Infiltrative breast cancer

What is infiltrating breast cancer and how is it different from other breast cancers?

This type of cancer is characterized by an extremely aggressive course. Cancer cells spread very quickly through the blood and lymphatic system to the lymph nodes, muscles, liver, joints and bones, kidneys, and respiratory organs. Metastases in infiltrative cancer have their own peculiarity: they can latently exist for a fairly long period of time, without revealing themselves, and begin to grow and multiply sometimes ten years after the complete removal of the initial malignant formation.

We will talk about other features and characteristics of this dangerous disease in this material.

ICD 10 code (diagnosis code):

• C 50 – malignant neoplasms in the mammary gland.
  • C 50.0 – nipple and areola area.
  • C 50.1 – central area of the mammary gland.
  • C 50.2 – inner-upper quadrant.
  • C 50.3 – inner-lower quadrant.
  • C 50.4 – outer-upper quadrant.
  • C 50.5 – outer-lower quadrant.
  • C 50.6 – armpit area.
  • C 50.8 – the process has spread to two or more of the above-mentioned zones.
  • C 50.9 – unspecified location.

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Causes infiltrative breast cancer

Unfortunately, the exact pathogenesis of infiltrative cancer has not been studied to date. There are some versions according to which the following factors can contribute to the development of cancer:

• increased sensitivity of receptors to estrogen or progesterone;
• participation of some specific genes in tumor formation;
• disruption in the signaling pathway system: in the regulation of the inflammatory process, chemotaxis and the adhesion process.

It was also possible to identify the main risk factors for the development of pathology:

• unfavorable heredity, when one of the relatives on the female line suffered from malignant breast disease;
• woman's age after 40 years;
• hormonal imbalance in the body, long-term use of hormonal drugs, lack of pregnancy, frequent abortions, early puberty, late menopause, etc.

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Symptoms infiltrative breast cancer

In the vast majority of cases, the disease proceeds practically without symptoms. Of course, some patients notice external suspicious phenomena, but often the tumor is discovered by chance, during a preventive examination.

The first signs that should alert a woman are the appearance of a dense swelling with unclear contours, fused with nearby tissues, as well as retraction of the nipple and areola. The swelling can have different sizes, from 1 to 10 cm, but this size tends to increase rapidly.

The following symptoms of the disease should not be ignored:

• changes in the volume, boundaries and shape of the gland;
• palpation of a compacted area or node that remains unchanged throughout all phases of the monthly cycle;
• visible changes in the skin in the areola area, or on the mammary gland as a whole;
• the appearance of areas of redness on the skin of the gland;
• the appearance of discharge from the milk ducts, possibly mixed with blood;
• characteristic "marbling" of the skin of the affected breast.

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Forms

• Edematous infiltrative breast cancer (inflammatory cancer) is observed in approximately 5% of cases of all known forms of breast cancer. The disease is characterized by the distribution of malignant tissue in the breast in the form of infiltrate and swelling of the skin. Since it is impossible to palpate an obvious node or compaction, this pathology is quite difficult to diagnose - as a rule, in the initial stages, a cancerous tumor is mistaken for secondary swelling of the skin due to an inflammatory process. Edematous infiltrative cancer is characterized by relatively slow growth and a latent course.
• Infiltrative ductal breast cancer (carcinoma) is considered one of the most common malignant breast tumors. As the name suggests, the disease begins to develop in the inner surface of the milk ducts. The tumor most often spreads to other tissues and skin of the affected gland, and also metastasizes to the nearest lymph nodes. In addition, degenerated cells often involve the fatty layer of the axillary zone in the process (via lymph and blood flow).
• Infiltrative lobular breast cancer occurs as a consequence of advanced lobular cancer, and the tumor can spread in various ways. Most often, individual cellular elements are involved in the process, which seem to separate from the alveoli or glandular complexes. The affected cells are located in the form of chains along connective tissue structures, sometimes localizing near intact intralobular ducts. They can also be located diffusely. Detection of this type of tumor in the early stages is somewhat difficult.
• The term "infiltrative non-specific breast cancer" includes those types of cancer that can be encountered in extremely rare cases. For such neoplasms, there are also differences in the treatment and prognosis of the disease. Non-specific types of cancer include colloid cancer, low-grade tumors, and squamous cell metaplasia.

