A malignant tumor appears as a result of the rapid multiplication of mutated cells of the glandular tissue of the mammary gland. Unlike benign neoplasms, cancer can spread to nearby organs. At the initial stage, most often the tumor does not bother a woman. But if, upon self-examination, seals are found in the chest, then you must immediately go to the doctor. Lumps in the breasts are not necessarily a sign of cancer, but a diagnosis can only be made after an examination by a mammologist.

1. Nodal. It is a seal with a size of 0.5 cm and more. This form is more common than others.
2. Diffuse. Such tumors rapidly increase in size, and their configuration changes. The tumor spreads to the mammary gland.
3. Nipple cancer. The nipple thickens, enlarges, ulcers and crusts appear on it. Gradually spreads to the entire gland.

In addition to these forms of cancer, there are also so-called non-cancerous malignant formations (sarcomas and metastases spreading from other tumors).

Video: The Importance of Early Diagnosis of Breast Cancer

Forms and signs of diffuse breast cancer

A tumor of a diffuse type can exist in the following forms: pseudo-inflammatory, erysipelas, armored.

A pseudo-inflammatory tumor is characterized by redness of the skin, fever, pain in the mammary gland. Tumors of this type are sometimes mistaken for inflammatory diseases. The erysipelas has the same symptoms, ulcers appear on the skin of the diseased gland. The carapace form is characterized by the formation of a crust that tightens the skin of the breast, due to which the size of the gland decreases.

Recommendation: In case of reddening of the skin of the chest, the appearance of back pain (if it is not associated with movement or breathing), it is necessary to urgently go to an appointment with a mammologist, as these may be hidden symptoms of breast cancer.

Breast cancer stages and their signs

The development of breast cancer occurs in 4 stages:

1. Zero. These include: ductal carcinoma (the tumor develops inside the milk ducts, does not spread to neighboring organs), invasive lobular carcinoma (consists of cells that form lobules).
2. First. The size of the tumor is less than 2 cm. The lymph nodes are not affected.
3. Second. The size of the tumor is up to 5 cm, grows into adipose tissue, can spread to the lymphatic system or remain within the gland. At these stages, the probability of a cure is 75-90%.
4. Third. The size of the tumor is more than 5 cm, spreads to the skin of the breast, lymph nodes, chest.
5. Fourth. The tumor extends outside the chest, spreads to the bones, liver, lungs, and also to the brain. At this stage, cancer is incurable.

Symptoms of breast cancer in women

Sometimes breast cancer manifests itself only as swelling of the axillary lymph nodes. At the same time, the tumor has no other external signs. It is especially difficult to notice their appearance in large breasts. If the lymph nodes are slightly swollen, painless and move when palpated, then this is not dangerous, it may indicate an inflammatory disease. But if they are large, solid, merge with each other, then this indicates the malignant nature of the tumor, about the defeat of the lymph nodes by metastases.

The first symptoms of the appearance of a cancerous tumor

The first symptoms of breast cancer can be detected with self-diagnosis. A woman should conduct a breast examination on a monthly basis. First of all, you need to pay attention to the following signs:

• the appearance of seals - in cancer they are shapeless, the surface is uneven;
• painful sensations when pressing on the chest;
• asymmetric arrangement of the mammary glands, violation of the symmetry of the nipples.

Since breast diseases are inextricably linked with diseases of the reproductive system, endocrine glands, then the woman should also be alerted by indirect signs, such as menstrual irregularities, infertility.

The mammary glands can differ from each other in size even in a healthy woman. It is worth paying attention to this sign if the sensations in the mammary glands that occur during menstruation are intensified in one of them. Such symptoms are typical for mastopathy, fibroadenoma.

One of the signs of the appearance of benign or malignant breast tumors in women is an increase in the size of the lymph nodes. Benign tumors differ from malignant ones in that seals move freely when pressed on the chest, do not grow together with the skin, have a smooth surface and a spherical shape, soft to the touch. They consist of overgrown cells of connective or adipose tissue, do not spread to neighboring areas, grow, as a rule, slowly, and may not show themselves for years.

Video: Signs of Breast Cancer

Typical symptoms of a malignant tumor

Symptoms distinguish breast cancer from benign neoplasms:

• rapid increase in the size of the seals (from 0.5 to 10 cm);
• retraction of skin areas over the tumor;
• a rapid change in external signs (the seals become harder, the skin over them coarsens, ulcers appear);
• redness of the skin, the appearance of swelling;
• discharge from the nipple (purulent, with blood impurities);
• retraction of the nipple;
• changes in the surface of the mammary gland, the appearance of a resemblance to a lemon peel.

Video: Unusual Signs of Breast Cancer

Breast Cancer Causes

Possible causes of breast cancer include:

• chest trauma, surgery (for mastitis, for example);
• hormonal disorders caused by endocrine diseases, as well as infectious diseases of the genitourinary system, liver;
• disruption of the reproductive system, the onset of menstruation at an early age, late onset of menopause, lack of sexual activity in reproductive age, abortion;
• tumor diseases of other organs;
• exposure to radiation.

