Diagnosis of breast cancer at an early stage: independent and with a doctor. breast cancer. Causes, symptoms, diagnosis and treatment of the disease How to distinguish breast cancer from

Breast cancer is the uncontrolled growth of abnormal cells in breast tissues. It is the most common cancer in women, although it also affects men. The exact cause of breast cancer is unknown, but some women are at higher risk than others.

This is a category of women who have a negative heredity for breast cancer, and women with certain gene mutations. Predisposition to developing cancer are women who have a menstrual cycle at an early age, menopause - at a later age, or those who have never been pregnant.

Treatment outcomes are always better if breast cancer is diagnosed and treated early. It is important to have regular breast exams and schedule mammograms starting at age 45. If a woman is at risk, diagnostics should be carried out regularly, starting at the age of 40.

The schedule for breast cancer screening is best agreed with a mammologist.

Because mutated cells can metastasize or spread to other organs, it's important to recognize early signs of breast cancer. If the disease is diagnosed at the initial stage and treatment is started, the prognosis is favorable.

How to distinguish pathology from other diseases?

Women often feel pain and tenderness in their breasts and assume that they have cancer. However, discomfort is rarely the first noticeable symptom of cancer. Many other factors can lead to pain.

Clinically known as mastalgia, chest pain can be caused by:

A tumor in the breast is usually associated with breast cancer, but in most cases, a lump in the breast is not cancer. The reason for the formation of seals can be very diverse: from hormonal changes in the body to damaged adipose tissue.

More than 90 percent of all breast masses in women aged 20 to 50 are benign.

The most common causes of benign breast lumps are:

• breast infections;
• fibrocystic disease;
• fibroadenoma (non-cancerous tumor);
• necrosis of fat cells (damaged tissues).

Fat necrosis is very difficult to distinguish from a malignant tumor without analysis of gland tissue elements.

Signs of pathology, both at an early and late stage

Early signs of breast cancer include:

Later signs of breast cancer include:

If a patient has several of these symptoms, this does not mean the presence of a malignant tumor. Only a doctor, by prescribing additional studies, can make a diagnosis.

If breast cancer has spread to other parts of the body, it is called metastatic cancer or stage 4 breast cancer. The organs most commonly affected by metastatic cancer are the bones, lungs, brain, and liver. Symptoms will vary depending on the organs affected by the cancer.

Symptoms of bone metastases include bone pain and increased fragility.

Signs of possible brain damage include vision changes, seizures, frequent headaches, and nausea.

If metastases have affected the liver, then the symptoms include:

Patients with lung metastases may experience chest pain, chronic cough, or breathing problems.

The presence of these symptoms does not mean that the tumor has spread to neighboring organs. Depression or anxiety often makes the usual symptoms of a cold or infection look like they don't exist. It is possible to talk about metastases only if special diagnostics have shown their presence.

Types of pathology and features of their external manifestation

Breast cancer is often a type of cancer called adenocarcinoma that develops in glandular tissue. Other types of cancer can also occur in the breast, such as sarcoma, which affects muscle, fat, or connective tissue.

Sometimes one tumor can be a combination of different types of cancer. And in some cases, cancer cells do not form tumors at all. Malignant tumors can be divided into different types depending on how the cancer cells look under a microscope and how the appearance of the breast changes:

Intraductal carcinoma

Ductal carcinoma, also known as intraductal carcinoma, is considered a non-invasive or pre-invasive type of cancer. This means that the channel cells have changed and look like atypical cells. The difference between the non-invasive and invasive types of the disease is that the mutated cells have not penetrated the walls of the ducts into the surrounding tissues.

Approximately one in five cases is diagnosed with intraductal carcinoma.

Symptoms of the disease:

External manifestations of the disease may resemble mastitis, erysipelas and other inflammatory diseases. Symptoms of the initial stage are usually blurred or absent. If the disease is diagnosed at this stage, the treatment gives a 100% result.

Invasive (or infiltrative) ductal focal carcinoma

With ductal carcinoma, cells in the milk duct are first affected, then the tumor breaks through the wall of the duct and grows in the fatty tissue of the gland. Cancer can spread to other organs using the lymphatic system and blood.

We can talk about ductal carcinoma if the following characteristic signs are found:

Invasive (or infiltrative) focal carcinoma affects the lobes of the mammary glands that produce milk. Approximately 1 in 10 cases of invasive breast cancer is focal. It is difficult to diagnose even with the help of mammography, because it does not appear as a tumor, but as a small seal that is difficult to palpate.

Inflammatory breast cancer and Paget's disease

Inflammatory breast cancer is a rare type of disease that accounts for about 1% to 3% of all cancer cases. Its feature is the absence of a tumor. The main symptom is red, hot skin of the chest. Outwardly, it may look like an orange peel, coarsens and thickens. The affected breast looks larger and firmer than the healthy one. Sometimes patients complain of itching.

