Malignant tumor of the breast. Breast tumors: types, early diagnosis, treatment and prognosis Breast cancer oncology

– malignant neoplasm of the breast. Local manifestations: change in the shape of the mammary gland, retraction of the nipple, wrinkling of the skin, discharge from the nipple (often bloody), palpation of lumps, nodules, enlargement of the supraclavicular or axillary lymph nodes. The most effective treatment is surgical treatment in combination with radiation or chemotherapy in the early stages. In later stages, tumor metastasis to various organs is noted. The prognosis of treatment largely depends on the extent of the process and the histological structure of the tumor.

General information

According to WHO statistics, more than a million new cases of malignant breast tumors are diagnosed every year worldwide. In Russia this figure reaches 50 thousand. One in eight American women will develop breast cancer. Mortality from this pathology is about 50% of all cases. The reduction of this indicator is hampered by the lack of organized preventive screening of the population in many countries for the early detection of malignant neoplasms of the mammary glands.

Causes of breast cancer

Certain factors contribute to the occurrence and development of breast cancer:

• Floor. The vast majority of breast cancer occurs in women; the occurrence of malignant tumors in men is 100 times less common;
• Age. Most often, breast cancer develops in women after 35 years of age;
• Complicated gynecological history: menstrual irregularities, hyperplastic and inflammatory pathologies of the genital organs, infertility, lactation disorders;
• Genetic predisposition: malignant tumors occurring in close relatives, milk-ovarian syndrome, cancer-associated genodermatoses, combination of breast cancer with sarcoma, malignant tumors of the lungs, larynx, adrenal glands;
• Endocrine and metabolic disorders: obesity, metabolic syndrome, diabetes mellitus, chronic arterial hypertension, atherosclerosis, pathologies of the liver, pancreas, immunodeficiency.
• Nonspecific carcinogenic factors: smoking, chemical poisons, high-calorie unbalanced diet, rich in carbohydrates and poor in proteins, ionizing radiation, work in conflict with biorhythms.

It must be remembered that existing factors of increased carcinogenic risk will not necessarily lead to the development of a malignant breast tumor.

Classification

Breast cancer is classified according to its stages of development.

• On Stage I the tumor does not exceed 2 centimeters in diameter, does not affect the surrounding tissue, and there are no metastases.
• IIa stage characterized by a tumor of 2-5 cm that has not grown into the tissue, or a tumor of a smaller size, but affecting the surrounding tissue (subcutaneous tissue, sometimes skin: wrinkling syndrome). There are also no metastases at this stage. The tumor acquires 2-5 cm in diameter. Does not grow into the surrounding subcutaneous fatty tissue and breast skin. Another type is a tumor of the same or smaller size that grows into the subcutaneous fatty tissue and adheres to the skin (causing symptoms of wrinkling). There are no regional metastases here.
• On Stage IIb metastases appear in regional lymph nodes in the armpit. Metastasis to intrathoracic parasternal lymph nodes is often noted.
• Tumor Stage IIIa has a diameter of more than 5 centimeters, or grows into the muscle layer located under the mammary gland. Characterized by the symptom of “lemon peel”, swelling, retraction of the nipple, sometimes ulcerations on the skin of the gland and discharge from the nipple. There are no regional metastases.
• IIIb stage characterized by multiple metastases of the axillary lymph nodes or single supraclavicular ones (or metastases in the parasternal and subclavian nodes).
• IV stage- terminal. Cancer affects the entire mammary gland, grows into surrounding tissues, disseminates to the skin, and manifests itself as extensive ulcerations. The fourth stage also includes tumors of any size that have metastasized to other organs (as well as to the second mammary gland and lymph nodes of the opposite side), formations that are firmly fixed to the chest.

Symptoms of breast cancer

In the early stages, breast cancer does not manifest itself in any way; upon palpation, a dense formation in the gland tissue can be detected. Most often, a woman notices this formation during self-examination, or it is detected during mammography, ultrasound of the mammary glands, and other diagnostic methods during preventive measures. Without appropriate treatment, the tumor progresses, enlarges, and grows into the subcutaneous tissue, skin, and chest muscles. Metastases affect regional lymph nodes. Through the bloodstream, cancer cells travel to other organs and tissues. Breast cancer most often metastasizes to the lungs, liver, and brain. Necrotic decay of the tumor and malignant damage to other organs leads to death.