The factor of heredity plays an important role. Breast cancer is more common in older women than in younger women. The risk of the disease is increased in women who smoke and drink alcohol regularly.

Breast Cancer Diagnostic Methods

To determine the stage of the disease and the possibility of treatment, the tumor is examined using mammography, ultrasound. A biopsy of the tumor tissue is done. The most accurate method to determine the nature of the tumor, its size, shape, spread of metastases, is MRI. Such information is of particular value before the operation and in the postoperative period.

Content

A malignant tumor of the breast occurs in every 10 women. Oncology is characterized by a tendency to metastasis and aggressive growth. Breast cancer has a number of symptoms that are similar to other breast conditions in women. For this reason, at the first disturbing symptoms, you should immediately contact a qualified specialist.

What is breast cancer

A malignant tumor of the breast is an uncontrolled growth of epithelial cells. Oncology of this type develops mainly in women, but sometimes it also occurs in the male population. A malignant neoplasm in the breast is one of the most dangerous cancers. The mortality rate from the incidence of this type of cancer is 50%. The main cause of death is neglect of the disease. If breast cancer is diagnosed at 1 or 2 stages, then there is a very high survival rate after treatment and long-term results are favorable.

Symptoms

Precancerous manifestations are often seen on the breast. Peeling of the skin, edema, soreness of the nipples - these are not only hormonal disruptions, but also symptoms of infections, cysts or mastopathy. All these pathologies are a manifestation of a precancerous condition. Symptoms of breast cancer for which you should urgently see a doctor:

1. Discharge from the nipples. Observed at all stages of breast cancer. The liquid is yellow-green or transparent in color. After a while, reddening of the nipple skin, ulcers, spots and wounds on the halo are formed on the chest.
2. Lumps in the chest. You can easily feel them yourself.
3. Deformation of appearance. With the growth of the tumor into the denser tissues of the mammary glands and the appearance of metastases, the structure of the breast changes (especially in the case of an edematous form or armored cancer). The skin above the lesion becomes crimson, peeling occurs, dimples are formed like "orange peel".
4. Flatness, elongation of the chest. A sunken or wrinkled nipple is pulled into the gland.
5. Enlargement of the lymph glands. Raising the arms causes pain in the armpits.

First signs

At the initial stage of the disease, the clinical picture is almost always asymptomatic. More often it resembles different types of mastopathy. The only difference is that with a benign tumor, the seals are painful, but with oncology they are not. According to statistics, in 70% of women diagnosed with cancer, the presence of a lump in the chest, which was easily palpable, was first determined. The reason for going to the doctor is soreness in the mammary gland, even a slight one. The first sign of cancer is a lump in the breast that does not disappear after your period.

Causes

The main factor in the occurrence of cancer is a change in hormonal levels. The cells of the ducts of the mammary glands mutate, acquiring the properties of cancerous tumors. Researchers analyzed thousands of patients with this disease and deduced the following factors contributing to the risk of pathology:

• female;
• heredity;
• the absence of pregnancy or its occurrence after 35 years;
• malignant neoplasms in other organs and tissues;
• exposure to radiation;
• the presence of menstruation for more than 40 years (increased activity of estrogens);
• high growth of a woman;
• alcohol abuse;
• smoking;
• low physical activity;
• hormone therapy in high doses;
• obesity after menopause.

Stages

A woman may notice the first symptoms of breast cancer at 1 or 2 stages of the disease. The zero (initial) stage is non-invasive, so the carcinoma may not appear for a long time. As a rule, a woman first learns about an oncological disease during the examination. The primary tumor can also be recognized by palpation. At the second stage of cancer, the size of the neoplasm already reaches 5 cm, the lymph nodes are enlarged above the clavicles, near the sternum and in the armpits.

The third degree of breast oncology is characterized by an increase in body temperature, retraction of the skin and / or nipple in the places where the carcinoma is located, the tumor begins to grow on the surrounding tissues, and affects the lymph nodes. High risk of detecting metastases in the lungs, liver, chest. In the fourth stage of breast cancer, internal organs and bones are affected, and the cancer spreads to the entire gland (Paget's cancer). This degree is characterized by the presence of metastases. The disease is almost resistant to treatment, so the likelihood of death is very high.

Types

Breast cancer is classified by type:

1. Ductal. It is characterized by the fact that the cellular structures are not transferred to the healthy breast tissue.
2. Lobular. Localization of the tumor is found in the lobules of the breast.
3. Medullary. Has an accelerated increase in the size of the tumor, quickly begins and gives metastases.
4. Tubular. The origin of malignant cells occurs in epithelial tissue, and growth is directed to adipose tissue.
5. Inflammatory. Very rare. The inflammatory disease is aggressive, the diagnosis is difficult, since it has all the signs of mastitis.

Is breast cancer treated?