Breast cancer (carcinoma)- the most common malignant tumor of the mammary glands.

The disease is characterized by a high prevalence. In developed countries, it occurs in 10% of women. Europe is leading the way. Japan has the lowest prevalence of breast cancer.

Some epidemiological data on breast cancer:

• most cases of the disease are registered after the age of 45 years;
• after 65 years, the risk of developing breast carcinoma increases by 5.8 times, and compared with a young age (up to 30 years) it increases by 150 times;
• most often the lesion is localized in the upper outer part of the mammary gland, closer to the armpit;
• 99% of all patients with breast carcinoma are women, 1% are men;
• isolated cases of the disease in children are described;
• mortality in this neoplasm is 19 - 25% of all other malignant tumors;
• Breast cancer is one of the most common tumors in women today.
  At the moment, there is an increase in the incidence worldwide. At the same time, in a number of developed countries there are downward trends due to well-organized screening (mass examination of women) and early detection.

Causes of breast cancer

• female;
• unfavorable heredity (the presence of cases of the disease in close relatives);
• the onset of menstruation before the age of 12 or their end after 55 years, their presence for more than 40 years (this indicates increased estrogen activity);
• no pregnancy or its onset for the first time after 35 years;
• malignant tumors in other organs (in the uterus, ovaries, salivary glands);
• various mutations in genes;
• the effect of ionizing radiation (radiation): radiation therapy for various diseases, living in an area with an increased radiation background, frequent fluorography for tuberculosis, occupational hazards, etc .;
• other diseases of the mammary glands: benign tumors, nodular forms of mastopathy;
• the action of carcinogens (chemicals that can provoke malignant tumors), some viruses (so far, these points have been poorly studied);
• tall woman;
• low physical activity;
• alcohol abuse, smoking;
• hormone therapy in high doses and for a long time;
• constant use of hormonal contraceptives;

Usually, malignant tumors of the mammary glands are heterogeneous. They are made up of different types of cells that multiply at different rates and respond differently to treatment. In this regard, it is often difficult to predict how the disease will develop. Sometimes all symptoms grow rapidly, and sometimes the tumor grows slowly, without leading to noticeable disturbances for a long time.

The first signs of breast cancer

Symptoms that require immediate medical attention:

• breast pain that has no apparent cause and persists for a long time;
• feeling of discomfort for a long time;
• seals in the mammary gland;
• change in the shape and size of the breast, swelling, deformation, the appearance of asymmetry;
• nipple deformities: most often it becomes retracted;
• discharge from the nipple: bloody or yellow;
• changes in the skin in a certain place: it becomes retracted, begins to peel off or wrinkle, its color changes;
• a dimple, a depression that appears on the mammary gland, if you raise your hand up;
• swollen lymph nodes in the armpit, above or below the collarbone;
• swelling in the shoulder, in the region of the mammary gland.

• Regular self-examination. A woman should be able to properly examine her breasts and identify the first signs of a malignant neoplasm.
• Regular visits to the doctor. It is necessary to visit a mammologist (specialist in breast diseases) at least once a year.
• Women over the age of 40 are advised to regularly undergo mammography, an x-ray examination aimed at early detection of breast cancer.

How to examine your breasts on your own?

Inspection of the mammary glands should be carried out on the 5th - 7th day of the menstrual cycle, preferably on the same days.

visual inspection

• Are the right and left mammary glands symmetrical?
• has one mammary gland increased compared to the other (it is worth remembering that normally the sizes of the right and left mammary glands may differ slightly)?
• does the skin look normal, are there any suspicious areas with a changed appearance?
• do the nipples look ok?
• nothing else suspicious seen?

Feeling

First, one mammary gland is felt, then the second. Start from the nipple, then move the fingers outward. For convenience, you can feel in front of a mirror, conditionally dividing the mammary gland into 4 parts.

Moments to pay attention to:

The general consistency of the mammary glands - has it become denser since the last examination?

• the presence of seals, nodes in the tissue of the gland;
• the presence of changes, seals in the nipple;

• Mammography - X-rays of the breast. Existing seals in the tissue are revealed. The modern method is digital mammography.
• Determination of the level of female sex hormones - estrogen. If it is high, there is an increased risk of developing breast cancer.
• Oncomarker CA 15-3 is a substance that is produced by breast carcinoma cells.

