Invasive breast carcinoma

Invasive carcinoma of the breast is a pathology capable of hitting absolutely any person - at any age, both man and woman. Nevertheless, most often the disease is found in women of reproductive age.

Unfortunately, for a long time patients with carcinoma can live without suspecting that they have a dangerous pathology.

But in order to successfully cure it is very important to seek medical help as soon as possible: for this it is necessary to understand and distinguish the typical signs for carcinoma.

ICD Code 10

• D 00-D 09 - tumors in situ;
• D 05 - non-invasive breast carcinoma;
• D 05.0 - non-invasive carcinoma lobular;
• D 05.1 - non-invasive intracardiac carcinoma;
• D 05.7 - non-invasive breast carcinoma of other localization;
• D 05.9 - non-invasive breast carcinoma, unspecified;
• C 50 - malignant tumor of the mammary gland.

Causes of invasive breast carcinoma

The causes of the appearance of an invasive neoplasm in the mammary gland have not yet been fully established. Specialists identify only risk factors that can serve as an impetus to the development of malignant pathology.

• Hereditary predisposition. If the next of kin were ill with oncology, the likelihood that other members of the family will become ill also increases.
• Malignant tumor on one breast. If the patient had a cancerous tumor on one gland, then the risk of developing cancer on another gland is increased.
• Features of sexual development and reproduction of the patient. The risk of carcinoma increases if a woman has premature puberty, late menopause, late first pregnancy or primary infertility, etc.
• Benign neoplasm in the mammary gland. A benign process (cysts, fibroadenomas) can sometimes be regenerated or serve as a trigger mechanism for the development of malignant neoplasm.
• Exposure to radiation. Radiation as an environmental factor, or used for medicinal purposes, significantly increases the risk of cancer.
• Endocrine disorders, disorders of metabolic processes. To promote the growth of atypical cells, diseases such as diabetes, thyroid dysfunction, hypertension, obesity.
• Hormonal therapy, intake of oral contraceptives. Imbalance of hormones can also become an indirect cause of the appearance of neoplasms in the mammary gland.

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

Pathogenesis

Such stages of progression of carcinoma, as initiation, promotion and progression, are not fully studied. It is known that pathogenesis provokes mutational processes of proto-oncogenes, which are transformed into oncogenes and activate cell growth. Also, protooncogenes increase the synthesis of mutational growth factors, or affect external cellular receptors.

If the integrity of the cell is violated by hormones, estrogens, the replication of the destroyed cell is activated even before the process of its regeneration. Intervention of estrogens is one of the prerequisites for the onset of a cancerous tumor in the chest. In this way, a stage is launched such as promotion. Long metastasis occurs in the latent period (clinical symptoms are not yet expressed) - usually this occurs when the angiogenesis stage begins in the focus.

Symptoms of invasive breast carcinoma

Carcinoma can last for a long time, hidden, without revealing itself as any symptoms. The first signs of pathology often appear at a later stage:

• the appearance of a dense patch in the chest, independent of the phase of the monthly cycle;
• visible changes in the shape, volume or shape of one of the glands;
• the appearance of liquid secretions from the milk ducts (often light or bloody);
• external changes of the skin on the gland (wrinkles, peeling, redness, "marbling", etc.);
• the appearance of seals in the armpits (an increase in lymph nodes).

Later, signs of disease progression can be observed:

• The nipple becomes flat or retracted, the areola swells;
• some areas of the gland take the form of "lemon peel";
• the gland is noticeably deformed;
• the skin over the focus of pathology is drawn (runs);
• distant metastases are detected.

Pain for breast carcinoma is uncharacteristic.

Classification of invasive breast carcinomas

Invasive breast carcinoma is a cancer that forms outside the lobular membrane or duct, directly into the breast tissue. Gradually, the process affects the lymph nodes in the armpit, as well as the bone system, brain, respiratory organs and liver.

If cancer cells are found in other organs, then it is a question of metastasis (that is, the spread of metastases).

There are several variations in the course of carcinoma:

• invasive ductal carcinoma of the breast - originates from the dairy channels (ducts), after which the degenerate cellular structures spread through the tissues into the fatty tissue of the breast. Atypical cellular structures penetrate into the lymphatic and circulatory system and spread throughout the body. Invasive ductal carcinoma is considered the most common form of oncological pathology of the breast;
• pre-invasive ductal carcinoma is a condition that precedes the spread of a cancerous tumor deep into tissues;
• invasive lobular carcinoma of the mammary gland - occurs in approximately 15% of all cases of oncology of the mammary glands. Invasive lobular carcinoma develops in lobular breast structure, spreading further on the principle of the previous two variants.