Complications

Breast cancer is prone to rapid metastasis to regional lymph nodes: axillary, subclavian, parasternal. Then, with the flow of lymph, cancer cells spread through the supraclavicular, scapular, mediastinal and cervical nodes. The lymph system of the opposite side may also be affected, and the cancer may spread to the second breast. Hematogenously, metastases spread to the lungs, liver, bones, and brain.

Diagnostics

One of the most important methods for early detection of breast cancer is regular and thorough self-examination of women. It is advisable to perform self-examination for women at risk for breast cancer, as well as all women over 35-40 years old, every month. The first stage is to examine your breasts in front of a mirror. Deformations and a noticeable enlargement of one breast compared to the other are detected. Determining the symptom of “lemon peel” (skin retraction) is an indication for immediate contact with a mammologist.

After the examination, a thorough palpation is performed, noting the consistency of the gland, discomfort and soreness. Press on the nipples to identify pathological discharge. In the diagnosis of breast cancer, examination and palpation make it possible to detect a neoplasm in the gland tissue. Instrumental diagnostic methods make it possible to examine the tumor in detail and draw conclusions about its size, shape, and the degree of damage to the gland and surrounding tissues. if breast cancer is suspected, the following is carried out:

• X-ray examination: mammography, ductography.
• Ultrasound of the mammary glands. Ultrasound examination is complemented by examination of regional lymph nodes and Doppler ultrasound.
• Breast biopsy. Subsequent cytological examination of tumor tissue shows the presence of malignant growth.
• Additional diagnostics. Among the newest methods for examining the mammary glands, scintiomammography and microwave RTS can also be noted.

Breast cancer treatment

Breast cancer is one of the most treatable solid malignancies. Small tumors localized in the tissues of the gland are removed, and, often, cases of recurrence of non-metastasized removed cancer are not observed.

Treatment for breast cancer is surgical. The choice of surgery depends on the size of the tumor, the degree of damage to surrounding tissues and lymph nodes.

• Mastectomy. For a long time, almost all women diagnosed with a malignant breast tumor underwent a radical mastectomy (complete removal of the gland, nearby lymph nodes and chest muscles located underneath it). Nowadays, a modified analogue of the operation is increasingly being performed, when the pectoral muscles are preserved (if they are not affected by the malignant process).
• Breast resection. In cases of early stages of the disease and small tumor sizes, a partial mastectomy is currently performed: only the area of ​​the gland affected by the tumor with a small amount of surrounding tissue is removed. Partial mastectomy is usually combined with radiotherapy and shows cure results quite comparable to radical surgery.

Removal of lymph nodes helps reduce the likelihood of recurrence of the disease. After removal, they are examined for the presence of cancer cells. If metastases are found in the lymph nodes removed during surgery, women undergo radiation therapy. Among other things, patients with a high risk of malignant cells entering the bloodstream are prescribed chemotherapy treatment.

There is now a way to identify estrogen receptors in breast cancer cells. They are detected in approximately two thirds of patients. In such cases, it is possible to stop the development of the tumor by using hormone therapy for breast cancer.

Prognosis and prevention

After surgical removal of a malignant breast tumor, women are registered with a mammologist-oncologist, regularly observed and examined to detect relapse or metastases to other organs. Most often, metastases are detected in the first 3-5 years, then the risk of developing a new tumor decreases.

The most reliable measure for preventing breast cancer is regular examination of women by a mammologist, monitoring the condition of the reproductive system, and monthly self-examination. All women over 35 years old should have a mammogram.

Timely detection of pathologies of the genital organs, hormonal imbalances, metabolic diseases, and avoidance of carcinogenic factors help reduce the risk of breast cancer.

Breast cancer is very common in women and its incidence is constantly increasing. This is partly due to improved detection of the disease, but it should be noted that the disease itself has begun to occur more often (approximately 60-70 people per 100,000 women per year). The incidence of morbidity among patients of working age is increasing.

Statistics say that this disease is one of the most common causes of female mortality. Among the regions where there is a fairly high incidence are Moscow, St. Petersburg, the Chechen Republic and the Kaliningrad region.