Symptoms and appearance of different forms of breast cancer

Nodular form of breast cancer	A painless dense formation is palpated in the thickness of the mammary gland. It can be round or have an irregular shape, it grows evenly in different directions. The tumor is soldered to the surrounding tissues, therefore, when a woman raises her hands, a depression forms on the mammary gland in the corresponding place. The skin in the area of ​​the tumor is wrinkled. In the later stages, its surface begins to resemble a lemon peel, ulcers appear on it. Over time, the tumor leads to an increase in the size of the breast. Lymph nodes are enlarged: cervical, axillary, supraclavicular and subclavian. What does nodular breast cancer look like?
Edema-infiltrative form	This form of breast cancer is most common in young women. Pain is often absent or mild. There is a seal that occupies almost the entire volume of the breast. Symptoms: compaction of the mammary gland; redness of the skin, which has uneven edges; increased temperature of the skin of the breast; during palpation, the nodes are not detected. What does erysipelas-like breast cancer look like?
shell cancer	The tumor grows through the entire glandular tissue and adipose tissue. Sometimes the process goes to the opposite side, to the second mammary gland. Symptoms: reduction of the mammary gland in size; restriction of mobility of the affected mammary gland; compacted, with an uneven surface, the skin over the focus. What does breast cancer look like?
Paget's cancer	A special form of breast cancer occurs in 3-5% of cases. Symptoms: crusts in the nipple area; redness; erosion - superficial defects of the skin; wetting of the nipple; the appearance of shallow bleeding ulcers; nipple deformity; over time, the nipple is finally destroyed, a tumor appears in the thickness of the mammary gland; Paget's cancer is accompanied by metastases to the lymph nodes only in the later stages, so the prognosis for this form of the disease is relatively favorable. What does Paget's cancer look like?

Breast cancer grades

• T is the state of the primary tumor;
• M - metastases to other organs;
• N - metastases in regional lymph nodes.

Classification depending on the location of the tumor:

• breast skin;
• nipple and areola (skin around the nipple);
• upper inner quadrant of the breast;
• lower inner quadrant of the breast;
• upper outer quadrant of the breast;
• lower outer quadrant of the breast;
• posterior axillary part of the mammary gland;
• the location of the tumor cannot be determined.

Breast Cancer Diagnosis

Inspection

During the examination, the doctor:

• ask the woman in detail, try to get the most complete information about the course of the disease, the factors that could contribute to its occurrence;
• will examine and palpate (palpate) the mammary glands in the prone position, standing with arms raised and lowered.

Instrumental diagnostic methods

Diagnostic method	Description		How is it carried out?
Mammography- a section of diagnostics that deals with non-invasive(without incisions and punctures) by examining the internal structure of the mammary gland.
X-ray mammography	X-ray examination of the breast is carried out using devices that generate low-intensity radiation. Today, mammography is considered the main method of early diagnosis of malignant neoplasms of the breast. Has an accuracy of 92%. In Europe, X-ray mammography is mandatory for all women over the age of 45 on a regular basis. In Russia, it is mandatory for women over 40 years old, but in practice it is not carried out by all. With the help of X-ray mammography, tumors with a size of 2-5 cm are best detected. An indirect sign of a malignant neoplasm is a large number of calcifications - accumulations of calcium salts, which are well contrasted in the pictures. If they are found more than 15 per cm 2, then this is a reason for further examination.		The study is carried out in the same way as a conventional x-ray. The woman is stripped to the waist, leans against a special table, puts her mammary gland on it, after which a picture is taken. X-ray mammography devices must comply with the requirements established by WHO. Types of x-ray mammography: film- use a special cassette with a film on which the image is fixed; digital- the image is fixed on the computer, later it can be printed or transferred to any medium.
MRI mammography	MRI mammography is a study of the mammary glands using magnetic resonance imaging. Advantages of MRI mammography over X-ray tomography: there is no x-ray radiation, which negatively affects tissues, is a mutagen; the opportunity to study the metabolism in the breast tissue, to conduct spectroscopy affected tissues. Disadvantages of magnetic resonance imaging as a method for diagnosing malignant neoplasms of the mammary glands: high price; lower efficiency compared to X-ray tomography, the inability to detect calcifications in the gland tissue.		Before the study, you must remove all metal objects from yourself. You can not take any electronics, as the magnetic field that the device generates can disable it. If the patient has any metal implants (pacemaker, joint prostheses, etc.), you need to warn the doctor - this is a contraindication to the study. The patient is placed in the apparatus in a horizontal position. She must be in a stationary position during the entire study. The time is determined by the doctor. The result of the study are digital images that show pathological changes.
Ultrasound mammography	Ultrasound examination is currently an additional method for diagnosing malignant neoplasms of the mammary glands, although it has a number of advantages over radiography. For example, it allows you to take pictures in different projections, does not have a harmful effect on the body. The main indications for the use of ultrasound diagnostics in breast cancer: observation in dynamics after the tumor was detected during x-ray mammography; the need to distinguish a cyst filled with fluid from dense formations; diagnosis of breast diseases in young women; control during the biopsy; the need for diagnosis during pregnancy and lactation.		The procedure is no different from conventional ultrasound. The doctor uses a special sensor that is applied to the mammary gland. The image is transmitted to the monitor, can be recorded or printed. Dopplerography and duplex scanning may be performed during an ultrasound examination of the mammary glands.
Computed tomomammography	The study is a computed tomography of the mammary glands. Advantages of computed tomomammography over x-ray mammography: the ability to obtain images with layered tissue sections; the possibility of clearer detailing of soft tissue structures. Disadvantages of computed tomomammography: The study is worse than x-ray mammography, reveals small structures and calcifications.		The study is carried out in the same way as a conventional computed tomography. The patient is placed on a special table inside the apparatus. It must remain motionless throughout the study.
Biopsy- excision of a fragment of breast tissue with subsequent examination under a microscope.
Needle biopsy	The accuracy of the technique is 80 - 85%. In 20 - 25% of cases, a false result is obtained.	A fragment of breast tissue for research is obtained using a syringe or a special suction gun. The procedure is performed under local anesthesia. Depending on the thickness of the needle, there are two types of puncture biopsy: fine needle; thick-needle. Manipulation is often performed under the guidance of ultrasound or x-ray mammography.
Trepanobiopsy	Trepanobiopsy of the mammary glands is performed in cases where it is necessary to obtain more material for research. The doctor receives a piece of breast tissue in the form of a column.	Trepanobiopsy is performed using a special tool consisting of a cannula with a mandrel, into which a rod with a cutter is inserted. The intervention is performed under local anesthesia. The surgeon makes an incision in the skin and inserts a trepanobiopsy instrument through it. When the tip of the incisor reaches the tumor, it is pulled out of the cannula. With the help of a cannula, a column of tissues is cut off, and it is removed. After receiving the material, the wound is carefully coagulated to prevent the spread of cancer cells. During a study in the laboratory, it is possible to determine the sensitivity of tumor cells to steroid hormones (which include estrogens). This helps in the further choice of treatment tactics.
Excisional biopsy	Excision - complete removal of the tumor with surrounding tissues. The entire mass is sent to the laboratory for analysis. This makes it possible to detect tumor cells at the border of the incision, to study the sensitivity of the tumor to sex hormones.	The surgeon removes the tumor with surrounding tissues during the operation. Thus, excisional biopsy is both a therapeutic and a diagnostic procedure.
Stereotactic biopsy	During a stereotaxic biopsy, samples are taken from several different locations through a single needle.	The procedure resembles a conventional needle biopsy. It is always carried out under the control of x-ray mammography. The needle is inserted in a certain place, a sample is obtained, then it is sipped, the angle of inclination is changed and it is inserted again, this time in a different place. Multiple samples are obtained, making diagnosis more accurate.