At stage zero, breast cancer treatment leads to 100% recovery. At a later date, there are rarely cases of healing, the question is mainly about extending life. After detecting cancer in breast tissue, doctors rely on a patient's five-year survival rate. These are average statistics. There are many cases when, after treatment, a woman lived for 20 years or more, forgetting about the terrible diagnosis. It should be remembered that the earlier cancer is diagnosed, the better the prognosis.

Diagnostics

Breast cancer detection is a multi-method approach. The main goals of diagnosis are to detect lumps at an early stage and choose a more appropriate treatment. Primary changes in the breast can be detected during examination, both independently and by a surgeon, endocrinologist, oncologist or mammologist. To clarify the nature of the tumor and the extent of the spread of cancer, the doctor prescribes laboratory and instrumental studies:

• Ultrasound of the mammary glands;
• mammography;
• biopsy;
• blood for a tumor marker;
• cytology of nipple discharge;
• blood for abnormal genes (in familial cancer).

How to examine your breasts

Regular self-examination is an important step towards early detection of breast lumps. The procedure should become a habit of every woman, regardless of age, in order to recognize cancer at an early stage. First, you should evaluate what the breast looks like: shape, color, size. Then you need to raise your hands up, examine the presence of protrusion of the skin, depressions, redness, rash, edema or other changes.

Next, you should feel the axillary lymph nodes - they should not be large and cause soreness. Then the right and left breasts are carefully examined in circular movements from the armpits to the collarbone, from the nipple to the upper abdomen. It is imperative to pay attention to the presence of secretions. Any suspicion is a reason to see a doctor.

Breast cancer treatment

Cancer therapy is prescribed only after all of the above examination methods have been carried out. They try to treat breast cancer with the help of local and systemic therapy. With early diagnosis, surgical intervention is more often prescribed. If cancer is detected at a late stage, patients are recommended complex treatment, in which surgical removal of the mammary glands is combined with hormonal, radiation or chemotherapy. Additionally, biological, immunological and alternative treatment can be prescribed.

Treatment without surgery

When a malignant tumor occurs in the breast, some patients refuse surgery, radiation and chemotherapy, citing toxicity and side effects. Among the methods of non-surgical treatment, there is acupuncture, Ayurveda, yoga, massage, homeopathy. Sometimes hypnosis, reading prayers, therapeutic fasting, and the use of dietary supplements are considered alternative methods of treatment. The effectiveness of these methods has no evidence, therefore, such therapy is a great risk for the patient's life.

Hormone therapy

It is indicated if the malignant neoplasm is sensitive to hormones. To determine this, after examining the mammary glands, an immunohistochemical study of the biopsy material is performed. According to the results of the examination, the following drugs can be prescribed:

1. Estrogen receptor modulators. Prescribed if the tumor has estrogen, progesterone receptors. These drugs include: Tamoxifen, Toremifen, Raloxifen.
2. Estrogen receptor blockers. Do not allow estradiol molecules to attach to estrogen receptors. The most famous medicines of the group: Faslodeks, Fulvestrant.
3. Aromatase inhibitors. Used to reduce the production of the ovarian hormone estrogen during menopause. In oncological practice, Exemestane, Anastorozole, Letrozole are widely used.
4. Progestins. Reduce the secretion of pituitary hormones that produce estrogens, androgens. Use tablets for oral administration, vaginal suppositories or ampoules for intramuscular injections. This group of drugs includes: Exluton, Continuin, Ovret.

Radiation therapy

It is not used as monotherapy. The role of radiation exposure in complex treatment increases with organ-preserving operations. Depending on the purpose, the lymph nodes or breast (from the side of the lesion) can be exposed to radiation. Radiation therapy is divided into several types:

• preoperative;
• postoperative;
• independent (with inoperable tumors);
• interstitial (with a nodular form).

Chemotherapy

The principle of the method is based on the use of anticancer drugs. They are administered intravenously, drip or orally. The duration of chemotherapy depends on the patient's condition. One course consists of 4 or 7 cycles. The procedure is prescribed both before and after breast removal. For breast cancer, chemotherapy requires individualized medication.

13.04.2019

A cancerous tumor in the area of ​​the breast is a malignant formation, which is characterized by rapid growth.

Why does it appear?

Before diagnosing this disease, let's look at the reasons for its occurrence.

Such a diagnosis develops against the background of the reasons:

• mastitis;
• negative impact of the environment;
• hereditary factors;
• regular abortions;
• taking hormonal drugs for a long time;
• mastopathy;
• excess weight;
• frequent x-rays and radiation.

How to define a disease?

It is important to know how to identify breast cancer early when it is critical. So, the symptoms below may indicate the presence of cancer in the mammary gland:

• you can manually feel a dense formation in the chest, while there is no pain;
• a strong change in the shape of the breast is visually observed;
• the skin of the breast is wrinkled or pulled in;
• in the direction of the gland of the affected tumor, there is an increase in lymph nodes in the armpit;
• swelling or hardening of the nipple;
• bloody discharge is observed from the nipple;
• the feeling of discomfort and pain gradually increases.

