Breast cancer by stages. Malignant tumor in the breast in women: breast cancer

A breast tumor is a malignant neoplasm of the glandular tissue of the breast.

There are many names, but they all have the same meaning. Unfortunately, neoplasms in the breasts of women are common, and now about 1,500,000 women suffer from this disease all over the planet. Breast tumors can be benign or malignant.

The function of women's breasts is reproductive, that is, the production of milk for feeding the baby. Milk is the secret of the mammary glands. The mammary glands are paired glands of external secretion. Thus, if part of the gland tissue is mutated, the entire sequence will be disrupted. Malignant neoplasms interfere with the performance of the breasts, their functions.

Symptoms of breast cancer

• The presence of "lumps" or compaction in the chest area;
• Specific discharge not associated with lactation;
• You may find that the nipple has sunk inward;
• Back pain, heaviness;
• Asymmetry of the chest, which you did not notice before;
• Breast skin may wrinkle, crack, peel off;
• When you raise your hand, you will notice depressions in small areas of the mammary glands;
• swelling of the bust;
• Itching of the nipples or the breast itself;
• Progressive weight loss;
• Increase in local and general temperature;
• Pain on touch.

These 12 symptoms of cancer will tell you how to identify breast cancer. If you find any sign, be sure to contact a mammologist or oncologist.

Forms of breast cancer

Varieties	What does it look like
non-invasive tumor(with limited localization) is divided into: 1.Ductal breast cancer(ductal carcinoma) - cancer cells are found only in the ducts of the breast and do not spread further. (lobular cancer) - this oncology originates in the lobes of the mammary gland.	1. 2.
Infiltrative ductal breast cancer - Cells that have gone beyond the mammary glands and penetrated into the breast parenchyma.
Inflammatory form - extremely rare, but one of the more severe forms of cancer (stage 3 cancer).
Paget's disease is a disease in which an eczema-like lesion appears at the site of the nipple, and there may also be a rash on the entire chest in the form of eczema and erythema. Also, the confluence of the nipple can be an ulcer. Eczema can be weeping and dry. The tumor needs to be removed.
Tubular cancer - cancer cells are shaped like straws or tubules. The figure shows a histological section in order to clearly see these "tubules".
Mucous cancer (colloidal, cricoid cancer) - a huge amount of mucus is found in the tumor, with atypical cells. The figure shows the cancer itself. a.- cancer cells b.- copious amounts of mucus in the cytoplasm.
Medullary (brain cancer) - On section, the tumor cells resemble brain tissue.
The figure shows papillary cancer, which was localized in the cyst. a. - contents of the cyst b. - cancer cells in. - cyst wall
Armored breast cancer - in the early stages it manifests itself as a seal. Aggressive tumor growth is characteristic, which seems to eat tissue.

Breast cancer in women and prognosis

Varieties of cancer	Breast Cancer Symptoms. Clinical signs.	Forecast
Non-invasive: 1. Ductal 2. Lobular	1. to the touch the bust is soft, painful, there is a slight swelling. 2. Slightly firmer than normal breast consistency, almost imperceptible. There are also aching pains in the chest.	More often favorable.
Infiltrative ductal breast cancer	Signs of breast cancer: Dense inflammation of irregular shape. The nipple and skin are retracted. The neoplasm is closely adjacent to the surrounding tissue.	One of the most unfavorable outcomes, as there is a rapid growth of the tumor and in the future, the rapid formation of metastases.
Inflammatory form of the tumor	The first sign is redness (hyperemia) of the mammary gland. With swelling of the mammary gland, the skin takes on the appearance of a lemon (orange) peel. An increase in local temperature, the chest is hot to the touch, spots of blue and red colors can be seen on the bust.	In the early stages - relatively favorable. At later times, the prognosis is not favorable.
	Peeling of the skin on the nipples. Rash and redness around this area. The skin of the chest has an uneven surface. In some cases, itching and burning.	In the later stages, the prognosis is unfavorable - the average life span is 4-5 years.
tubular	Small in size, there are no symptoms. With large neoplasms, thickening, retraction of the skin or nipple occurs.	In the early stage of detection, it is favorable, since the tumor grows slowly. The exact prognosis depends on the size of the tumor.
Slimy	The skin of the chest does not hurt, the degree of swelling is small. On palpation, hard nodules can be felt.	Relatively favorable, since this pathology rarely metastasizes.
	Does not cause pain until the tumor reaches a large size. There is a change in the mammary glands (seal).	Quite favorable, survival rate reaches 70-90%
Papillary	Severe pain near the nipple, during the development of the tumor, discharge from this location appears (can be: transparent, bloody or putrefactive).	Relatively favorable in the early stages. When polycystic is formed in the bust, an operation is required. Another not unimportant factor is in which part the tumor is localized.

The risk group includes women who:

1. Genetic predisposition (blood relatives who had this neoplasm). The risk of getting breast cancer increases.
2. First menstruation before 12 years of age.
3. The onset of menopause after 55 years. Therefore, women after 40 years of age need an annual examination by a mammologist.
4. Medical abortion.
5. Late birth (after 35 years).
6. Breast mastitis.
7. Improper nutrition
8. Ecology

Stages of tumor development

1 stage

At this stage, it is very difficult to feel for any neoplasms in the breast, since the size of the tumor is small - up to about 2 cm. In women who have a large bust, it is almost impossible to feel the neoplasm. Sometimes oncology is confused with mastitis and other breast diseases.

Breast carcinoma of the first stage is considered to be non-invasive, it is so called, since this form of neoplasm grows inside the milk ducts, but does not spread further. The lymph nodes are normal and cannot be felt.

Pathological changes in the first stage can only be determined by modern diagnostic methods.

2 stage

At this stage, the size of the tumor can reach 2-5 cm.
This size of education is not large.

A characteristic sign of the second stage of cancer of a malignant tumor in the breast is the probing of the lymph nodes. It is generally accepted that only axillary and supraclavicular lymph nodes are palpated, but no, parasternal lymph nodes can also be palpated.

