Invasive breast cancer

Invasive breast cancer is a disease characterized by the spread of the tumor to the lymph nodes and other organs and tissues.

Let's consider the features of the pathology, the main symptoms, diagnostic methods, treatment and prognosis for recovery.

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Causes invasive breast cancer

Invasive cancer develops from epithelial cells and extends beyond a certain structure. For example, invasive ductal cancer develops from atypical cells in the walls of the milk duct. But the tumor does not remain within the lobule, but penetrates it, affects fat and other tissues. That is, the malignant formation grows into normal, healthy tissues, affecting them. The tactics of treatment and its effectiveness depend on the invasiveness or non-invasiveness of the tumor. Invasive or infiltrative cancer is carried with the bloodstream through the lymphatic vessels, organs and tissues of the body.

Breast cancer can occur in any person, no one is immune from this pathology. The disease does not depend on age, ethnic group or gender. But it occurs most often among women. The female breast consists of fat, connective and fibrous tissue, glands, ducts and 15-20 lobules. The breast also contains lymphadenitis, which protects the body from pathologies, traps bacteria, harmful substances and cancer cells.

The causes of invasive breast cancer depend on many factors. The disease develops against the background of precancerous diseases of the body, for example, mastopathy or fibroadenoma. Let's consider in more detail the causes of invasive malignant breast lesions.

Mastopathy

One of the causes of cancer is mastopathy. This is a pathological condition of the gland that occurs due to hormonal imbalance in the body. Most often it occurs in women aged 30-40 years. With mastopathy, pain bothers constantly and can be accompanied by discharge from the nipples. Tumor-like nodules appear in the breast (they are denser in structure than the tissues of the gland). In the future, this leads to more serious deformations and changes in the tissues of the organ and, as a result, invasive cancer.

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Fibroadenomas

This pathology most often occurs in girls and young women. Benign nodular formations appear in the breast - dense round nodules with a smooth surface. But due to hormonal imbalance, injuries or lack of treatment, the neoplasms begin to increase, affect healthy tissue and transform into a cancerous tumor.

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Abortion

Termination of the first pregnancy leads to inflammation of the uterine appendages, hormonal imbalance and even infertility. Abortion not only terminates pregnancy, but also causes the reverse development of glandular cells in the breast. This leads to the formation of seals, from which invasive cancer develops.

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Lactation

The causes of invasive breast cancer include refusal to breastfeed. This leads to the appearance of lumps that can become malignant. Irregular sexual activity or its absence disrupts the hormonal balance in the body, which negatively affects the condition of the mammary glands and the entire reproductive system as a whole.

Symptoms invasive breast cancer

Symptoms of invasive breast cancer vary. Some women experience no symptoms at the early stages of the disease. Others experience discomfort and pain when trying to palpate their mammary glands.

That is, the symptoms of malignant breast diseases are individual for each woman. But there are a number of warning signs that can signal cancer.

• A small lump or swelling that persists throughout the menstrual cycle.
• The breasts change in size, contour, or shape.
• Bloody or clear liquid discharge appears from the nipples, causing painful sensations or burning.
• A change in skin color on the nipple or gland, that is, a distinct difference in the area on the chest.
• Changes in skin appearance: wrinkled skin, inflammation, flaking, marbled areas.

Changes of this kind can be diagnosed independently by examining and palpating the breast. Invasive breast cancer can manifest itself at any age, but older women are at risk. According to medical statistics, invasive cancer is diagnosed in 1 in 8 women aged 45 and in every 3 over 55.

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Forms

Some types of breast cancer begin in the glands themselves, but most begin in the ducts and channels that connect the lobules to the nipple. There are several types of invasive cancer, and we'll look at them:

• Invasive ductal carcinoma – develops in the milk ducts. Cancer cells gradually affect fatty tissue and can enter the lymphatic system and bloodstream. This type of disease quickly metastasizes to organs and tissues. Ductal carcinoma is the most common type of invasive breast disease and accounts for 80% of all malignant diseases.
• Preinvasive ductal carcinoma – develops and remains in the milk ducts, does not affect adjacent tissues and organs. Without early diagnosis and effective treatment, it can develop into an invasive ductal form.
• Invasive lobular breast cancer – occurs in 15% of cases of invasive cancer. It develops in the lobules and ducts and can metastasize throughout the body, affecting healthy organs and tissues. The main symptom of the pathology is pain in the mammary gland and a lump determined by palpation.

Invasive ductal carcinoma of the breast

Invasive ductal breast cancer is the most common type of malignant breast disease. It develops in the milk ducts and has a huge number of different types of structure, which depend on the constituent cells. The degree of differentiation of tumor cells plays an important role in the development and treatment of cancer.

