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Breast tumor

Breast tumor is a malignant neoplasm, which in the Russian Federation is the most frequently diagnosed cancer in women.

The who indicates that every year in the world reveal more than a million new cases of cancer of the breast. Mortality from this disease remains high and is equal to 50% of the total number of cases. To reduce this figure, most of the world organizes preventive population screening aimed at early detection of breast cancer.

It is established that the majority of patients are women over the age of 45 and after the age of 65 years the risk of breast carcinoma increases 5.8 times. In 99% of cases, the pathology affects women and only 1% are men.

Currently identified more than 30 forms of mammary tumors, the most common being nodular and diffuse tumors. This is the most rarely detected in tumor breast cancer is Paget's.

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Types of breast cancer

There are different types of breast tumors. They are divided into benign and malignant neoplasms.

A benign tumor of the breast

A benign tumor is a conglomeration of cells with unregulated mechanisms of division, but with preserved capacity for cellular differentiation. Benign tumors are characterized by slow growth, they do not tend to metastasize.

There are the following types of benign tumors of the breast:

  • Mastitis is diffuse. The diffuse forms include adenos, adenos sclerosing, diffuse polycystic disease, fibrosis and fibroadenomatosis;

  • Nodal mastopathy. To nodular forms include fibroadenoma, cyst, intraductal papilloma, angioma, geartray and phyllodes tumor;

  • Lipoma is a tumor consisting primarily of fat cells in the breast.

In most cases, benign tumors require surgical removal.

Malignant tumor of the breast

Malignant tumor of the mammary gland also has several varieties, among which are:

  • Nodular malignant tumor. This is the most common cancer, which is often localized in verkhnemelovykh quadrants of the breast. As the progression of the disease is the involvement in the pathological process of healthy tissue located around and fat and skin;
  • Diffuse malignant tumor. This lesion is divided into 4 subspecies: melitopolska form, edematous-infiltrative form, aistopoda form and curb the swelling. Although diffuse tumor is diagnosed less frequently than the hub, they are prone to more rapid growth and worse are treatable;
  • Paget's disease affects the nipple. The cancer progresses slowly, its diagnosis is rather difficult, as the symptoms of this tumor are very similar to erosive processes;
  • A rare form of malignant tumors include lymphomas, sarcomas and metastases of other tumours that have infiltrated the tissue of the breast.

Causes of breast tumors

The causes of breast cancer are the following:

Complicated gynecological history

It is established that there is a certain interdependence between the reproductive functions of women and the frequency of occurrence of malignant tumors.

Tumors that are dependent on hormonal background, most will be developed for the following:

  • The beginning of menstruation in girls under the age of 12 years;
  • The end of the menstrual period after the age of 55 years;
  • Pregnancy after the age of 30, or no pregnancies throughout a woman's life. The risk group includes women with one child and those who had disorders of lactation;
  • Long-term treatment with hormones. Although this topic is still an ongoing debate among scientists, however, most experts are of the view that to prescribe hormone replacement therapy should be short-term and clear evidence. Also you should not start this treatment under the age of 20 years.

Genetic predisposition

In the 90-ies of the last century, scientists have selected genes thatresponsible for the development of breast cancer have blood relatives. The genes BRCA1 and vRsA2. Of the total number of diagnosed tumors, innate tumor is not more than 10%.

Inherited most often tumors, which have several characteristic features:

  • The tumor found in the age between 40 to 45 years;
  • Most often, cancer involving both Breasts;
  • In parallel detected tumors in other organs;
  • In the mammary gland develops several tumors.

If the mutated BRCA1 gene is inherited, the risk of tumor development in these women under the age of 70 years is 65%. Also increase by 60% the risk that they will have discovered the ovarian tumors and 50% of these women suffer from tumors of both Breasts.

If BRCA2 is found in men, they have up to 45% increases the risk of breast cancer. In 15-30% of cases detected testicular cancer.

To reduce the risks of formation of such cancer pathology people with mutated genes suggesting prophylactic removal of both Breasts, ovaries and anti-estrogen drugs.

In addition, the causes of breast cancer include:

  • Non-specific carcinogenic factors. For example, a diet enriched with fats, ionizing radiation, exposure to chemical carcinogens from the outside. Risks increase with Smoking, poisons and poisoning when working in hazardous occupations;
  • Metabolic disorders, endocrine disorders. In this respect, the risk of tumor development increases with overweight. Proven that fat is a real base, that makes estrogens. The more, the chances of formation of tumors above. In addition, the risk is diabetes mellitus, metabolic syndrome, arterial hypertension, atherosclerosis, immunodeficiency, liver disease and pancreas;

  • Accessory female sex and age older than 35 years.

Symptoms of breast cancer

To independently determine the symptoms of breast cancer, women need once a month thoroughly examine and feel.

