Prognosis for breast cancer

The prognosis for breast cancer is considered to be the most favorable of all oncological diseases among men and women. This became possible due to the fact that this disease is well studied, and enough measures have been developed for the qualitative and timely treatment of breast tumors.

Breast cancer is the most common oncological disease among women. Moreover, this "misfortune" is subject to the inhabitants of the European part of the globe, American women of the North and South Continent, as well as representatives of a number of Asian countries.

Each year, the global medical community records more than one million cases of breast cancer. Over the past quarter century, the number of cases of breast cancer has grown rapidly, and in the first place, this trend concerns women in large and medium-sized cities. It can be noted that the incidence of breast cancer for this period has increased by approximately thirty percent. Moreover, the most affected woman is over thirty-five years old.

What specific measures should be taken to prevent the possibility of breast cancer or to reduce the degree of neglect of the disease? First of all, women need to know that an annual preventive check-up with a mammologist can detect a breast tumor at an early stage. This increases the chances of a favorable prognosis for a cure for this ailment. But in our culture it is customary to resort to specialist advice if the problem has already declared itself "in full growth." Most sick women turn to mammologists or oncologists already in a state where the tumor has obvious external signs, and also affects the overall well-being of the patient and shows significant symptoms of cancer. This situation greatly complicates the treatment, while reducing at times a favorable prognosis for getting rid of breast cancer and extending the life of the patient.

Therefore, any woman who cares about her health, especially living in a large city, should take as a rule an annual dispensary examination from a mammologist. This procedure does not take a lot of time, but at the same time, it helps to prevent the disease or significantly reduce the risks in the early detection of tumor processes. After a certain critical age (usually, after thirty-five years), the mammologist appoints a special X-ray examination of the breast, a mammogram. Such a procedure allows to reveal the tumor processes in the chest at the earliest stages of their development and to take optimal measures to fight the disease.

It should be noted that oncology of the breast is also susceptible to representatives of the stronger sex, although it must be taken into account that this problem is much less common in men than in women. Some oncologists believe that breast cancer does not depend on the sex, age and ethnic group to which a person belongs. There are other factors that influence the possibility of the disease by breast tumor processes.

The nature of the oncological processes in the mammary gland depends on a number of conditions, to which, first of all, the age of the woman and her hormonal status are related. Representatives of the fair sex at a young age, especially during pregnancy and lactation, are prone to rapid growth of tumors, as well as the early appearance and spread of metastases throughout the body. In contrast to the above, women of advanced age can live more than eight to ten years with cancer of the breast, which does not give metastasis.

Of course, do not forget that the degree of cure and life expectancy after the therapy depends on the stage of the disease. The early stages of oncology (I-II) are amenable to treatment and the probability of relapse is rather low in this case. In later stages, treatment of breast cancer without relapse is problematic enough. In medical practice, it is known that a ten-year prognosis for the survival of patients with stage I breast cancer is ninety-eight percent, and IV stage of breast cancer - ten percent. Accordingly, the ten-year survival rate for stage II and III breast cancer is about sixty-six and forty percent of cases.

In addition to the stage of the oncological disease process, the following factors influence the prognosis of the life of a patient with breast cancer:

1. The location (or localization) of the tumor in a specific area of the breast.
2. The size of the tumor.
3. Clinical form of the disease
4. The degree of malignancy of oncological processes and the rate of their course.
5. Age of the patient.
6. The nature of the treatment.

Let's consider these parameters in more detail.

• The prognosis of favorable or not favorable treatment for breast cancer is influenced by the location of the tumor in a certain quadrant of the breast. Such localization of tumor processes is closely related to the rate of growth and spread of metastases, as well as the direction in which these metastases will germinate.

The most favorable predictions are the formation of a tumor in the outer quadrants of the breast. A complete cure for the disease is possible, mainly due to the fact that these foci of oncological processes can be diagnosed at an early stage, as well as regional metastasis. Also in this case, when the tumor is located in the outer quadrants of the breast, more radical treatments can be used, including surgical intervention.

