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Breast cancer: symptoms and signs, stages, treatment, prognosis

A common cancer among women is breast cancer. The success of the treatment and the life expectancy of the patient depends on the timely detection of the disease. The symptoms, stages of development, methods of diagnosis and treatment of breast cancer are described below.

Content

Breast cancer, what is it?

The mammary glands consist of lobules, or glands, channels for transferring milk to the nipples, adipose, connective tissue, blood vessels and lymphatic vessels.

Breast cancer what is it

Breast cancer is a lesion of the breast with malignant neoplasms that replace glandular tissue. Most often, a carcinoma that develops in the lobules or ducts is detected, but in addition to it there are about 20 other types of malignant tumors of the breast.

The incidence is high among women over the age of 40, and the maximum number of cancer cases is observed between 60-65 years.

Cancer cells have an abnormal structure and high rate of division due to the rapid metabolism in them. Appearing in the breast tissues, as the disease progresses, they penetrate the nearby lymph nodes, and in the later stages they also infect distant tissues, including the bones and internal organs.

In addition, the life cycle of malignant cells is shorter than healthy ones, and their disintegration causes a general intoxication of the organism.

Doctors see the main cause of breast cancer in hormonal changes . Most often, the disease develops in women in menopause , when hormone production changes dramatically. Progesterone and estrogen are produced at the same time less, which affects the state of the mammary glands.

Not only the deficiency is considered unfavorable, but also an excess of female sex hormones, for example, the risk of developing breast cancer is increased in non-pregnant women after 30 years and as a result of abortions. Pregnancy, childbirth and breastfeeding, in contrast, significantly reduce the likelihood of malignant cells in the breast.

Stages of breast cancer, symptoms

Stages of breast cancer

The international classification of breast cancer stages identifies four stages in the development of the disease.

Stage 1

The pathological focus does not exceed 2 cm in diameter, and the cancer has not yet affected the adjacent tissues and lymph nodes. Metastases are absent, fatty tissue of the breast and skin are not affected.

Palpation gropes for a small, painless compactness - this is the only sign of early-stage breast cancer.

Stage 2

The tumor reaches from 2 to 5 cm; it does not grow into the adjacent tissues. The second stage is divided into two categories:

  • IIb - neoplasm increases in size;
  • IIa - penetration of cancer cells into the axillary lymph nodes.

Symptoms of breast cancer in stage 2a are wrinkled areas of the breast and a decrease in the elasticity of the skin over the tumor. After compression of the skin in this place, wrinkles do not smooth out for a long time.

No more than two metastases in the affected gland can be detected, and a symptom of umbilization often appears - a nipple or skin retract at the location of the tumor.

Stage 3

The neoplasm diameter is greater than 5 cm; it can affect the subcutaneous fat layer and the dermis. Symptoms of stage 3 breast cancer: the skin resembles a lemon peel, it is drawn over the tumor, often swollen, if there are metastases, then no more than two.

Stage 4

Pathology affects the mammary gland as a whole, and ulcers appear on the skin of the breast. Metastases are multiple and spread to other organs and tissues, primarily affecting the lymph nodes located under the scapula, in the armpits and clavicle.

Distant spread of metastases affects the skin and soft tissues, from the internal organs - the lungs, ovaries, liver, from the bones - the femoral and pelvic.

Symptoms and signs of breast cancer by stages

Symptoms and signs of breast cancer

In breast cancer, the symptoms and signs can be divided into four groups:

  1. The appearance of seals;
  2. Breast skin changes;
  3. Discharge from juices;
  4. Swollen lymph nodes.

In the first stage, with small sizes, the cancer does not manifest itself actively. It can be detected by chance when a dense nodule is found in the mammary gland. If the tumor is malignant, in most cases it is painless to the touch, and the presence of pain during palpation often indicates a good quality of education (mastitis, mastopathy).

The cancer site is very dense, with an uneven surface (bumpy), fixed or displaced slightly when exposed, often attached to the skin or surrounding tissues, fixed. Large seals appear at stages 2-4 of breast cancer (3 to 10 cm).