Complications and consequences

Unfortunately, infiltrative breast cancer can lead to the following complications:

• spread of metastases (daughter cells of the tumor) through the lymph into the axillary region, into the parasternal, supraclavicular lymph nodes, retrosternal and mediastinal lymph nodes, into the second breast. Through the blood, metastasis can occur into the pleura, lungs, musculoskeletal system (primarily into the bones of the ribs, pelvis, vertebrae, femur), as well as into the liver tissue, into the appendages, adrenal glands, and brain;
• problems with motor ability in the shoulder area, upper limb on the affected side;
• phenomena of lymphostasis of the upper limb;
• recurrence of cancer (after about 5-10 years).

Without treatment, there is a spread of nearby and distant metastases, damage to other organs and systems, tumor disintegration, and death.

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Diagnostics infiltrative breast cancer

• As with any diagnostics, the patient's examination begins with collecting information about the history of the disease. The doctor finds out information about the presence of a hereditary predisposition, previous gynecological diseases, injuries and diseases of the breast. Next, a visual examination of the glands is carried out, where special attention is paid to the density, size, shape, mobility, and limitation of the breasts. In addition, the doctor checks the condition of the nearest subclavian and supraclavicular, as well as axillary lymph nodes.
• Instrumental diagnostics are mandatory. One or more research methods can be used:
  • X-ray method (mammography) is performed in two projections (mediolateral and craniocaudal projection). This method allows to recognize tumors from 0.5 cm in size, as well as microcalcifications (one of the reliable signs of oncology). Another method based on the use of X-rays - galactography - is rarely prescribed. It is used when secreting from the nipple;

• ultrasound examination in the presence of a single cancerous tumor indicates a deterioration in the transmission of ultrasound in the area of the neoplasm;
• Magnetic resonance imaging with the use of a contrast agent is used mainly to detect relapses, as well as to assess the condition of the glandular tissue in the presence of an implant;
• thermography - this method is based on the phenomenon of hyperthermia in the area of malignancy. It is rarely used;
• A biopsy is a puncture or resection of a neoplasm with the collection of material for further histological examination. Histology will not only indicate the degree of malignancy of the tumor, but will also help determine its receptor status.
• Laboratory tests (analyses) include the determination of tumor markers (pathology control values) and an assessment of hormone levels in the body. As a rule, an analysis is performed for the content of prolactin, LH, FSH and estrogen.
• Additional tests may include chest x-ray, CT scan, scintigraphy, and abdominal ultrasound.

Differential diagnostics are carried out with mastopathy, benign neoplasms, abscesses, cysts, sarcoma, malignant lymphoma.

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Treatment infiltrative breast cancer

A comprehensive approach to treatment should combine several treatment options:

• surgical and radiation treatment;
• chemotherapy and hormonal therapy.

Hospitalization of the patient is mandatory.

Non-drug therapy

Radiation therapy is rarely prescribed as a stand-alone treatment. It is mainly an additional method used in a comprehensive approach. Radiation therapy may be prescribed after conservative or surgical treatment to prevent recurrence of the tumor process. Radiation therapy is used immediately after surgery or in combination with medications, but no later than six months after surgery.

Chemotherapy and drugs

Chemotherapy is one of the options for systemic breast therapy and is used in the vast majority of cases. Cancer treatment drugs are prescribed without fail in the following cases:

• in the presence of metastases in the lymphatic system;
• if the tumor size exceeds 2 cm;
• if the patient is under 35 years old;
• if the malignancy of the tumor is determined to be between grade II and IV;
• for receptor-negative (non-hormone-dependent) tumors.

