by a violation of the appearance of the organ, which brings significant psychological discomfort to the woman, in most cases plastic surgeons are involved in the treatment, replacing the defect with the patient's own tissues or artificial implants.

During surgical treatment, the primary focus of tumor growth is removed, but this does not protect against the possibility of neoplasia spreading beyond the localization of the neoplasm. Chemotherapy in breast cancer is aimed at the destruction of malignant cells that have left the organ and are a source of metastases in the future.

The most effective drugs are adriamycin, cyclophosphamide, methotrexate and others. Such treatment, simply called "chemistry", is quite toxic and requires the appointment of maintenance therapy (hepatoprotectors, vitamins, antioxidant complexes).

Radiation therapy used to reduce the likelihood of tumor recurrence after removal. In severe cases, when the removal of the neoplasm is not possible, radiation is designed to alleviate the suffering of patients (palliative care). If distant metastases cause serious damage (in the brain, for example), then they can also be exposed to radiation.

In all cases, adequate pain relief and support for the function of other organs is necessary, especially in the presence of metastases and severe intoxication.

Nutrition in breast cancer does not have any significant features, however, in the postoperative period, indigestible and heavy foods should be avoided. At all stages of treatment, it is useful to consume vegetables, fruits, herbs, cereals containing a large amount of vitamins, trace elements and natural antioxidants.

Folk remedies are very popular, especially in cases where patients are trying to cling to at least some "straw" or do not trust traditional medicine and doctors. In order to treat breast cancer, infusions of walnuts, nettles, decoctions of burdock root, valerian and even fly agaric are used. It is worth remembering that only treatment by a doctor using modern methods of fighting cancer can be really effective, and traditional medicine has the right to exist as a supplement. In all cases when it is planned to use this or that herbal remedy, it is imperative to discuss this issue with your doctor so as not to cause even more harm by using them.

Life expectancy after treatment of malignant tumors of the breast depends on the stage at which the disease was detected. In early forms, up to 95% of patients survive with a relatively good prognosis. Only two or three years of life remain for neglected patients.

In some cases of successful cancer treatment, there may be such adverse consequences as the appearance of distant metastases many years after the operation. This must be remembered and regularly visit a doctor to monitor the patient's condition.

How to prevent cancer?

Often women ask themselves: is it possible to prevent breast cancer? Yes, it is possible. Moreover, the own efforts of the fair sex are also necessary. Regular self-examination, which is available to everyone without exception, should be the norm for women who care about their health. After forty years, you should undergo a mammogram every year, and if at least some, even seemingly insignificant, changes appear, you should immediately consult a doctor.

Self-examination is a fairly effective way of personal prevention. To carry it out, it is necessary to examine the mammary glands in the mirror, paying attention to changes in shape, contours, skin color, the appearance of deformation, etc. In the supine position, in a circular motion, you can feel the entire thickness of the gland, studying its consistency and uniformity of the parenchyma. Slightly pressing on the nipple, you need to make sure that there is no discharge.

A healthy lifestyle, the absence of bad habits, properly selected underwear, timely delivery and breastfeeding are those non-specific factors that also help to avoid malignant tumors of the breast.

Separately, it should be noted that in rare cases, breast cancer may also occur in men, especially those suffering from obesity and endocrine pathology, so any changes should alert and become a reason for consulting a specialist.

The issue of the likelihood of breast cancer in cats and dogs, sometimes becoming practically family members, also worries their owners. It is known that among all tumors in pets, cancer of this localization ranks third, most often affecting cats. Pet owners, if such a disease is suspected, can turn to veterinarians who will offer, among other things, surgical methods of treatment to save the life of their furry pets.

Video: treatment and prevention of breast cancer

It is advisable for every woman to have an idea of ​​the main symptoms that accompany the emergence and development of this malignant neoplasm.

After all, not only the success of the upcoming therapy, but also the life of a person depends on how timely the signs of the disease are detected and measures are taken for its treatment.

The localization of oncological processes in women in the area of ​​​​the mammary glands is most common. After the transition from a benign to a malignant form, neoplasms in the mammary gland fundamentally change the nature of their behavior and the dynamics of development.

The disease acquires a pronounced aggressive direction and, in the absence of timely surgical intervention, gives a clear negative prognosis. Information about cases of recovery in the absence of necessary medical care is sporadic and extremely unreliable.

Symptoms

In the process of its development and progression, oncological diseases of the breast go through certain stages. They are distinguished depending on changes in the following main parameters:

• tumor size;
• degree of damage to the lymph nodes;
• appearance of distant metastases.

The accepted classification by stages is very conditional, being largely dependent on the form of the disease. In addition, since information about the causes of oncological processes is still at the level of hypotheses and assumptions, the forecast of the dynamics of the transition from one stage of the disease to another is still very approximate.

precancerous stage

It is also called zero. Its characteristic feature in terms of signs of the disease is the complete absence of symptoms. That is, the active pathological degeneration of tissues has not yet begun, but the overall balance of the body has already shifted towards the disease.

In cases where it is possible to diagnose oncological processes at this stage and take appropriate adequate measures, the treatment prognosis is the most favorable.

Conventionally, the zero stage can be classified into the following two categories:

The initial stage of the non-invasive oncological process, in which cancer cells do not yet interact with tissues located in their immediate vicinity. For example, it may be a type of adenocarcinoma of the mammary gland, in which the lesion affects only its individual lobes.

This category also includes a variant of atypical hyperplasia localized in individual ducts (or small groups of ducts) of the gland. However, in this case, the mutated cells, however, do not spread beyond the walls of the ducts and still do not have a detrimental effect on healthy tissues.

This category includes such stage of development of any neoplasm of unknown etiology, in which the process of onco-degeneration has not yet been diagnosed, but an increased level of tumor markers in the blood already gives the doctor grounds for oncological alertness and the appointment of an additional examination.