Onthat occur in breast cancer processes, you can specify the following characteristics:

  • Any entity in the breast. It may be dense, may be different mobility or to be welded to the skin;
  • The nipple on the breast was involved, became denser or thicker;
  • Skin breast looks stretched and tense;
  • On the chest there appeared a patch of skin resembling the appearance of lemon peel;
  • It is possible that the skin of the breast is reddened, or has sores or crusts;
  • Lymph nodes are almost always react to the presence of a tumor seal. They often increase in size in the supraclavicular region and become stationary;
  • Before the menstrual cycle and breast pain will emerge;
  • The pain may radiate to the arm. Sometimes the limb swells;

  • If the tumor is allowed metastasized, the symptoms will manifest depending on which organs are involved in the pathological process.

If it was discovered at least one of the above symptoms, then the mandatory consultation with a specialist. The diagnosis to be confirmed with instrumental methods. If time does not begin treatment, the tumor will grow, affecting the subcutaneous tissue and chest muscles. In the regional lymph nodes, the tumor sends her abnormal cells and the bloodstream they spread throughout the body. This, in turn, will lead to rapid death.


Stage breast tumors

There are 4 stages of development of breast tumors:

  • The first stage is characterized by the fact that education in the sizes does not exceed 2 cmit doesn't grow into the tissue and does not spread;
  • For stage 2A is characterized by the increase of the tumor to 5 cm in size with involvement of the subcutaneous tissue and the skin itself. It is at this stage you may notice a distinct change. However, germination in tissue does not occur and metastases are absent. Alternatively, it is possible the sealing of the tumor to the skin;
  • The next stage is 2B. At this stage of the disease is proliferation of atypical cells in nearby lymph nodes. The first to suffer nodes of axilla and intrathoracic parasternal nodes. It is not excluded lose subscapular, sub - and supraclavicular nodes;
  • Forstage 3A is characterized by the increase of the tumor sizes more 5 cm. Here are related tumors that grow in muscles located under the Breasts. While the gland becomes edematous, it becomes a characteristic wrinkled, the nipple retracts, there are metastases in regional lymph nodes;
  • For stage 3B is characterized by the discovery of a large number of metastases in regional lymph nodes, which are themselves in size can already achieve 2 cm;
  • The terminal is considered stage 4 disease. The tumor when it affects the breast completely, there are extensive changes in the skin. Tumor size can be any, but for the fourth stage is always characterized by the distribution of metastases in other organs.

Diagnosis of breast tumors

Initial diagnosis of breast tumors is a task of the woman. In this regard, it is important to have regular self-breast examinations. This should be done monthly. Initially, the Breasts should be carefully examined in front of a mirror to detect visual abnormalities, and then palpate along the entire circumference. Upon detection of any suspicious symptoms you must immediately contact the gynecologist or mammologu.

Diagnostic activities may include the following tests:

  • The breast exam and General gynecological examination;
  • X-rays of the chest;
  • Computed tomography of the chest, brain, abdominal cavity. These diagnostic methods for its purpose the detection of metastases in other organs;
  • Mammography should be done annually to every woman after the age of 45 years. It is established that such measure of prevention can reduce the risk of death from breast cancer by 20%. During the procedure, pictures are of the chest in two projections;
  • Ultrasound examination of the breast and lymph nodes. Ultrasound is preferable to carry out women of young age who have breast mainly consists of glandular tissue. After 40 years, this diagnostic method is not used.
  • Cytological examination. For his conduct from the tumour itself or a lymph node is a collection of cells. The fact that tumor cells are different in structure from the normal, so this method is used for the final confirmation of the diagnosis;
  • Conducting genetic tests for the detection of mutated genes;
  • Histological study;
  • Latest techniques – scintimammography and microwave RS. These methods enable not only to identify tumor at the earliest stage of development, but also suggests its sensitivity to radiation and chemotherapy.

It is proven that early screening of the female population reduces mortality from breast cancer by 30-50%. No less important is regular self-examinations of a woman of their mammary glands. Still in some regions of Russia the death rate from breast cancer is increasing because of insufficient preventive work with the population.


Treatment of breast tumors

Treatment of breast tumor is the responsibility of medical oncologists. In addition, the work involved, medical doctors specialising in chemotherapy and radiotherapy. On the tactics of treatment and to the combination of different methods will be affected by a number of factors. First, it is important the location of the tumor and its prevalence in other tissues. Secondly, age of the patient and her gynecologic history. Thirdly, it is important the presence of other diseases, and whether you have previously held any therapy for the treatment of cancer pathology.

There are three basic component of a possible treatment is surgery, drug and radiation therapy.

Surgical treatment of breast cancer

Radical removal of the breast and tissues, beneath it is the most common practice in the 90-ies of the last century. Such interference was very traumatic for the patient and hard for them postponed.

Modern techniques involve the removal of the breast, shell, chest muscles, and lymph nodes located nearby. When this operation is completed, the majority of women are in the prosthetics of mammary glands, which relieves you of the burden of psychological stress.

