Sarcoma of a mammary gland — the malignant neepitelialny new growth of a mammary gland which is characterized by rapid growth and a dessemination, an adverse current. Sarcoma is shown by existence in a mammary gland of a dense hilly tumor, thinning and hyperaemia of skin over education, expansion of network of hypodermic veins. Detection of sarcoma of a mammary gland is made on the basis of a complex of ekhografichesky, radiological, tomographic, cytologic data. At sarcoma of a mammary gland radical surgical treatment (an expanded mastectomy) with beam and chemotherapy is shown.
Sarcoma of a mammary gland
In a mammology and oncology sarcoma of a mammary gland belongs to rare types of malignant new growths, making among them from 0,6 to 2%. Sarcoma of a mammary gland can develop at women and at men; histologically this type of a new growth is identical to the similar tumors of soft fabrics which are found in in other anatomic areas. Most often sarcoma develops against the background of a listovidny tumor of a mammary gland. Sarcoma of a breast is inclined to rapid growth and metastasis, has extremely malignant current and the adverse forecast.
Classification of types of sarcoma of a mammary gland
In structure of sarcoma there is no epitelialny and ferruterous fabric. Most often sarcomas come from a stromalny component — cross-striped or smooth muscles, a fatty, nervous, bone tissue, etc. In a mammary gland development of various histologic types of sarcomas is possible. The sizes of sarcoma of a mammary gland vary in the range from 1,5 to 15 cm.
According to morphological option distinguish fibrosarky, liposarky, hondrosarky, angiosarky, leyomiosarky, rabdomiosarky, osteosarcoma, a malignant fibrous gistiotsitoma, etc. At a histologic research fibrosarkoma (about 30%) coming from fibers of connecting fabric which, reach the big sizes come to light more often and are not followed by an ulceration.
Liposarkoma - malignant mesenchymal tumors from fatty tissue, are also characterized by rapid progressing, but at the same time izjyazvlyatsya often and synchronously affect both mammary glands. Rabdomiosarkoma, presented by elements of cross-striped muscles, differ in an extreme zlokachestvennost, rapid growth with infiltration of fabrics. This type of sarcoma of a mammary gland strikes mainly young women who did not reach 25 years.
Angiosarkoma, formed by cages an endoteliya of vessels, are the fast-growing tumors which are characterized by a persistent recidivous current; come to light mainly at the age of 35-45 years. Hondrosarkoma and osteosarcoma of extra skeletal localization make 0,25% of cases of all sarcomas of mammary glands, differ in the expressed zlokachestvennost degree; occur at women 55 years are more senior. By origin distinguish primary sarcoma of a mammary gland and secondary, developing from originally good-quality educations (for example, listovidny tumors).
Reasons of development of sarcoma of a mammary gland
The true causes of sarcoma of a mammary gland are not defined. Among the factors disposing to development of sarcoma chemical carcinogens, radiation, traumatizing a mammary gland, burdened family can act.
Quite often to emergence of sarcoma insufficiently radical carrying out a sectoral resection of a mammary gland concerning any good-quality new growth — a fibroadenoma precedes, to a listovidny or veretenokletochny tumor. Sarcoma of a mammary gland can be combined with fibroadenomy or cancer of opposite gland, cancer of a neck of a uterus and vagina, rectum cancer.
Symptoms of sarcoma of a mammary gland
Development of sarcoma begins with emergence in a mammary gland of the dense nodal education having accurate contours and a hilly surface. In process of growth of tumoral knot skin over it becomes thinner, gets a cyanotic-crimson shade against the background of which the expanded hypodermic venous drawing is selected.
Growth of a tumor leads to increase in volume of the affected mammary gland, asymmetry of a breast, morbidity, an integument ulceration over a tumor. In the started stages the breaking-up tumor can bleed. At rapid growth of sarcoma the expressed inflammatory reaction imitating abscess of a mammary gland sometimes develops.
Rates of local spread of sarcoma of a mammary gland can be slow, progressing, spasmodic and rough. It is noted that high-malignant sarcomas develop violently or in steps, for several months; tumors with rather favorable forecast - slowly, sometimes within long years. The hematogenic way of metastasis to lungs and a skeleton is characteristic of sarcomas of a mammary gland; involvement of regionarny lymph nodes is noted seldom.
Diagnosis of sarcoma of a mammary gland
Accurate criteria of diagnosis of sarcoma of a mammary gland in a mammology are not developed in view of rare occurrence of pathology and a big range of histologic variability. The mammologist-oncologist is engaged in diagnostics and treatment of sarcoma of a mammary gland. Palpatorno in a mammary gland is defined the krupnobugristy, elastic, mobile tumor having a non-uniform consistence; at survey puffiness and hyperaemia of skin, sites of an ulceration pays attention.
Given to survey mammography and ultrasonography of mammary glands at sarcoma are not specific. In the course of the research shadows in the form of a conglomerate of knots with the hilly contours which are pushing aside aside surrounding fabrics come to light. Well thinning of skin over a tumor and expanded hypodermic veins of a mammary gland is defined. In addition MRT or a stsintigrafiya of mammary glands with technetium-99 can be carried out.
Finally the diagnosis of sarcoma of a mammary gland can be confirmed only by means of a morphological and cytologic research of the samples of a tumor received at tonkoigolny or is frayed - biopsies. Microscopically sarcoma is presented by stroma elements, a cellular atipiya with expressed polimorfizy and the increased kernels, lack of an epitelialny component.
Treatment of sarcoma of a mammary gland
The adequate volume of intervention at detection of sarcoma of a mammary gland is the mastectomy. More rare, at the high-differentiated sarcomas, the radical resection is carried out. Limfadenektomiya is shown at identification of metastasises in regionarny lymph nodes or in case of a close arrangement of sarcoma to lymphatic structures, especially at disintegration of a tumor.
An integrated approach to treatment of sarcoma of a mammary gland allows to improve the remote results. Therefore in the post-operational period the chemotherapy is carried out by antratsiklinovy antibiotics. Need of radiation therapy is considered only at doubtful radicalism of surgery.
The forecast at sarcoma of a mammary gland
As the predictive factors influencing duration of the bezretsidivny period and survival serve sarcomas of a mammary gland, differentiation degree, the tumor sizes. The best indicators of survival are noted at the high-differentiated sarcomas and lack of metastasis in regionarny lymph nodes.
Sarcoma of a mammary gland is inclined to a local retsidivirovaniye in the field of post-operational hems, to a stump of a mammary gland, and also the remote metastasis in a pulmonary and bone tissue. Question of expediency of carrying out a reconstructive mammoplastika .