Most often, ductal cancer occurs in older women. The tumor does not manifest itself for a long time, even with palpation it is not always possible to feel the seal, much less determine its adhesion to the tissues and displacement. With further progression, the cancer spreads to the peripapillary area, which leads to deformation of the shape of the nipple or areola, discharge of different colors and consistencies. Let's consider the main types of invasive ductal breast cancer.

• Highly differentiated

It consists of small monomorphic cells that develop inside the duct in the form of cribriform, micropapillary and other structures. The cells have nuclei of the same size and rare mitotic figures. Descended cells may appear inside the affected ducts, which indicate tissue necrosis.

• Intermediate degree of differentiation

Cancer cells are similar to low-grade invasive breast cancer, form various structures and may contain intraductal necrosis. This category includes tumors with an intermediate degree of nuclear apathy, while necrosis may be absent or present.

• Low-differentiated

The neoplasm may be more than 5 mm in diameter and consists of morphological structures typical of intraductal cancer. Tumor cells line the entire surface of the duct, forming cribriform, micropapillary and other structures. This type of cancer is characterized by the presence of necrotic masses, i.e. comedonecrosis.

I diagnose invasive ductal carcinoma using mammography. If the doctor considers the results of the study unreliable to confirm a malignant disease, the woman undergoes a biopsy. In the case of ductal lesions of the breast, fine-needle aspiration biopsy and thick-needle biopsy are used to collect tissue from suspicious areas of the gland. The resulting samples are examined under a microscope and checked for the presence of hormonal receptors. Please note that a biopsy is performed for diagnosis, not tumor removal.

The diagnosis of invasive ductal carcinoma is life-threatening. Without timely treatment, the tumor metastasizes throughout the body, affecting healthy organs and tissues. Treatment consists of surgical removal of the tumor, radiation therapy, and chemotherapy. In addition, a woman may be prescribed hormonal therapy to prevent relapses of the disease or the degeneration of cancer into another form.

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Lobular invasive breast cancer

Lobular invasive breast cancer accounts for 15% of all cases of breast cancer. It is most often diagnosed in elderly women, and half of them have symmetrical lesions of both glands. The pathology is characterized by high multicentricity - 60-80% and bilateral lesions - 30-65%.

The first symptoms of lobular cancer can be determined independently during a breast self-examination. The main sign of the disease is a lump or dense neoplasm.

• Most often, the lump is found in the upper outer quadrant of the breast.
• The tumor can occur in one or both glands at once.
• When palpated, the lump has uneven contours and is painless.
• In the late stage, lobular cancer causes skin changes, the gland tissues become retracted and wrinkled.

Classic signs of invasive lobular breast cancer: fibrous stroma is well developed, trabecular strands of anaplastic cells occur, which arise around healthy lobules and ducts. Cancer cells can be small, monomorphic, or large with clear nucleoli. In addition to the classic type, solid, alveolar, mastitis-like, tubular cancer are also distinguished. In any case, the morphological picture of the tumor lesion requires careful study.

To diagnose lobular invasive cancer, a cytological examination is performed, which most often gives a false-negative result. This occurs because the composition of the puncture may be poor, and the cells and monomorphic nuclei are small. The assumption of lobular cancer occurs when, during a puncture of the neoplasm, clinical signs indicate its malignancy and there are signs of cancer in the smears. In this case, the patient undergoes a repeated puncture, which allows us to identify scattered cells with coarse nuclei, which is typical for lobular invasive cancer. The aspirate may be bloody, which complicates the examination of the smear, since small cells are mixed with erythrocytes.

The most characteristic sign of the disease is the formation of chains of 3-4 cells. If several such groups were found during cytological examination, this allows diagnosing lobular invasive breast cancer. It is treated with hormonal therapy and surgery. After this, the patient undergoes radiation and chemotherapy to prevent relapses of the disease and destroy possible metastases.

Invasive unspecified breast cancer

Invasive unspecified breast cancer indicates that the morphologist is unable to determine the tumor type. In order to determine the ductal or lobular type of neoplasm, an immunohistochemical study is performed. Let's consider the main types of invasive unspecified lesions.

• Medullary cancer

Characterized by weak invasiveness and a large neoplasm in volume. Occurs in 5-10% of malignant tumors.

• Inflammatory cancer

In its course and symptoms it resembles mastitis. A lump appears in the breast, the skin becomes red, and the body temperature rises. It occurs in 5-10% of cases.

• Infiltrating ductal carcinoma

Occurs in 70% of cases of breast cancer. Metastasizes quickly, growing into neighboring organs and tissues in the form of cords and nests.

• Paget's disease (lesion of the nipple and areola of the mammary gland)

The main symptoms of the disease are lesions of the nipple, which resemble eczema, that is, an allergic disease.

