Adenocarcinoma of the breast

Adenocarcinoma of the mammary glands is a malignant neoplasm. It can develop against the background of glandular epithelial cells. Most patients do not even realize that breast cancer can be diverse and include several types. Cancer is caused by a malignant tumor that develops against the background of changes in epithelial tissue. Depending on the degeneration of this tissue, neoplasms are classified.

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

Causes breast adenocarcinomas

This pathology can appear for a number of main reasons. Nothing happens just like that, there is always a certain irritating factor. Thus, aggravating heredity and genetic predisposition play a major role. There is a special gene that can increase the likelihood of developing breast cancer.

An important role is played by the violation of the content of hormones in the woman's body. First of all, this concerns sex hormones. Often, trauma to the mammary gland affects everything. Late childbirth can make its negative contribution to this process. We are talking directly about the first childbirth. Early puberty, as well as the difficult establishment of the menstrual cycle, also have a negative effect. Infertility often causes cancer in women.

Menopause at the age of over 50 can lead to a neoplasm. An increased dose of hormonal drugs can also provoke the problem. Benign neoplasms can also lead to a malignant tumor. Mastopathy is also dangerous. Tumors of other organs can lead to the development of breast cancer during metastasis.

Even smoking and alcohol abuse can lead to the appearance of a tumor. Because these "components" often lead to the concentration of a large number of carcinogenic substances. Improper nutrition with a high content of dyes, preservatives and fats entails a similar problem.

Pathogenesis

Today, there are many factors that can trigger the mechanism of carcinogenesis. These can be substances or environmental factors. Chemical carcinogens include various aromatic hydrocarbons, aflocastins, and others. All of them can react with cellular DNA and thus lead to various malignant formations.

As for carcinogens of physical nature, they are diverse. This can be radiation, radioactivity. All of them provoke the development of tumors. There are also biological factors. In this case, we are talking about viruses that carry specific oncogenes. They are the ones that lead to the modification of genetic material.

A special role is given to hormonal factors that can lead to tissue degeneration. These include even some types of sex hormones. Ovarian, breast and prostate cancer are especially sensitive to their influence.

Genetic factors include diseases that can lead to the appearance of a tumor. They actively affect cells and thereby disrupt their structure and functions. A damaged cell acquires a pronounced potential for malignancy. If a carcinogen has a repeated effect, this leads to serious violations. Thus, the cell is not able to divide, grow and differentiate normally. As a result, a number of its normal abilities disappear. Tumor cells have one feature: they are able to divide quickly and thereby cause a non-specific structure. As soon as differentiation decreases, uncontrolled division increases. Ultimately, in addition to a malignant neoplasm, metastases appear. Metastasis occurs exclusively through the lymphogenous or hematogenous route. Malignant cells spread throughout the body to various organs.

[ 6 ]

Symptoms breast adenocarcinomas

The presence of a problem can be noticed only visually. There is usually no pain syndrome. It appears only in the last stages. Thus, a woman may notice thickening of the breast tissue during examination. At the same time, her nipple is retracted, which should immediately alert.

The mammary gland can change its shape under the influence of the tumor. Lymph nodes can be seen under the armpits, under the collarbone and above it. Liquid of various nature is released from the nipples. It can be blood, pus or mucus.

A certain area of the mammary gland, directly affected, can change its color. The woman's breast changes its level. Thus, one mammary gland can be lower or higher than the other. Edema is clearly visible. All these symptoms should make a woman seek help from a mammologist.

Poorly differentiated adenocarcinoma

Adenocarcinoma is a malignant neoplasm. The low-differentiated stage is characterized by low cell development. They are tuned exclusively to the consumption of nutrients. Their "duties" do not include any functions that healthy tissues perform. Glandular epithelium can be detected in absolutely any organs. This allows the disease to be localized anywhere.

This type of neoplasm is a malignant neoplasm that originates from glandular epithelium. Low grade is characterized by rapid tumor growth and is the most aggressive.

The question of prognosis in this case remains quite serious. Everything depends on how quickly the person sought help. It is necessary to understand that the lower the level of development of the disease, the more difficult its course and the less favorable the prognosis.