If it is a carcinoma, then it may differ in the presence of a very different localization site. Cancer can affect both breasts with the same frequency. If there is an oncological process in one breast, then it can go to the second breast, being an independent formation or metastases. Even on self-examination, you can find a small seal that resembles dough to the touch.

In some situations, if the survey was not carried out in a timely manner, then the formations can reach extremely large sizes.

Diagnosis of breast cancer is carried out in the following ways: mammography, ultrasound, biopsy. However, in any case, you should not panic ahead of time. If you yourself find a small lump in the chest, you need to consult a doctor to establish its cause after the necessary diagnosis.

Stages of the disease

At the moment, the malignant process can have one of five stages:

1. Cancer tumor with a permanent localization, without passing into the rest of the tissues of the organ.
2. At this stage, the formation from benign turns into malignant, but does not affect the lymph nodes and does not spread to other organs.
3. The nodes rapidly begin to increase in size, they can be 5 centimeters, there is also a lesion of the lymph nodes, but they are not welded together.
4. There is damage to the chest, lymph nodes and skin. At the same time, the skin on the chest becomes very hot, reddens and flakes. At this stage, the disease may resemble mastitis.
5. Metastases are observed throughout the body (bones, lymph nodes, lungs, liver and brain).

Mammography

If breast cancer diagnosis is required, a procedure such as mammography is recommended. With its help, you can determine the following:

• accumulation of the smallest inclusions of lime - micro-calcifications;
• deformation of a heavy pattern;
• local compaction of the fabric of the pattern - the shadow of the knot.

If there is breast cancer, diagnosis with mammography can only be effective if the formation is 2 to 5 cm in size.

Identification of intraductal carcinoma has a number of difficulties, since the lump can be microscopic in size. Focal accumulations of calcifications of various sizes, densities and shapes acquire the maximum diagnostic value.

Such a specific diagnostic method allows you to identify the disease at an early stage, so that the doctor will be able to prescribe a quick and effective treatment.

In clinical practice, it is necessary to take into account the fact that in women who have had radical treatment in the past, the likelihood of developing oncology in the second mammary gland increases 10 times compared to the rest.

The differential method for detecting an oncological process in another mammary gland primarily consists in clarifying the nature of the formation (malignant or benign) and identifying this primary formation or metastases.

Bilateral breast cancer is primary if:

• proven lobular or intraductal structure of the tumor in two mammary glands at once;
• in one breast there is an invasive type of tumor, in the other - a pre-invasive one;
• structures of a pre-invasive nature were found around the malignant tumor in the tissues of the mammary gland;
• the location of the tumor is observed in the parenchyma of symmetrical areas of two breasts at once, and not in soft tissues and subcutaneous tissue;
• there is no multiple spread of metastases to regional lymph nodes, separate and extraorganic metastases;
• the degree of malignant tumors differs among themselves.

If several focal formations are found at once within one square of the mammary gland, then the process is considered multifocal. As an example, intraductal cancer can be called, whose foci are located in a square.

If there is breast cancer, the diagnosis should be carried out immediately, since in this case it is possible to determine the degree of the disease, to prescribe an effective therapy that can help the patient cope with the pathology.

Do not neglect the examination by a doctor, because this is how you can determine the formation, which is still at an initial stage and is easily treatable.

Breast biopsy

Today, there are several types of biopsies that are performed to detect cancer in the breast area. These include:

• stereotaxic;
• trepanabiopsy;
• excisional;
• puncture.

Puncture biopsy

Thanks to the puncture biopsy, it is possible to obtain the necessary material for cytological examination by aspiration of material from the tumor through a special aspiration gun or syringe. In 80-85% of all situations, the cytological examination of the taken substance allows the correct diagnosis of the patient. The frequency of false negative morphological conclusions is in this case 15-20%.

Excisional biopsy

The technique of excisional biopsy consists in excision of a completely detected seal with an area of ​​skin that surrounds it. It can be used to study the cutoff edges for the presence of cancer cells, as well as the ability to identify receptors for steroid hormones in the formation.

Trepanabiopsy

This procedure is carried out using special needles, thanks to which it is possible to obtain from the tumor a column of tissue sufficient for subsequent histological examination. After such a procedure, the walls of the wound canal are coagulated in order to exclude the dissemination of tumor cells.

Stereotactic biopsy

Thanks to this type of biopsy, it is possible to obtain accurate material for subsequent morphological examination. However, a stereotaxic biopsy requires mammography equipment.

Cytological examination

In the presence of spontaneous nipple discharge, it is recommended to conduct their immediate examination. When isolated polymorphic and rounded lily of vacuolated cells are found among erythrocytes and epithelial cells, it indicates that a woman has an oncological process in the mammary gland.

In case of suspicion of the presence of Paget's cancer from the surface of the nipples, using tweezers, it is necessary to remove the crust and make an "imprint" on a glass slide with ulcerated or eroded skin for subsequent staining and cytological examination.

