Breast cancer – a malignant new growth of a mammary gland. Local manifestations: change of a shape of a mammary gland, retraction of a nipple, rugosity of skin, allocation from a nipple (often bloody), probing of consolidations, small knots, increase in supraclavicular or axillary lymph nodes. The most effectively surgical treatment in combination with beam or chemotherapy at early stages. At late stages tumor metastasis in various bodies is noted. The forecast of treatment in many respects depends on prevalence of process and histologic structure of a tumor.
According to statistical WHO data, more than one million new cases of development of malignant tumors of mammary glands annually are around the world diagnosed. In Russia this indicator reaches 50 thousand. Every eighth American develops a breast cancer. This pathology mortality makes about 50% of all diseased. Decrease in this indicator is interfered by absence in many countries of organized preventive screening of the population for early identification of malignant new growths of mammary glands.
The analysis of a technique of an onkoskrining of a mammary gland among the population shows that mortality of the women who took part in the preventive program is 30-50 percent lower, than in groups where prevention was not carried out. Dynamic decrease in indicators of mortality from malignancies of mammary glands is noted in those countries where preventive events (training of women in a self-research of mammary glands, medical inspection) at the national level are held. In many regions of Russia growth of incidence and mortality from cancer of mammary glands in connection with insufficiency of coverage of the population preventive measures still takes place.
Now the breast cancer is subdivided more than into 30 forms. Nodal crayfish (unicentric and multicentric) and diffusion cancer are most widespread (includes edematous and infiltrative and mastitopodobny forms). It is possible to carry Pedzhet's disease and cancer of chest glands at men to rare forms.
The reasons and the contributing factors of a breast cancer
Emergence and development of a breast cancer are promoted by certain factors:
- in the majority the breast cancer occurs at women, developing of malignancies occurs at men 100 times less often;
- most often cancer of mammary glands develops at women after 35 years;
- the complicated gynecologic anamnesis increases probability of developing of malignant pathology of a mammary gland: violations of a menstrual cycle, hyper plastic and inflammatory pathologies of genitals, infertility, frustration of a lactation;
- the breast cancer finds a certain genetic dependence: the malignancies taking place at close relatives, dairy a syndrome, the cancer associated genodermatoza, a combination of a breast cancer to sarcoma, malignant tumors of lungs, throats, adrenal glands;
- endocrine and metabolic frustration: obesity, metabolic syndrome, diabetes, chronic arterial hypertension, atherosclerosis, pathologies of a liver, pancreas, immunodeficiency.
- nonspecific cancerogenic factors: smoking, chemical poisons, the high-calorific unbalanced diet rich with carbohydrates and poor in proteins, the ionizing radiation, work in discrepancy with biorhythms.
It is necessary to remember that the factors of the increased cancerogenic risk taking place not necessarily will lead to development of a malignant tumor of a mammary gland.
Classification by stages
The breast cancer is classified by development stages.
At the I stage the tumor does not exceed 2 centimeters in the diameter, does not affect the cellulose surrounding gland, there are no metastasises.
IIA the stage is characterized by the tumor of 2-5 cm which did not sprout in cellulose, or a tumor of the smaller sizes, but mentioned surrounding fabrics (hypodermic cellulose, sometimes skin: rugosity syndrome). Metastasises at this stage are also absent. The tumor gets 2-5 cm in the diameter. Does not sprout in surrounding hypodermic fatty cellulose and skin of a mammary gland.
Other version - the tumor of the same or smaller size sprouting hypodermic fatty cellulose and soldered to skin (causes rugosity symptoms). Regionarny metastasises are absent here.
On IIB stages appear metastasises in regionarny lymph nodes in an axillary hollow. Quite often note metastasis in intra chest parasternalny lymph nodes.
The tumor of IIIA of a stage has more in the diameter, than 5 centimeters, or sprout in the muscular layer which is settling down under a mammary gland. The symptom of "a lemon crust", puffiness, retraction of a nipple, sometimes ulcerations on skin of gland and allocation from a nipple is characteristic. Regionarny metastasises are absent.
IIIB a stage is characterized by multiple metastasises of axillary lymph nodes or single supraclavicular (or metastasises in parasternalny and subclavial knots).
The IV stage - terminal. Cancer affects all mammary gland, sprouts in surrounding fabrics, dessiminirut on skin, is shown by extensive ulcerations. Also the tumors of any sizes spreading in other bodies (and also in the second mammary gland and lymph nodes of the opposite side), the educations which are strong fixed to a thorax belong to the fourth stage.