[ 7 ], [ 8 ], [ 9 ]

Well differentiated adenocarcinoma

This form is classified as a malignant pathology. Compared to low-differentiated adenocarcinoma, this type is characterized by a low polymorphism index at the cellular level. The affected cells are practically no different from healthy ones. It is not so easy to notice the changes. The main sign is an increase in the nuclei of the affected cells, they become long and change their size. Perhaps this is the only way to suspect a tumor in a person.

It is quite difficult to diagnose an unfavorable prognosis. Everything is made easier by the fact that the neoplasm has a favorable prognosis and passes easily. Effective treatment will eliminate the problem and allow the patient to live a full life. The best prognosis is observed when the pathology is detected at early stages. Another feature of this form is the absence of metastasis. It happens, but extremely rarely. Therefore, the risk of complications is reduced several times.

Moderately differentiated adenocarcinoma

This form is somewhat similar in its course and development to highly differentiated adenocarcinoma. Its main feature is the appearance of cells in which the pathology itself develops. A high degree of polymorphism of their changes is observed. This type of tumor differs from its predecessor in that cell division in the affected area occurs at an increased rate. A considerable number of cells participate in the process of mitosis.

The pathology is represented by a tumor, with a rather severe course. The risk of complications is quite high. This type is capable of spreading metastases, which are capable of expanding the lesion and penetrating further into the body through the lymph.

Metastasis via the lymphatic system occurs in almost every 10th case of the disease. Treatment depends entirely on the patient's age and the characteristics of the disease itself. Metastases are not observed at the age of up to 30 years.

First signs

Symptoms may vary depending on the form of the disease. After all, there are several phases of pathology development. Despite this, there are common signs that need to be paid attention to. During examination, a woman may find lumps in her breasts of absolutely any size. Most often, the tumor is localized under the nipple, as well as on any other part. The affected mammary gland changes shape, the skin on it becomes wrinkled, the density changes, the shade becomes yellowish, blue or red. Ulcers can be seen on the surface.

During examination, you can see a discrepancy in the contours. Thus, the mammary glands can be at different levels, become convex or, on the contrary, retracted. Enlarged lymph nodes are clearly palpable in the armpit area. The pathology is characterized by the development of small balls of varying consistency. They are painful when palpated. It is worth noting that pain appears at later stages of development.

When examining the nipple, discharge may appear. Normally, there should be none. The exception is the period before childbirth and lactation. Pathology can develop under the influence of inflammatory diseases, so they must be eliminated in a timely manner. In some cases, adenocarcinoma occurs without any manifestations. It can be recognized only by ultrasound. Therefore, visits to the doctor and examinations should be systematic.

[ 10 ], [ 11 ], [ 12 ]

Forms

ICD-10 code

The international classification includes all existing diseases and pathologies. Thus, the heading C76-C80 contains all malignant neoplasms that are characterized by inaccurate localization. To accurately determine the functional activity of the tumor, it is worth resorting to the additional code of class IV.

In order to identify the histological type of neoplasm, a special nomenclature of neoplasm morphology was given. To characterize the pathology, its form and course should be taken into account.

Thus, the ICD-10 code includes malignant disease of the mammary gland and codes it under number C50. C50.0 Nipple and areola. C50.1 Central part of the mammary gland. C50.2 Upper inner quadrant. C50.3 Lower inner quadrant. C50.4 Upper outer quadrant. C50.5 Lower outer quadrant. C50.6 Axillary region. C50.8 Spread to more than one of the above areas. C50.9 Localization, unspecified. D05.0 Lobular carcinoma in situ. D05.1 Intraductal carcinoma in situ.

[ 13 ], [ 14 ], [ 15 ], [ 16 ]

Distinguishing severe breast dysplasia from adenocarcinoma

Severe dysplasia is a precancerous condition. It is a congenital pathology that begins to progress due to certain circumstances. Over time, the problem becomes severe and becomes a cancerous neoplasm. The severe stage is stage III dysplasia. This condition is characterized by the capture of 2/3 of the epithelial cells.