Laboratory methods for diagnosing breast cancer

Breast Cancer Treatment

• surgical;
• chemotherapy;
• hormone therapy;
• immunotherapy;
• radiation therapy.

Usually, combined treatment is carried out using two or more methods.

Surgery

Types of surgical interventions for breast cancer:

• Radical mastectomy: complete removal of the mammary gland along with fatty tissue and adjacent lymph nodes. This version of the operation is the most radical.
• Radical resection: removal of the breast sector along with subcutaneous fatty tissue and lymph nodes. Currently, surgeons increasingly prefer this variant of surgical intervention, since radical mastectomy practically does not prolong the life of patients compared to resection. The intervention must be supplemented with radiation therapy and chemotherapy.
• Quadrantectomy- removal of the tumor itself and surrounding tissues within a radius of 2 - 3 cm, as well as nearby lymph nodes. This surgical intervention can be performed only in the early stages of the tumor. The excised tumor must be sent for a biopsy.
• Lumpectomy- the smallest operation in terms of volume, during which the tumor and lymph nodes are removed separately. The surgical study was developed during the studies of the National Breast Surgery Augmentation Project (NSABBP, USA). The conditions for the intervention are the same as for quadrantectomy.

Radiation therapy

• directly the tumor itself;
• lymph nodes located in the armpit;
• lymph nodes located above and below the collarbone;
• lymph nodes located in the sternum.

Chemotherapy

Cytostatics are drugs that have numerous side effects. Therefore, they are always prescribed strictly in accordance with established regulations and taking into account the characteristics of the disease.

The main cytostatics used in malignant tumors of the mammary glands:

• adriblastin;
• methotrexate;
• 5-fluorouracil;
• paclitaxel;
• cyclophosphamide;
• docetaxel;
• xeloda.

• CMF (Cyclophosphamide, Fluorouracil, Methotrexate);
• CAF (Cyclophosphamide, Fluorouracil, Adriablastine);
• FAC (Fluorouracil, Cyclophosphamide, Adriablastine).

hormone therapy

Methods of hormone therapy:

How does a doctor choose tactics for breast cancer treatment?

Features that the doctor should consider:

• the size of the neoplasm;
• the presence of metastases in the lymph nodes;
• germination in neighboring organs, the presence of distant metastases;
• laboratory data characterizing the cellular composition, the degree of malignancy of the tumor.

