Breast cancer is considered to be one of the most common female oncological diseases.
The most significant risk factors for the development of breast cancer are the following:
Inflammatory diseases of the ovaries and uterus;
Mastopathy or breast cancer in blood relatives;
Mastopathy in a history is also a precancerous disease.
External signs of breast cancer.
In case of self-examination for breast cancer, the following manifestations may indicate:
Retraction of nipples;
Changing the color and shape of the nipples;
The appearance of ulcers on the nipples;
Changes on the skin of the mammary glands (swelling, discoloration).
An important symptom of the possible development of breast cancer are signs of mastopathy.
The initial stages of breast cancer are characterized by the presence of a small painless tumor in the form of a dense knot. It is possible to determine the motility of the axillary lymph nodes.
Skin symptoms of the initial stage – wrinkling and umbiliculation. Also characteristic is the “symptom of the site”.
In the presence of cancer III or IV stage, the tumor becomes much larger. The mammary gland changes its shape, ulcers and a “lemon peel” symptom can be seen on the skin. Perhaps swelling of the hand.
A tumor with breast cancer can grow at different rates. Primary swelling can be doubled in a period of 1 to 12 months. The faster the growth, the higher the degree of malignancy.
Methodology of self-examination.
The breast cancer detected at an early stage is much easier to treat and has a favorable prognosis with timely treatment. Therefore self-examination is an important component of prevention and early detection of the disease. It should be performed on the 6-12th day of the menstrual cycle: standing or lying on your back you need to feel the chest and axillary cavities.
Primary diagnostic methods.
Mammography (application of the X-ray method) gives very high diagnostic indices. The reliability of mammography research in case of suspected breast cancer is 80-90%.
Doktografiya – a method of diagnosis by means of the introduction of contrast material in the ducts of the mammary glands.
Ultrasound is recommended for women under 40 years of age. The effectiveness of this method for the diagnosis of breast cancer according to different sources is from 60 to 90%.
At the slightest suspicion of malignant process in the mammary gland, a deeper examination is needed: analysis of the discharge from the nipple and examination of the tissue taken (puncture biopsy).
If a breast cancer is suspected, the health facility sends the patients for a full examination.
Symptoms of breast cancer in stages.
The described system of allocation of stages of a cancer of a mammary gland corresponds to the international classification of stages of a cancer of a mammary gland TNM.
The size of the tumor is not more than 2 cm in diameter. There are no regional metastases, there is also no germination in the skin and surrounding fatty tissue.
The size of the tumor is 2-5 cm in diameter, the germination in the tissue does not occur at all or there is partial adhesion to the skin. There are no metastases.
The main symptoms of breast cancer stage IIa are.
“A symptom of wrinkles” – the appearance of superficial wrinkles on the skin of the breast when seizure in the fold; Wrinkles are perpendicular to the fold,
“Symptom of the site” – appearance on the skin of the breast with a reduced elasticity; This area of the skin does not crack down after even a brief infringement.
The size of the tumor is 2-5 cm in diameter. The presence of no more than 2 metastases on the affected side of the chest. Initial manifestations of umbilicalization are possible.
The size of the tumor is more than 5 cm in diameter. There is no germination in the skin and surrounding fatty tissue.
Symptoms of breast cancer Stage III:
A symptom of umbiliculation is the drawn skin over the tumor;
Symptom of “lemon peel”;
Swelling of the skin, possibly a nipple entanglement.
For this stage, no more than 2 metastases are allowed.
The tumor spreads, affecting the entire mammary gland. There may be extensive ulceration, metastasis.
Breast cancer gives metastases to various tissues and organs. The defeat of metastases occurs through the milk passages, capillaries and vessels. In breast cancer, metastases spread to the axillary, subscapular, sub- and supraclavicular lymph nodes. Remote metastasis occurs in soft tissues, the skin. Metastases can affect the liver, lungs, ovaries, as well as pelvic and femur.
Treatment of breast cancer.
Modern medicine has several thousand ways to treat breast cancer patients. The treatment regimen is chosen individually and is based on a number of factors.
In I and IIa stages of breast cancer, there are two possible options for surgical treatment:
Mastectomy or organ-preserving surgery + radiotherapy.
Patients on IIb and III stages are subject to complex treatment:
Surgery + chemotherapy (in patients before menopause) surgery +
Radiation therapy (in the period of menopause).
Methods of treatment
1. Surgical treatment.
It stands at the leading positions in the treatment of breast cancer.
Removal of small (and in some cases, large) chest muscles of the breast, affected by cancer. Lymph nodes located in the sternum can also be removed.
Radical sectoral resection of the breast.
Allows to keep the mammary gland, as only a part of the pectoral muscles affected by the tumor is removed. With sectoral resection, the risk of recurrence is high enough. Therefore, after such an operation, radiotherapy is usually prescribed.
2. Radiation therapy.
In the treatment of breast cancer is used to prevent relapse in the postoperative period. Radiation therapy in the preoperative period is designed to reduce the degree of malignancy of the tumor.
It is aimed at blocking the spread of metastases of the breast tumor. Chemotherapy in many cases helps to lower the stage of breast cancer, also improves the results of operations and helps to control the symptoms of the disease. The duration of chemotherapy for breast cancer is 14 days. Repeat the course is necessary every month.
Estrogens play a huge role in breast cancer. This is why hormonal therapy plays a significant role in treatment.
Since in the process of chemotherapy and radiation therapy, and especially in surgical intervention, the immunological status of the organism decreases, then immunotherapy is called to increase the body’s defenses. For this, various immunomodulators are used.
Rehabilitation after treatment.
Since the characteristics of treatment of breast cancer in many patients are associated with social and psychological difficulties, now much attention is paid to rehabilitation measures. In addition to psychological and social adaptation (preservation or rehabilitation of work capacity), medical attention is directed to the use of reconstructive and plastic surgeries to restore the appearance of the mammary gland.
The most important data for predicting the results of treatment of patients with breast cancer are the prevalence of the tumor, the number of metastases in the lymph nodes, the degree of swelling of the breast, malignancy of the tumor.
These and many other factors determine the effectiveness of treatment. Thus, with the timely treatment of stage I breast cancer treatment efficiency reaches 96%, in the II stage – 80-90%. Patients with Stage III breast cancer are cured in 60-80% of cases.
A cure is understood as the absence of a progressive or recurrent tumor within 5 years.