The risk group includes patients suffering from diseases such as mastitis, various forms of mastopathy, adenomas and fibroadenomas, calves, hyperthelia and other pathologies of the nipple, lipogranuloma and others.

In this category, all the sensations that can be felt and the manifestations that can be seen are not yet associated with the onset of the development of an oncological disease, but are only symptoms of pathologies that can create favorable conditions for the onset of a cancerous tumor.

Observed in some cases, weak pain syndromes of unexpressed localization, as a rule, are cyclical in nature and are caused by fluctuations in the general hormonal background.

The level of stability of the endocrine system and the degree of hormonal imbalance in a woman's body have a significant impact on the nature and dynamics of the further development of the disease.

1 stage

Starting with it, cancer cells become invasive in nature - that is, they acquire the ability to influence nearby healthy tissues.

Symptoms of the disease at this stage are often mild, however, having shown attentiveness, it is quite possible to notice some of them. These may include the following:

• An increase in the size of tumors (up to 2 cm in diameter). This value already allows you to easily detect them even with self-examination. In the case of the appearance of multiple seals or nodules, they may be of small size, however, as a rule, they are clearly contoured on palpation. Their distinguishing feature is painlessness and limited mobility.

A slight increase in regional lymph nodes of the axillary zone on the side of the neoplasms associated with increased activity in their work. After all, atypical cells that make up a cancerous tumor are characterized by accelerated metabolic processes, increased reproductive capacity and a shortened lifespan.

The influence of these factors creates an overload in the work of the lymphatic system, which may also provoke some swelling in the arm, shoulder, or chest.

• Partial retraction of the nipple with possible slight deformation- characteristic of Paget's disease, when the lesion is localized in the nipple.
• Reducing the diameter of the area of ​​pigmentation of the peripapillary region (areola) associated with changes in tissue trophism.
• Discharge from the nipple(usually light, with a yellowish tinge; may have bloody impurities) - typical in forms of cancer, when tumors form in the milk ducts.
• Minor irregularities in the shape of the breast- associated with the onset of pathological changes in the structure of its tissues.
• Slight increase in body temperature to subfebrile- caused by inflammatory processes in the affected tissues of a low level of intensity.
• Sharp unreasonable fluctuations in body weight(more often - weight loss), loss of appetite, depressed emotional state. The main reason for these symptoms is a violation of the hormonal balance in the body.
• General weakness, decreased ability to concentrate, increased fatigue- all these are manifestations of a symptom of intoxication.

Timely diagnosis and treatment of the disease at this stage of its development makes it possible not only to restore the woman's health, but also to save the mammary gland, thereby preserving the ability to breastfeed.

2 stage

It can manifest all the symptoms inherent in stage 1, only of a more pronounced nature. Features include the following:

• The size of individual tumors can already reach up to 5 cm in diameter. In the case of multiple seals or nodules, their number and size may increase.

Tissue retraction in the affected area observed visually, and is especially noticeable when slowly raising and lowering the hand. Changes in the skin (redness, roughness and roughness, loss of elasticity, wrinkling and remaining folds after palpation).

These symptoms are due to the activation of the process of cell degeneration, which caused atypical hyperplasia and an irreversible metabolic disorder in tissues.

A significant increase in the size of the regional lymph nodes of the axillary zone on the side of the neoplasms is possible. As a rule, they are already easily palpable. The pattern of subcutaneous venous vessels appears (or increases in clarity). There are no pronounced pains yet, but painful sensations of a aching nature may appear in the breast and axillary region.

The cause of these symptoms are significant overloads in the work of the lymphatic and venous systems, which served as the beginning of the development of irreversible pathologies in them.

3 stage

Starting from this stage, as a rule, it is already impossible to cure the patient, therefore, medical treatment provides only symptomatic therapy. In this case, the efforts of doctors have two main goals:

1. to slow down the rate of development of the disease as much as possible;
2. alleviate, as far as possible, the suffering of the patient.

At this stage of the disease, the severity of the symptoms of the previous stages increases. Features are as follows:

• Pains appear. They can be caused by severe swelling in the affected area and tissue compression, as well as the appearance of ulcers on the skin. The pains are monotonous and constant, as a rule, slowly and steadily intensifying. Temporary relief brings only the use of analgesics.
• The tumor is enlarged (more than 5 cm), showing pronounced invasive properties - the capture of adjacent tissues. In the case of multiple seals, they can be further enlarged and (or) further merged into a single whole.
• There are crusts on the nipple, and when they fall off, an ulcerated surface remains in their place - it is characteristic of an erysipelas-like form of cancer.
• The number of enlarged lymph nodes becomes even greater (up to 10), they become inflamed and painful.
• The deformity of the mammary gland is clearly expressed.
• Body temperature can rise significantly due to increased intoxication of the body and activation of inflammatory processes.

At this stage, the processes of metastasis are launched.

4 stage

This is the terminal stage. It is characterized by severe pain and metastases of both nearby and distant organs, bones, brain, etc.

Peculiarities:

• Tumors grow and capture the entire breast.
• The skin is covered with multiple ulcers, erosions, etc. - characteristic of the erysipelatous form.
• Inflammation covers the entire lymphatic system.

Treatment at this stage is exclusively symptomatic. The efforts of doctors are focused on alleviating the suffering of the patient.

