How to determine breast cancer in women, symptoms and causes
Malignant cells can form in all organs of the human body. The most common neoplasm in women is breast cancer. That is why ultrasound diagnostics and mammography are included in the list of mandatory studies when conducting a preventive medical examination. If a doctor suspects a breast cancer patient, the symptoms of the disease will help establish an accurate diagnosis. A tumor that appears in the chest is not only a female symptom, such formations can rarely be found in the mammary glands of men.
Causes of cancer
- Changes in the hormonal background:
- early onset of the menstrual cycle,
- late menopause,
- later the birth of the first child,
- absence of birth,
- multiple miscarriages or abortions,
- long-term use of hormonal drugs (hormone replacement therapy or contraceptives).
- Heredity (a malignant tumor of the mammary glands or ovaries of the next of kin).
- Incorrect way of life:
- alcohol abuse,
- unbalanced nutrition, leading to excessive weight,
- lack of physical activity.
- Diseases of the mammary glands:
Forms of breast cancer
Depending on its location and ways of spreading, breast cancer is divided into:
- Nodular cancer;
- diffuse form (there are several types: edematous, erysipelas, armor and mastitis);
- cancer of Paget.
The most common cancer is the nodular form. Under the skin of the breast, the lump or hardening of the gland is palpable. This dense formation does not have clear boundaries and does not separate from surrounding tissues. As the compaction develops, decay may occur with the appearance of an ulcer and opening it on the surface of the skin. The ulcer looks like an ordinary inflammation, but it does not heal for a long time, it does not give in to local treatment with anti-inflammatory drugs. An infection can join the wound site, while the body temperature rises, signs of intoxication appear. The tumor of the breast can sprout deeper, reaching the ribs and sternum.
With a diffuse tumor, the focus is large, often occupying the breast segment or the entire breast. In the chest, a large cone is palpated. Seals have no clear boundaries, are welded to the surrounding tissue. Externally on the chest appear changes that are similar to erysipelas - the breast becomes swollen, reddens, the body temperature rises. For a malignant tumor with a swollen version, a skin change like a lemon peel is characteristic. With a reduction in breast size and retraction of the nipple, they speak of a carcinoma of cancer. Such a cancer quickly metastasizes.
The third type of tumor is Paget's cancer. With this kind of cancer, a lump appears near the nipple of the breast. This type of tumor grows slowly, is less common than other types of cancer. At the beginning of the disease near the nipple, small scales are formed. Then the nipple retracts, inflammation can develop around it. The cone grows deep into the gland with the development of regional or distant metastases.
Classification of breast cancer
|According to the form||
|By tumor volume||T1, T2, T3, T4|
|On detection of metastases in the lymph nodes||N0, N1, N2, N3|
|By the presence of distant metastases||M0, M1|
Modern oncology provides for the division of cancer into 4 stages depending on the size of the tumor:
- at stage T1, the tumor size does not exceed 2 cm, the tumor does not go beyond the tissue;
- stage T2 is characterized by a focal size of up to 5 cm;
- Stage 3 tumor size exceeds 5 cm;
- in stage T4, the formation spreads beyond the boundaries of the mammary gland, sprouting into other tissues.
The letter N in the classification means the presence of metastases in the lymph nodes.
- N0 - there are no metastases in the lymph nodes.
- N1 - metastases are detected in the armpit, they are not soldered, one or two lymph nodes are affected.
- At stage N2, the lymph nodes of the axillary region are joined together.
- Stage N3 is established at detection of the increased internal lymphonoduses of a mammary gland. The appearance of metastases in the lymph nodes is detected at the 3 stages of the disease.
Stage 3 cancer can manifest itself as distant metastases, which are indicated by the letter M. M0 - distant metastases are absent. M1 - there are distant metastases.
Symptoms of cancer
In the early stages, the tumor does not manifest itself in any way. The first signs of cancer are detected accidentally during a medical examination. It is possible to detect seals themselves during palpation or routine medical examination by a gynecologist, an ultrasound examination or a mammogram. Condensation, revealed in the chest in women, should always be alarming for cancer.
Breast cancer reveals the first symptoms often already in the late stage.
- On examination, you can see the nipple's contraction, skin discoloration, unevenness and tuberosity of the breast, the appearance of redness and ulcers, discharge from the nipple.
- In the presence of regional metastases in 3 stages, axillary lymph nodes increase.
- Sometimes, on examination, you can see a dense path leading from the mammary gland to the armpit.