Symptoms of a breast cancer
At early stages the breast cancer does not prove in any way, at a palpation it is possible to find dense education in gland fabric. Most often the woman notices this education at self-inspection, or it comes to light at mammography, ultrasonography of mammary glands, other diagnostic methods during the preventive actions. Without the corresponding treatment the tumor progresses, increases, sprouts in hypodermic cellulose, skin, in thorax muscles. Metastasises affect regionarny lymph nodes. With blood current cancer cells get to other bodies and fabrics. The breast cancer most often extends metastasises in lungs, a liver and a brain. Necrotic disintegration of a tumor, malignant defeat of other bodies conducts by death.
Diagnosis of a breast cancer
One of the most important methods of early detection of cancer of mammary glands is regular and careful self-inspection of women. Self-inspection to the women entering into risk group on a breast cancer, and also all women is more senior than 35-40 years, it is desirable to make every month. The first stage – survey of a breast in front of the mirror. Reveal deformations, noticeable increase in one breast in comparison with another. Definition of a symptom of "a lemon crust" (retraction of skin) is the indication to the immediate address to the mammologist.
After survey make careful palpation, noting gland consistence, discomfort and morbidity. Press on nipples for identification of pathological allocations.
In diagnosis of a breast cancer survey and a palpation allow to find a new growth in gland fabric. Tool methods of diagnostics (mammography, ultrasonography with dopplerography, a duktografiya, a termografiya, MRT of a mammary gland) allow to investigate in details a tumor and to draw conclusions on its size, a form, extent of defeat of gland and surrounding fabrics. The biopsy of a mammary gland and the subsequent cytologic research of fabrics of a tumor shows presence of malignant growth. Among the newest techniques of inspection of mammary glands it is also possible to celebrate a radio isotope research, a stsintiomammografiya, SVCh-RTS.
Complications of a breast cancer
The breast cancer is inclined to bystry metastasis in regionarny lymph nodes: axillary, subclavial, parasternalny. Further with lymph current cancer cells extend on supraclavicular, scapular, mediastinalny and cervical knots.
Also the limfosistema of the opposite side can be surprised, and cancer can pass to the second breast. In the hematogenic way metastasises are carried in lungs, a liver, bones, a brain.
Cancer therapy of a mammary gland
Breast cancer – one of the dense malignant new growths which are giving most in to treatment. The small tumors localized in gland fabrics delete, and, often, do not note cases of a retsidivirovaniye of not spreading remote cancer.
Cancer therapy of a mammary gland – surgical. The choice of operation depends on the size of a tumor, degree of a prevalence of surrounding fabrics and lymph nodes. Long time practically to all women with the revealed malignant tumor of a mammary gland the radical mastectomy (full removal of gland, the nearby lymph nodes and muscles of a thorax which are settling down under it) was made. Now even more often make the modified operation analog when pectoral muscles keep (if they are not affected by malignant process).
In cases early the stage of a disease and the small sizes of a tumor make a partial mastectomy now: only the site of gland affected with a tumor with a small amount of surrounding fabrics is exposed to removal. The partial mastectomy is usually combined with radio radiation therapy and shows results of treatment, quite comparable to radical operation.
Removal of lymph nodes promotes decrease in probability of a retsidivirovaniye of a disease. After removal they are investigated on presence of cancer cells. If in the lymph nodes removed during operation metastasises are found, women take a course of radiation therapy. In addition to patients with high risk of hit of malignant cages in a blood-groove chemotherapeutic treatment is appointed.
After expeditious removal of a malignant tumor of a mammary gland of the woman are on the account at the mammologist-oncologist, are regularly observed and examined for identification of a recurrence or metastasises in other bodies. Most often metastasises come to light in the first 3-5 years, then the risk of development of a new tumor decreases.
Now there is a way of identification of receptors to estrogen in cells of cancer of mammary glands. They come to light approximately at two thirds of patients. In such cases there is an opportunity to stop development of a tumor, having changed the hormonal status of the woman.
Prevention of a breast cancer
The most reliable measure of prevention of a breast cancer is regular inspection of women by the mammologist, control of a condition of a reproductive system, monthly self-inspection. To all women 35 years are more senior it is necessary to make mammography.
Timely detection of pathologies of genitals, violations of hormonal balance, exchange diseases, avoiding of action of cancerogenic factors promote decrease in risk of developing of cancer of mammary glands.