If the lymph nodes are affected, the patient will feel pain in the area where the lymph node is localized. Enlarged lymph nodes (hyperplasia), inflammation (lymphadenitis) and damage to them.

First of all, breast cancer usually affects the axillary (axillary) lymph nodes. Further supraclavicular, subclavian. After them, already and peristernal (prarasternal) - are located along the internal thoracic vessels. Mammograms and x-rays are required.

3 stage

The tumor reaches more than 5 cm.

A characteristic feature is the "accumulation of lymph nodes". Feels like a bunch of grapes of different sizes (small or medium). Tumor cells at this stage penetrate the blood and lymphatic system, which forms metastases.

At this stage, bone metastasis is possible. According to the latest scientific data, bone metastases can also occur in the early stages of breast cancer, but not more than 5% of cases.

4 stage

At this stage, the size of the malignant clot does not matter, the lymph nodes are palpated in packages (clusters) on both sides, and can also be collected in separate groups of lymph nodes.

Accompanied by a serious condition of the patient, ulcers, crusts, lesions, erosions, cysts appear in the bust area. There is a feeling of aching in the bones, this indicates the defeat of their metastases. In the absence of proper treatment of the patient, the growth of the tumor progresses, the state of health regresses. At the fourth stage of cancer, multiple metastases are found in the bones and liver. Metastases can be seen on ultrasound.

NOTE! Methods, treatment, therapy and diagnosis of breast cancer are prescribed to everyone individually. Chemotherapy drugs are selected individually. Therefore, at the first symptoms, it is necessary to consult a doctor: a general practitioner, an oncologist, a mammologist.

self-examination

Self-examination of your breasts should be carried out 1-2 times a week. This will allow you not to miss the development of the neoplasm. Most often, in the early stages of changes in the chest, it is almost impossible to determine palpation or visually. Examination of women should be carried out on the 6th-7th day of the menstrual cycle.

visual inspection

Inspection of underwear. With neoplasms in the breast from the mammary gland, there may be discharge and have a purulent, sanious character and, most importantly, a specific smell. When examining your body, this can not be detected, but when examining a bra, it is clearly visible.

Examining your body in the mirror. You need to choose a bright, warm room in which there is a mirror. You need to pay attention to:

• Symmetry or asymmetry of the chest. Is everything as before. Both halves of the mammary glands should be at the same level.
• Raise your arms vertically (up), take them to the side, back. Lower your body, turn left, right. The chest should move evenly and there should be no pain.
• Pay attention to the skin. On the skin should not be any peeling, hemorrhage and eczema.

Feeling

Palpation of the chest (palpation) should be done while standing. If the bust is large, larger than size C (3), then you need to take a position lying on your back.

• Put your right hand behind your head. With light circular motions, palpate the soft part, first the right, then the left with three middle fingers. You need to start from the top outer part, moving clockwise. This method will allow you to find any seals in the chest. Perhaps, with this method, there may be discharge from the nipples, pain.

Content

One of the most dangerous diseases for women is breast cancer. So called malignant damage to the glandular tissue, mutation and active growth of epithelial cells. This can be caused by hormonal failure, trauma, late pregnancy. In men, this type of cancer is almost never found.

Malignant tumor of the breast

Neoplasms in the breast are not necessarily a cause for despair. However, a breast tumor requires immediate treatment, which should include a doctor's consultation and a series of examinations. Lack of timely action can lead to serious complications. If the tumor is malignant, breast cancer treatment should be started as soon as possible.

A significant proportion of cases of this disease occur in women. The tumor can be benign (not life-threatening) or malignant. In each of these cases, the course of therapy is different. The most important thing in this case is to start treatment on time, because a slight delay can lead to negative consequences. It should be noted that only 20% of all cases are malignant.

If a cancerous tumor is suspected, an ultrasound examination of the breast is recommended. This allows you to determine the location of cancer cells, to establish the shape, size, number of new formations. In addition, the study gives a clear picture of the state of the ducts, how the tissues and skin have changed, what is the nature of vascularization. In most cases, the tumor affects the upper outer square. This is due to a significant concentration of milk ducts in this area.

Cancer Symptoms

If you find the following signs, you should consult a doctor and start treatment for breast cancer:

1. Sharp weight loss. Everyone can determine this symptom, because it will be difficult not to notice an uncharacteristic weight loss at a time when a person is not on a diet.
2. Persistent peeling and rash on the chest, which are characterized by itching, rapid development and different stages (ripe lesions, healing or ripening). Rashes can then sharply decrease, then, on the contrary, increase.
3. The shape of the nipple changes (this is normal only for those women who are breastfeeding). Moles near the chest, increasing in size, especially in combination with discharge from the nipples.
4. Soreness in the armpit.
5. The size and shape of the breast changes.
6. The blood vessels in this area swell.
7. During probing, hard places, seals can be identified.
8. Thickening of the nipple. In addition, there may be discharge from it.

breast cancer by stage

There are several stages in the development of this disease:

1. Stage zero (non-invasive cancer). Tumor nodes are within. These include lobular or ductal carcinoma.
2. Stage 1 (invasive cancer). The tumor reaches a size of about 2 cm and partially affects neighboring tissues. There is a chance to completely get rid of the disease through surgical treatment.
3. 2 stage. The tumor of the breast increases to 5 cm, spreads into the subcutaneous region. This stage of cancer development is divided into substages: A) metastases are not typical; B) metastases in the axillary region. The tumor grows, affects the lymph nodes. Requires treatment in several stages.
4. Stage 3 is divided into two groups. During this period, it grows up to 5 cm in diameter. In addition, patients note nipple retraction, discharge, and numerous metastases. At stage 3A, the tumor is larger than 5 cm, the lymph nodes are enlarged, soldered to each other and adjacent tissues. 3B is characterized by the germination of cancer cells under the skin, into the chest wall, lymph nodes (internal). The skin of the chest turns red, becomes like an orange peel, warm to the touch. Sometimes this stage is confused with mastitis (inflammation of the breast).
5. The last 4th degree is a complete lesion of the mammary gland, numerous metastases to neighboring tissues. In this case, the tumor grows outside the chest: in the armpit, internal lymph nodes, liver, lungs, brain.