What alternative methods of treatment can be used for breast cancer?

Alternative methods are not able to provide an effective fight against the tumor process. Self-medication delays the visit to the doctor. Often such patients turn to a specialist when there are already distant metastases in the lymph nodes. At the same time, 70% of patients do not survive for 3 years.

The only right decision for a patient with suspected breast cancer is to see a doctor as early as possible, carry out diagnostics and, if necessary, start treatment in an oncology clinic.

13.04.2019

A cancerous tumor in the breast area is a malignant formation that is characterized by rapid growth.

Why does it appear?

Before diagnosing this disease, let's look at the causes of its occurrence.

Such a diagnosis develops against the background of reasons:

• mastitis;
• negative impact of the environment;
• hereditary factors;
• regular abortions;
• taking hormonal drugs for a long time;
• mastopathy;
• excess weight;
• frequent X-ray examinations and radiation.

How to define a disease?

It is important to know how to detect breast cancer at an early stage, when it is extremely important. So, the following symptoms may indicate the presence of oncology in the mammary gland:

• manually, you can feel a dense formation in the chest, while there is no pain;
• a strong change in the shape of the breast is visually observed;
• the skin of the breast is wrinkled or drawn in;
• in the direction of the gland affected by the tumor, there is an increase in the lymph nodes in the armpit;
• swelling or hardening of the nipple;
• bloody discharge is observed from the nipple;
• the feeling of discomfort and pain gradually increases.

If it is a carcinoma, then it may differ in the presence of a very different localization site. With the same frequency, cancer can affect both mammary glands. If there is an oncological process in one breast, then it can go to the second breast, being an independent formation or metastases. Even with self-examination, you can find a small seal that resembles dough to the touch.

In some situations, if the survey was not carried out in a timely manner, the formations can reach extremely large sizes.

Diagnosis of breast cancer is carried out in such ways: mammography, ultrasound, biopsy. However, in any case, you should not panic ahead of time. If you yourself find a small lump in your chest, you need to see a doctor to determine its cause after the necessary diagnosis.

Stages of the disease

At the moment, the malignant process can have one of five stages:

1. A cancerous tumor with a permanent site of localization, without passing into the rest of the tissues of the organ.
2. At this stage, the formation turns from benign to malignant, but does not affect the lymph nodes and does not spread to other organs.
3. The nodes rapidly begin to increase in size, they can be 5 centimeters, there is also damage to the lymph nodes, but they are not soldered to each other.
4. There is damage to the chest, lymph nodes and skin. At the same time, the skin on the chest becomes very hot, reddens and peels off. At this stage, the disease may resemble mastitis.
5. Metastases are observed throughout the body (bones, lymph nodes, lungs, liver and brain).

Mammography

If a diagnosis of breast cancer is required, a procedure such as a mammogram is recommended. It can be used to determine the following:

• accumulation of the smallest inclusions of lime - micro-calcifications;
• deformation of the heavy pattern;
• local compaction of the fabric of the pattern - the shadow of the node.

If there is breast cancer, diagnosis using mammography can only be effective if the formation is 2 to 5 cm in size.

Identification of intraductal carcinoma has a number of difficulties, since the compaction can be microscopic in size. Focal accumulations of calcifications of different sizes, density and shape acquire the maximum diagnostic value.

Such a specific diagnostic method allows you to identify the disease at an early stage, so that the doctor can prescribe a quick and effective treatment.

In clinical practice, it is necessary to take into account the fact that in women who have had radical treatment in the past, the likelihood of developing oncology in the second mammary gland increases 10 times compared to the rest.

The differential method for detecting an oncological process in another mammary gland primarily consists in clarifying the nature of the formation (malignant or benign) and identifying whether it is a primary formation or metastases.

Bilateral breast cancer is primary if:

• proven lobular or intraductal structure of the tumor in two mammary glands at once;
• in one breast there is an invasive type of tumor, in the other - pre-invasive;
• structures of a preinvasive nature were found around the malignant tumor in the tissues of the mammary gland;
• the location of the tumor is observed in the parenchyma of symmetrical sections of two breasts at once, and not in the soft tissues and subcutaneous tissue;
• there is no multiple spread of metastases to regional lymph nodes, individual and extraorganic metastases;
• the degree of malignant tumors differs among themselves.

If several focal formations are found within one square of the mammary gland at once, then it is considered that the process is mulfocal. An example is intraductal cancer, whose foci are located in a square.

If there is breast cancer, diagnosis should be carried out immediately, since in this case it is possible to determine the degree of the disease, prescribe an effective therapy that can help the patient cope with the pathology.

Do not neglect the examination by a doctor, because this way you can determine the formation, which is still at an early stage and is easily treatable.

Breast biopsy

To date, there are several types of biopsies that are performed to detect cancer in the breast area. They must include:

• stereotaxic;
• trepanabiopsy;
• excisional;
• puncture.