In the presence of unclear data during a simple mammography, as well as to determine the diagnosis with intraductal papillomas, you can also carry out additional diagnostic steps, among which should be noted computed tomomammography, galactography or dictography.

Each of these diagnostic methods has its own advantages and features of the conduct:

• discography is performed by introducing a contrast agent through a special needle into the opening of the excretory duct that opens on the nipple. Then you need to take an X-ray in two projections;
• only galactography makes it possible to determine the exact location of the duct lesion and makes it possible to distinguish dystrophic and inflammatory processes from tumors;
• carrying out computed tomomammography makes it possible to obtain an image (cut in layers) of any part of the mammary gland. It detects the presence of soft tissue structures better than conventional mammography, but it cannot detect small tumors, in particular calcifications.

Ultrasonography

Ultrasound examination is necessary to verify palpable lesions, towhich cannot be detected on mammograms, being an important additionto the x-ray method of research. Diagnostics does not have a harmful effect on the body, therefore it can be used several times.

With its help, it is possible to reveal the depth of the tumor process, its structure, length, relationship with the surrounding tissues.

Thanks to ultrasound examination, it is possible to determine additionally the presence of fluid in the palpable formation. Ultrasound is not used to detect breast cancer as an independent diagnostic method.

Conclusion

Only a timely study will make it possible to identify the disease at the initial stage, when the most effective treatment can be carried out, saving the patient from oncology.

If you have any suspicions about the development of a malignant process in the mammary glands, you should urgently consult a doctor.

In this situation, in no case should you hesitate, because such a cancerous process is characterized by rapid development. Take care of your health, do not neglect it, especially when it comes to cancer.

Breast cancer is the uncontrolled growth of abnormal cells in the breast tissue. It is the most common cancer in women, although it also affects men. The exact cause of breast cancer is unknown, but some women are at higher risk than others.

This is a category of women who have a negative inheritance in relation to breast cancer, and women with certain gene mutations. Women who have menstrual periods at an early age, menopause at a later age, or those who have never been pregnant are susceptible to developing cancer.

Treatment results are always better if breast cancer is diagnosed and treated early. It is important to have regular breast exams and schedule mammograms starting at age 45. If a woman is at risk, diagnostics should be carried out regularly, starting at the age of 40.

It is better to agree on a breast cancer screening schedule with your mammologist.

Because mutated cells can metastasize or spread to other organs, it is important to recognize early signs of breast cancer. If the disease is diagnosed at the initial stage and treatment is started, the prognosis is favorable.

How to distinguish pathology from other diseases?

Often women, feeling pain and tenderness in their breasts, assume that they have cancer. However, discomfort is rarely the first noticeable symptom of cancer. Many other factors can lead to pain.

Clinically known as mastalgia, chest pain can be caused by:

A lump in the breast is usually associated with breast cancer, but in most cases, a lump in the breast is not cancer. The reason for the formation of seals can be very diverse: from hormonal changes in the body to damaged adipose tissue.

More than 90 percent of all breast lumps in women between the ages of 20 and 50 are benign.

The most common causes of benign breast lumps are:

• breast infections;
• fibrocystic disease;
• fibroadenoma (non-cancerous tumor);
• fat cell necrosis (damaged tissue).

Fat necrosis is very difficult to distinguish from a malignant tumor without analyzing the elements of the gland tissue.

Signs of pathology and early and late stages

Early signs of breast cancer include:

Later signs of breast cancer include:

If a patient has several of these symptoms, this does not mean the presence of a malignant tumor. Only a doctor, by prescribing additional studies, can make a diagnosis.

If breast cancer has spread to other parts of the body, it is called metastatic cancer or stage 4 breast cancer. The organs most commonly affected by metastatic cancer are bones, lungs, brain, and liver. Symptoms will vary depending on the organs affected by the cancer.

Symptoms of bone metastases include bone pain and increased bone fragility.

Signs of possible brain damage include vision changes, seizures, frequent headaches, and nausea.

If liver metastases are present, symptoms include:

People with lung metastases may experience chest pain, chronic cough, or breathing problems.

The presence of these symptoms does not mean that the tumor has spread to neighboring organs. Depression or anxiety often endows the common symptoms of a cold or infection with nonexistent symptoms. It is possible to talk about metastases only if special diagnostics have shown their presence.

Types of pathology and features of their external manifestation

Breast cancer is often a type of cancer called adenocarcinoma that develops in glandular tissue. Other cancers such as sarcoma, which affects muscle, adipose, or connective tissue, can also develop in the breast.

Sometimes, a single tumor can be a combination of different types of cancer. And in some cases, cancer cells do not form tumors at all. Malignant tumors can be classified into different types depending on how the cancer cells look under a microscope and how the appearance of the breast changes:

Intraductal carcinoma

Ductal carcinoma, also known as intraductal carcinoma, is considered a non-invasive or pre-invasive type of cancer. This means that the cells of the channels have changed and look like atypical cells. The difference between non-invasive and invasive disease is that the mutated cells have not penetrated through the duct walls into the surrounding tissue.