Medicines can be used in the following combinations:

• regimen with cyclophosphamide, methotrexate, 5-fluorouracil;
• regimen with Adriamycin and cyclophosphamide;
• regimen with 5-fluorouracil, adriamycin and cyclophosphamide;
• combination of anthracyclines and taxanes.

The additional use of agents such as Trastuzumab and Bevacizumab may increase the effectiveness of chemotherapy.

Hormone therapy is rarely used as a stand-alone treatment, but its effect in combined and complex courses of therapy is undeniable. The following types of hormone therapy are most often used:

• using estrogen-competing drugs;
• using agents that reduce estrogen production.

Among antiestrogenic agents, Tamoxifen is considered the most common drug. It is a substance that competes with estrogens, providing control over cellular receptors.

The second group of drugs includes aromatase inhibitors, which helps reduce endogenous estrogen levels. Typical representatives of this group are Anastrozole and Letrozole.

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Surgical treatment

For infiltrative breast cancer, the following types of surgical treatment may be prescribed:

• standard radical mastectomy (chest muscles are preserved, there is a possibility of further primary plastic surgery of the gland);
• mastectomy with preservation of the areola and the possibility of further primary breast plastic surgery;
• organ-preserving surgery with subsequent irradiation
• radical resection (tumorectomy with lymph node dissection), in combination with radiation and drug treatment.

Radical mastectomy with preservation of the chest muscles is performed at early stages of tumor development or when it is in a central position. During the operation, the tissue in the axillary, intermuscular, subclavian and subscapular areas is removed. Breast plastic surgery can be performed directly with this operation.

Patients with inoperable forms of cancer undergo palliative surgery aimed at alleviating their condition and prolonging life expectancy.

Homeopathy

Homeopathic medicines are often used by medical professionals to improve the effectiveness of rehabilitation of patients after surgical interventions, to prevent relapses, to strengthen and fortify the body's immunity. The following medicines are prescribed for oral administration:

• Galium-heel;
• Psorinocheel;
• Lymphomyosot;
• Phosphorus Homaccord.

The drugs are taken 10 drops 6 times a day. After 2 months, they switch to taking 10 drops 4 times a day, and after another 2 months - 3 times a day. Additionally, injections of drugs such as Nux vomica-Homaccord, Hepeel, Berberis-Homaccord, Helidonium-Homaccord can be prescribed, which promote the removal of toxic substances from the body.

Diet

Changes in the diet of patients with infiltrative breast cancer are aimed at maintaining normal body weight, strengthening the body's defenses, and ensuring a full supply of nutrients. When making a daily menu, it is recommended to adhere to the following rules:

• monitor the calorie content of food, do not overeat;
• eat more cereals, plant foods, fiber;
• When choosing bread, give preference to dark varieties;
• limit the consumption of animal fats, giving preference to vegetable fats;
• consume sufficient amounts of foods rich in calcium and vitamin D;
• avoid drinking alcohol;
• limit consumption of sweets, sugar, artificial additives;
• It is better to replace red meat with white meat.

In addition, it is recommended to follow a drinking regimen - drink clean, non-carbonated water in sufficient quantities. Unsweetened green tea is also useful.

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Folk remedies

Traditional medicine methods are most often used in the following cases:

• when treatment with traditional methods does not bring the expected result;
• when it is necessary to enhance the effectiveness of traditional treatment methods.

Of course, you shouldn’t expect miracles from folk remedies, but in many cases they won’t be superfluous.

Often, folk recipes provide for treatment with herbs that contain toxic substances. This must be taken into account in order not to harm your body - it is important to strictly adhere to the dosage indicated in the recipe.

It is also not recommended to take several folk remedies at the same time - switch to other tinctures or decoctions when you have completed the course of previous medications.