In the multilayered epithelium, foci of growth arise that have a heterogeneous structure. Proliferation completely affects the entire cell. In the layers of glandular epithelium, the severity of the pathology is determined by the structural features of the tumors themselves. The glands have a chaotic arrangement and can have a branched character.

In most cases, dysplasia takes a malignant form. The causes of this phenomenon are still unknown. Dysplasia is one of the dangerous pathologies that can easily become malignant. The catalyst is unknown. A timely visit to a doctor will help to identify the problem at an early stage and eliminate it.

Adenocarcinoma is initially a malignant tumor. It is not benign. Perhaps this is one of the most important differences between dysplasia and adenocarcinoma. This pathology affects almost every 13th woman. Cancer can metastasize and thereby worsen the situation.mm

Complications and consequences

As is known, the tumor is removed exclusively by surgery. For better efficiency, chemotherapy is also used. It is capable of damaging and eliminating affected cells. After all, they are especially dangerous due to their rapid growth and division. Such cells include: cells of the mucous membranes, reproductive system, hair follicles and bone marrow. Chemotherapy actively destroys them, as a result of which a number of consequences arise.

From the gastrointestinal tract, nausea, vomiting may be observed, appetite often worsens, and stomatitis also occurs. The bone marrow also suffers, anemia, fatigue, tiredness and complete apathy develop. There is a possibility of bleeding. From the hair follicles, their loss is observed, and as a result, a person goes completely bald.

Treatment leads to a decrease in immunity, which allows many infections to penetrate the body. They can damage organs of various systems. These can be the kidneys, nervous system and bladder. After the end of chemotherapy, most side effects disappear. If serious damage occurs, the symptoms can persist from one to several years.

[ 17 ], [ 18 ], [ 19 ]

Complications

The main complication of the tumor is metastasis. It occurs through the lymphatic and blood vessels. Lymphogenous metastases can appear in regional lymph nodes. These include the anterior sternum, armpits, and the area above and below the collarbone.

As for hematogenous metastases, they can be recognized only in the area of bones, lungs, kidneys and liver. For breast cancer, latent or dormant metastases are characteristic. They can manifest themselves after 7-10 years, even after surgical removal of the tumor. This leads to a new formation and requires no less rapid elimination of the problem. This is why after the operation, a person is registered and his condition is monitored for several years. After all, if there is no relapse and the tumor has not returned, you can breathe a sigh of relief.

[ 20 ], [ 21 ], [ 22 ]

Diagnostics breast adenocarcinomas

First of all, the doctor examines the patient. During this process, the mammary gland is examined, any changes in it are recorded. This measure will allow the problem to be identified at an early stage. If the doctor has suspicions, an additional set of diagnostic measures is prescribed.

Ultrasound is widely used. It is the safest and cheapest method of examination. It should be carried out regularly, preferably once a year. This will allow you to detect the problem at an early stage and begin to quickly eliminate it.

Mammography is one of the most common methods of examining the mammary gland. The main objective of the method is to detect a tumor. The essence of the method itself is to obtain a picture with increased clarity, which allows you to see all the structures of the affected organ. Today, mammography is divided into several methods: X-ray, magnetic resonance, computed tomography.

A biopsy is a removal of the affected tissue, or rather a small section of it. If the tumor is located quite deep, the doctor has to use a special needle.

Often, histological and cytological examinations are prescribed. This allows the affected area to be examined under a microscope and the nipple or ulcer imprint to be thoroughly examined. This procedure will help in detecting a malignant cell.

CT and MRI are widely used. They are accurate methods and allow obtaining sufficient information about the patient's condition, as well as identifying metastases. The set of diagnostic methods may vary depending on the symptoms observed in the patient.

[ 23 ], [ 24 ], [ 25 ], [ 26 ], [ 27 ]

Tests

After a patient consults a doctor with certain symptoms, he needs to take special tests to confirm his condition. Thus, it is simply impossible to determine the presence of oncology by a blood test. After all, a neoplasm of this type is not specific. Therefore, in this case, there are specific clinical and biochemical studies.