It is worth noting the successes of healthcare in the fight against breast cancer. In addition to improving the detection of the disease, based on mass preventive studies using mammography, there is a decrease in mortality in the first 12 months after confirmation of the diagnosis. That is, the disease is now detected at earlier stages, it is successfully treated, and the life expectancy of patients with this diagnosis is increasing.

Causes and conditions of development

The direct cause of the disease has not been reliably established, but breast cancer is most likely associated with mutations in certain genes that are inherited. That is, the risk of getting sick increases significantly if two close relatives have breast cancer, as well as ovarian cancer.

More often, pathology occurs in patients with the following concomitant conditions:

• irregularity, abnormal duration of the menstrual cycle, infertility, absence of childbirth, breastfeeding, onset of menstruation before the age of 12 years, at the age of over 60;
• inflammatory diseases of the uterus and ovaries;
• endometrial hyperplasia (for example);
• obesity, high blood pressure, atherosclerosis;
• liver disease and hypothyroidism;
• the patient has a brain tumor, sarcoma, lung cancer, larynx, leukemia, carcinoma of the adrenal cortex, intestines and other tumors associated with syndromes (for example, Bloom's disease).

To reduce the likelihood of illness, you should avoid certain external factors, for example:

• influence of ionizing radiation;
• smoking;
• chemical carcinogens, preservatives;
• a high-calorie diet containing too much animal fat and fried foods.

The role of hormonal imbalance in the female body is high. Diseases of the ovaries, adrenal glands, thyroid and hypothalamic-pituitary systems increase the possibility of breast cancer.

Finally, the role of genetic disorders has been proven. They can be of two types:

• genetic mutation in genes that are responsible for cell growth and reproduction; when they change, cells begin to divide uncontrollably;
• induction of cell proliferation, that is, intensification of their division in the formed node.

Pathology is also registered in men; their ratio to sick women is 1:100. Their symptoms, diagnosis and treatment principles are the same as for female patients, adjusted for gender characteristics of hormonal levels and anatomical structure.

Preventive actions

Prevention of breast cancer is necessary both in healthy women and in those who have a unilateral tumor, to prevent metastasis and spread to the second breast.

Currently, according to foreign and latest domestic recommendations, bilateral breast cancer followed by prosthetics is indicated for the prevention of breast cancer in healthy women. Such an intervention reduces the likelihood of a tumor appearing almost to zero.

However, before surgery for preventive purposes, it is recommended to consult a geneticist, who will confirm the increased risk of developing the disease, given the presence of mutated BRCA1 and BRCA2 genes in the woman.

Surgical removal may be offered to patients with certain precancerous signs:

• atypical ductal hyperplasia;
• atypical lobular hyperplasia;
• lobular carcinoma in situ (unspread).

When tissue is removed directly during the intervention, an emergency histological analysis is performed. If cancer cells are detected, the scope of intervention can be expanded depending on the characteristics of the resulting pathological changes.

The same tactics (removal of a healthy gland for cancer of the second breast) are also indicated for unilateral lesions, if gene mutations are genetically confirmed or there are precancerous conditions.

It is believed that removal of the mammary glands for preventive purposes is indicated even if a woman’s risk of getting the disease is the same as the average population. However, in our country, mass mastectomy is viewed with caution as a means of preventing breast cancer.

Traditionally, three components of prevention are used to prevent breast cancer in Russia.

Primary prevention is carried out in healthy women and includes educating the population and promoting breastfeeding. It is necessary to explain the benefits of regular sexual relations with a regular partner and the timely birth of a child. A woman should avoid external risk factors - radiation, smoking, carcinogens. When planning a family with a person in whose family there have been repeated cases of this tumor in women, it is better to visit a geneticist.

Secondary prevention is aimed at diagnosing and eliminating diseases that can later cause a malignant tumor:

• endocrine disorders;
• diseases of the female reproductive system;
• liver diseases.

For secondary prevention, you should regularly undergo a medical examination with a therapist and gynecologist.

Tertiary prevention is aimed at timely detection of re-development and metastasis of the tumor in a woman who has already been treated for this disease.

Classification

Stages of breast cancer

Depending on how the tumor grows, diffuse and nodular forms of the tumor, as well as atypical cancer (). The rate is characterized by a rapidly growing cancer (the total mass of tumor cells doubles in 3 months), a tumor with an average growth rate (the mass doubles within a year) and a slowly growing tumor (the tumor doubles in size within more than a year) .