Stages of invasive breast carcinoma:

• 0 - the process does not affect nearby tissues;
• I - the malignant focus is less than 20 mm, the lymphatic system is unaffected;
• II - the size of the tumor is less than 50 mm, metastases are detected in the axillary lymph nodes from the affected side;
• III - tumor size may be more or less than 50 mm, with soldered metastases in the lymph nodes, or in the lungs or skin;
• IV - there are distant metastases.

Up to stage II, carcinoma is considered to be early. In the third stage we talk about the local spread of the process. Stage IV is called common, or metastatic.

The degree of differentiation of the neoplasm (g) is estimated by the microscopic method and can be determined by values from 1 to 3. The larger the value of g, the smaller the degree of differentiation the tumor has, and the more unfavorable the prognosis.

• g1 - high degree of differentiation.
• g2 is the average degree of differentiation.
• g3 - low degree of differentiation.
• gx - it is not possible to establish the degree of differentiation.
• g4 - undifferentiated tumor (invasive breast carcinoma of unspecific type).

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

Consequences and complications of invasive breast carcinoma

Invasive carcinoma is a very common pathology, and complications in this disease can occur with or without treatment. Malignant tumor grows directly in the tissues of the breast or milky ducts. It damages and presses nearby tissues, nerve endings and blood vessels. The consequence of this situation can be bleeding, pain. An inflammatory reaction may occur if external skin damage occurs.

Mastitis can significantly worsen the course of carcinoma and speed up the malignant process.

In the case of distant metastasis, complications can also occur in the affected organs. Violated the function of the respiratory or bone system, liver, brain (depending on the spread of metastases). Often there is a constant headache, frustration of consciousness, problems with defecation and urination.

After surgery, too, there may be difficulties. For example, complete removal of the gland often provokes the appearance of psychological problems, and operative resection of axillary lymph nodes can cause swelling and a decrease in the amplitude of movements in the upper limb.

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

Diagnosis of invasive breast carcinoma

External examination and feeling of the chest is the first and the main examination for suspected invasive carcinoma. Palpable gland is desirable in the first half of the monthly cycle - this will provide an opportunity to get enough information about the state of the breast. Palpation helps to suspect carcinoma, but in the early stages of development with a small tumor size, this method may not be effective.

Laboratory tests include tests for cancer markers - this is an insufficiently studied method of diagnosis, which demonstrates the body's tendency to develop cancerous tumors.

Instrumental diagnostics includes:

• mammograms;
• doktografiyu;
• pneumocystography;
• ultrasound examination of the mammary glands;
• magnetic resonance and X-ray computed tomography.

Given the unpredictability of the malignant process, most specialists insist on a comprehensive examination of patients. It should include not only instrumental and laboratory diagnostic methods, but also an evaluation of the function of the respiratory system, liver, etc. This may require the consultation of narrow specialists such as pulmonologist, orthopedist, gastroenterologist, gynecologist and surgeon.

Differential diagnosis is carried out with a nodal form of mastopathy, with adenoma, mastitis and erysipelatous process in the mammary gland.

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

Treatment of invasive breast carcinoma

Treatment of carcinoma involves a comprehensive approach, with the use of chemotherapy, hormonal therapy, radiation and, in most cases, surgical intervention.

• Radiation therapy is always used in conjunction with other medical procedures, and never - alone. Irradiation is prescribed after the course of taking medications, after surgery, etc. At the same time they affect not only the area of the affected breast, but also the places of possible metastasis (for example, in the area of axillary lymph nodes). Sessions are conducted either immediately after resection, or on the background of drug therapy, but not later than six months after surgical treatment.

• Chemotherapy for the treatment of breast carcinoma is prescribed in the vast majority of cases, especially in the presence of metastases or in the late stages of the disease. The choice of drugs for this method of treatment is very wide. With the expressed progression of the tumor, usually drugs such as cyclophosphamide, adriamycin, 5-fluorouracil, which promote the prolongation of the life of patients, even in the most neglected cases are usually used.

Often, chemotherapy is used in the preoperative period to reduce the volume of neoplasm, which greatly improves the prognosis of the operation. And the simultaneous use of such drugs as trastuzumab or bevacizumab makes treatment as effective as possible.

• Hormone therapy is also rarely used on its own - this is allowed only in old age to provide long-term remission. Hormonal preparations are successfully used in combination with other methods of treatment. In this case, drugs with estrogen-like action, controlling tumor growth, or agents that reduce the synthesis of estrogens are prescribed. The first drugs include tamoxifen, and the second group includes anastrozole or letrozole. These drugs are considered first choice drugs for invasive carcinoma. The scheme of application of these medicines is painted strictly individually.

