Cancer of the nipple

One of the varieties of malignant breast tumors is nipple cancer, or Paget's eczematic disease. This disease most often occurs against the background of other cancers in the mammary glands, mainly in elderly patients.

[1], [2], [3], [4], [5]

Causes of the nipple cancer

Experts do not know the exact reasons for the appearance of nipple cancer. However, there are two versions of the development of the disease:

• the transition of the malignant process from the deep tissues of the breast to the parotid zone;
• atypical cell degeneration in the paranasal zone.

The first version is due to the fact that more than 90% of patients with nipple cancer have cancer in other areas of the breast. This suggests the possibility of spreading the malignant process from internal tissues to external ones.

[6], [7], [8], [9], [10]

Risk factors

The risk factors that favor the development of a breast cancer tumor can be:

• an unfavorable family history (a cancer of the gland in the immediate family);
• early sexual development;
• late menopause;
• primary infertility;
• presence of cystic formations and foci of hyperplasia in one of the glands.

In short, the main factors that create the prerequisites for the occurrence of nipple cancer are: hormonal imbalance - a change in the level of sex hormones, and hereditary predisposition.

[11], [12], [13], [14]

Pathogenesis

Malignant cells in nipple cancer are cells from ducts that migrate from the duct to the epidermal tissues of the nipple. Evidence of this is the facts of the combined defeat of carcinoma patients, as well as the same immunochemical processes occurring in the cells of the protocol cancer and malignant nipple lesions.

Often speak about malignant degeneration of usual cells of a gland. As a result of this degeneration, the epidermal layer of the nipple zone and the underlying breast tissue are affected.

Indeed, the data obtained using an electron microscope indicated the presence of microscopic villi and the functional interaction of keratinocyte cells and nipple cancer cells. In addition, transitional types of cellular structures were found, which are a cross between keratinocytes and Paget cells. This allowed to explain some features of the pathogenesis of the disease, as well as the combined course of several types of cancer in one gland.

[15], [16], [17], [18], [19], [20], [21]

Symptoms of the nipple cancer

Symptoms of nipple cancer are usually the appearance of redness and scales in the paranasal zone. The first signs are manifested in the form of mild irritation and usually do not cause concern for a woman. Sometimes, after some time, even a temporary "recovery" occurs, which can also affect the fact that the patient does not turn to the doctor in time. However, the symptomatology subsequently increases and becomes more diverse:

• sensation of tingling and itching;
• hypersensitivity of nipples;
• feeling of soreness and burning;
• ductal discharge.

A retracted nipple in cancer can also be a characteristic feature if the disease has already spread to the ducts and tissue of the breast.

Approximately in every second patient with a nipple cancer, a gland is found in the gland, which is a sign of the further spread of the malignant process.

Signs of cancer can only cover the nipple and areola area, or be combined with other mammary tumors, for example, with carcinoma. Skin cancer of the nipple can visually "disappear", while malignant formation within the body continues to progress.

In addition to the main signs of the tumor, metastases are often found in the axillary lymph nodes.

Nipple cancer also occurs in male patients. At the same time, the clinical picture of the disease differs little from that of women:

• hyperemia of the nipple;
• scaly;
• sores;
• itching of the parotid zone;
• bleeding nipple.

True, nipple cancer is diagnosed in men not so often, due to the atypical nature of this disease.

Complications and consequences

Malignant tumor can germinate deep into the gland tissues and into the milk ducts, destroying and squeezing them, disrupting the integrity of blood vessels and nerves. As a result, bleeding and pain can occur.

In addition, nipple cancer can be complicated by an infectious process. Most often this occurs when ulcers and erosions appear on the surface of the skin. Inflammatory process - mastitis - can have an extremely negative impact on the course of malignant pathology.

If the spread of metastases has begun, complications can occur in the organs where the metastasis has occurred. The function of the liver, respiratory system, bones, brain may be impaired.

In severe complications, sometimes it is necessary to resort not to radical, but to symptomatic treatment, in order to alleviate the suffering of the patient and prolong his life.

[22], [23], [24], [25]

Diagnostics of the nipple cancer

If a nipple cancer is suspected, the patient's tissue sample is examined first - a biopsy. The expert considers the material using a microscope, determining the presence of atypical cells. Sometimes immunohistochemistry is used for this method - applying a special contrast in order to facilitate the identification of pathological cells. In addition to a piece of tissue, microscopic examination of liquid secretions from the milk ducts is permissible.

Analyzes of blood and urine are of little informative, in some cases prescribe a blood test for oncomarkers.

Instrumental diagnostics is represented by the following methods:

• Ultrasound is used most often, since it is a safe method that provides the doctor more information than radiography;
• mammography is used to diagnose cancer in older patients, since the method involves the use of X-rays;
• the method of magnetic resonance imaging helps to detect a tumor even when the changes in the nipple are not so noticeable.