The structure of the tumor is determined by its source, therefore invasive ductal (growing from the ducts of the gland) and invasive lobular (growing from glandular cells) cancer and combinations of these forms are distinguished.

Based on their cellular structure, adenocarcinoma, squamous cell carcinoma and sarcoma are distinguished. Malignancy also varies depending on the type of cells.

TNM classification

The classification of this malignant neoplasm is carried out according to the TNM system. According to this classification, the stages of breast cancer are characterized by a certain combination of the qualities of the tumor node itself (T), the involvement of lymph nodes (N) and the presence of metastases (M).

• Stage 0 disease

It is characterized by an extremely small volume of damage without the participation of neighboring tissues.

• Stage 1 disease

It does not metastasize to other organs, except for the possible entry of tumor cells into the lymph nodes of the axillary group on the corresponding side. The diameter of the node does not exceed 2 cm; penetration of its cells into the surrounding healthy tissue does not occur.

• Breast cancer stage 2 (stages)

Does not form metastases, with the exception of possible involvement of the axillary lymph nodes of the corresponding side. The main difference is the characteristics of the node. It can grow up to 5 cm and even penetrate the surrounding glandular tissue.

• Breast cancer stage 3 (stages)

It does not cause metastatic damage to distant organs, but can affect axillary lymph nodes. Other groups of regional lymph nodes lying under the scapula, under the collarbone and above it, near the sternum, may also be involved. In this case, the node can be of any diameter, there is germination into the chest wall, and the skin is affected. The third stage also includes inflammatory cancer - a disease in which thickening of the skin with dense edges without a clearly defined tumor area is noted on the mammary gland.

• Breast cancer stage 4 with metastases

Characterized by the spread of tumor cells to the following organs:

- lungs;
- axillary and supraclavicular lymph nodes on the opposite side;
- bones;
- the walls of the pleural cavity surrounding the lungs;
- peritoneum;
- brain;
- Bone marrow;
- leather;
- adrenal glands;
- liver;
- ovaries.

The most common localization of distant lesions is bone tissue (for example, vertebrae), lungs, skin, and liver.

External signs and symptoms

Types of breast cancer (more precisely, forms):

• nodal;
• diffuse;
• atypical.

The diffuse form includes tumors that affect the entire gland. Externally, diffuse cancer manifests itself:

• swelling and swelling of the gland;
• resembles in features;
• similar to erysipelas;
• causes compaction and reduction of the gland (armored form).

Atypical forms are rarely recorded; they have features of localization and/or origin:

• nipple damage;
• tumor arising from skin appendages;
• two-way education;
• a tumor growing from several centers at once.

Suspicion of breast cancer should appear when a small, dense, painless node forms in the breast. You should pay attention to areas of skin wrinkling or nipple retraction. At the onset of the disease, enlarged axillary lymph nodes are often visible. With intraductal forms, discharge from the nipple appears - light, yellowish, sometimes mixed with blood.

The first signs of breast cancer at an early stage, listed above, as the disease progresses, are supplemented by redness of the skin, the formation of a “lemon peel” on it, enlargement of the tumor, deformation or the appearance of non-healing ulcers. In the axillary region there are conglomerates of immobile lymph nodes, and swelling of the arm develops due to stagnation of lymph in it.

Symptoms for individual types of breast cancer are characterized by their own characteristics.

• Edematous-infiltrative is accompanied by the formation of a large infiltrate - edematous compacted tissue. The gland enlarges significantly, turns red, swells, the skin becomes marbled in color, and a “lemon peel” appears.
• The mastitis-like form is manifested by enlargement and thickening of the gland. An infection occurs, causing tissue breakdown. The temperature rises.
• The erysipelas-like form, upon external examination, is similar to inflammation caused by microflora (erysipelas): bright red lesions on the surface of the gland spreading to the surface of the chest, skin ulcers are often observed.
• Armored is an advanced stage of cancer, in which the gland shrinks, changes shape, and several nodules form in it.
• Paget's cancer is identified as a special variant that primarily damages the nipple and the area around it.

Do breasts hurt with breast cancer?