Operative treatment can be carried out by several methods:

• the standard method of radical mastectomy involves the removal of the mammary gland (while retaining the pectoral muscles for the possibility of mammoplasty);
• mastectomy is partial, with the possibility of mammoplasty.

In the future, the shape and bulk of the gland is restored by the operation of endoprosthetics or reconstruction with autologous tissues.

In particularly severe cases, operations are performed, the purpose of which is to facilitate the patient's condition and prolong his life. Such surgical interventions are called palliative.

Homeopathy for the treatment of invasive carcinoma is a controversial issue in medical circles. Most traditional medicine specialists admit the use of homeopathic remedies for prevention, but not for the treatment of malignant tumors. Of course, every home patient decides whether to trust homeopathy or not. The main thing is not to miss the time and not to bring the disease to the neglected inoperable stage, when the success of treatment can no longer be discussed.

Of the most common carcinoma glands of homeopathic remedies are Conium, Thuja, Sulfuris, Kreosotum.

Alternative treatment can be used only simultaneously with the traditional, but not in its place. Here are a few popular recipes that help inhibit tumor growth.

• Approximately 150 g of pits from cherries are poured with goat milk, 2 liters, and sent to the oven for a small fire for 6 hours. Drug obtained is drunk to 100 ml three times a day in the intervals between meals. Duration of treatment - at least two months.
• Pure propolis is consumed 4-5 times a day for 6 grams, in between meals.
• The color of the potatoes is collected, dried in the shade and the infusion is prepared: for 1 tsp. Raw materials - 0.5 liters of boiling water. Insist for 3 hours. Take 100 ml three times a day for 30 minutes before meals. Duration of admission is one month.
• The birch mushroom is rubbed and insisted for 2 days in warm boiled water at a rate of one to five. Next, the infusion is filtered and drunk at least three times a day for 30 minutes before meals. Store the medicine in a refrigerator no more than 4 days.

In addition, you can use and gifts of nature - herbs, leaves, berries or fruits of plants. Herbal treatment involves the use of plants that have the following properties:

• stimulate the work of immunity in the fight against malignant cells (spurge, astragalus, duckweed, red brush, etc.);
• damage to tumor cells (natural cytostatics - periwinkle, autumn crocus, comfrey, labaznik, burdock, etc.);
• stabilize the hormonal balance, compensate for the lack or excess of a hormone, for example, estrogen or prolactin (sparrow, klopogon, comfrey, black-legged, etc.);
• accelerate the removal of toxic substances and decay products from the body (milk thistle, dandelion, chicory, yarrow, etc.);
• eliminate pain (pacifist, peony, willow, black-legged).

Prevention of invasive breast carcinoma

The danger of developing a cancerous tumor haunts almost every woman, especially over 45 years of age. However, do not be afraid, because there are preventive recommendations that often help to avoid the disease.

Of course, the existing hereditary predisposition can not be eliminated. If there is one, then the only way out is a regular visit to the gynecologist and mammologist who will be able to monitor the health of the reproductive system in general and the breast in particular.

What recommendations should all women adhere to without exception:

• do not smoke, do not abuse alcohol;
• timely treatment of infectious diseases, inflammatory processes in the genital area;
• Avoid stress, excessive stress, which can adversely affect the hormonal background;
• avoid x-ray exposure (only in case of emergency);
• to eat properly and fully;
• do not take hormone preparations unnecessarily, and if oral contraceptives are used for a long time, periodically check and, if possible, take breaks or change contraceptives;
• Do not allow abortions, avoid injuries to the genitals and mammary glands;
• watch your own weight and prevent the development of obesity.

Despite the fact that a person is not able to fully control his body and prevent all diseases, adherence to the above simple rules will significantly reduce the risk of oncology.

Forecast

The prognosis for patients with invasive carcinoma depends on a number of conditions:

• from the presence of metastases;
• from the size of the neoplasm;
• from the degree of penetration into surrounding tissues;
• of the growth rate of the tumor.

Unfortunately, in recent years, the incidence of carcinoma in the world has increased by more than 30%. For this reason, preventive programs have become mandatory in many countries, helping to recognize the disease at an early stage of development.

Invasive breast carcinoma, diagnosed in the first or second stage, ends in more than 90% of cases with recovery. If the malignant pathology was discovered much later, when the process of metastasis spread has already started, the prognosis becomes much more unfavorable.

[20], [21], [22], [23], [24]