Help in setting the right diagnosis can scrape off the affected nipple. This procedure is carried out by a specially trained doctor - a cytopathologist.

[26], [27], [28], [29]

Differential diagnosis

Differential diagnosis is carried out mainly with skin diseases of the nasal region: herpes, mushroom mycosis, mammary syphilis, psoriasis, dermatitis. For this reason, a consultation of a dermatologist is often required.

Treatment of the nipple cancer

The most radical and common method for eliminating a cancer is surgical treatment. The scale and mode of operation directly depends on the stage at which the malignant process is located.

Resection of the gland can be used to diagnose a cancer or carcinoma. The operation is a complete or partial removal of the gland and some of the nearest lymph nodes. But most often the nipple cancer removes the nasal region, subject to subsequent radiotherapy (to prevent relapse).

Radiation therapy is a procedure through which it is possible to control the growth of a tumor. The use of remote gamma irradiation sometimes avoids surgery for patients who have contraindications to it. In the early stages of nipple cancer, gamma irradiation can be prescribed as an independent treatment method (with locally advanced malignant process).

Chemotherapy is prescribed for two main reasons:

• to prevent metastases;
• for the localization of the tumor process before proceeding to other methods of treatment (for example, to surgery).

Most often, drugs are prescribed:

• young patients;
• at hypersensitivity of receptors;
• with multicentric tumor growth;
• with an aggressive-malignant tumor.

Also, chemotherapy is mandatory in the presence of metastases in the nearest lymph nodes. Optimal use of anthracyclines and taxanes - drugs of choice are often such drugs as Taxol and Paclitaxel.

Preparations for chemotherapy are almost never used on their own, but only in combinations. A significant disadvantage of this treatment is a large number of side effects. For example, in 80% of cases there is nausea and vomiting, loss of appetite. However, there are a number of means that reduce the severity of such manifestations. The advisability of their use should be consulted by a doctor.

In some cases, hormone therapy is prescribed to treat nipple cancer - this can significantly improve patient survival. More commonly used drugs such as Nolvadex, Tamoxifen, Zitazonium. The hormone-containing preparations can be used only in the presence in the neoplasm of receptors sensitive to steroids.

Alternative treatment can be used only as an addition to the main method of treatment prescribed by the doctor. Nipple cancer is considered to be one of the most malignant forms of breast cancer, therefore it is strongly advised not to choose herbal therapy instead of traditional therapy.

As information, we offer you several recipes that herbalists use to treat nipple cancer:

• 20 g of wormwood, 20 g of yarrow, 20 g of celandine, 40 g of sophora, 20 g of sweet clover, 40 g of birch buds, 30 g of rhizome of calamus - of these herbs are prepared with infusion (5 g of mixture - 1 glass of boiling water). Take for 2-3 months before meals, 200 ml per day;
• extract eleutherococcus take in the morning for 1 tsp, can be mixed with liquid;
• tea from chamomile, aloe juice and colanchoe - drink twice a day;
• broth from the oak bark (1 tbsp bark for 200 ml of boiling water, cook for half an hour) is used for compresses in the morning and at night, for 60-90 days.

Many are wondering: does homeopathy help with nip cancer? Let's say directly that at the moment there is no reliable data on the positive effect after the application of any homeopathic remedies for the treatment of such cancerous tumors. If you practice homeopathic treatment, it still makes sense to consult a doctor who adheres to traditional methods of treatment.

Prevention

The main method of prevention is to minimize the effect of provoking factors. Therefore, it is recommended that you follow the following recommendations.

• It is necessary to use the hormonal contraceptives reasonably, take breaks in their reception, consult a doctor.
• Do not allow abortion, since abortion is a huge burden on the hormonal background of a woman.
• The birth of a child up to the age of 30 years is welcome, as well as full-fledged breastfeeding.
• It is extremely undesirable to have bad habits, such as smoking, drinking alcohol, etc.
• It is very important to conduct a periodic examination of the mammary glands, including breast self-examination.

It is also desirable to visit a doctor regularly - gynecologist, mammologist. All these measures in the complex will allow timely warning or detect any diseases of the mammary glands and take appropriate measures.

[30], [31], [32], [33], [34],

Forecast

Due to the fact that the nipple cancer is not always found in the early stages of development, a further prognosis can depend only on the correct diagnosis and timeliness of the treatment started. Of course, the possibility of a repeated outbreak of the disease is not ruled out even after an operative intervention, since this cancer tumor is quite aggressive.

Prognostic criteria are:

• stage of tumor;
• age category of the patient;
• number of affected lymph nodes;
• presence of other mammary tumors;
• degree of aggressiveness of the tumor.

The average life expectancy of patients diagnosed with nipple cancer is three years, and in the presence of metastases, 1 year.

[35], [36]