Erz-positive (hormone-dependent) tumors most often occur in the postmenopausal period. In this case, 60-70% of primary cancer lesions have estrogen receptors. Erz-negative neoplasms occur in premenopause. The most favorable prognosis is given for medullary cancer. A less favorable prognosis is distinguished by Paget's cancer, ductal, and lobular cancer.

Diagnostics invasive breast cancer

Diagnosis of invasive breast cancer begins with self-examination. As a rule, during breast palpation, it is possible to detect seals, nodes, skin changes, nipple depression and other signs indicating the seriousness of the pathology, its possible malignancy.

• Mammography is the most common and most informative method of diagnosing mammary glands. It allows to detect any pathologies, even at early stages of development.
• Ultrasound examination – visualizes the neoplasm, allows determining the size of the tumor and the characteristics of the vascular bed.
• Magnetic resonance imaging – this method can produce a high-resolution image that can be used to determine the characteristics of the tumor.
• Biopsy is a diagnostic method based on taking material for histological examination. Based on its results, it is possible to judge the nature and type of neoplasm.
• Ductography is an X-ray examination that detects tumors as small as 5 mm.

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Treatment invasive breast cancer

Treatment of invasive breast cancer begins with a full diagnosis. Treatment options depend entirely on the stage of the disease, the location of the tumor and its morphological structure. Therapy should be comprehensive, so it may include surgery, hormonal therapy, chemotherapy and radiotherapy.

• Surgical treatment is the main method of therapy, with the help of which a malignant tumor is removed from the mammary gland, thereby preventing its further growth and metastasis.
• Radiation therapy and radiotherapy are performed after surgery and can increase the effectiveness of treatment by 70%. Irradiation is mandatory for tumors larger than 5 cm and for lesions of the lymph nodes. These methods destroy distant metastases and prevent relapses of invasive cancer.
• Chemotherapy, hormone therapy, biological therapy - are systemic treatment methods. Chemotherapy is performed for tumors larger than 2 cm and in the absence of progesterone or estrogen receptors in the gland tissues. If receptors are present, then hormone therapy is used for treatment.

The choice of treatment for invasive breast cancer is influenced by the size and location of the tumor, the results of diagnostic methods, laboratory tests, and other studies performed on the cancer cells.

Menopausal status, general health, age and personal preferences of the patient are the final factors in choosing treatment.

The doctor can use either one separate method or a combination of them. The main goal of treatment is to achieve complete removal of cancer cells from the body. Today, invasive breast cancer can be cured with minimal consequences for the body. Many medical centers conduct modern clinical trials that make standard treatment more effective, and therefore increase the chances of recovery.

Prevention

Prevention of invasive breast cancer is regular examinations by a mammologist and self-examination of the breast. Moreover, the earlier the examination of the mammary gland is carried out, the better. Doctors recommend visiting a gynecologist and mammologist from the very beginning of puberty. But with the onset of menopause and the fading of ovarian function, visits to the doctor should be more frequent. Since the older a woman becomes, the more attention should be paid to her health. Prevention of invasive breast cancer consists of a complete revision of the lifestyle. Without this, it is impossible to prevent the disease.

• A healthy lifestyle is one of the main factors influencing the risk of malignant diseases, including invasive cancer. Giving up bad habits, regular exercise, and the ability to deal with negative emotions protect the body from any disease.
• Proper nutrition provides the body with the vitamins, minerals and microelements necessary for normal functioning.
• Regular sexual activity with a permanent partner and the birth of the first child before the age of 30 also contribute to the prevention of cancer.
• Breastfeeding is another factor that prevents the risk of developing breast cancer. According to medical statistics, women who have 2 or more children and who breastfed have a lower chance of encountering invasive cancer and any other malignant lesions of the mammary gland.

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Forecast

The prognosis of invasive breast cancer depends on the results of treatment and preventive measures. The risk of this pathology depends on the woman's age. Patients aged 60-65 are at risk, and over the past 5-10 years, the number of people affected by breast cancer has increased by almost 40%. Invasive breast disease has a high mortality rate.

That is why many countries have screening programs that make it possible to detect cancer at an early stage. If the disease is diagnosed at stage I-II, then in 90% of cases it leads to recovery. That is, the prognosis for recovery depends on the stage of the malignant lesion. So, if the tumor is detected at stage I, then the survival rate is 90%, at stage II 70%, at stage III 47%, and at stage IV - about 16%. Pathology detected at late stages is practically untreatable. The prognosis is significantly worsened by the presence of metastases and damage to the lymph nodes.

Invasive breast cancer is a disease that can be prevented. Regular palpation and examination of the mammary glands make it possible to detect a lump in time and begin treatment. A healthy lifestyle, proper nutrition, regular sex life and a minimum of stress are the key to women's health.

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