Needle biopsy

Thanks to the puncture biopsy, it is possible to obtain the necessary material for cytological examination by aspiration of the material from the tumor through a special aspiration gun or syringe. In 80-85% of all situations, a cytological examination of the taken substance allows you to correctly diagnose the patient. The frequency of false-negative morphological conclusions is equal in this case to 15-20%.

Excisional biopsy

The technique of excisional biopsy is to excise a completely detected seal with a patch of skin that surrounds it. With its help, it is possible to conduct a study of the cut-off edges for the presence of cancer cells, as well as the ability to identify receptors for steroid hormones in the formation.

Trepanabiopsy

The implementation of this procedure occurs with the help of special needles, thanks to which it is possible to obtain a column of tissue from the tumor, sufficient for subsequent histological examination. After such a procedure, the walls of the wound channel are coagulated in order to exclude the dissemination of tumor cells.

Stereotactic biopsy

Thanks to this type of biopsy, it is possible to achieve the capture of accurate material for subsequent morphological examination. However, stereotaxic biopsy requires mammography equipment.

Cytological examination

In the presence of spontaneous discharge from the nipples, it is recommended that they be examined immediately. When isolated polymorphic and rounded lily or vacuolated cells are found among erythrocytes and epithelial cells, it indicates that a woman has an oncological process in the breast area.

In case of suspected presence of Paget's cancer, it is necessary to remove the crust from the surface of the nipples with tweezers and make an "imprint" on a glass slide with ulcerated or eroded skin for subsequent staining and cytological examination.

If there are unclear data during a simple mammography, as well as to determine the diagnosis with intraductal papillomas, additional diagnostic steps can also be carried out, among which should be noted computed tomomammography, galactography or dictography.

Each of these diagnostic methods has its own advantages and features:

• discography is carried out by introducing a contrast agent through a special needle into the opening of the excretory duct that opens on the nipple. Then you need to take an x-ray in two projections;
• only galactography makes it possible to determine the exact location of the ductal lesion and makes it possible to distinguish dystrophic and inflammatory processes from tumors;
• conducting computed tomomammography makes it possible to obtain an image (section by layers) of any part of the mammary gland. It detects the presence of soft tissue structures better than conventional mammography, but it cannot detect small tumors, in particular calcifications.

Ultrasonography

An ultrasound examination is necessary to verify palpable formations, towhich cannot be determined on mammograms, being an important additionto the x-ray method. Diagnostics does not have a harmful effect on the body, so it can be applied several times.

It can be used to identify the depth of the tumor process, its structure, extent, relationships with surrounding tissues.

Thanks to ultrasound, it is possible to additionally determine the presence of fluid in the palpable formation. Ultrasound is not used in the detection of breast cancer as an independent diagnostic method.

Conclusion

Only conducting a timely study will make it possible to identify the disease at the initial stage, when it is possible to carry out the most effective treatment, saving the patient from oncology.

If you suspect the development of a malignant process in the mammary glands, you should immediately consult a doctor.

In this situation, in no case should one hesitate, because such a cancerous process is characterized by rapid development. Take care of your health, do not neglect it, especially when it comes to cancer.

One of the most common malignant lesions in the female body is a tumor focus in the mammary gland. Early diagnosis of breast cancer is a priority for all preventive medical examinations of women.

In the risk subgroup are representatives of the beautiful part of the population who have not given birth and have reached menopausal age. Among them, the detection of a malignant neoplasm reaches 45–65%.

However, there are a number of signs that help on their own and then turn to a specialist, which significantly increases a woman's chances of recovery.

Warning Signs

Answering the question of how to determine breast cancer on their own, experts point out a number of warning signs that are noticeable to a woman who is attentive to her own health:

• detection by manual probing of dense formations in the gland, however, without pain impulses in the area of ​​​​their localization;
• visually noticeable change in the shape of the breast;
• the skin is either retracted in one area, or wrinkled;
• gradually increasing local discomfort;
• thickening, swelling of the nipple becomes noticeable;
• often, when pressing on the nipple, a drop of liquid flows out of it, sometimes with a reddish coloration;
• on the part of the gland affected by the tumor process, compaction and an increase in lymph nodes in the armpit are revealed.

All of the above signs require immediate consultation with a specialist. Only a highly qualified doctor can make an adequate diagnosis - after appropriate diagnostic procedures, such as, for example, a test for tumor markers.

Self-examination at home

Every woman needs to pay maximum attention to her health. Early diagnosis of breast cancer is 85–90% the merit of the patients themselves.

At the beginning of the formation of a tumor focus, the female body increases the secretion of sex hormones that promote the growth of gland tissues. The pathological focus grows towards the surface of the skin, which makes it wrinkled or retracted.

The follicles above the pathological focus also change - they swell, expand, so the skin becomes excessively porous, rough. The coloring may also change - to brown, yellowish, cyanotic.