Attention! There are forms of breast cancer in which the mammary gland is painful to the touch - these are erysipelatous and pseudo-inflammatory forms of a diffuse tumor. They are characterized by rapid growth, the absence of individual tight knots, reddening of the skin of the breast, and an increase in body temperature.

With a malignant formation on the chest there is a skin intake, folds, wrinkles, localized swelling in the area above the tumor. With the further development of cancer on the skin, the nipple or in the areola, small non-healing ulcers appear, which then merge, bleed, and suppuration develops (last stage).

The next symptom of breast cancer in women is nipple discharge. Depending on the form and stage of the disease, they may be cloudy or transparent, whitish or yellowish, contain impurities of pus or blood.

The nipple is compacted and looks puffy. Any discharge from the mammary gland, especially outside of pregnancy and the breastfeeding period, should be regarded as a warning signal and a reason to be examined by a breast specialist.

Starting from stage 2, cancer cells penetrate into the nearest lymph nodes, which leads to an increase in the latter. If the tumor affects only one mammary gland, then this symptom is observed on one side.

A clear sign of metastatic lymph nodes is their large size, density, draining, more often they are painless. At the same time, the armpit area may swell, and in the later stages the arm will also swell due to poor lymphatic and blood outflow (lymphostasis).

Breast Cancer Diagnosis

The main methods for the diagnosis of breast cancer:

  • mammogram removal;
  • blood test for the presence of tumor markers (in women under 30 years of age);
  • Breast ultrasound;
  • biopsy (taking a piece of tissue for examination).

The following methods can be used to assess the general condition of the patient and the prevalence of cancer cells in the body:

  • blood tests - general and biochemical (to determine the level of formed elements, ESR, cholesterol, amylase, liver function tests, glucose, total protein, creatinine);
  • CT scan;
  • urine test to exclude pathology from the urogenital area;
  • Ultrasound of the internal organs;
  • X-ray of bones, chest.

Determining the course of the disease, doctors use the TNM system, in conclusion, next to each letter they put a number:

  • T is the size of the tumor (from 0 to 4);
  • N - the degree of damage to the lymph nodes (from 0 to 3);
  • M - the presence or absence of distant metastasis (0 or 1).

Self-examination

Self-examination for breast cancer photo Since breast cancer does not manifest itself in the initial stages of development, regular self-diagnosis is of paramount importance. It should be carried out on the 5-7 day of the monthly cycle, in good light, in front of a large mirror, completely removing clothes to the waist.

The mammary glands should be inspected with the arms raised and with the arms lowered, paying attention to their size, skin condition, color, symmetry. After that, you need to carefully feel the chest - any tissue seals (both nodular, focal, and diffuse, affecting the whole gland evenly) should be alerted.

During the self-examination, it is also checked whether there is a discharge from the nipples by clicking on them. At the end of the examination, palpation of the axillary, supra- and subclavian lymph nodes is carried out - for cancer, they are even, dense, enlarged, often painless.

Breast Cancer Treatment

Breast Cancer Treatment

Breast cancer treatment is aimed at the complete destruction of malignant cells. At a late stage, when it is impossible to fully recover, symptomatic therapy is prescribed, for example, the administration of powerful anesthetics to relieve the condition. Treatment includes several areas that are most often combined with each other.

Radiation therapy

The task of this method is to stop the aggressive development of the tumor, its growth for surgical intervention. It is considered as a preparatory stage before the operation and is carried out after the removal of the tumor.

Radiation therapy is also indicated if it is impossible to operate, for example, in the presence of metastases in the brain.

Hormonal therapy

It is used if receptors sensitive to progesterone and estrogen are detected in laboratory cancer cells. For the treatment of breast cancer used analogues or antagonists of sex steroids.

In some cases, in addition to hormone therapy, ovaries are removed because they produce hormones that trigger tumor growth.

Targeted therapy

It is also called sighting. Cancer cells are able to protect themselves from exposure to radiation, chemotherapy and hormone therapy, releasing special substances (EGFR factor). This is a definite barrier to a quick cure.

For immunocorrection, that is, reducing the response of malignant cells to therapeutic agents, the drug Herceptin (Trastuzumab) is used. These are purified monoclonal antibodies specific for the protective factor of cancer cells.