Features of symptoms of various forms

• nodal- the most common form. The above consideration of symptoms by stages of the disease is especially characteristic of her.
• erysipelatous- this is an extremely aggressive form with a rapid pace of development and transition to the spread of metastases. It is characterized by high fever, severe pain, severe swelling of the chest and redness of the skin. Symptoms are atypical for oncological processes, which makes it difficult to make a correct diagnosis.
• Mastitis-like- according to signs it is similar to erysipelatous, but hyperemic skin has a bluish tint, and the gland itself is significantly limited in mobility. Diagnosis is difficult due to the significant similarity with mastopathy.
• Edema-infiltrative form accompanied by swelling of the breast (especially in the areola) and the effect of "lemon peel" on the skin. Characterized by the absence of clear boundaries of the tumor. Most often seen in young women. Has a poor prognosis.
• Paget's disease. It starts with a nipple injury. In the areola there is itching and burning. Outwardly, the first symptoms resemble eczema or psoriasis. The difference is in pronounced redness of the skin, followed by the appearance of crusts on it and further ulceration of the epithelium after they fall off. Having destroyed the nipple, the disease spreads to the entire breast.
• armored- a rare form, characterized by a long and sluggish development. Accompanied by the growth of a colony of cancerous nodules, outwardly resembling a shell. The skin is pigmented, thickened, loses elasticity. Progressing, the disease captures the second breast and passes to the entire chest.

Content

When a person is told that he has a malignant tumor, there is a feeling that the world is collapsing. Women should know that breast cancer that is detected at an early stage is treatable and has a good prognosis. Why the disease develops, what are the first signs of pathology, how recovery occurs - it is necessary to understand these issues in order to avoid terrible consequences.

What is breast cancer

The female body is complex, there are many reasons why hormonal changes occur in it. The mammary glands are very sensitive to changes. Pathological processes begin to develop in them. Uncontrolled growth of aggressive tumor cells occurs, which leads to the emergence of a dangerous neoplasm. A high percentage of cancer incidence is observed in women over 50 years old, but cases of pathologies in young people are not excluded. The tumor grows and metastasizes to:

• The lymph nodes;
• bones of the pelvis, spine;
• lungs;
• liver.

Symptoms

To start treatment for breast cancer in a timely manner, you need to know how it manifests itself. The danger is that at an early stage, the processes proceed without visible signs. This complicates treatment and prognosis - women turn to specialists when radical interventions are required. Symptoms for the development of cancer are:

• the formation of seals in the chest;
• thickening or retraction of the nipple;
• the appearance of a "lemon peel" over the focus;
• redness of the skin.

If one or more symptoms are detected, it is necessary to be examined by a doctor. A malignant tumor of the breast is characterized by the formation of signs:

• compaction of retrosternal, axillary lymph nodes;
• disproportionate increase in the size of one breast;
• the appearance of pain;
• chest deformity;
• edema formation;
• the occurrence of ulcers, crusts;
• the presence of discharge from the nipple;
• temperature increase;
• weakness;
• dizziness;
• sharp weight loss;
• manifestations of pain in the bones, liver with metastases at an advanced stage of cancer.

Does your chest hurt

It is necessary to know that the development of cancer does not always accompany the onset of pain, especially with early detection of pathology. The location of the tumor affects the appearance of the symptom. The mammary glands, like other organs, have nerves. With an increase in the size of the neoplasm:

• swelling occurs;
• healthy tissues are pushed aside;
• there is pressure on the nerve endings;
• there is a constant aching pain.

Umbilization

This symptom of the occurrence of cancer is observed at an early stage of the disease. It signals that an infiltrative process is developing in the depths of the mammary gland, causing tissue fibrosis. When umbilical:

• the ligaments of the organ are pulled up to the tumor;
• a small depression is observed above the focus of inflammation;
• there is a retraction of the surface of the skin inside;
• a similar process can take place in the nipple.

Lemon peel on breast

The occurrence of this symptom of breast cancer is typical for the last stages of cancer. The phenomenon is often observed in the lower part of the chest. With an increase in the tumor, the shape of the mammary gland changes, ulcerations and a “lemon peel” form on the skin. Reasons for this phenomenon:

• with an increase in lymph nodes, the outflow of lymph is disturbed;
• tissue swelling occurs;
• the skin thickens;
• pores increase in size;
• a “lemon peel” is observed on the surface of the skin.

Kernig's symptom

At one of the stages of development of breast cancer, lymphatic and venous vessels are involved in the malignant process. There is a decrease in the elasticity of breast tissue. For Kernig's symptom:

• compaction occurs in the thickness of the glandular tissues;
• the size of the tumor formation - up to several centimeters;
• the site is dense, mobile, painless.

Signs of early breast cancer

To avoid the risk of complications, women should have monthly breast self-exams. With regular monitoring, you can notice changes, detect cancer at an early stage and successfully cure. Having found the first symptoms of the disease, it is necessary to contact a mammologist for a clinical examination. It is possible that it will be a benign tumor or fibroadenoma, but if left untreated, everything can develop into cancer.

How does breast cancer start? Women discover during self-examination:

• seals in the chest;
• damage to the armpits;
• expansion of the saphenous veins;
• the occurrence of ulcers;
• retraction of the skin of the nipple;
• change in the shape of the breast;
• the appearance of "lemon peel" on the skin;
• redness;
• thickening of the skin of the nipple, areola around;
• an increase in the lymph nodes of the sternum of the armpits;
• retraction of the skin over the site of the focus;
• discharge from the nipple.

Causes

It is not clear what causes breast cancer in women. There are many provoking factors for the development of pathological neoplasms. Breast cancer can progress for reasons:

• advanced benign diseases;
• the presence of relatives with cancer;
• chest injury;
• age over 40;
• alcohol abuse;
• smoking;
• obesity;
• early onset of the menstrual cycle;
• diabetes;
• gynecological inflammatory diseases.

A malignant neoplasm in the breast can occur as a result of:

• frequent abortions;
• late first birth;
• a short period of breastfeeding;
• absence of children;
• history of hormone therapy;
• late menopause;
• exposure to chemical carcinogens;
• irregularity of the menstrual cycle;
• stressful situations;
• infertility;
• ovarian cysts;
• brain tumors;
• carcinomas of the adrenal cortex;
• high-fat diets
• exposure to radiation.

Classification

In medicine, several classifications of breast cancer are used. They differ in characteristics, structural features of the neoplasm, macroscopic forms. When considering histotypes, one encounters:

• non-invasive cancer - malignant cells are located within the duct or lobule of the breast;
• invasive carcinoma - infiltrating cancer - originates in one structure, gradually moves to others.