It is necessary to pay attention to the condition of the nipple and the area around it. When the cancerous process spreads to the ducts of the gland, the nipple retracts, ulcerative defects can form on it. The appearance of various discharges from the nipple is also characteristic - transparent, bloody.

When self-feeling, a woman can identify a small area of ​​compaction in herself, with uneven contours, which, however, does not cause unpleasant omissions. The presence of discomfort rather indicates the good quality of the process. An unfavorable sign is the detection of a simultaneous increase in axillary lymph nodes.

Regular examination of the mammary glands at home should become familiar to a woman, like applying makeup. The execution does not take a long time, but is of great importance for health.

Instructions for self-diagnosis

How to detect breast cancer at home:

1. The procedure is recommended to start with a thorough looking in front of a mirror- carefully evaluate the shape of the breasts, skin coloring, size. Healthy glands have the same size and shape, without visually distinguishable distortions, swelling, retractions. Then the hands are wound behind the head, and the examination is carried out in this position, looking for the above changes. The reason for contacting a specialist should be the identification of retraction or wrinkling of the dermis over one of the areas of the breast, a change in the position and shape of the nipple, rashes or various irritations, protrusions.
2. Further self-examination is carried out lying down. With the right hand, the woman should carefully palpate the left gland. To this end, with her fingers folded together in a circular motion, she carefully examines the entire chest. Recommended directions are from the collarbone to the border with the upper half of the abdomen, as well as from the armpit towards the collarbone. It is more convenient for someone to start from the nipple, moving in a circle to the outer border of the gland.
   

   It is necessary to press gently, trying not to injure the breast tissue, however, with a suspicious area, you can press harder so that the ribs are felt. Likewise with the second breast.

3. The next step is to conduct an independent palpation in the position sitting and then standing. The procedure is the same as above. Many women indicate that the procedure is easier to carry out in the shower - the skin is steamed, moist, the tissues are more easily squeezed through.

Particular attention is paid to possible discharge from the nipple - normally they should not be. Or a small drop with transparent contents. A diagnostic warning sign is the detection of a seal, painless, not soldered to surrounding tissues.

Instrumental diagnostics

After a careful collection of complaints made by the patient and a physical examination, the specialist will recommend the following instrumental methods for diagnosing cancer:

Primary, publicly available method of visualization of the oncoprocess - breast ultrasound. The procedure is absolutely safe and completely painless. As a rule, it is carried out in the position of the patient, lying on the couch. If the chest differs in large parameters - sitting.

Ultrasound allows you to determine the location of the neoplasm, its size, the presence of metastases, the involvement of neighboring organs and tissues in the malignant process, for example, lymph nodes. Dopplerography is often used during ultrasound - it allows you to assess the state of general blood flow in the chest vessels. If the tumor has its own vessels, it is most likely malignant.

Laboratory research

In the arsenal of specialists there are also various laboratory methods for diagnosing breast cancer. Oncomarkers are widely used - they make it possible to identify pathology at the very early stage of its formation, we wrote about them in detail.

The bottom line is the detection of specific proteins that enter the bloodstream of a woman if a tumor focus has formed in the mammary gland. This diagnostic method is even able to indicate whether the process is benign, a cyst, or malignant, a carcinoma.

Tumor markers are divided into specific and nonspecific. The former allow the specialist to orientate with the type of tumor process, while the latter only indicate the deviation that has arisen in the woman's health.

It is strictly forbidden to rely only on the results of oncomarkers when making a diagnosis. It is necessary to evaluate the completeness of the examination - and ultrasound, mammography, biopsy.

Cancer (carcer) is a malignant formation, in other words, a tumor of a special type of pathology that develops very rapidly in the focus of the rudiment of atypical cells. A malignant cell tends to transmit information of development, growth and metastasis to other cells in the process of their regeneration. The occurrence of such a process can be observed at any point of a living organism.

Tumor in the mammary glands of a woman

The occurrence of malignant epithelioma in the mammary gland of a woman is the most common oncological disease today, which sooner or later leads to the death of the patient. Symptoms of breast cancer clinic in women are quite diverse in the early stages of the disease. Signs of breast cancer are characterized by its rapid onset and course, most often developing up to six months.

Neoplasms can be located unevenly in the mammary gland. These are malignant tumors that often affect the upper outer square of the breast, less often they occur in the upper inner part of the organ and very rarely in the lower sections. Sometimes cancer affects the areola.

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early cancer

It is possible to diagnose breast cancer in the early stages, since the tumor that has arisen is related to the visual forms of malignant tumors. Therefore, it is possible to palpate the tumor or examine it with instruments.