In about one out of five cases, intraductal carcinoma is diagnosed.

Symptoms of the disease:

The external manifestations of the disease can resemble mastitis, erysipelas and other inflammatory diseases. Initial symptoms are usually blurred or absent. If the disease is diagnosed at this stage, the treatment gives a 100% result.

Invasive (or infiltrative) ductal or focal carcinoma

In ductal carcinoma, cells in the milk duct are first affected, then the tumor breaks through the wall of the airway and grows in the adipose tissue of the gland. Cancer can spread to other organs using the lymphatic system and blood.

You can talk about ductal carcinoma if the following characteristic signs are found:

Invasive (or infiltrative) focal carcinoma affects the milk-producing lobes of the mammary glands. About 1 in 10 cases of invasive breast cancer are focal. It is difficult to diagnose even with the help of mammography, because it manifests itself not as a tumor, but as a small lump that is difficult to feel.

Inflammatory breast cancer and Paget disease

Inflammatory breast cancer is a rare type of disease that accounts for about 1% to 3% of all cancers. Its peculiarity is the absence of a tumor. The main symptom is red, hot breast skin. Outwardly, it may look like an orange peel, coarse and thicken. The affected breasts appear larger and healthier. Sometimes patients complain of itching.

Breast cancer is a very dangerous disease primarily because it slowly and practically without any symptoms invades the woman's body.

Symptoms of this disease may be different, moreover, these signs may indicate other diseases of the mammary gland, but still, if they are detected, you should immediately contact a mammologist. A woman can herself reveal the presence of a tumor by means of an external examination of the breast and its palpation. As a rule, the tumor at the initial stage does not exceed 2 centimeters in size, and its structure may be of an irregular shape, bumpy.

The main signs of breast cancer: the formation of a small abrasion, wounds on the nipple, some soreness in some areas of the mammary gland, bloody discharge from the nipple, changes in the shape of the mammary gland when examined by palpation (when feeling). When the subcutaneous layer is pulled up to the tumor, then a kind of "retraction" occurs, which is another sign of a cancerous tumor. Irritation or peeling may appear on the nipples, and retraction of the nipple is often observed. In a neglected form, an ulcer appears on the skin of the mammary gland. Also, swelling and redness of the mammary gland is often observed. Because cancerous tumors metastasize, then there is an edema of the axillary lymph nodes.

Cancer can be localized in different ways in the mammary gland. Both the right and left breasts are affected with the same frequency. Moreover, a node in the second breast can represent both an independent tumor and a metastasis from the first neoplasm. Breast cancer that affects both breasts is much less common.

The naked eye may notice on the affected breast a small lump, similar to small cartilage, or a rather soft knot, resembling dough in consistency. Such formations, as a rule, have a round shape, clear or blurred boundaries, a smooth or knobby surface. Sometimes neoplasms reach impressive sizes.

If at least one was found

of the above symptoms, you should immediately go to the hospital. Today, there are many methods for diagnosing a malignant breast tumor: ultrasound, biopsy, mammography, tumor markers, etc. But remember that half of women over the age of 30 have some changes in the mammary glands and if you notice some seals, then you should not panic prematurely, but just visit a doctor immediately.

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BREAST CANCER

STRUCTURE OF THE BREAST

The mammary gland is located on the anterior surface of the chest from 3 to 7 ribs. The mammary gland consists of lobules, ducts, adipose and connective tissue, blood and lymph vessels. The lymphatic vessels carry lymph, a clear fluid that contains cells of the immune system. Inside the mammary glands are lobules that produce milk after the baby is born and the tubes that connect them to the nipple (ducts). Most of the lymph vessels in the breast drain into the axillary lymph nodes. If tumor cells from the breast reach the axillary lymph nodes, they form a tumor in that area. In this case, there is a possibility of the spread of tumor cells to other organs.

the incidence of breast cancer.

Breast cancer is the most common cancer in women and is the second leading cause of cancer death after lung tumors. Breast cancer affects about 1 million women worldwide every year. Breast cancer is diagnosed every 2 minutes in the European Union; every 6 minutes one woman dies. It is also one of the most studied, and early discovered, most treatable forms of cancer. Breast cancer is most common between the ages of 55 and 65, however, there are regional and age differences, which is why breast cancer can be found in much younger women.

WHY DOES BREAST CANCER HAPPEN?

Although there are several known risk factors that increase the likelihood of breast cancer, there is no exact information about what causes most types of breast cancer or how these factors turn normal cells into cancerous ones. Female hormones are known to sometimes stimulate the growth of breast cancer. However, how this happens has not yet been clarified.

Another challenging issue is understanding how certain DNA changes can convert normal breast cells into tumor cells. DNA is a chemical that carries information about the various activities of all cells. We are usually like our parents because they are the sources of our DNA. However, DNA affects more than just our physical resemblance.