How to treat breast cancer

The scheme according to which the therapy will take place depends on the specific clinical case and the degree of growth of the malignant neoplasm. Immunohistochemical studies, genetic parameters, tests and background diseases are also taken into account. At the first stage, a method of surgical intervention is used. If done in time, then local therapy will help cure cancer.

If the disease has moved to the second stage of development, then complex treatment of breast cancer is used. Specific actions depend on the biological characteristics of the tumor. In addition to surgery, chemotherapy, radiation treatment, hormonal drugs, and maintenance of the immune system are used. Modern medicine offers many techniques that help control the situation and destroy cancer cells.

Surgery to remove the mammary glands

After identifying this disease, the main medical task is to accurately diagnose and restore the patient's health. Often, the effectiveness of breast cancer treatment requires the removal of one of the mammary glands. However, already 6 months after the operation (mastectomy), the patient will be able to undergo plastic surgery and lose the unwanted visual defect. The modern surgical method assumes the safety of the organ if the tumor is not more than 25 mm. Removal of the mammary glands for cancer entails getting rid of several lymph nodes to prevent recurrence.

The most famous types of operations:

1. Ovariectomy is the removal of the ovaries. Helps reduce the risk of cancer by 50%.
2. Lumpectomy - removal of the tumor with a small area of ​​adjacent tissue.
3. Traditional mastectomy - removal of the breast completely (without axillary lymph nodes).
4. Modified radical method - complete removal of the mammary glands and lymph nodes.
5. Radical resection of the mammary gland is the removal of not only the breast, but also the breast muscles located under the mammary gland.
6. A subcutaneous mastectomy is the removal of all breast tissue (except the nipple).

Chemotherapy

To prevent metastases from spreading in the body, a method such as chemotherapy for breast cancer is used. Due to this, the size of the neoplasm is reduced. In addition, this method of treating breast cancer is usually used after surgery to control the symptoms of the disease. The course lasts 14 days, after which the process is repeated monthly.

Radiation therapy

Often, patients may experience progress in the development of cancer cells, so they require systematic exposure to CT gamma rays. As a result, the malignant process is inhibited, thereby reducing the risk of relapse. Radiation therapy for breast cancer is given before or after surgery.

New cancer treatments

Scientists in the US and Germany started treating cancer with AIDS drugs a few years ago. But such drugs do not affect the cells of the body without traces of mutation, but strengthen the protective functions and start the process of destruction of malignant cells. Additionally, for the treatment of breast cancer, a targeted technique and hormone therapy are used.

Hormone therapy for cancer

The reason why this disease affects the female population is the sex hormones in the blood. They tend to act on healthy and infected cells (this can be compared with the process of turning on certain functions). Most cancers are hormone-dependent, so without estrogen and progesterone, tumors do not grow.

Targeted therapy in oncology

Biochemical research centers around the world have thrown all their efforts into obtaining targeted drugs. They differ from standard medicine in that they clearly identify the modified cells of the body and destroy only them at a high speed. At the same time, healthy tissues are not affected. Treatment of breast cancer with such drugs inhibits tumor growth and the formation of metastases. However, the price of "smart drugs" is many times higher than the cost of traditional anti-cancer drugs.

Treatment of oncology with folk remedies at home

Traditional medicine has been accumulating its unique arsenal of recipes for the treatment of cancer for years. Some folk remedies for breast cancer are listed below:

1. Take dry dandelion roots, burnet, immortelle flowers, calendula, angelica, succession, St. John's wort, celandine, sage, yarrow. Plants are mixed in equal parts, take 1 spoon of the collection and brew with 1 cup of boiling water. The remedy is insisted for half an hour and drunk during the day. Every day you need to prepare a fresh infusion. The course of application of the drug is at least three months.
2. Use dry spotted arum root. A powder is prepared from it, which is taken 1 g daily or the plant is insisted on alcohol. For tincture, pour a spoonful of crushed root with 300 ml of alcohol. You need to insist the remedy for about 14 days, sometimes shaking the composition. After that, the tincture is filtered and drunk daily, 30 drops three times.

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Breast cancer is the most common cancer in women. The tumor consists of undifferentiated malignant cells that replace glandular tissue. The urgency of the disease increased in the late seventies of the last century. The disease was characterized by a predominant lesion of women over the age of fifty. A feature of modern oncopathogenesis is a disease in childbearing age.

How long do people live with breast cancer?

This question is of interest to all patients admitted to the oncology dispensary. It is asked in order to find out the truth, even if it is terrible.

Any doctor knows that predictions of the outcome of the disease should be approached with caution. There are known examples of inhibition of carcinogenesis of advanced stages and accelerated development of breast cancer detected in the early stages.

However, a patient with an early operable form of oncology is more likely to recover, if we abstract from:

individual characteristics (age, the presence of concomitant diseases, support and understanding of relatives and friends, attitude to the struggle for life);

efficiency and timeliness of treatment.

There are known cases of preservation of the mammary gland in the detection of pathogenesis in the early stages of the disease. Oncologists sometimes decide to remove the breast. It's annoying, but not fatal. The support of loved ones is important.

In pathogenesis with metastases to other parts of the body, the prognosis is cautious, it is necessary to fight, because it is possible to suppress the growth of pathological cells even at this stage.

The first signs of breast cancer

Women often face breast problems in the form of nodular or extensive seals and other signs that are frighteningly similar to oncology. Fortunately, not all formations are malignant.

Pain and tightness in the chest are accompanied by:

Refrain or refuse to use:

Products containing soy (added to sausages, sausages, some vegetable products);

Canned, smoked meat of any kind (ham, ham);

Moderate consumption of sugar, salt;

Canned juices.

Helpful information: Few people know that regular beta-carotene (provitamin A) reduces the likelihood of developing mastopathy and breast cancer by 40%!

Disability in breast cancer

The duration of treatment for breast cancer is about four months, then the issue of working capacity is decided. A favorable factor for the restoration of working capacity is the most complete elimination of the symptoms of the disease, confirmed by all studies.