Early and small breast cancer is formed inside the duct or lobules of the mammary gland in the form of up to 1 cm and without metastases. In the presence of metastasis to the lymph nodes, small cancer is not considered early. Diagnosing an early form of cancer is very difficult. With the palpation method, small seals can be identified that are not reliably examined with mammography and ultrasound waves. To do this, they resort to a biopsy of the material of the mammary gland, followed by histology, and also try to find metastases.

Varieties of breast cancer are noted in three clinical forms:

1. nodal;
2. diffuse;
3. Paget's disease.

nodular form of cancer the most common pathology in breast cancer. Such a formation is located under the skin in the amount of 10-20 mm, which is easily palpable. In the case of a large node, it is clearly visible on the mammary gland, and these are the first signs of breast cancer. Cancer nodes are dense and do not have clear boundaries, so they are poorly separated from the surrounding tissue. With the rapid growth of such a tumor, tuberous nodes begin to grow on the surface of the chest and open on the skin in the form of a bleeding ulcer. Over time, the tumor decays and the smell of rot appears. This process of necrosis can expand and deepen to the bones of the chest. As a result, patients experience severe pain and infection, leading to a terminal state of the body.

Diffuse form of cancer It looks like an infiltrate that diffusely affects the entire organ or its segment. Tumor infiltration has several types, and these are erysipelas, armored, edematous and mastitis. Infiltrate of such species without clear boundaries and dense consistency. The chest, at the same time, increases, swells, turns red, the temperature rises. With an erysipelas-like tumor, the mammary gland looks with a characteristic hyperemic inflammation and with a sheen of the skin. The mastitis form covers all glandular breast tissue and skin, followed by their necrosis. The type of "lemon peel" is acquired by the mammary gland with an edematous form of malignant infiltration. If the breast is visually deformed, reduced in size and with an inverted nipple, then we are talking about damage to the tissue and subcutaneous tissue by infiltrative nodes of the shell-like form of cancer. With the rapid development of such a tumor, the entire surface of the thoracic region is affected, the skin of which is covered with a large number of pinkish nodular infiltrates.

The development of these forms of cancer proceeds quite quickly with the spread of metastases to regional lymph nodes.

Breast nipple cancer (Paget's disease) . Compared with other forms of breast malignant tumors in women, it occurs much less frequently and develops for a long time. The first symptoms of a tumor appear as scales on or around the nipple. Such delaminations can be observed in dry and wet form. The breast nipple begins to slowly retract, and the increasing dense infiltrative formation gradually grows into the subcutaneous tissue of the breast and metastasizes to the lymph nodes.

In a histological study of nodular and diffuse breast cancer in a woman, the tumor is often represented by hard tissue, nodular, granular, with cords, as well as with the presence of mucus and colloid inside the infiltrates.

Metastases in breast cancer

The progression of malignant formation occurs through the spread of metastases to the vessels of the body, which spread throughout the body in search of a new focus of cancer development. These vessels are the circulatory and lymphatic systems. In the mammary gland, lymph is drained through two plexuses. According to one, the lymph is discharged from the subcutaneous tissue and skin, and according to another, deep, from the glandular tissue of the mammary organ. The outflow of lymph flows into the axillary and parasternal lymph nodes. The defeat of these lymph nodes by metastases is expressed by their increase and soreness. The path of metastasis does not end there, further an atypical process is observed in the subclavian, cervical and subscapular lymphatic vessels. Through the parasternal lymph flow, metastases enter the liver and the parenchymal tissue is damaged by a cancerous tumor.

Symptoms of breast cancer can be noticed by the presence of a large number of lymph nodes on the skin of the breast. They are mobile and often do not cause pain.

With the help of the circulatory system, cancer also spreads its metastases and affects, at the same time, other organs. More often, with breast cancer, the bones, liver and lungs of women suffer. Symptoms of such lesions are expressed by pain that occurs during a night's rest.

Stages of breast cancer in a woman

In modern oncology, there are four stages of breast cancer. It is for this body that the system is defined TNM:

T– primary (primary) education. This category assesses the presence of a tumor and its size. For example, T0 means that the presence of a tumor is not determined. T1, T2, T3, T4- speaks of the size of the formation, from one to more than five centimeters, as well as visual symptoms of contouring and fixation to nearby tissues;

N- Distant lymph nodes. When the nodes of the lymphatic system are not palpable, then a category is distinguished from the classification N0. Data N1, N2, N3 indicate the displacement of the affected axillary and supraclavicular lymph nodes, as well as their metastaticity. If, during the examination of a woman, the data on the state of the lymph nodes are doubtful, then the category is set Nx;

M– detection of metastases in distant areas. If present, indicate the category M1 and if in doubt, Mx, and if distant metastases are not detected, then М0.

According to the grouping of such indicators, which are set according to the symptoms of an external examination of a woman and after an accurate diagnosis is confirmed, the stage of tumor development is determined. The first two are set according to the specified data: T1-T2, N0, N1 and M0. With the increase of these categories, the third and most dangerous, fourth stage of cancer is determined.