There is a classification of malignant tumors of the breast according to macroscopic forms. It includes:

• diffuse cancer - differs in the rate of development, damage to the lymph nodes, edema, an increase in the size of the mammary glands, the formation of ulcerations;
• nodal view - located outside and at the top of the chest, captures adipose tissue, muscles, skin;
• Paget's cancer - accompanied by an increase in the nipple, the appearance of crusts and ulcers on the surface, the tumor is diagnosed late - the symptoms are similar to eczema.

stages

For the convenience of diagnosis, selection of methods of exposure, it is customary to divide the development of pathological neoplasms into stages. Each has certain characteristics. There are four stages:

		Tumor size, cm	Changes in the lymph nodes	Metastatic lesions
		No more than 2	Not amazed	Not observed
			Is absent	Invasion into adjacent tissues
			axillary	Do not penetrate the skin, adipose tissue
			Not observed	Sprouting into muscles, tissues, skin
			Parasternal, subclavian, axillary
Fourth		Irrelevant		Throughout the body

How fast does cancer develop?

The growth of a malignant tumor of the breast can occur at different rates. It depends on the timeliness of treatment, hormonal sensitivity, aggressiveness of cancer cells. Some women live after the detection of malignant neoplasms for many years, others die in a few months. According to the growth rate, cancer is distinguished:

• rapidly growing - in three months the number of malignant cells doubles;
• with average development - similar changes occur in a year;
• slow growing - tumor growth 2 times occurs in more than 12 months.

Diagnostics

The basis of effective treatment of breast cancer is timely diagnosis. After detecting symptoms of the disease during self-examination, women go to the clinic to see a mammologist. Examination methods for detecting cancer include:

• visual inspection;
• palpation;
• a survey about the likelihood of hereditary cancer;
• biopsy - examination of cells;
• mammography - an x-ray method, reveals cysts, fibroadenomas, the location of the tumor.

• ultrasound scanning of the armpits, chest, to detect metastases, tissue lesions;
• immunohistochemical analysis - determination of the resistance of a malignant neoplasm to hormonal therapy;
• cytological examination - assessment of the structure of cells;
• tests for tumor markers - the determination of proteins that are produced only in the presence of a malignant tumor;
• computed tomography to detect metastases in organs.

Treatment

The choice of treatment regimen is influenced by the stage of the disease, the age and health of the woman. The location and size of the tumor plays a role, primary cancer or secondary. There are radiation, drug methods of exposure and surgical removal. Effective treatments:

• amputation of the breast with preservation of the lymph nodes;
• sectoral resection of the mammary gland - excision of a part of the breast with axillary tissue;
• tumor embolization - stopping the nutrition of cancer cells;
• radiation therapy - to exclude recurrence of the disease.

In the last stages:

• radical removal of lymph nodes is used along with the mammary gland, fiber, muscles - extended axillary-sternal mastectomy;
• excision of the ovaries is practiced as a source of production of sex hormones estrogen;
• chemotherapy is given after tumor removal;
• with large lesions, hormone therapy is performed;
• A combination of the last two methods is possible.

Treatment without surgery

Russian scientists have developed a technique for influencing malignant neoplasms with electromagnetic radiation at a certain frequency - NIERT. When exposed to a cancer cell, it is heated and destroyed. The method of treatment avoids operations. During the process:

• aggressive cells throughout the body are exposed;
• healthy tissues that have a different resonant frequency do not change.

Drug therapy

An alternative to surgery is hormonal therapy. Its task is to reduce the effect of estrogens on the growth of tumor cells. The method is effective in the sensitivity of malignant neoplasms to hormones. The treatment is carried out as a preventive measure, applied in the early stages of cancer development, after operations. Therapy involves:

• the use of drugs to suppress the function of the endocrine system;
• the introduction of hormone antagonists at the cellular level - Bromocriptine, Tamoxifen.

Organ-preserving operations

When the tumor is small and it is possible to save the breast, organ-preserving operations are used. There is a gentle intervention in the body of a woman. There are 3 types of impact that are effective:

• embolization of the tumor - in a large vessel, a special substance is injected near the neoplasm, malnutrition occurs, the death of cancer cells;
• quadrantectomy - a quarter of the chest and axillary lymph nodes are removed;
• radical resection - only the affected sector, lymph nodes, and the pectoralis major muscle sheath are excised.

Mastectomy

If huge lesions are found, the spread of metastases, a mastectomy is performed. The operation includes resection of the breast, surrounding tissues and organs. There are 4 methods of intervention:

• simple - only the chest is removed, muscles and nodes are not touched;
• radical modified - the mammary gland, lymph nodes, the sheath of the pectoralis major muscle are excised;
• Mastectomy according to Halstred - fatty tissue, all lymph nodes, muscles and the entire chest are removed;
• bilateral - both glands are excised.

Radiation therapy

Irradiation of a malignant neoplasm is used in the complex treatment of breast cancer. This helps to avoid the spread of aggressive cells, to eliminate relapses. Radiation therapy is applied:

• after organ-preserving operations;
• at risk of relapse;
• if the size of the primary tumor is more than 5 cm;
• after radical resection of invasive cancer;
• in the presence of several tumors;
• detection of cancer cells in 4 or more lymph nodes.

Chemotherapy

The use of chemicals for the treatment is practiced after the operation or before it begins in order to reduce the size of the tumor. With shell-like, metastatic cancer, when metastases spread throughout the body, the method improves the patient's quality of life. The duration of the course is 2 weeks, repeated monthly. Chemotherapy helps:

• lower the stage of cancer;
• improve the outcome of the operation;
• contributes to the control of symptoms.