Extension of the period of incapacity for work is possible after passing a medical and social examination. Based on its results, the issue of assigning disability is decided in relation to the patient.

There are disabilities according to the degree of preservation of viability:

III degree - the smallest loss;

II degree - moderate loss;

I degree - a pronounced limitation.

For each degree of disability there are objective criteria, confirmed by clinical, laboratory and instrumental studies. In the case of an extremely hopeless condition, a sick woman is prescribed palliative care.

Education: completed residency at the Russian Scientific Cancer Center named after N.N. N. N. Blokhin” and received a diploma in the specialty “Oncologist”

Breast cancer or carcinoma is a pathological transformation and uncontrolled synthesis of breast tissue cells. It belongs to the most dangerous and frequent pathologies, sometimes affecting the male population.

Women are more susceptible to this disease, due to hormones such as estrogen, prostaglandin, progesterone, accompanying the fairer sex from adolescence to menopause, including the timing of childbearing and breastfeeding.

The risk of this pathology has nothing to do with breast size.

Signs of breast cancer

Uncharacteristic symptoms of a malignant tumor, with the manifestation of which it is fundamentally important to contact a specialist as soon as possible for the purpose of examination and diagnosis:

Carcinoma in almost all cases is combined with the formation of nodular, dense formations. But still, sometimes there are forms, in association with neoplasms in the mammary gland, which are considered cancerous until the moment of malignancy (turning into a cancerous induration). There are also forms that do not reveal themselves as a malignant tumor for a long period.

There are also mastitis, nodular, diffuse mastopathy, fibrotumors, characterized by focal or growing violations of the integrity of the epithelium of the mammary gland.

Also in medical practice, there are other malignant formations for the gland, similarly manifested at different stages and terms:

Causes of breast cancer

A number of underlying causes are identified that somehow help the formation of breast cancer. However, almost all of these factors have one common root - an increase in the activity of estrogens, or a hereditary predisposition.

The main causes of the disease include:

A variety of causes contribute to the emergence and growth of carcinoma in the breast in different forms. For example, if a patient is taller than average and has an impressive figure, then this fact is not a reason to think that she will definitely get cancer. Danger in general implies a confluence of many factors.

Often, carcinoma formations are different in their structure. They are formed from different types of cells that multiply and grow at different speeds, in a peculiar way responding to methods of getting rid of them.

Therefore, it is very difficult to assume a picture of the development of the disease process. In some cases, all the signs are clearly manifested, and in some - when the neoplasm increases gradually, the symptoms are very vague.

Diagnosis of the disease

There are excellent ways to perform diagnosing carcinoma diagnostics.

These methods include physical examinations, which are divided into:

• screening
• additional examination.

With the definition of cancer symptoms, their separation is carried out. The final stage of the diagnosis is a consultation with a specialist.

As an example, some of the methods of standard examination, which are used in medical practice for the diagnosis of carcinoma:

Other ways of making a diagnosis are carried out according to the symptoms, and depend on the technical equipment of the medical institution. Laboratory studies of biofluids (blood test without changes, stabilized analysis, blood plasma, etc.) for composite, biochemical, and other indicators are of an additional nature, for the most part, in order to accurately determine the patient's condition.

self-examination

Breast self-examination for oncology is short in time, only half an hour. It should be done at least twice a month.

In some cases, the neoplasm may not be felt, and with this in mind, it is recommended to keep records, noting in them your own feelings and all indicators based on the results of each self-examination.

The mammary glands are best examined for 5-7 days menstrual cycle, preferably on the same days.

Inspection

Visual examination should be carried out in a well-lit room, with a mirror. You need to undress to the waist, and standing right in front of the mirror, calm the rhythms of breathing.

Then you need to track the following parameters:

probing

Probing the chest is carried out in a comfortable position (standing, sitting, or lying down).

You should feel each of the breasts with your fingertips.

At the same time, it is not worth putting pressure on it, it is best to feel the slightest changes in the content of the mammary glands.

Each mammary gland is palpated in turn. Starting from the nipple, gradually moving the fingers to the periphery. For comfort, you can palpate looking at your reflection in the mirror, conditionally dividing the mammary gland into 4 components.

Moments to pay attention to

Is there any tightness in the chest:

• the presence of seals, nodes inside the gland;
• the presence of transformations, formations in the nipple.

If there are changes, you should definitely visit such specialists:

• mammologist;
• gynecologist;
• oncologist;
• therapist (visual examination and referral to the right doctor).

With the help of self-examination, it is possible to determine not only breast oncology, but also benign tumors, mastopathy. Situations where dubious formations are present do not yet indicate cancer. Only a specialist can say more precisely, after the analysis.

Medical examination

Diagnosis of malignant tumors of the breast begins with an examination by an oncologist or mammologist.

At the time of the visual examination, the doctor:

• Will try to get full information about the manifestations of the disease, possible root causes of its occurrence;
• Perform a visual inspection, palpation (palpation) of the chest in two circumstances: lying and standing with arms along the body and with arms raised.

ultrasound

Now ultrasound has become an auxiliary method for detecting a disease, although it has a number of advantages, in contrast to radiography. For example, it makes it possible to study images from different angles, while there is no harmful radiation.

The main reasons for the use of ultrasound diagnostics in tumors:

Mammograms in most cases are carried out for screening, but they are advisable to use if cancer is suspected.

Therefore, they are often referred to as detection mammograms.

The examination clarifies the situation in the presence or absence of pathology, which is very acceptable for routine checks when no deviations are detected.

For a different situation, a biopsy may be necessary (taking a piece of tissue for detailed examination under a microscope).

A biopsy may be needed in a circumstance where mammography is negative but a mass is present in the breast. Such a detailed study is not carried out if the ultrasound revealed the existence of a cyst.

MRI

MRI mammography– study of the chest cavity by means of magnetic resonance imaging.

Before analysis, all metal objects should be removed. It is forbidden to hold any electronic device, so as not to cause interference.

When a woman has some kind of metal implants (pacemaker, joint prostheses, etc.), the specialist should be informed - this fact is considered a contraindication to the examination.