General blood test. It allows to detect oncology due to the number of leukocytes. They can be either elevated or lowered. Attention is drawn to the shift of the leukocyte formula to the left. Low hemoglobin level is responsible for this. Constantly high ESR indicates the presence of a tumor, especially if no symptoms are observed.

General urine analysis. If there is a tumor, it is very informative. Biochemical blood analysis allows you to determine the state of the urinary system, liver and protein metabolism. All changes can tell the doctor about the person's condition.

A blood test in the presence of a tumor allows for a complete examination of the hemostasis system. Due to the fact that a certain number of tumor cells are released into the blood, it becomes possible to detect blood clotting.

Tumor markers. They are an immunological diagnostic of neoplasms. Thanks to this method, tumor antigens or tumor markers can be identified. They help determine the stage of the tumor and prevent relapse.

[ 28 ], [ 29 ], [ 30 ], [ 31 ], [ 32 ], [ 33 ], [ 34 ], [ 35 ]

Instrumental diagnostics

This type of diagnostics includes methods based on the examination of a person by means of special devices. Mammography is most often used. It is a special type of X-ray that allows you to determine the presence of a tumor. Thanks to it, two images can be taken, in horizontal and vertical projection. During this process, the breast is placed between two special plates. Mammography allows you to see dead cells that have been saturated with calcium salts.

Ultrasound. This method is considered one of the most effective and safe. It does not irradiate a person and therefore does not pose any danger. Mammography, in turn, is associated with a share of radiation. Infiltrating ductal cancer can be seen on ultrasound. However, this procedure is recommended exclusively for young women.

CT and MRI. These methods are widely used in cases of suspected metastases in adjacent tissues and organs. They will help determine the seriousness of the situation and the depth of spread.

Cytological picture

Diagnostic puncture should be performed exclusively by the attending physician or a specialist in this field. The discharge from the nipple, then the area around it, as well as the tissue are subject to detailed examination. Particular attention is paid to bloody and serous discharge. Scraping is performed after purulent masses and crusts have been removed from the surface of the affected area.

The main principles of cytological diagnostics are the difference in the cell composition in a normal state and in the presence of pathology. This also includes cell evaluation. The main task of cytological research is to establish an accurate diagnosis. This method is based on a detailed study of the cell, its nucleus.

The cytological method allows studying the therapeutic pathomorphosis without traumatizing the patient at all. The use of this study allows specifying the nature of the tumor and the degree of its development. Moreover, all this is done before the operation. These factors are among the most important. They allow the operation to be carried out qualitatively.

[ 36 ], [ 37 ], [ 38 ]

Differential diagnosis

First of all, anamnesis is collected. The doctor listens to the patient's complaints, writes down the symptoms. In addition, a personal or family history is taken. It is necessary to know whether there have been similar cases in someone in the family. After all, such a formation can be a hereditary predisposition. There are certain people who belong to the risk group.

Palpation. The mammary gland must be palpated for the presence of formations in it. This will allow the doctor to give a lot of useful information about the presence, size and structure of the tumor itself. Initially, it is worth examining the healthy breast, then move on to the affected one.

In addition, a general blood test, urine test, and biochemical blood test are taken. A biopsy is performed. All this will allow changes in the body to be identified and, as a consequence, the diagnosis to be confirmed and quality treatment to be prescribed. Differential diagnostics are closely related to instrumental research methods.

Treatment breast adenocarcinomas

Today, doctors use many methods to combat malignant tumors. They are often combined with each other to achieve maximum effect.