The use of target therapy requires the presence of special equipment and highly qualified personnel in the clinic.

Chemotherapy

This method involves the introduction of drugs, is prescribed taking into account the characteristics of the patient and is indicated if:

  • The diameter of the tumor more than 2 cm;
  • Tumor cells are low differentiated;
  • The woman is in childbearing age;
  • Cancer cells have no receptors sensitive to progesterone and estrogen.

For chemotherapy in breast cancer, cytostatics are used - anticancer agents that have a detrimental effect on cancer cells. Examples of drugs - Cyclophosphamide, Adriablastin, Mitoxantrone, Doxorubicin, Fluorouracil.

In oncology, there are three types of such treatment:

  1. Adjuvant (prophylactic, additional) therapy is indicated if the tumor is operable, and is used before and / or after surgery. It prepares the neoplasm for surgical removal.
  2. Therapeutic treatment is prescribed for a generalized form of cancer, that is, for metastatic lesions of other tissues and organs. This method is aimed at the destruction or reduction of metastasis to a minimum.
  3. The induction type of chemotherapy is indicated if the tumor is inoperable, and its size should be reduced to possible for the operation.

Cytostatics have a number of side effects that are a negative side of their use. When chemotherapy along with cancer inevitably die and part of the healthy cells.

Of the side effects, this can be felt:

  • dyspnea;
  • nausea and vomiting, diarrhea;
  • coloring mucous in a yellowish tint, skin pigmentation;
  • dizziness, blurred consciousness;
  • reduced visual acuity;
  • swelling of the legs ;
  • hematuria (urine mixed with blood);
  • arrhythmia, palpitations;
  • hair loss;
  • itching, allergic skin rash.

These problems are temporary, they pass after rehabilitation treatment. Before chemotherapy, a detailed consultation and thorough preparation of the woman for the procedure is carried out.

Surgical treatment of breast cancer

The operation to completely remove the mammary gland is called a mastectomy, it is shown starting from stage 3. Together with the breast, regional lymph nodes are also removed. After the operation, in breast cancer, radiation therapy is prescribed, as well as an additional examination of the stored lymph nodes and surrounding tissues.

In the absence of contraindications simultaneously with the removal of the breast, it is possible to perform plastic surgery for its reconstruction.

Complications after mastectomy:

  • bleeding from a wound;
  • temporary limitation of mobility of the shoulder joint;
  • swelling of the arms and chest.

At stages 1 and 2 of the breast cancer, surgery is more often limited to an organ-preserving intervention, that is, the removal of only the tumor focus with the preservation of the mammary gland. In any case, psychological support from close people and specialists is important for a woman.

Forecast and life expectancy

longevity for breast cancer

In oncology, 5-year survival is an indicator of treatment success. After breast cancer therapy, a little more than half of all patients cross this threshold. This is a conditional border, since having overcome it, many women live for many more years.

The form of a cancer tumor, the degree of its aggressiveness (growth rate), as well as the stage at which treatment began, affect the lifespan.

The diffuse type of neoplasm and the 4th stage of breast cancer have the worst prognosis for life - no one has lived out of all cases of 5 years.

In breast cancer 2 degrees of life expectancy, or rather the achievement of a five-year, and often ten years of survival, is about 80%. Moreover, more than half of this number of women will live 20 years or more.

Chances are higher with effective selection and combination of several therapies. If cancer of grade 3 is found, then life expectancy at 5 years or more reaches from 40 to 60% of women, depending on the substage (3A, 3B).

Breast cancer has a tendency to reappear, in most cases it occurs in the first two years after treatment.

Prevention

Effective prevention of breast cancer includes such measures:

  • Attention to the state of the endocrine system - hormonal correction during menopause , taking oral contraceptives;
  • Pregnancy and childbirth;
  • Lack of abortion, and accordingly - effective contraception;
  • Prevention and timely treatment of benign breast tumors - mastopathy , cystic disease , fibroadenoma;
  • Regular mammography screening - 1-2 times a year;
  • Refusal of bad habits, healthy food, active lifestyle, good sleep.
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