The woman is placed in the apparatus in a prone position. The patient must remain still during the examination. The time spent in the device is set by the doctor.

Based on the results of the MRI examination, images are studied, in which all negative transformations in the chest are shown.

PCR diagnostics by oncomarkers

tumor markers- individual substances that are present in the bloodstream in malignant formations. For any tumor, tumor markers identical to it are characteristic.

CA 15-3 is a protein located on the passages of the mammary glands and secreting fragments. Its presence in the bloodstream is increased in 10% of patients with the initial stages of the disease and in 70% with formations associated with metastases.

For analysis, material is taken from the intra-ulnar vein. Smoking is prohibited prior to blood sampling.

Reasons for the implementation of the analysis:

• detection of reoccurrence of seals;
• monitoring the effectiveness of the treatment;
• the need for tumor classification;
• Identification of the size of the neoplasm: the greater the presence of a tumor marker, the larger the lesion.

Myths about breast cancer

Every year, more than a million episodes of breast cancer are diagnosed in the fairer sex in the world. This fact often becomes a reason for panic, a sense of fear for one's own life and a number of myths that do not correspond to reality.

Some of these misconceptions become, in turn, the basis for a categorical refusal of the examination, for a completely safe diagnosis:

Stages of breast cancer

The formation of an oncological tumor of the breast occurs in 4 stages:

• Zero. Carcinoma of the mammary passages (a neoplasm forms inside the mammary passages, without affecting nearby organs), invasive lobular carcinoma (structured by cells that develop lobules).
• First. The volume of the negative cavity is less than 2 cm. The lymph nodes are not affected.
• Second. The volume of the negative cavity is up to 5 cm, embedded in the fatty layer, can capture the lymph nodes, or remain within the gland. The possibility of a complete cure at this stage is 75-90%.
• Third. The volume of the malignant cavity is more than 5 cm, it manifests itself on the surface of the skin of the chest, lymph nodes, chest.
• Fourth. The cancer spreads and crosses the borders of the chest, grows on the bone tissue, the cavity of the liver, lungs and brain. At this stage, a cure for cancer is unlikely.

Breast Cancer Treatment

Methods for the treatment of breast cancer:

• surgical;
• chemotherapy;
• hormone therapy;
• immunostimulation;
• radiation treatment.

Treatment is usually carried out in association with additional methods.

Surgery

Surgery is often the main way to get rid of breast cancer. Modern surgeons tend to remove small volumes of breast tissue using auxiliary methods: drug treatment and laser therapy.

Types of surgical manipulations in getting rid of the tumor:

• Complete mastectomy. Complete removal of the breast, along with the fatty layer and located nearby lymph nodes. This method of surgery is the most radical ;
• Complete resection. Removal of a breast area, along with subcutaneous fat and lymph nodes. Modern surgeons mainly use this option because, unlike a complete mastectomy, resection increases the chances of survival. With this option, auxiliary therapy is used: chemo-radiation treatment;
• Quadrantectomy– removal of the tumor itself and adjacent tissues in a location of 2–3 cm, as well as lymph nodes located in the immediate vicinity. This operation can be performed only at the initial stage of the disease. The cavity that needs to be removed must be sent for a biopsy;
• Lumpectomy- the smallest operation in terms of location, in which only the neoplasm and lymph nodes need to be removed. The conditions for the implementation of this surgery are similar to quadrantectomy.

The volume of surgical removal is determined by the doctor himself, under the influence of the type, area of ​​​​damage, localization and volume of carcinoma.

hormone therapy

The main focus of hormonal treatment is to block the effect of female sex hormones (estrogens) on the neoplasm. Such methods are used only in situations with seals that have a certain reaction to hormones.

Methods include:

• surgery to remove appendages;
• drug blockade;
• taking anti-estrogen medications;
• the use of androgens (male hormones);
• taking drugs that inhibit aromatase enzymes;
• the use of progestins.
  

Chemotherapy

Chemotherapy (chemistry)- drug treatment of breast cancer, in which cytostatics are used. These drugs destroy cancer cells and inhibit their reproduction.

Cytostatics- medicines that have many side effects. Therefore, in each individual case, they are prescribed strictly in accordance with the generally accepted regulations and taking into account the characteristics of the disease.

Cytostatics most commonly used in breast malignancies:

• Methotrexate;
• 5-fluorouracil;
• Paclitaxel;
• Cyclophosphamide;
• Docetaxel;
• Xeloda.

Associations of medicines often used in the treatment of breast cancer:

• CMF (Cyclophosphamide, Fluorouracil, Methotrexate);
• CAF (Cyclophosphamide, Fluorouracil, Adriablastine);
• FAC (Fluorouracil, Cyclophosphamide, Adriablastine).

Effective short sessions of irradiation are carried out.

Direction of pre-surgical radiotherapy for breast tumors:

• Complete elimination of malignant tissues along the borders of the tumor to prevent recurrence.
• Transformation of education from an inoperable form to an operable one.

Postoperative

The main focus of radiation therapy in the postoperative period is the prevention of relapses.

Areas exposed to radiation in the postoperative period:

• Actually the tumor itself;
• lymph nodes that could not be removed at the time of the operation;
• lymph nodes close in location, for prevention.

At the time of the operation

Radiation treatment can be done right at the time of the operation, when the surgeon seeks to preserve breast tissue.

This is acceptable at the following stages of the disease:

• T 1-2;
• N0-1;
• M0.

Independent

Indications for the use of gamma therapy without surgery:

• the impossibility of getting rid of the neoplasm in an operable way;
• contraindications to surgery;
• refusal of the patient from surgery.

Interstitial

The source of radiation is as close as possible to the localization of the pathology. Intracavitary radiation treatment is used simultaneously with remote radiation treatment (the source is located at a distance) often for nodal cancers.

Orientation of therapy: to bring the maximum increased dose of radiation closer to oncological education, in order to completely eliminate it.

Targeted (targeted therapy)

Targeted, targeted therapy- this is essentially the activity of monoclonal antibodies that adhere to certain receptors on the membrane of an oncological cell.