Forecast

Predicting the results of treatment of a malignant tumor depends on its prevalence, aggressiveness, and the presence of metastases. A positive result is the absence of relapses within five years. The frequency of tragic outcomes due to late detection of the tumor reaches 30%. Some time after recovery, the resumption of the cancer process is not ruled out. The five-year survival rate of patients, depending on the stage of the disease, is as a percentage:

• the first - up to 95;
• the second - 50-80;
• the third - up to 40;
• fourth - 5-10.

Prevention

There are no methods that can completely protect a woman from breast cancer. There are tools that help reduce the risk of developing pathology. Women who have relatives with cancer that contain a gene that provokes oncology should be especially careful. They are advised to have their ovaries removed. Primary prevention methods include:

• self-examination;
• regular mammography;
• pregnancy planning;
• weight control;
• breastfeeding;
• prevention of mastitis;
• taking hormonal drugs after the examination.

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Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

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Malignant tumor in the breast in women: breast cancer

breast cancer (breast cancer)- epithelial tumor originating from the ducts or lobules of the gland.

Every day, 50 women in Ukraine are diagnosed with breast cancer. Every month about 750 women die from this disease in Ukraine. Breast cancer rarely occurs in women under the age of 20, and with increasing age, the number of cases increases. The peak incidence occurs during the menopause and postmenopausal period. Unfortunately, a high mortality rate from this disease persists in our country, which is associated with the lack of screening programs for examining the population and the late visit of a woman to a doctor.

Historical Descriptions of Breast Cancer (Breast)
Breast cancer is one of the most studied and researched forms of cancer. The oldest known description of breast cancer (although the term "cancer" itself was not yet known or used) was found in Egypt and dates back to around 1600 BC. The so-called "Edwin Smith Papyrus" describes 8 cases of tumors or ulcerations of the mammary gland, which were treated by cauterization by fire. The text reads: “There is no cure for this disease; it always leads to death.” At least one of the eight cases of breast cancer described in the papyrus occurred in a man.

For centuries, doctors have described similar cases in their practice with the same sad conclusion. No advances in the treatment of breast cancer occurred until, in the 17th century, doctors gained a better understanding of how the body's circulatory and lymphatic systems work, and were able to understand that breast cancer spreads (metastasizes) through the lymphatics and in the first place affects the nearest - axillary - lymph nodes. The French surgeon Jean-Louis Petit (1674-1750) and shortly after him the Scottish surgeon Benjamin Bell (1749-1806) were the first who guessed to remove not only the mammary gland itself, but also the nearest lymph nodes and the underlying pectoral muscle in case of breast cancer. Their successful work was taken up by William Steward Halsted, who in 1882 introduced a technically improved version of this operation, which he called the "radical mastectomy", into wide medical practice. The operation became so popular for breast cancer that it was even named after its inventor - "Halstead mastectomy" or "Halstead mastectomy".

At present, the expression of various genes in breast tumors has been studied and various molecular types of the tumor have been isolated. Clinically, they have a significantly different risk of developing metastases and require different therapies. A collection of data on 17,816 gene expression in breast tumors is available online and is used not only for biomedical research, but also as a classic test case for data visualization and mapping.

According to the US Cancer Institute, with timely detection, breast cancer can be cured in 98.1% of women!

What provokes / causes of breast cancer (breast cancer):

Risk factors for breast cancer (breast cancer)
age over 40 years;
high levels of estrogen in the blood;
the presence of relatives of the 1st line (mother, sister, aunt, grandmother) with breast cancer;
taking hormonal drugs for the purpose of contraception or regulation of the menstrual cycle, hormone replacement therapy in menopause;
first pregnancy over the age of 30;
previous ovarian or breast cancer;
contact with sources of radiation;
changes in the mammary gland, interpreted by the doctor as the occurrence of atypical epithelial hyperplasia. Despite the fact that fibrocystic mastopathy is not a precancerous condition, atypical changes in the epithelium of the breast ducts increase the risk of breast cancer;
absence of childbirth and pregnancy;
endocrinological and metabolic disorders (thyroid disease, obesity);
early onset of menses (before age 12) and/or late onset of menopause;
increased intake of fatty foods.

In the development of breast cancer, an important role is played by previous pathological processes in its tissues, mainly repeated dyshormonal hyperplasia with the formation of foci of fibrocystic mastopathy (fibroadenomatosis). The causes of these changes in the breast tissue are a number of endocrine disorders, often due to concomitant ovarian diseases, repeated abortions, improper feeding of the child, etc. The risk increases with increasing size of the gland. Some importance in the development of breast cancer may have anatomical and embryological abnormalities - the presence of additional lobules of glandular tissue, as well as previous benign tumors - breast fibroadenomas. All these formations, regardless of their tendency to malignant transformation, are subject to removal, because sometimes it is difficult to distinguish them with sufficient certainty from incipient cancer.

Pathogenesis (what happens?) during Breast Cancer (breast cancer):

According to the histological structure, breast cancers are more often referred to as adenocarcinomas or solid cancer with many transitional forms. There are ductal and lobular cancers, represented by infiltrating and non-infiltrating forms.

It should be noted that, in addition to cancerous tumors, non-epithelial malignant tumors - sarcomas, in the diagnosis and treatment of which there are no fundamental differences from cancer, can extremely rarely (only in 1% of cases) occur in the mammary glands.

Breast cancers are classified by the presence or absence of ERts (Estrogen Receptor Condition). The condition of the ER can completely change the course of the disease. ERc-positive tumors are more often observed in postmenopausal women (after the onset of menopause). About 60-70% of primary breast cancers are characterized by the presence of ERts. ERc-negative tumors are more often observed in premenopausal patients (before menopause). The state of estrogen receptors affects the choice of treatment tactics.

Metastasis
The lymph flow, which is very developed in the breast tissue, tumor cells are transferred to the lymph nodes and give initial metastases. First of all, axillary, subclavian and subscapular groups of nodes are affected, and when the tumor is located in the medial quadrants of the gland, a chain of parasternal lymph nodes is affected. The next stage is metastasis to the supraclavicular, cervical and mediastinal lymph nodes, as well as crosswise to the opposite axillary cavity. There is cross-metastasis to the second mammary gland. In some cases, metastases in the axillary lymph nodes appear before a tumor is detected in the mammary gland, and then, first of all, it is necessary to exclude its cancerous lesion.