• Surgical removal. This method is the most popular and effective. It is used at almost all stages. The size of the neoplasm plays a major role.
• Lumpectomy. Thanks to this method, removal occurs within healthy tissue. This allows you to preserve the mammary gland and not remove it. Moreover, there is a chance to maintain a good cosmetic effect.
• Mastectomy. This method involves removing not only the entire mammary gland, but also the surrounding nodes and tissues. If necessary, plastic surgery can be performed immediately. This will allow the breast to be restored.
• Radiation therapy. This method is one of the modern technologies. It allows for precise irradiation of a tumor while causing minimal harm to a person. As a result of such exposure, the tumor decreases in size, making removal much more convenient. This method is often used together with surgical removal.
• Chemotherapeutic treatment. It involves the use of special drugs that act properly on tumor cells and allow them to be completely removed. This method reduces the likelihood of metastasis.
• Hormonal therapy. This method is good and effective. It is actively used in cases where sex hormones are found in tumor cells.

Medicines

Medicines are actively used to eliminate the tumor. Thus, certain drugs are actively used during chemotherapy, as well as hormonal drugs. During chemotherapy, Alkeran, Methotrexate and Fluorouracil Teva are used. Zoladex, Honvan and Microfollin forte are used as hormonal drugs.

• Alkeran. The dosage is prescribed individually. The duration of administration depends on the person's condition. The dose can vary from 8 to 30 mg per square meter. Contraindications: hypersensitivity to the main component. Side effects: nausea, vomiting, fatigue, drowsiness, pneumonia, allergic reactions.
• Methotrexate. It is used both as an independent remedy and in combination with others. The dosage is prescribed individually. Usually it does not exceed 200-500 mg. Everything depends on the stage of the tumor and its course. Contraindications: hypersensitivity, pregnancy, lactation, renal and hepatic insufficiency. Side effects: anemia, cystitis, excessive lacrimation, conjunctivitis.
• Fluorouracil Teva. It is recommended to administer it daily for 4 weeks at 500 mg per square meter. Further treatment is discussed with the attending physician and depends on the patient's condition. Contraindications: cancer of the intestine, penis, neck, head, stomach, esophagus. Side effects: leukopenia, nausea, vomiting, anorexia, allergic reactions, heart attack, asthenia.
• Zoladex. Adults take one capsule of the drug once every 28 days. The duration of treatment does not exceed six months. Contraindications: hypersensitivity, pregnancy, lactation and childhood. Side effects: hot flashes, increased sweating, arthralgia, ovarian cyst.
• Hongwan. The initial dose of the drug is 150 ml. In some cases, it reaches 1200 mg per day. The duration of administration is 10 days. This is an individual process that requires strict adherence to certain rules. Contraindications: hypersensitivity. Side effects: breast tenderness, intestinal colic, flatulence, nausea, vomiting.
• Microfollin forte. The drug is used at 0.02-0.1 mg per day. The dosage depends on the person's condition. You cannot take the drug on your own. Contraindications: pregnancy, hypersensitivity, endometriosis. Side effects: pain, hepatitis, nausea, vomiting.

Folk remedies

Traditional medicine is used exclusively in combination with other means. It is impossible to eliminate the problem only with herbs. It is necessary to use a whole range of different methods. Below are the main methods of fighting breast cancer using traditional medicine.

• Recipe 1. To prepare an effective remedy, you will have to take cleavers. Take 4 tablespoons of this ingredient and pour 500 ml of boiling water. After that, the remedy should be infused for 2-3 hours. You need to use the remedy 4 times a day before meals, in small sips.
• Recipe 2. Watermelon is actively used for malignant neoplasms in the mammary glands. It is necessary to take the roots of the plant and make a paste from them. It is applied to the affected areas.
• Recipe 3. Yellow mullein. Mix 10 grams of the plant with 200 ml of vodka. Let it steep for several hours. Take one tablespoon 3 times a day.

[ 39 ], [ 40 ], [ 41 ], [ 42 ]

Herbal treatment

This method of eliminating the problem is possible only together with other options. You should not use folk recipes on your own. They should be used together with other methods to achieve maximum effect.

• Recipe 1. Take one tablespoon of marsh stachys. Pour a glass of boiling water over it. Then let the mixture sit. Use it as a compress, apply it at night. Use until the swelling resolves.
• Recipe 2. Medicinal grass + flax seeds are taken in the amount of one tablespoon. All this is poured with 300 ml of boiling water. After which the remedy should be boiled for 10 minutes. It should be taken one tablespoon 5 times a day.
• Recipe 3. Oregano. Take 3 tablespoons of this remedy and pour 500 ml of liquid over them, then boil for 2-3 minutes. Let the remedy steep for 12 hours. Take 50-100 ml of the preparation 4 times a day. The duration of treatment does not exceed a month.