These proteins are prototypes of real human antibodies that reproduce B-lymphocytes. But B-lymphocytes do not produce antibodies against molecular receptors located on the membrane of cancer cells.

For example, targeted treatments can disrupt the function of negative proteins (like HER2) that help cancer cells grow.

In cases where laboratory studies have detected the presence of a significant excess of the HER2 protein in the breast neoplasm, the patient is prescribed trastuzumab (Herceptin®) or lapatinib (Taykerb®).

Medicinal products of monoclonal proteins (monoclonal antibody – MAB) have become super-nanotechnological drugs of our time.

Targeted treatment can be used both in radical therapy in association with other methods of fighting breast cancer (adjuvant regimen), and for the treatment of carcinoma with branches (treatment regimen).

Forecast

Still, the prognosis for recovery with such a serious illness is a little more optimistic than with ordinary cancer, which does not have resistance to hormonal treatment.

For a positive prognosis, some circumstances are important:

In order to achieve a positive prognosis, the treatment of carcinoma must be given the same pace as the development of the disease. Patients in whom the pathology was identified at the initial stage have a chance for a complete recovery.

In today's realities, many of the world's minds in medicine are busy with the problem of curing cancer, more precisely, a close study of the root cause and nature of the appearance of malignant cells.

Most scientists have not yet determined exactly what is the main reason for the situation when a completely healthy mammary cell begins to acquire pathological properties, forming an oncology that can deceive the body by synthesizing pseudohormones.

If we note some victories on this topic, we can talk about the creation of experimental drugs that can inhibit this process.

Disease prevention

It is no secret that the excess of female sex hormones in the blood causes breast cancer.

Estrogen levels decrease during pregnancy and breastfeeding.

Independent and unregulated use of hormonal contraceptives also leads to a violation of the normal content of hormones in the blood and causes a tumor.

In pre-climatic and during the onset of menopause, the presence of hormones in the blood should be monitored in order to recognize and prevent the formation of the disease.

Gestation, delivery and breastfeeding is the best prevention of breast tumors and helps to defeat cancer.

Symptoms of a breast tumor in women in the early stages of development often do not manifest themselves. Therein lies their danger. All types of breast tumors are divided into benign and malignant. The number of these diseases continues to grow steadily and get younger. Benign tumors in the mammary gland are related to mastopathy, and there are more than 50 types of them. Clinicians distinguish between the most common forms - nodular and diffuse mastopathy.

Symptoms of a breast tumor in women in the early stages of development often do not manifest themselves.

The mammary glands are 2/3 composed of glandular tissue, which ensures their functioning. And when the cells of this tissue begin to divide uncontrollably, various neoplasms arise. All breast tumors are mostly hormone-dependent, so hormonal disruptions are ready ground for the development of tumors.

The exact causes are still unknown today, but a number of provoking factors have been identified that can serve as a trigger:

• genetic predisposition - with it, the risk of cancer is doubled in offspring;
• old age - from 55 to 65 years;
• early menarche;
• late menopause - after 55 years;
• protracted climacteric syndrome;
• absence of pregnancy and childbirth up to 30 years;
• the woman was not breastfeeding;
• frequent abortions;
• lack of sexual life;
• late childbirth and pregnancy - after 35 years;
• inflammatory diseases of the ovaries;
• infertility;
• any tumors and cysts of the ovaries;
• endocrinopathy - diabetes, disorders of the thyroid gland, adrenal glands, pituitary tumors;
• long-term use of OK;
• any injury to the mammary glands;
• radiation;
• obesity;
• hypodynamia;
• stress;
• tight underwear;
• hypovitaminosis A, E, D, C;
• smoking and alcohol - taking even small portions of alcohol, but regularly, by 50% increases the risk of breast cancer, CAS;
• insolation, sunbathing topless;
• bad ecology;
• hepatitis;
• inflammatory diseases of the genital area of ​​a chronic nature.

Symptoms of breast cancer (video)

Benign formations

Mastopathy - hormone-dependent growths of connective and glandular tissues in different proportions. Therefore, diffuse and nodular mastopathy are distinguished. Diffuse mastopathy occurs more often at a young age, responds well to conservative treatment. This pathology is characterized by small multiple growths, common throughout the mammary gland. Diffuse mastopathy is characterized by a connection with the menstrual cycle, in the second half of it chest pains and swelling of the glands are always found. With a nodular form, single nodes are formed, this is typical for the elderly. Treatment is only surgical - excision of the node.

Forms of mastopathy:

1. Fibrocystic mastopathy (FCM) - affects mainly the connective tissues of the mammary gland. They grow, which leads to a decrease in the lumen of the milk ducts or their complete blockage. Over time, cysts begin to form in such a gland.
2. Cysts are cavities in the mammary gland filled with fluid. In the breast, they can be of different sizes, usually associated with menstruation. Cysts occur if there is a blockage of the duct, while the secretion of the lactiferous duct accumulates and, having no way out, is converted into a cyst. They can be single or multiple. More often, with small sizes, they do not manifest themselves in any way, but then before menstruation there is a burning sensation and soreness in the chest. If the cyst is filled with milk, it is called a galactocele. It is an enlargement of the lactiferous duct, occurs in lactating women who have had problems with breastfeeding in the form of lactostasis or mastitis.
3. Fibroadenoma - it is characterized by the growth of connective and glandular tissues. This tumor in the chest looks like a dense hard seal. Fibroadenomas are the most common. They look like rounded tumors with clear boundaries - soft, elastic, mobile and not soldered to the underlying tissues. They appear more often in women under 35 years of age. They can reach 5 cm in diameter. Fibroadenomas are common and leaf-shaped. They are considered hormone dependent. A phylloid or leaf-shaped tumor is defined as a type of fibroadenoma - it is also benign. It is the least common, but is considered the most dangerous in terms of malignancy and degeneration into sarcoma (in 10% of cases). Its signs: clear boundaries, absence of a capsule, immobility, pain on palpation. This type of tumor is treated only surgically, without attempts at conservative therapy. During operations, not only the tumor itself is removed, but also neighboring tissues. Even after such treatment, relapses are possible for 4 years.
4. Lipoma is a benign formation of adipose tissue, wen. Education is usually soft, elastic, spherical. Lipoma does not require treatment, it grows very slowly and does not manifest itself. Only if it, increasing, begins to compress the vessels and nerves, it is surgically removed.
5. Intraductal papillomas - outgrowths of tissue resembling papillae are formed from the epithelium of the ducts. Their structure is similar to skin papillomas, for which the pathology got its name. With this form of mastopathy, a characteristic symptom is discharge from the nipples, often brown. Their volume is different - from abundant to 2-3 drops per day. They are dangerous because they can be reborn, so their sectoral excision is carried out.
6. Lipogranuloma - most often the result of trauma, radiation or sudden weight loss. In this case, any area of ​​the injured, usually adipose tissue ceases to receive nutrition due to destroyed capillaries and begins to transform into aseptic fat necrosis.
7. Adenoma is a hormone-dependent benign tumor in the breast. It develops from glandular epithelium. Occurs at a young age, after 40 years does not occur. It is presented as an elastic ball under the skin, usually shallow, so palpation is possible. It can be single or multiple, on one or two mammary glands. Treatment involves only surgery.