Hematogenous metastases occur in the lungs, pleura, liver, bones and brain. Bone metastases are characterized by damage to the spine, flat bones of the pelvis, ribs, skull, as well as the femur and humerus, which is manifested at first by intermittent aching pains in the bones, which later take on a persistent painful character.

Symptoms of breast cancer (breast cancer):

Localization of cancerous tumors in the mammary glands is very different. Both the right and left glands are equally often affected; about 2.5% have bilateral breast cancers. A node in the second gland can be both a metastasis and a second independent tumor.

In the mammary gland itself, most often (approximately in 1/2 patients) tumors occur in the upper outer quadrant, sometimes at its very edge on the border with the armpit.

Unfortunately, obvious manifestations of breast cancer appear, as a rule, already with advanced forms of the tumor. As a rule, these are dense painless formations in the mammary glands. When germinating into the chest wall, the tumor and the entire gland become immobile. And when the tumor grows on the skin, it is deformed, retracted, ulcerated, the nipple is retracted. Discharge from the nipple, usually bloody, can also be a manifestation of cancer. When the process spreads to the lymph nodes, they increase, which can cause discomfort in the armpits.
In addition to the usual clinical picture of breast cancer, its special forms are distinguished: mastitis-like form, erysipelatous form, shell cancer and Paget's cancer.

Mastitis-like cancer characterized by a rapid course with a sharp increase in the mammary gland, its swelling and soreness. The skin is tense, hot to the touch, reddish. The symptoms of this form of cancer are similar to acute mastitis, which in young women, especially against the background of a postponed childbirth, often leads to severe diagnostic errors.

erysipelatous form cancer is distinguished by the appearance of a sharp redness on the skin of the gland, sometimes extending beyond its limits, with uneven jagged edges, sometimes with a high rise in temperature. This form can be mistaken for ordinary erysipelas with the corresponding prescription of various physiotherapeutic procedures and medicines, which leads to a delay in the correct treatment.

Third form - shell cancer occurs due to cancerous infiltration through the lymphatic vessels and crevices of the skin, which leads to a tuberous thickening of the skin. A dense shell is formed, covering half, and sometimes the entire chest. The course of this form is extremely malignant.

A special form of planar lesions of the nipple and areola is Paget's cancer. In the initial stages, peeling and weeping of the nipple appear, which is often mistaken for eczema. In the future, the cancerous tumor spreads deep into the ducts of the gland, forming its typical cancer node in the tissue with metastatic lesions of the lymph nodes. Paget's cancer proceeds relatively slowly, sometimes for several years, limited only to the defeat of the nipple.

In general, the course of breast cancer depends on many factors, primarily on the hormonal status and age of the woman. In young people, especially against the background of pregnancy and feeding, it proceeds very quickly, early giving distant metastases. At the same time, in older women, breast cancer can exist for 8-10 years without a tendency to metastasize.

When to see a doctor:
Have you found a lump in your chest?
There were discharge from the nipples;
Breast skin has changed (“lemon peel”, retraction, redness, swelling);
The nipple has changed (it has retracted, a bleeding wound has appeared).

In the early stages, the main manifestation of breast cancer is the presence of a volumetric formation in the mammary gland, detected by mammography, ultrasound or other research methods, or by the woman herself (much less often, and mainly in women with small breasts). But it must be understood that it is impossible to detect a tumor characterized by diffuse growth (without a dense part) without special instrumental methods. Regular preventive examinations once a year in most cases are sufficient to detect breast cancer in the early stages.

Diagnosis of breast cancer (breast cancer):

Modern diagnostic methods used all over the world are the key to successful treatment. As a result of a comprehensive diagnosis, it becomes clear to the doctor how widespread the process is. Then he can choose the optimal treatment tactics for each patient. Diagnostic methods can be divided into 3 groups:

Imaging methods for breast cancer (breast cancer):
X-ray (mammography);
ultrasonic;
method of magnetic resonance imaging (MRI).
Mammography is the most informative diagnostic method.

Diagnostic biopsy
A biopsy is necessary to make an accurate diagnosis. Biopsy - a minimally invasive method - allows you to take a piece of suspicious tissue for histological examination before starting treatment. Histopathological examination determines the type of tumor, and immunohistochemical tests can determine the hormone dependence of the tumor (i.e., the presence of estrogen and progesterone receptors, as well as the presence of Her2neu receptors). hormonal status affects the prognosis and choice of treatment. All necessary types of biopsies are performed in our hospital, including high-tech stereotaxic biopsy, which is rare for Ukraine. A special installation allows you to very accurately and almost painlessly take for research, and sometimes completely remove, formations with a size of 1 mm. The procedures are performed with anesthesia on an outpatient basis, no special preparation is required before such manipulations.

Additional Research in Breast Cancer
ultrasound examination of the abdominal organs;
radiography of the lungs;
computed tomography of the abdominal cavity and chest;
scintigraphy (radioisotope study) of the skeleton;
general clinical analyzes and examinations;
examination of the lymph nodes before treatment.

These studies are carried out to assess the prevalence of the tumor process in the body, the presence or absence of metastases in the lymph nodes or other organs. They also characterize the general condition of the body, comorbidities, which can also affect the choice of treatment.

Treatment for breast cancer (breast cancer):

In the last decade, global oncology has made significant progress in the treatment of breast cancer. The basis of successful treatment is an integrated approach - the optimal combination
surgical;
chemotherapeutic;
radiotherapy steps.

Treatment tactics are chosen jointly by clinical oncologists, surgeons, radiotherapists. If necessary, a plastic surgeon is involved in this, participating in advance in planning the optimal operation or in performing its plastic stage.

