Nipple cancer

One of the types of malignant tumors of the mammary glands is nipple cancer, or eczema-like Paget's disease. This disease most often occurs against the background of other cancerous formations in the mammary glands, mainly in elderly patients.

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Causes nipple cancer

Experts do not yet know the exact causes of nipple cancer. However, there are two versions of the disease development:

• the transition of the malignant process from the deep tissues of the mammary gland to the areola area;
• atypical degeneration of cells in the areola area.

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

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Risk factors

Risk factors that contribute to the development of breast cancer may include:

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

In short, the main factors that create the preconditions for the development of nipple cancer are: hormonal imbalance – changes in the level of sex hormones, and hereditary predisposition.

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Pathogenesis

Malignant cells in nipple cancer are ductal cells that migrate from the duct into the epidermal tissues of the nipple. This is evidenced by the fact that patients are simultaneously affected by carcinoma, as well as by the same immunochemical processes occurring in the cells of ductal cancer and malignant lesions of the nipple.

Often they talk about malignant degeneration of normal cells of the gland. As a result of such degeneration, the epidermal layer of the nipple area and the underlying breast tissue are affected.

Indeed, electron microscopic data indicated the presence of microscopic villi and functional interactions between keratinocyte cells and nipple cancer cells. In addition, transitional types of cellular structures were found that were something between keratinocytes and Paget cells. This made it possible to explain some of the features of the pathogenesis of the disease, as well as the combined occurrence of several types of cancer in one gland.

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Symptoms nipple cancer

Symptoms of nipple cancer usually include redness and scaling in the areola. The first signs appear as mild irritation and usually do not cause concern in women. Sometimes, after some time, there is even a temporary "recovery", which can also affect the fact that the patient does not seek medical attention in a timely manner. However, the symptoms subsequently increase and become more varied:

• a tingling and itching sensation;
• hypersensitivity of the nipples;
• a feeling of pain and burning;
• ductal discharge.

An inverted nipple in cancer can also be a characteristic sign if the disease has already spread to the ducts and breast tissue.

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

Signs of cancerous lesions may involve only the nipple and areola area, or may be combined with other breast tumors, such as carcinoma. Skin cancer of the nipple may visually "disappear", while the malignant formation inside the organ continues to progress.

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

Nipple cancer also occurs in male patients. However, the clinical picture of the disease is not much different from that in women:

• hyperemia of the nipple;
• scaly;
• ulcers;
• itching of the areola;
• bleeding from the nipple.

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

Complications and consequences

A malignant tumor can grow deep into the gland tissue and into the milk ducts, destroying and squeezing them, disrupting the integrity of blood vessels and nerves. As a result, bleeding and painful sensations can be observed.

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. The inflammatory process - mastitis - can have an extremely negative effect on the course of malignant pathology.

If metastases have begun to spread, complications may arise in the organs where metastases have occurred. The function of the liver, respiratory system, bones, and brain may be impaired.

In severe complications, it is sometimes necessary to resort to symptomatic rather than radical treatment in order to alleviate the patient’s suffering and prolong his life.

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Diagnostics nipple cancer

If nipple cancer is suspected, the first step is to examine a tissue sample from the patient – a biopsy. The specialist examines the material using a microscope, determining the presence of atypical cells. Sometimes immunohistochemistry is used for this method – applying a special contrast agent to facilitate the identification of pathological cells. In addition to a piece of tissue, microscopic examination of liquid secretions from the milk ducts is allowed.

Blood and urine tests are not very informative; in some cases, a blood test for tumor markers is prescribed.

Instrumental diagnostics is represented by the following methods:

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

A scraping from the affected nipple can help in making the correct diagnosis. This procedure is carried out by a specially trained doctor - a cytopathologist.

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Differential diagnosis

Differential diagnostics are mainly carried out with skin diseases of the peripapillary region: herpes, mycosis fungoides, syphilis of the mammary glands, psoriasis, dermatitis. For this reason, a consultation with a dermatologist is often required.

Treatment nipple cancer

The most radical and widespread method for eliminating a cancerous tumor is surgical treatment. The scale and method of surgery directly depend on the stage of the malignant process.

Resection of the gland may be used when a cancerous tumor or carcinoma is diagnosed. The operation involves complete or partial removal of the gland and some nearby lymph nodes. But most often, in the case of nipple cancer, the area around the nipple is removed, subject to subsequent radiation therapy (to prevent relapse).

Radiation therapy is a procedure that helps control tumor growth. The use of external gamma irradiation sometimes allows patients who have contraindications to surgery to avoid surgery. In the early stages of nipple cancer, gamma irradiation can be prescribed as an independent treatment method (for locally advanced malignant processes).

Chemotherapy is prescribed for two main reasons:

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

Most often, medications are prescribed:

• young patients;
• in case of receptor hyposensitivity;
• in case of multicentric tumor growth;
• in case of aggressive malignant tumor.

Chemotherapy is also mandatory in the presence of metastases in the nearest lymph nodes. The optimal use of anthracyclines and taxanes - drugs of choice are often such as Taxol and Paclitaxel.

Chemotherapy drugs are almost never used independently, but only in combinations. A significant disadvantage of such treatment is the large number of side effects. For example, in 80% of cases, nausea and vomiting, loss of appetite occur. However, there are a number of drugs that reduce the severity of such manifestations. You should consult a doctor about the advisability of their use.

In some cases, hormone therapy is prescribed to treat nipple cancer - this allows to significantly increase the survival rate of patients. The most commonly used drugs are Nolvadex, Tamoxifen, Zitazonium. Hormonal drugs can be used only if the tumor has receptors sensitive to steroids.

Folk remedies can only be used as a supplement to the main treatment method prescribed by a doctor. Nipple cancer is considered one of the most malignant forms of breast cancer, so it is strongly not recommended to choose herbal treatment instead of traditional therapy.

For your 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 calamus rhizome - an infusion is prepared from the listed herbs (for 5 g of the mixture - 1 glass of boiling water). Take for 2-3 months before meals, 200 ml per day;
• Eleutherococcus extract is taken in the morning, 1 teaspoon, can be mixed with liquid;
• tea made from chamomile, aloe and Kalanchoe juice – drink twice a day;
• a decoction of oak bark (1 tbsp. bark per 200 ml of boiling water, boil for half an hour) is used for compresses in the morning and at night, for 60-90 days.

Many people wonder: does homeopathy help with nipple cancer? Let's be honest, there is currently no reliable data on the positive effect of any homeopathic remedies for the treatment of such cancers. If you practice homeopathy, it still makes sense to consult with a doctor who adheres to traditional methods of treatment.

Prevention

The main method of prevention is considered to be minimizing the effect of provoking factors. Therefore, it is recommended to adhere to the following recommendations.

• It is necessary to use hormonal contraceptives wisely, take breaks from taking them, and consult a doctor.
• Abortions should not be allowed to take place, as abortion is a huge burden on a woman’s hormonal background.
• Having a child before the age of 30 is encouraged, as is full breastfeeding.
• It is highly undesirable to have bad habits such as smoking, drinking alcohol, etc.
• It is very important to conduct regular breast examinations, including breast self-examination.

It is also advisable to visit a doctor regularly - a gynecologist, a mammologist. All these measures in combination will allow you to promptly prevent or detect any diseases of the mammary glands and take appropriate measures.

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Forecast

Since nipple cancer is not always detected in the early stages of development, the further prognosis can only depend on the correct diagnosis and timeliness of the treatment. Of course, the possibility of a relapse of the disease even after surgery is not excluded, since this cancerous tumor is quite aggressive.

The following are considered prognostic criteria:

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

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

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