Several genes (parts of DNA) control the growth, division, and death of cells. Breast cancer, like most cancers, arises from the natural aging process of cells and is caused by accumulated gene damage. Some genes promote cell division and are called oncogenes. Other genes slow down cell division or cause cell death and are called tumor suppressor genes. It is known that malignant tumors can be caused by mutations (changes) in DNA that trigger the development of a tumor or turn off genes that inhibit tumor growth.

The BRCA gene is a tumor suppressor gene. When it mutates, it stops inhibiting tumor growth. In this regard, the likelihood of developing cancer arises. Certain inherited DNA changes can cause a high risk of cancer in humans.

BREAST CANCER RISK FACTORS.

Risk factors increase the chance of getting cancer. However, having a risk factor or even multiple risk factors does not mean cancer will develop. The risk of breast cancer can change over time through, for example, changes in age or lifestyle.

Risk factors that cannot be changed:

Floor. Just being a woman means you have a major risk factor for breast cancer. Because women have significantly more breast cells than men, and possibly because their breast cells are affected by female growth hormones, breast cancer is significantly more common in women. Breast cancer is also possible in men, but this disease occurs 100 times less often than in women.

Age. The risk of developing breast cancer increases with age. About 18% of breast cancer cases are diagnosed in women aged 40-50, while 77% of cancers are diagnosed after 50 years.

Genetic risk factors. About 10% of breast cancers are inherited as a result of gene changes (mutations). The most common changes occur in the BRCA1 and BRCA2 genes. Normally, these genes help prevent cancer by making proteins that prevent cells from turning into tumor cells. However, if the altered gene is inherited from one of their parents, then there is an increased risk of breast cancer.

Women with an inherited BRCA1 or BRCA2 mutation have a 35-85% chance of developing breast cancer in their lifetime. Women with these inherited mutations also have an increased risk of ovarian cancer.

Other genes have been identified that can lead to inherited breast cancer. One of them is the ATM gene. This gene is responsible for repairing damaged DNA. In some families with a high incidence of breast cancer, mutations in this gene have been identified. Another gene, CHEK-2, also increases the risk of breast cancer if it is mutated.

Inherited mutations in the p53 tumor suppression gene can also increase the risk of developing breast cancer, as well as leukemia, brain tumors and various sarcomas.

Familial breast cancer. The risk of breast cancer is higher among women whose close (blood) relatives have had such a disease.

The risk of developing breast cancer is increased if:

have one or more relatives with breast or ovarian cancer, breast cancer occurred before the age of 50 in a relative (mother, sister, grandmother or aunt) on the mother's or father's side; the risk is higher if the mother or sister has breast cancer, has relatives with breast or ovarian cancer, has one or more relatives with two breast and ovarian cancers or two different breast cancers, has a male relative (or relatives) with breast cancer, there are cases of breast or ovarian cancer in the family, there are diseases in the family associated with inherited breast cancer (Li-Fraumeni or Cowdens syndromes).

Having one immediate family member (mother, sister, or daughter) with breast cancer approximately doubles a woman's risk of breast cancer, and having two immediate family members increases her risk by 5 times. And although the exact risk is unknown, women who have had breast cancer in their family with a father or brother also have an increased risk of breast cancer. Thus, about 20-30% of women with breast cancer have a family member with this condition.

Individual history of breast cancer. A woman who has cancer in one breast has a 3 to 4 times increased risk of developing a new tumor in another gland or in another part of the same breast.

Race. White women are slightly more likely to develop breast cancer than African American women. However, African American women are more likely to die of this cancer due to later diagnosis and advanced stages that are more difficult to treat. It is possible that African American women have more aggressive tumors. Women of Asian and Latino descent have a low risk of developing breast cancer.

Previous irradiation of the breast. If women at a younger age were treated for another tumor and received radiation therapy to the chest area, then they have an increased risk of developing breast cancer. Younger patients have a higher risk. If radiation therapy is given in combination with chemotherapy, then the risk is reduced, as it often leads to the cessation of the production of ovarian hormones.

Menstrual periods. Women who start menstruating early (before age 12) or who menopause late (after age 50) have a slightly increased risk of breast cancer.

Lifestyle factors and breast cancer risk:

Lack of children. Childless women and women who have given birth to their first child after age 30 have a slightly higher risk of developing breast cancer.

COMPLAINTS

Breast cancer is not always expressed in all women as a mass in the breast. It also happens that women who find a formation in their breasts go to the doctor only after many months. Unfortunately, during this time, the disease could already progress.

The most common symptoms of breast cancer are pain and the discomfort... There may be other changes in the appearance and sensation of the breasts as well.

Breast formation

The doctor will determine the properties of education:

size (by measuring); location (clockwise and distance from the areola); consistency; connection to the skin, chest muscle, or chest wall.

Skin changes

The following changes in the skin of the breast can be observed:

erythema; edema; indentations; nodules.

Nipple changes

Breast cancer can cause the following nipple changes:

retraction; color changes; erosion; discharge.

The lymph nodes

Breast cancer often spreads to the nearby lymph nodes, so a doctor examines the lymph nodes:

in the armpit; over the collarbone; under the collarbone.