- As the tumor spreads, there are common signs of intoxication - weakness, fatigue, weight loss.
Does the chest hurt with cancer? In the later stages, the mammary gland begins to ache. This is due to the fact that the nerves that innervate the mammary gland are affected by the process. The pain occurs pulling, can give in an arm or an axillary area.
Palpation of the mammary gland is performed in the supine and standing position. To determine the quality or malignancy of the tumor, surgeons use the palm symptom. If you put your hand on the area of the breast, then the malignant tumor will stick out and be felt under the fingers, then they speak about the positive symptom of the palm. A benign tumor is not felt when touched, then they speak of a negative symptom.
With ultrasound examination, seals in the mammary gland are determined. The cone has an uneven fuzzy outline and increased blood flow. The outbreak can be identified by mammography. Doctors often prescribe both methods of research to clarify the diagnosis. In the general analysis of blood, the level of ESR increases, anemia occurs. To clarify the tumor process, a blood test for a specific oncomarker CA 15-3 is prescribed. Less specific are the markers of CEA and CA 2, 9. Some oncologists believe that these oncomarkers need to be assessed in aggregate. To determine the cancer will help biopsy a suspicious tissue site.
Method of self examination of the breast
In the early diagnosis of the disease, self-examination helps. Detection of the tumor at an early stage improves the prognosis for the patient.
When examining the breast, there is a certain order. Before the beginning of the feeling, it is necessary to examine the mammary glands from the outside. They should be the same size, not have defects in the skin or nipples. The same thing needs to be done when raising your arms up above your head. If no changes in the mammary glands are detected, they begin palpation. To examine the right breast, the right arm is raised behind the head, and the feeling of the gland is carried out with the left hand. The palm is laid flat on the mammary gland and begins to gradually move along a spiral, probing each area and determining if there are seals in the chest. Then you need to examine the area of the nipple and areola, make sure that there are no secretions. Then the same examination is carried out in the supine position. The examination of palpation of the axillary lymph nodes ends.
The tactics of managing a patient with a tumor depend on the stage of the disease. In the absence of separated metastases, surgical treatment is performed. Modern oncology assumes carrying out of radical operation which consists in complete removal of a mammary gland with a fatty tissue and axillary lymph nodes. With a large tumor size and germination in adjacent tissues, a radical mastectomy is performed together with the removal of the pectoral muscles and, sometimes, the ribs. With early detection of cancer at the initial stage, a sparing operation is possible - sectoral removal of the tumor site and axillary lymph nodes.
After any operation, radiotherapy is always prescribed. Chemotherapy can be prescribed before surgery to reduce the tumor in size or after - to prevent metastasis. Usually, several courses of such treatment are conducted. In the detection of distant metastases, radiation therapy and chemotherapy are carried out, which is supplemented by hormonal therapy. Supportive treatment and periodic examination of a woman with breast cancer is carried out for 5 years after the operation. The question of the methods of treatment for a particular patient is solved individually by the onconsult.
The prognosis depends on the detected stage of the disease. In cancer of the initial stage without the detected metastases, the prognosis is favorable. Timely surgery and radiation or chemotherapy can prolong the life of the patient and avoid relapse. The prognosis for breast cancer with metastases is uncertain. It is possible only conservative therapy, aimed at the removal of intoxication.
Pathological cells are entered into other organs by the lymphatic and blood vessels. Usually this is characteristic of cancer of stages 3 and 4. Axillary lymph nodes are the first to be affected. Then the tumor extends to the peri-chest, subclavian, cervical and subscapular nodes. They become painful, increase in size, are soldered to the surrounding tissue. Remote metastases are usually formed in the liver, lungs, bones and brain. When the appearance of metastases, the prognosis is unfavorable.
It has long been known that an increase in the blood of estrogen leads to an increased risk of swelling. Their lowest activity is observed during pregnancy and lactation.
The independent or uncontrolled use of hormonal contraceptives also leads to a shift in the level of hormones in the blood and may contribute to the development of the tumor. In the period preceding menopause, and in the menopausal period, it is necessary to control the level of hormones in the blood to prevent the risk of the disease.
The birth of a child and breastfeeding is the best prevention of breast cancer!
Breast cancer often occurs in nulliparous women over 30 years of age, especially with adverse heredity for cancer. This is the main risk group. During this period, an annual examination of the gynecologist with additional instrumental research is necessary.
The main prevention of cancer is its earlier detection. It is necessary to visit the gynecologist every year, carry out ultrasound of the mammary glands or mammography, and self-examination.