Homeopathy

Homeopathic remedies are widely used to eliminate malignant neoplasms. There are several basic recommendations regarding their use. Thus, they must be used from the moment the pathology is detected until it completely disappears. It is important to maintain the mental state of the victim. When performing a biopsy, it is necessary to prevent the appearance of a hematoma. Homeopathic remedies can heal wounds faster after surgery.

During radiation therapy, it is worth avoiding skin redness. It is important to fight hot flashes in time, as well as eliminate joint pain. Taking homeopathic remedies is most important during chemotherapy. This will help to avoid most of the unpleasant symptoms. In this case, we are talking about nausea, headache, fatigue.

The most commonly used homeopathic remedies are Arnica montana 30, Nux vomica, Colchicum autumnale 15, Medulos 4, Toxilentron 15 and Sepia 15. Information on dosage and recommendations for use can be obtained from a homeopathic physician.

Surgical treatment

Adenocarcinoma can only be removed surgically. Thus, when performing a mastectomy using the Halsted method, it is necessary to completely remove the mammary gland, along with the pectoral muscles. Today, such an operation is not performed. After all, it is very crippling.

Mastectomy according to Patey-Dyson. This method is the most common. Thanks to it, both pectoral muscles can be preserved, which will allow the mammary gland to be restored in the future. The technique allows for less trauma and promotes rapid healing.

Madden mastectomy. This method allows you to save most of the breast and is the most gentle. Surgeons often resort to this method.

Mastectomy, which allows preserving the skin, is the most suitable. Especially if the patient plans to restore the mammary gland in the future. This method involves removing the areola and nipple area. This will allow for a satisfactory shape of the mammary gland in the future.

Subcutaneous mastectomy allows preserving the nipple-areolar complex. Moreover, complete reconstruction is possible in the future, both with one's own tissues and with the help of an implant.

The type of surgical intervention is determined by the doctor, depending on the patient’s condition, as well as the stage of development of the cancerous tumor.

Prevention

Prevention depends entirely on how quickly the alarming symptoms were detected. There are quite a few diseases that have a similar picture of manifestations as adenocarcinoma. Therefore, if any suspicions arise, it is necessary to immediately seek help from a medical institution. If the diagnosis reveals adenocarcinoma, immediate treatment should be started.

Cancer diseases can be successfully eliminated. Especially if they are detected at early stages. Immediate treatment will allow you to quickly get rid of the problem and live a full life again.

The best prevention of cancer is regular check-ups. Not every woman is able to recognize the problem on her own. Therefore, it is necessary to visit a mammologist as often as possible. The main preventive method is to follow a proper diet, lifestyle, and maintain a healthy body mass index. Naturally, it is worth eliminating bad habits. It is worth eliminating problems with the reproductive system in time, because they are the ones that can provoke a malignant breast tumor.

[ 43 ], [ 44 ], [ 45 ]

Forecast

The prognosis is influenced by many factors. One of the main ones is the invasiveness of the tumor. Simply put, the ability to quickly metastasize and thereby worsen the condition. In this case, the prognosis is less favorable. If you do not start eliminating the pathology in time, the problem can spread to neighboring organs and lymph nodes. When the tumor is diagnosed in time and treatment is started, the prognosis is favorable.

A positive result is possible in the absence of metastases, and also if the tumor has not grown into the tissue. If the neoplasm is highly differentiated, then the probability of a favorable prognosis is high.

Treatment of the pathology mainly consists of surgical removal of the affected area. Healthy tissues are usually affected as well, to prevent the tumor from spreading to them. In combination with the surgical method, radiation, hormonal and chemotherapy are used. This allows increasing the chance of recovery and completely getting rid of the problem.

[ 46 ], [ 47 ], [ 48 ]