• Potato flower infusion. One tablespoon of dried flowers is poured with 500 ml of boiling water and infused for at least 3 hours in a thermos. Filter and squeeze, store in a glass jar in the refrigerator. Take three times a day half an hour before meals, 160 ml. The duration of the first course of treatment is 14 days. Treatment can be continued after a week's break. The total duration of treatment is six months.
• Birch mushroom infusion. Grated mushroom is infused for 2 days in warm boiled water at the rate of 1 part mushroom - 5 parts water. After 2 days, the infusion is filtered and taken three times a day, half an hour before meals. Store in the refrigerator for no more than 4 days.
• A tincture of the plant golden mustache has a good effect. Mix 30 ml of tincture (45 shoots per 1.5 liters of 40% alcohol) and 40 ml of unrefined sunflower oil, drink in one gulp. Repeat this three times a day 20 minutes before meals. The systematic intake is as follows: 10 days of treatment - 5 days of break, then 10 days of treatment - 10 days of break. Take the medicine this way for 3 months.
• Before and after surgery, it is recommended to take an infusion of 100 g of nettle, 100 g of plantain, 50 g of vegetable thistle, 50 g of wolfberry, 50 g of knotweed, the same amount of rue, St. John's wort and acacia flowers. One teaspoon of the mixture is poured with 250 ml of boiling water. Infuse for half an hour and drink 1 glass twice a day.
• Nettle honey. Grind equal parts of nettle leaves and walnuts in a coffee grinder. Mix three tablespoons of the crushed raw material with ½ kg of liquid honey. This honey can be added to dishes and drinks.
• Sea buckthorn oil helps well. It is taken up to 5 times a day, 1 tablespoon at a time, gradually dissolving in the oral cavity.
• Wormwood tincture. To prepare the tincture, take 200 ml of vodka per 20 g of dried herb, leave for one week, then put on low heat and evaporate by 1/3. Cool and use 1 teaspoon three times a day before meals.
• It is also recommended to drink fresh pomegranate juice, 200 ml per day – this can slow down the development of tumor cells.

Treatment with folk methods is recommended to be agreed with the attending physician. If during treatment you feel worse, stop treatment and immediately consult a doctor.

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Prevention

Preventive examinations and ultrasound examinations of the mammary glands should be carried out annually, starting from the age of 20.

In addition, a monthly self-examination of the breasts is important, which is carried out by the woman herself approximately on the 6th-10th day of the monthly cycle.

After the age of 50, mammography is recommended (once every 2 years, and after the age of 60 – once every 3 years).

In case of increased risk (unfavorable heredity or previous breast diseases), the listed measures are carried out more often. For example, to prevent the recurrence of cancer, patients should visit a doctor for a comprehensive examination once every six months for the first two years (then - once a year).

Also, in case of hereditary predisposition, it is recommended to periodically take blood tests for tumor markers, starting from the age of 25.

In order to maintain breast health for many years, a woman is advised to adhere to the following preventive principles:

• maintain normal body weight, especially after the age of 40;
• do not smoke or abuse alcohol;
• avoid a sedentary lifestyle, be active, walk in the fresh air more often, do physical exercises;
• do not deprive yourself of the joy of motherhood and do not stop breastfeeding prematurely;
• consume enough vitamins that are found in plant foods – vegetables, fruits, greens, berries, nuts and seeds;
• eat less junk food and red meat;
• Conduct monthly breast self-examinations.

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Forecast

According to statistics, about half of patients die from infiltrative breast cancer. The average five-year survival rate is about 75%, which depends on the stage of the disease at which it was detected. Also, the success of treatment directly depends on the presence of metastases and damage to the lymphatic system.

The earlier a malignant tumor is diagnosed, the more favorable the prognosis.

After surgery, particularly careful monitoring of health is required, since the risk of relapse may be present for about 10 years.

The duration of the patient's disability after the operation depends on the scale of the intervention and the volume of chemotherapy and radiation therapy. The shortest period of a woman's stay in hospital is from 18 to 21 days.

The decision on the patient's further ability to work must be made by the doctor. In most cases, the woman returns to her previous lifestyle in 5-6 months.

Infiltrative breast cancer is a common and dangerous disease. It should not be forgotten that tumor prevention can be started at any age. Make useful changes in your life today so that in the future there will be no reason to worry about your health.

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