Malignant tumors of the breast

These formations have a very complex classification according to the localization and metabolism of cells - more than 10 types. In addition, they are divided into sarcomas, adenocarcinomas and carcinomas. According to biochemical indicators, they are divided into hormone-dependent, invasive and estrogen-dependent, primary and secondary tumors.

Malignant tumors of the mammary gland often also develop from the ducts. The body cannot control the uncontrolled growth and division of cells, and the cells, growing, begin to penetrate into neighboring areas. Breast cancer is a disease of older women. If under the age of 30, breast cancer occurs only in every 400 women, then after 50 years - in every 38.

Forms of malignant tumors:

1. Nodular - a seal in the form of a painless node that does not have clear boundaries.
2. Erysipelas is a very aggressive breast tumor that metastasizes rapidly.
3. Edematous - there is no specific seal, but the skin thickens diffusely, it is hyperemic, has dense edges.
4. Mastitis-like - according to the signs it resembles mastitis, differential diagnosis is required.
5. Diffuse - has the form of a diffuse infiltrate that affects the glandular tissue in different organs. Also an aggressive form of cancer.
6. Hidden - with it, the reaction comes from the lymph nodes, which hypertrophy, metastases appear in them, and the signs in the gland itself are late.

Clinical forms of cancer:

1. Nodular cancer is the most common. It is localized usually in the upper-outer quadrants of the mammary gland. It quickly grows into the underlying tissues. Its risk of occurrence increases with age. The nodes in this cancer are dense, have no clear boundaries. With rapid growth, the manifestation of this type of cancer is characterized by a change of nodes into tubercles that grow on the surface of the skin and open in the form of bleeding ulcers. Over time, the tumor disintegrates, a fetid odor appears. Necrosis may extend to the bones. Patients are in pain. Secondary infection and death easily occur.
2. Diffuse cancer is less common but has poor prognosis. The gland is all permeated with this tumor, it increases in size, turns red, swells and hurts. Has no clear boundaries. Diffuse cancer has several varieties. The edematous form is distinguished by skin in the form of a lemon peel. The mastitis form leads to necrosis. Armored - the gland is reduced in size, the nipple is retracted, the chest is severely deformed. The gland tissue and subcutaneous fat are completely affected. Over the entire surface of the skin of the chest there is a scattering of pinkish nodular infiltrates. This form of cancer quickly metastasizes.
3. Cancer of the nipple, or Paget's disease, is the third form of breast cancer. This is an intraductal carcinoma of the breast. It can also be found in men. Outwardly, nipple cancer is similar to eczema in the nipple and areola. Its first signs are in the form of scales on the nipple or around it. The nipple gradually begins to retract, and the dense infiltrate around it increases and grows into the underlying tissues. The skin in this part of the gland becomes inflamed, the color becomes crimson. Weeping sores are formed, they are periodically covered with a crust. The tumor grows slowly, metastases in the lymph nodes can be in the complete absence of treatment. Treatment is only in the form of a mastectomy followed by radiation and chemotherapy, as well as hormonal treatment. The patient should be constantly monitored by a mammologist, because. the tumor is prone to frequent recurrence.
4. Breast sarcoma is also a malignant neoplasm in the gland. It develops from connective tissue, this differs from breast cancer, which often occurs with the growth of the epithelium. Sarcoma is an aggressive tumor with rapid growth, germination and metastasis. On palpation, it is bumpy, dense, the skin above it is thinned, hyperemic, the venous network on the chest is strengthened. Mastectomy for sarcoma is only extended - with the complete removal of all axillary, subclavian lymph nodes. Next, radiation and chemotherapy are prescribed.

Symptomatic manifestations

At an early stage, any breast tumor in women is small and often not detected. But benign tumors from the very beginning appear more vividly and painfully than malignant neoplasms. As they grow in various pathologies, they begin to compress neighboring tissues, blood vessels, nerve endings, and then obvious symptoms already appear.

The initial stage proceeds without any signs, a tumor is detected at this stage of development, often by chance in other studies. The first signs are the appearance of seals, determined by palpation. You may also notice:

• changes in the structure of gland tissue, breast shape, skin color;
• peeling;
• skin in malignant neoplasms is always wrinkled over the tumor;
• constantly retracted wrinkled nipple;
• if you put your hands behind your head, pits appear on your chest;
• discharge from the nipples: transparent or yellowish - this is mastopathy, green - a sign of infection and with blood - with malignant tumors;
• unilateral enlargement of lymph nodes;
• chest discomfort and pain.

At an early stage, any breast tumor in women is small and often not detected.

Symptoms at different stages of cancer

Breast cancer has 4 stages and zero. Clinical symptoms become more pronounced in stage 2. The effect of treatment is maximum at stage 1 - 96%.

The zero stage is a non-invasive course. This means that the tumor is growing but has not yet invaded neighboring tissues. Dimensions do not exceed 2 cm, detected during self-examination. There are no other manifestations.