The choice of treatment method is influenced by the type of tumor, its size, the presence of metastases, and the individual characteristics of each patient. The earlier a tumor is detected, the less spread of the disease - the easier, shorter, cheaper and more effective the treatment.

Until recently, the classical approach was considered to be the surgical removal of the tumor along with the entire mammary gland and the lymphatic drainage pathways - regional lymph nodes (mastectomy), followed by possible chemotherapy or hormone therapy. However, modern approaches to surgical treatment have changed significantly. Many studies have proven the possibility of a more "conservative" treatment. It is not always necessary to remove the entire breast and all lymph nodes. If the tumor is small, it is enough to remove only it, receding about 1 cm within healthy tissues (the so-called lumpectomy), and carry out postoperative irradiation of the mammary gland. This tactic gives results that are absolutely similar to mastectomy, but allows you to save the mammary gland.

Complete lymph node dissection, i.e. removal of all lymph nodes from the zone of lymph drainage of the mammary gland is necessary only if they are involved in the tumor process. If, according to the results of examinations, the lymph nodes are not enlarged, and the probability of their damage by a tumor remains, then a so-called study is possible. sentinel lymph node. This node is the first to receive lymph from the tumor area and is the first in which metastases develop. If metastases are not detected in the "sentinel" node, then the probability of their spread to other nodes does not exceed 2-3%. Thus, by examining the state of the sentinel lymph node, we can judge the state of all other lymph nodes with a very high degree of certainty, and save many patients from traumatic surgery and possible complications associated with it.

The procedure for detecting the sentinel lymph node is actively used throughout the world and is the standard in determining the prevalence of the tumor process with good long-term results. Unfortunately, this method is still unique for Ukraine.

After removal of the mammary gland or part of it, reconstruction is possible, i.e. restoration of its shape and volume. This is performed by the plastic surgeon during the primary operation (single-stage reconstruction) or after the end of the entire course of treatment (delayed reconstruction). Recovery is possible in three main ways:
plastic surgery with own tissues taken from other parts of the body (as a rule, this is the stomach, less often the back). At the same time, figure correction is possible;
plastic surgery with an artificial implant;
a combination of both methods.

The task of chemotherapy is the destruction of tumor cells not only in the main focus, but throughout the body. A tumor disease is initially considered as a systemic disease, i.e. tending to spread - metastasize - immediately to all systems and organs. In the early stages, the probability of spread is not high, and if it does, then at the level of individual cells. They cannot be detected by modern examination methods, but it is possible to destroy them with chemotherapeutic agents. The fewer tumor cells in the body, the easier and more effective it is to achieve a positive result. Therefore, local treatment - directly on the tumor - surgical or radiation, is almost always supplemented by systemic - chemotherapy. This significantly improves the results and, most importantly, the survival of patients.

Chemotherapy can be administered both before and after surgery. The goal of chemotherapy before surgery is to reduce the size of the primary tumor. In this case, conditions are created for radical removal of the tumor while preserving the mammary gland - lumpectomy.

Adjuvant chemotherapy is started 2-3 weeks after surgery. The most commonly used regimen is CMF (cyclophosphamide -100 mg / m2 orally, days 1-14 in combination with methotrexate - 40 mg / m2 IV, days 1 and 8 and 5-fluorouracil - 500 mg / m2 IV, 1st and 8th days; intervals between courses - 2-3 weeks, number of courses - 6). With a high content of ER and / or RP during menopause, tamoxifen is additionally given (20 mg daily for 2 years), and with a preserved menstrual cycle, oophorectomy is performed, then tamorsifen (20 mg) or prednisolone (10 mg) is used for a long time. With menopause for more than 10 years and a high level of EC, adjuvant therapy can be carried out only with tamoxifen.

With the development of distant metastases at various stages of the disease, drug therapy has the main therapeutic value. Chemotherapy regimens should include adriamycin:

1) adriamycin (20 mg/m2 IV, days 1, 8 and 15) in combination with methotrexate (20 mg/m2 IV, day 1), 5-fluorouracil (500 mg /m2 IV, day 8) and cyclophosphamide (400 mg/m2 IV on day 15); 2) adriamycin (40 mg/m2 IV, day 1) in combination with cyclophosphamide (600 mg/m2 IV, day 1); 3) adriamycin (30 mg/m2 IV, days 1 and 8) plus 5-fluorouracil (500 mg/m2, days 1 and 8) and cyclophosphamide (100 mg/m2 orally) , 1-14th days); 4) adriamycin (60 mg/m2, i.v., day 1) and vincristine (1.2 mg/m2, days 1 and 8). Courses of treatment are carried out every 4 weeks. There is no clear evidence of differences in the effectiveness of these regimens.

With resistance to CMP and adriamycin, partial regression can be obtained using mitomycin C, cisplatin, vinblastine. The use of thiophosfamide (20 mg intramuscularly 3 times a week for 3 weeks) is of independent importance, however, such treatment significantly reduces the reserves of hematopoiesis. More often, thiophosfamide is injected into the pleural cavity (30-50 mg) after removal of the exudate.

Tamoxifon occupies a leading position in the endocrine therapy of breast cancer. Assign it with positive or unknown receptors orally at 20 mg / day for a long time. With an insufficient effect of tamoxifen, it is advisable to use aminoglutethemide (orimethene) - 500 mg / day with cortisone acetate - 50 mg / day for a long time. Retain the medicinal value of androgens (testosterone or medrotestron propionate-100 mg / m daily or every other day; omnadren, proloteston - 3 times a month). With a high level of RE, drug therapy can be started with endocrine drugs, and later supplemented with cytostatic drugs.

Radiotherapy or radiation therapy for breast cancer It is used mainly in three cases:
to reduce the likelihood of recurrence after excision of a tumor in the mammary gland and after removal of the affected lymph nodes;
for symptomatic (palliative) treatment of intractable tumors, in case of complications - ulceration, bleeding;
for palliative treatment of distant metastases, if they cause severe complications - compression of the brain or spinal cord, severe pain, etc.