The pain caused by the tumor itself does not appear at an early stage of the disease. It is associated with swelling of the gland, compression of surrounding tissues, and the formation of skin ulcers. In this case, it is constant, aching, and goes away for some time after taking conventional painkillers.

The pain can also be cyclical, repeating from month to month in women of reproductive age. In this case, they are more associated with the existing precancerous disease - mastopathy and are caused by natural fluctuations in hormone levels. If you experience pain in the mammary gland of any nature, you should consult a doctor.

The earlier the disease is detected, the more effective the treatment will be. The prognosis for stage 1 breast cancer, which can be detected with timely diagnosis, is good. 5 years after confirmation of the diagnosis, survival rate is 98%, after 10 years – from 60 to 80%. This means that almost all women who were diagnosed with the disease at an early stage achieve remission of the disease. Of course, they have to monitor their health and regularly see a doctor.

The more advanced breast cancer is, the lower the survival rate. At stage 2 of the disease, the prognosis is satisfactory, 5-year survival rate is up to 80%, after 10 years - up to 60%. At stage 3, the prognosis is worse: 10-50% and up to 30%, respectively. Stage 4 breast cancer is a deadly disease, the 5-year survival rate is only from 0 to 10%, the 10-year survival rate is from 0 to 5%.

How quickly does breast cancer develop?

The process occurs in each patient at its own speed. Without treatment, the tumor can completely destroy the mammary gland and give distant metastases within a short time - up to a year. In other patients the course is slower. Therefore, at the first signs of trouble, it is necessary to contact a gynecologist or mammologist and undergo the necessary diagnostics.

Diagnostics

Early diagnosis was traditionally based on self-examination of the mammary glands: once a week, a woman carefully felt the glands in front of a mirror, paying attention to discharge from the nipples, skin unevenness, and enlarged lymph nodes. However, in modern guidelines the effectiveness of this technique is questionable. It is believed that a doctor should determine the disease at an early stage using an annual or ultrasound examination (ultrasound).

If a breast tumor is suspected, certain diagnostic interventions must be performed before starting any treatment.

Diagnosis of breast cancer includes the following steps:

• questioning the patient and her complete external examination;
• blood analysis;
• biochemical study, including liver parameters (bilirubin, transaminases, alkaline phosphatase);
• mammography on both sides, ultrasound of the glands themselves and surrounding areas, if necessary, clarifying diagnostics - magnetic resonance imaging (MRI) of the glands;
• digital chest radiography, if more accurate diagnosis is necessary - computed tomography (CT) or MRI of the chest;
• Ultrasound of the liver, uterus, ovaries; according to indications - CT/MRI of these areas with contrast;
• if the patient has a widespread process or metastases, she is prescribed a bone examination to identify tumor foci in them: scanning and radiography of areas of radiopharmaceutical accumulation. If the stage of cancer is proven T 0-2 N 0-1, such a study is carried out if there are complaints of bone pain and an increase in the level of alkaline phosphatase in the blood; even during the patient’s initial visit, the probability of having bone micrometastases is 60%;
• biopsy of the suspected tumor with examination of the resulting tissue; with the help of a biopsy taken before the start of any treatment, a pathological diagnosis is determined - the basis of therapy; a biopsy is not performed if a mastectomy is immediately planned - such an examination will be performed during it;
• determination of receptors for estrogen and progesterone, as well as HER-2/neu and Ki67 - special proteins that can be considered as tumor markers for breast cancer;
• fine needle biopsy of a lymph node if there is a suspicion that the tumor has spread there;
• fine needle biopsy of a cyst if a tumor is suspected of developing there;
• assessment of ovarian activity by determining the appropriate hormones;
• examination by a geneticist to detect a BRCA1/2 gene mutation (breast cancer test) - when breast cancer is confirmed in two or more close relatives, in women under 35 years of age, as well as in case of primary multiple cancer.

To determine the general health of a woman, she is prescribed the following tests and studies:

• verification of blood group and Rh factor;
• isolation of antibodies to Treponema pallidum (), to hepatitis C virus and human immunodeficiency, determination of hepatitis B virus antigen (HBsAg);
• coagulogram to determine blood clotting;
• Analysis of urine;
• electrocardiogram.

Breast cancer treatment

Treatment methods for the disease are varied. The number of their combinations exceeds 6000. The approach to each patient must be individual. A preoperative therapy plan is drawn up to reduce the volume of the tumor, surgical intervention is proposed, and postoperative measures are developed.