The first stage - the neoplasm is already invasive. The size becomes more than 2 cm, begins to grow into neighboring tissues. At this stage, a change in skin color may appear: redness, peeling, wrinkling, but there is no pain or discomfort yet.

The second stage - the size of the tumor is more than 5 cm. Atypical cells begin to spread into the lymph, there is a reaction of the lymph nodes. They increase, the skin of the chest turns red, discomfort appears. Stages 0-2 are considered early, treatment prognosis is very encouraging.

The third stage is 3A and 3B. Stage 3A - there is an accumulation of cancer cells in the lymph nodes, the size of the tumor exceeds 5 cm. Stage 3B - the neoplasm grows into the underlying and adjacent tissues. Pain and discharge become constant.

The fourth stage is the last. Common symptoms and distant metastases develop - to the lungs, liver and brain.

General differences in neoplasms

Benign breast tumors are characterized by slow growth. They do not grow into neighboring tissues, but only push them apart, rarely give relapses. Mastopathy can recur when the tumor has a base (pedicle). Benign tumors develop from any tissue, and malignant ones - more often from the epithelium. Among the symptoms of benign formations:

• pulling pains in the chest in the second half of the menstrual cycle;
• feeling of swelling of the chest;
• sensation of heat;
• seals on palpation.

There is no severe pain in benign tumors. There is no wrinkling of the skin, swelling of the breast and discharge from the nipples.

Malignant neoplasms affect the mammary gland more often in the upper outer quadrants, in the lower sections they are less common. Oncological tumors germinate quickly and everywhere. Benign ones do not cause general symptoms, they cause only local discomfort. With cancer, there are common symptoms in the form of intoxication, pallor, and weight loss.

With mastopathy, the seals are mobile, painful on palpation, there is no growth of lymph nodes, there is a dependence on menstruation. The tumor is usually smooth, elastic.

A malignant neoplasm of the mammary gland often does not hurt, looks like a large dense fixed knot. The axillary lymph nodes are enlarged, bloody discharge from the nipples is observed.

Differences between cysts and malignant tumors: the cyst is formed from normal tissues, there are no atypical cells in it. It does not grow into neighboring tissues, is small, can twist and tear. The tumor never ruptures.

Differences of fibroadenoma from malignant tumors: fibroadenoma is always smooth, elastic, spherical, movable on palpation.

Diagnostic measures

The gold standard for diagnosis is a trio of examinations: mammography, ultrasound, biopsy. Along with this, CT, MRI, ductography are used. In the latter case, a contrast agent is injected into the mammary duct - water-soluble radiopaque.

There is such a type of research as thermography. In this technique, the doctor determines the size of the tumor and the percentage of breast damage by the temperature difference in different parts of the breast on the monitor.

It can help to determine in the blood of oncomarkers - special proteins that are produced by atypical cells. They help to identify the tumor earlier than conventional methods. Breast tumor markers CA-15-3.

Primary signs of breast cancer (video)

Principles of treatment

Benign tumors can be treated conservatively and surgically. Treatment of malignant tumors is only surgical. Taking into account the size and germination in the lymphatic tissue, 2 types of operations are performed: organ-preserving and mastectomy.

Organ-preserving techniques:

1. Embolization of the tumor - an embolus is injected into the largest vessel that feeds the neoplasm, which creates ischemia for the tumor. This leads to her death.
2. Quadrantectomy - a quarter of the breast is removed with the formation and axillary lymph nodes.
3. Radical resection - performed in the early stages of breast cancer. The affected sector of the chest, part of the large pectoral muscle and part of the lymph nodes are removed. The size of the tumor should not be more than 3 cm, it should be localized only in the upper outer quadrant. With a different location and diffuse formation, this method is not used.

After sparing operations, radiation therapy of the remaining part of the breast is mandatory to reduce the risk of recurrence.

Mastectomy is performed in 4 ways:

1. A simple mastectomy is the removal of only the gland.
2. Radical modified mastectomy - the entire gland is removed, as well as the axillary lymph nodes and the sheath of the pectoralis major muscle.
3. Radical mastectomy according to Halsted - is performed when the tumor grows into the muscles of the chest. With it, the gland, both pectoral muscles, fatty tissue and lymph nodes in all neighboring areas are removed.
4. Bilateral (bilateral) mastectomy - removal of both glands. This is used for cancer in both glands. Such an operation is also performed at the request of the woman, if she is afraid of relapse.

All surgeries are performed under general anesthesia.

Drug therapy

Chemotherapy is given immediately after or before surgery to reduce the size of the tumor. With metastases, chemotherapy does not lead to recovery, but only improves the quality of life.

Hormone therapy is used only for hormone-dependent tumors. It aims to prevent the fusion of estrogen and progesterone with the hormone receptors of the breast cancer, because such a fusion accelerates the growth of cancer. 65% of atypical cells have hormone receptors. Of great importance in the development of breast cancer is the female hormone estrogen. The agonists used to treat LH-RH (Leuprolide and Goserelin) block the production of estrogen in the ovaries. They are used as injections into the abdomen. Another method to eliminate estrogen is to remove the ovaries, which are the main producers of this hormone. After removal, estrogen levels plummet. In postmenopausal women, removal of the ovaries has no effect.

Palliative therapy is carried out in the last stages of cancer not for recovery, but only to improve the quality of life and reduce pain. For this, narcotic and non-narcotic analgesics are used.

After operations it is necessary:

• monthly self-examination of the breast;
• visit a doctor - in the first year every 3 months, in the second and third years - once every 6 months, then - once a year.

For prevention, you should:

• get a mammogram every year after age 50;
• plan a pregnancy before the age of 35;
• to fully breastfeed the child after childbirth;
• normalize weight and hormonal levels under the supervision of a doctor;
• take OK only under the supervision of a gynecologist;
• prophylactic mastectomy, spaying, and tamoxifen can help with hereditary cancer (tamoxifen slows down the growth of existing atypical cells and reduces recurrence; taken for a long time - for 5 years);
• to refuse from bad habits;
• have sex regularly.

60% of patients after cancer surgery in the early stages can live another 5 years. At stages 3 and 4, the survival rate is only 35%.