In addition to the radical mastectomy, it is possible to perform the operation, maintaining its own breast of a woman. In this case cut only the sector of the breast, lymph nodes and fascia of the pectoral muscle. However, to perform this procedure is not always possible. Contraindications to carrying out such operations are a Central location of the tumor, multiple tumors, diffuse tumor orbelonging to the male gender.

Conclusion conserving surgery is the formation of breast cancer from the woman's own tissue. In addition, all patients go through radiation therapy.

However, the risks that such a procedure would fail, there are always. They rise in the case when the woman is not yet 35 years of age, if the tumor has a high degree of malignancy. In addition, against conserving surgery will be factors such as high activity of a specific oncogene (HER-2/neu), insensitivity to progesterone and estrogen, as well as the germination of tumor in nearby lymph node. If there is at least one of the listed factors, it is necessary either to expand the volume of surgical intervention or to enhance medication.

There are following types of surgery on the breast:

  • Standard radical mastectomy;
  • Enhanced axillary radical mastectomy;
  • Extended superradical mastectomy;
  • Modified radical mastectomy;
  • Mastectomy with lymph node dissection;
  • Simple amputation of the breast;
  • Radical sectoral resection;
  • Sectoral resection.

Radiation therapy of breast cancer

In the case where a woman performed the surgery with preservation of part of the mammary gland, the patient in the mandatory sent to the passage of radiation therapy. This procedure allows to reduce the risk of recurrence of the disease many times. Besides, surgical removal of the breast in most cases leads to relapse. Radiation therapy is used for more than a century, it was first tested in 1901.

When the patient detects the tumor of the fourth or third stage, she is shown holding irradiation even in the case when the breast is removed completely.

Drug treatment of breast tumors

Chemotherapy administered to patients immediately after the operation is completed. It is recommended in the initial stages of the disease. Sometimes chemotherapy women were subjected to the surgical intervention. This is done in order to make the tumor decrease in size. Another goal of chemotherapy is to improve the quality of life of women who have distant metastases. Drugswhich are used for the chemotherapy Paclitaxel, Cyclophosphamide, Docetaxel, Doxorubicin.

When the tumor is removed from the body, it is mandatory tested for sensitivity to the hormones. If she reacts to them, it shows the appointment blockers of estrogen. It may be anti-estrogenic drugs such as Tamoxifen or aromatase inhibitors, e.g. Anastrozole. If the woman is older, she most often recommend removal of the ovaries.

The drug Herceptin is prescribed in the case when detected by the increased activity of the gene HER-2/neu.

Immunotherapy of breast cancer

The indications of immunotherapy acts reduced to protect the body against the background of chemotherapy, as well as due to the presence of the cancer process. Before you assign drugs to enhance immunity, patients are conducting a study on immune status. To increase the protective forces of the body are used monoclonal antibodies, cytokines, antiangiogenesis factors.

Combined and complex therapy

Modern scientists developed complex methods of therapy due to the fact that there is a huge variety of breast cancer, very quickly giving metastases.

If the initial forms of the disease can only be applied surgical treatment with postoperative radiotherapy, the remaining stages require the mandatory use of chemotherapy.

Patients who successfully underwent treatment, all the same, in fact, can not be considered healthy. For example, they have disorders in the upper limbs that has a negative impact on their professional activities. In addition, other functional disorders and multiple organic disorders, ultimately lead to the fact that up to 80% of such patients recognized disability. The first and second group receive about 40% of them.

Also affected the quality of life of women, because the problem of removal of breast for them is very serious, especially if it happened at a young age. Therefore, it is important for social rehabilitation of such patients, be limited exclusively to cancer treatment impossible.

For correction of disorders occurring after surgery, patients showed performance physical therapy and therapeutic exercises and individually designed exercises that should be performed at home. In addition, mandatory sick needed massage.

Not the last place in the rehabilitation of such patients is physiotherapy techniques. As a rule, courses of laser therapy and phototherapy. They are carried out at intervals of 4 months. Each course consists of 10-12 procedures.


Recoveryafter the breast tumor

After the treatment, each woman put on dispensary registration. In the future, she needs regular monitoring by an oncologist. In addition, the patient is recommended to conduct monthly self breast examinations. At the doctor she will need to appear every three months for the first year. In the next two years the reception takes place every six months and after this period – once a year. During a visit to the doctor is required once a year will need to undergo a mammogram. It is done either on one breast or on both, if you have performed organ-preserving surgery.

When there is a suspicion that the tumor recurred, or the body was left spread is a more thorough examination.

We should also say a few words about the problem of mammary tumors in males. Breast enlargement they have observed in increased body mass, in other cases the mammary gland is represented by a small number of adipose, glandular and connective tissue. Tumor in men may develop in gynecomastia (increase in volume of glandular tissue) and also in excess in the body female sex hormones. Although this tumor is rare, it is very aggressive and responds poorly to therapy. Point to the tumor are pain, presence of tumor inside the breast, abnormal discharge from the nipple.