Breast cancer treatment methods:

• local (surgery, radiation);
• acting on the entire body (use of chemotherapeutic agents, hormones, immunotropic agents).

Treatment without surgery

It is carried out when the patient refuses more radical measures, her general serious condition, edematous-infiltrative form, but it will never be completely effective and can only temporarily improve the patient’s well-being. This therapy involves radiation.

Radical methods involve complete removal of the tumor and affected lymph nodes. Palliatives are designed to alleviate the patient’s condition. Symptomatic treatment relieves pain and reduces the severity of intoxication symptoms. Traditional recipes for this disease are ineffective.

Surgical intervention

Surgery for breast cancer is the basis of treatment.

The following operations can be performed:

• ordinary radical mastectomy - the entire gland, pectoral muscle, lymph nodes under the collarbone, armpit, under the scapula are removed;
• extended radical mastectomy – additionally, peri-sternal lymph nodes and thoracic vessels, through which metastasis can occur, are removed;
• superradical mastectomy – supraclavicular lymph nodes and tissue between the chest organs are additionally removed;
• modified radical mastectomy preserves the pectoral muscles and has better cosmetic results, so it is considered a more gentle operation;
• mastectomy with removal of axillary lymph nodes of only the lower group - performed in the early phase of the disease with the tumor located in the outer parts of the gland in weakened elderly patients;
• simple mastectomy is a palliative operation that involves removing only the gland; such an operation to remove a tumor is carried out in advanced forms of the disease, decaying formation, severe concomitant diseases;
• radical – removal of only a segment of the gland for a small tumor at an early stage; the mammary gland is preserved; After the intervention, an increased risk of recurrence remains, so additional radiation is performed.

Surgical treatment for metastases to regional lymph nodes must be supplemented with other methods, otherwise there is a high risk of distant metastases and relapse of the disease. Radiation is used both before and after surgery to destroy the most active tumor cells. Methods for irradiating tissue directly during surgery have been developed, which makes it possible to reduce the dose and increase the effectiveness of such therapy.

Chemotherapy

Breast cancer is a tumor prone to metastasis, so almost all patients are prescribed antitumor drugs. The use of chemotherapy significantly reduces the likelihood of relapse and death in patients. Chemotherapy drugs can reduce the stage of the disease, eliminate heavy operations or reduce their volume.

The best medications for treating breast cancer are:

• Cyclophosphamide;
• Fluorouracil;
• Methotrexate;
• Doxorubicin.

Especially in combination. Special schemes have been developed that allow choosing the best option for the patient in each case. Consecutive identical courses can be used (up to 10-12 courses of chemotherapy), and in other cases, after several courses, the drug regimen is changed.

Before chemotherapy, the tumor is tested for sensitivity to hormones. With low hormonal sensitivity, the use of polychemotherapy is recommended, since this is a factor in the unfavorable course of the disease.

Systemic therapy is sometimes not given to patients with an initial favorable prognosis - over 35 years of age, with a small tumor, sensitive to hormones and without lymph node involvement.

A malignant tumor appears as a result of the rapid proliferation of mutated cells of the glandular tissue of the mammary gland. Unlike benign tumors, cancer can spread to neighboring organs. At the initial stage, most often the tumor does not bother the woman. But if, during an independent examination, lumps are detected in the chest, then you should immediately go to the doctor. Lumps in the breast are not necessarily a sign of cancer, but a diagnosis can only be made after an examination by a mammologist.

1. Nodal. It is a compaction measuring 0.5 cm or more. This form is more common than others.
2. Diffuse. Such tumors rapidly increase in size and their configuration changes. The tumor spreads throughout the mammary gland.
3. Nipple cancer. The nipple thickens, enlarges, and ulcers and crusts appear on it. Gradually spreads to the entire gland.

In addition to these forms of cancer, there are also so-called non-cancerous malignancies (sarcomas and metastases spreading from other tumors).

Video: The importance of early diagnosis of breast cancer

Forms and signs of diffuse breast cancer

A diffuse type tumor can exist in the following forms: pseudoinflammatory, erysipelas, or armored.