Prognosis for breast cancer the prediction depends on the stage of the process, the speed of its course and the age of the patients. In advanced stages, life expectancy is 2-3 years. Early diagnosis of breast cancer ensures successful treatment of most patients. The five-year survival rate in the treatment of localized forms of stage I-II is 90%, with locally advanced cancer - 60%. The results of treatment are much worse in the presence of distant metastases.

Prevention of breast cancer (breast cancer):

Prevention of breast cancer consists primarily in the timely deliverance of patients from precancerous seals in the mammary glands, as well as in observing the normal physiological rhythm of a woman's life (pregnancy, feeding) with a reduction in the number of abortions to a minimum. In the diagnosis of breast cancer, systematic self-examinations (see the page "Self-examination of the mammary glands") and annual preventive medical examinations of women over the age of 40 are important. Mammography is recommended once every 2 years after the age of 40, once a year - after 50 years. For women at risk, an annual mammogram is recommended, starting as early as possible.

Early detection of breast cancer
The simplest and most accessible method of prevention, however, and the least effective, is self-examination - examination and palpation of the mammary glands by the woman herself. This procedure allows you to identify the tumor at an early stage. Self-examination is carried out once a month. First, an examination is made in front of a mirror. The following signs should be a mandatory reason to see a doctor:
skin retraction,
visual education,
changes resembling "lemon peel".

Then palpation is performed. If you find seals or heterogeneity in the structure of the gland, discharge from the nipple, you should contact an oncologist.
Screening is the most effective way to prevent breast cancer.

Breast Cancer Screening
Screening is a planned examination of a healthy population in order to identify the earliest forms of a tumor. Breast cancer screening procedures are very simple and painless. So, women are recommended, depending on age, to carry out:
at 20 - 39 years old - breast self-examination monthly, annually ultrasound (ultrasound), especially if the woman is at risk;
once at the age of 35-39 years, perform a mammogram;
from the age of 40 - self-examination monthly, annually - mammography.

When choosing a hospital for screening, it is important to remember that in the early stages, cancer is very mild or does not manifest itself, so it is very important that:
1. screening was carried out by a highly qualified specialist who knows how to detect even the most insignificant signs of the disease;
2. the equipment used for screening was high-precision and in line with modern standards of world oncology;
3. The hospital provided comprehensive and effective cancer care.

Which doctors should you see if you have breast cancer (breast cancer):

Are you worried about something? Do you want to know more detailed information about breast cancer (breast cancer), its causes, symptoms, methods of treatment and prevention, the course of the disease and diet after it? Or do you need an inspection? You can book an appointment with a doctor– clinic Eurolaboratory always at your service! The best doctors will examine you, study the external signs and help identify the disease by symptoms, advise you and provide the necessary assistance and make a diagnosis. you also can call a doctor at home. Clinic Eurolaboratory open for you around the clock.

How to contact the clinic:
Phone of our clinic in Kyiv: (+38 044) 206-20-00 (multichannel). The secretary of the clinic will select a convenient day and hour for you to visit the doctor. Our coordinates and directions are indicated. Look in more detail about all the services of the clinic on her.

(+38 044) 206-20-00

If you have previously performed any research, be sure to take their results to a consultation with a doctor. If the studies have not been completed, we will do everything necessary in our clinic or with our colleagues in other clinics.

You? You need to be very careful about your overall health. People don't pay enough attention disease symptoms and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called disease symptoms. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to several times a year be examined by a doctor not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the body as a whole.

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Other diseases from the Oncological diseases group:

pituitary adenoma

Adenoma of the parathyroid (parathyroid) glands

Thyroid adenoma

Aldosteroma

Angioma of the pharynx

Angiosarcoma of the liver

Astrocytoma of the brain

Basal cell carcinoma (basalioma)

Bowenoid papulosis of the penis

Bowen's disease

Paget's disease (cancer of the nipple of the breast)

Hodgkin's disease (lymphogranulomatosis, malignant granuloma)

Intracerebral tumors of the cerebral hemispheres

Hairy throat polyp

Ganglionoma (ganglioneuroma)

Ganglioneuroma

Hemangioblastoma

Hepatoblastoma

germinoma

Giant condyloma of Buschke-Levenshtein

glioblastoma

Glioma of the brain

Glioma of the optic nerve

Glioma chiasma

Glomus tumors (paragangliomas)

Hormonally inactive tumors of the adrenal glands (incidentalomas)

Fungal mycosis

Benign tumors of the pharynx

Benign tumors of the optic nerve

Benign tumors of the pleura

Benign oral tumors

Benign tumors of the tongue

Malignant neoplasms of the anterior mediastinum

Malignant neoplasms of the mucous membrane of the nasal cavity and paranasal sinuses

Malignant tumors of the pleura (pleura cancer)

Carcinoid syndrome

Mediastinal cysts

Cutaneous horn of the penis

Corticosteroma

Bone-forming malignant tumors

Bone marrow malignant tumors

Craniopharyngioma

Leukoplakia of the penis

Lymphoma

Burkitt's lymphoma

Thyroid lymphoma

Lymphosarcoma

Waldenstrom's macroglobulinemia

Medulloblastoma of the brain

Mesothelioma of the peritoneum

Mesothelioma malignant

Mesothelioma of the pericardium

Pleural mesothelioma

Melanoma

Melanoma of the conjunctiva

meningioma

Optic nerve meningioma

Multiple myeloma (plasmocytoma, multiple myeloma)

Neurinoma of the pharynx

Acoustic neuroma

Neuroblastoma

Non-Hodgkin's lymphoma

Balanitis xerotica obliterans (lichen sclerosus)

Tumor-like lesions

Tumors

Tumors of the autonomic nervous system

pituitary tumors

bone tumors

Tumors of the frontal lobe

Tumors of the cerebellum

Tumors of the cerebellum and IV ventricle