Other

Other possible signs and symptoms:

pain or tenderness in the breasts (about 15% of cases); changes in the shape or size of the breasts; deepening, retraction or hardening of the skin; lemon peel symptom, nipple retraction, rash or discharge.

SURVEY METHODS

Medical checkup

Gynecologists have extensive experience in examining the mammary glands, so they are able to make the most accurate diagnosis. If the specialist is not suspicious, then you shouldn't worry either. Many doctors prefer to play it safe and may suggest further testing.

Blood test

In some types of breast cancer, a compound known as CA153 appears in the blood. The presence of such a "marker" in the bloodstream indicates breast cancer, but, unfortunately, its absence does not mean the opposite, since in many types of cancer this substance is not produced. Therefore, a negative test result does not mean that there is no breast cancer.

Mammography

Mammograms are most often done for screening purposes, but they can also be used if cancer is suspected. Therefore, they are called diagnostic mammograms. The study can show that there is no pathology, and the woman can continue the routine examination using this method. Otherwise, a biopsy (taking a piece of tissue for microscopic examination) may be required. A biopsy may also be necessary if mammography data is negative, but tumor formation in the mammary gland is determined. The only exception is the situation when an ultrasound examination shows the presence of a cyst.

Ultrasound examination (ultrasound) of the mammary glands

This method helps to distinguish a cyst from a tumor formation.

Biopsy

The only way to prove breast cancer is with a biopsy. There are several methods of biopsy. In some cases, a very thin needle is used to extract fluid or cells from the tumor. In other cases, thicker needles are used, or some of the breast tissue is surgically removed.

A puncture biopsy uses a thick needle to obtain a tissue sample from the site of the suspected tumor. To make the procedure painless, local anesthesia is done before it is carried out.

If the diagnosis is still in doubt, an excisional biopsy, or in other words, an excisional biopsy, should be performed. The advantage of this method is the ability to determine the size of the tumor and to assess in more detail the features of the histological structure.

During aspiration cytology, a small amount of fluid is taken from a suspicious place using a needle and examined under a microscope to see if it contains cancer cells.

A common and relatively easy examination is fine needle aspiration. This method is often used when a cyst is suspected rather than breast cancer. The cyst usually contains a greenish fluid and usually resolves after aspiration.

Chest x-ray

It is used to detect damage to the lung tissue by the tumor process.

Bone scan

Allows you to identify their cancer. In this case, the patient receives very low doses of radiation. The detected lesions may not necessarily be cancer, but be the result of an infection.

Computed tomography (CT )

A special type of X-ray examination. With this method, multiple images are taken from different angles, which allows you to get a detailed picture of the internal organs. The study makes it possible to detect damage to the liver and other organs.

Magnetic resonance imaging (MRI)

Based on the use of radio waves and strong magnets instead of X-rays. This method is used to examine the mammary glands, brain and spinal cord.

Positron Emission Tomography (PET)

This method uses a special form of glucose that contains a radioactive substance. Cancer cells absorb large amounts of this glucose, and a special detector then recognizes these cells. PET is done when cancer is suspected but there is no evidence for examining the lymph nodes before removing them.

After detecting breast cancer, an additional examination is carried out and a decision is made regarding therapy.

breast cancer treatment

There are several treatments for breast cancer. Talking to your doctor after the examination will help you make the right decision regarding the method of treatment. It is necessary to take into account the patient's age, general condition and stage of the tumor. Each treatment method has positive and negative aspects. Side effects and complications are possible.

Local and systemic treatment

The goal of topical treatment is to target the tumor without damaging other parts of the body. Surgery and radiation are examples of such treatments.

Systemic treatment consists of oral or intravenous anticancer drugs to target cancer cells that may have spread outside the breast. Chemotherapy, hormonal therapy, and immunotherapy are among these treatments.

After surgery, when there are no obvious signs of a tumor, additional therapy may be prescribed. This is due to the fact that even in the early stages of breast cancer, tumor cells can spread throughout the body and eventually lead to the formation of foci in other organs or bones. The goal of this therapy is to kill invisible cancer cells.

Some women are given chemotherapy before surgery to shrink the tumor.

Operation

Most women with breast cancer undergo some type of surgery to treat the primary tumor. The aim of the operation is to remove the tumor as much as possible. The surgery may be complemented by other treatments, such as chemotherapy, hormonal therapy, or radiation therapy.

The operation can also be performed to determine the spread of the process to the axillary lymph nodes, to restore the appearance of the breast (reconstructive surgery) or to reduce the symptoms of intoxication with advanced cancer.

1. Do self-examination.

2. Consult your doctor.

3. It is best to play it safe by doing a blood test as described above.

4. Ultrasound examination once a year is safe and justified.

5. A suspicious area found during an ultrasound examination should be examined by mammography.

6. If cancer is suspected after mammography, a needle biopsy, excisional biopsy, aspiration cytology, or fine needle aspiration should be considered.