A pseudoinflammatory tumor is characterized by redness of the skin, increased temperature, and pain in the mammary gland. Tumors of this type are sometimes mistaken for inflammatory diseases. The erysipelas form has the same symptoms; ulcers appear on the skin of the diseased gland. The armored form is characterized by the formation of a crust that tightens the skin of the chest, due to which the size of the gland decreases.

Recommendation: If the skin of the breast becomes red or pain in the back appears (if it is not associated with movement or breathing), you should urgently go to see a mammologist, as these may be hidden symptoms of breast cancer.

Stages of breast cancer and their signs

The development of breast cancer occurs in 4 stages:

1. Zero. These include: ductal carcinoma (the tumor develops inside the milk ducts and does not spread to neighboring organs), invasive lobular carcinoma (consists of cells that form lobules).
2. First. The tumor size is less than 2 cm. The lymph nodes are not affected.
3. Second. The tumor size is up to 5 cm, grows into adipose tissue, can spread to the lymphatic system or remain within the gland. At these stages, the probability of cure is 75-90%.
4. Third. The size of the tumor is more than 5 cm, spreads to the skin of the chest, lymph nodes, and chest.
5. Fourth. The tumor extends beyond the chest, spreading to the bones, liver, lungs, and also to the brain. At this stage, cancer is incurable.

Symptoms of breast cancer in women

Sometimes breast cancer manifests itself only as swelling of the axillary lymph nodes. However, the tumor has no other external signs. It is especially difficult to notice their appearance in large breasts. If the lymph nodes are slightly swollen, painless and move when palpated, then this is not dangerous and may indicate an inflammatory disease. But if they are large, hard, and merge with each other, then this indicates the malignant nature of the tumor and damage to the lymph nodes by metastases.

The first symptoms of a cancerous tumor

The first symptoms of breast cancer can be detected through self-diagnosis. A woman should have her breasts examined monthly. First of all, you need to pay attention to the following signs:

• the appearance of compactions - with cancer they are shapeless, the surface is uneven;
• painful sensations when pressing on the chest;
• asymmetrical arrangement of the mammary glands, violation of the symmetry of the nipples.

Since breast diseases are inextricably linked with diseases of the reproductive system and endocrine glands, indirect signs, such as menstrual irregularities and infertility, should also alert a woman.

The mammary glands can vary in size even in a healthy woman. This sign is worth paying attention to if the sensations in the mammary glands that occur during menstruation intensify in one of them. Such symptoms are also characteristic of mastopathy and fibroadenoma.

One of the signs of the appearance of benign or malignant breast tumors in women is an increase in the size of the lymph nodes. Benign tumors differ from malignant tumors in that the lumps move freely when pressing on the chest, do not fuse with the skin, have a smooth surface and a spherical shape, and are soft to the touch. They consist of overgrown cells of connective or adipose tissue, do not spread to neighboring areas, grow, as a rule, slowly, and may not show themselves for years.

Video: Signs of breast cancer

Characteristic symptoms of a malignant tumor

Symptoms distinguish breast cancer from benign neoplasms:

• rapid increase in the size of seals (from 0.5 to 10 cm);
• retraction of skin areas above the tumor;
• rapid change in external signs (seals become harder, the skin over them becomes rougher, ulcers appear);
• redness of the skin, swelling;
• discharge from the nipple (purulent, mixed with blood);
• nipple retraction;
• change in the surface of the mammary gland, appearance of resemblance to lemon peel.

Video: Unusual signs of breast cancer

Causes of breast cancer

Possible causes of breast cancer include the following:

• chest injuries, surgeries (for mastitis, for example);
• hormonal disorders caused by endocrine diseases, as well as infectious diseases of the genitourinary system and liver;
• disruption of the reproductive system, onset of menstruation at an early age, late onset of menopause, lack of sexual activity during reproductive age, abortion;
• tumor diseases of other organs;
• exposure to radiation.

The factor of heredity plays an important role. Breast cancer is more common in older women than in younger women. The risk of the disease increases in women who smoke and regularly drink alcohol.

Methods for diagnosing breast cancer

To determine the stage of the disease and the possibility of treatment, the tumor is examined using mammography and ultrasound. A biopsy of the tumor tissue is performed. The most accurate method for determining the nature of the tumor, its size, shape, and spread of metastases is MRI. Such information is of particular value before surgery and in the postoperative period.