Low prognosis for curing the disease is different forecasts, which are typical for tumors in the medial and central regions of the breast. These centers of malignant processes are characterized by a high level of metastasis. First of all, it concerns the parasternal lymph nodes (in every third case).

• An important prognostic criterion is the size of the primary tumor, which is detected during the examination. Specialists distinguish the following degrees of growth of malignant neoplasms of the breast:
  • up to two centimeters in the largest dimension;
  • from two to five centimeters in the largest dimension;
  • more than five centimeters.

If we take into account the five-year survival of patients, which depends on the size of the tumor, then we must take into account the lack of metastases in the lymph nodes. In this case, the prolongation of the life of patients for five years is possible in ninety-three percent of cases with a tumor size of up to two centimeters. With tumors ranging in size from two to five centimeters, the five-year survival rate of patients ranges from fifty to seventy-five percent.

• Specialists distinguish two forms of breast cancer:
  • knotty,
  • diffuse.
  • The nodular form of breast cancer is divided into the following categories:
  • limited,
  • locally-infiltrative.
• In the diffuse form of breast cancer, the following varieties are distinguished:
  • hydropic,
  • diffuse-infiltrative,
  • lymphangitic.

The prognosis for tumors of infiltrative type is worse than for all other forms of tumors listed above. Infiltrative breast cancer is found most often in young women and in rare cases in elderly women in the stage of deep menopause. The most unfavorable predictions are inflammatory forms of breast cancer.

• With the possibility of radical treatment of breast cancer after therapy, predictions for five-year survival of patients with stage I cancer are from eighty-three to ninety-four percent. In the radical treatment of patients with III B cancer stage (a tumor more than five centimeters with the presence of metastases in regional lymph nodes), the five-year survival of patients ranges from thirty-four to forty-six percent of cases.

Other sources indicate a five-year survival of patients depending on the stage of the oncological process in the mammary gland after the treatment:

• Stage I - with a tumor size of less than two centimeters and no involvement of lymph nodes, as well as distant metastases - a five-year survival period is eighty-five percent of cases;
• stage II - with a tumor size of two to five centimeters and in the presence of affected lymph nodes in the armpits, distant metastases are absent - a five-year survival rate of patients is sixty-six percent;
• stage III - with a tumor size of more than five centimeters, sprouting into nearby breast tissue, lymph node involvement not only in the armpit area, but further, no distant metastases - a five-year survival period of patients is forty-one percent;
• stage IV - with a tumor size of more than five percent, lymph node involvement and the presence of distant metastases in vital organs, a five-year survival rate of such patients is ten percent.

It is important to note that the degree of recovery of a patient from breast cancer after treatment is determined after a lapse of ten years from the end of therapy.

There are data on the life expectancy of patients with breast cancer in the stage of metastasis. At this time, the disease in this form is incurable. Therefore, the average life expectancy in most patients who have received treatment since the discovery of metastases is a period of two to three and a half years. From twenty-five to thirty-five percent of such patients can live more than five years, and only ten percent of patients - more than ten years. Although, information about the life expectancy of patients who did not undergo treatment in stages III and IV of cancer, is about two years and seven months. What can call into question the very fact of being able to cure data of the degree of breast cancer by means of modern medicine.

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

Prognosis for invasive breast cancer

Malignant tumor in the mammary gland has several degrees of its development. Specialists dealing with this problem distinguish several stages that undergo oncological processes in the chest. Invasive breast cancer is one of them.

Invasive breast cancer is a neoplasm that has germinated into the breast tissue. With the help of blood and lymph flow, malignant cells spread throughout the body from the tumor formation zone. In the axillary basins, lymph nodes begin to be affected and increase. Cancer cells penetrate the main organs of a person - the liver, lungs, bone system and brain - where metastases begin to be formed at an accelerated rate.

Invasive breast cancer is divided into certain types:

• Pre-invasive ductal breast cancer.

Such an oncological disease is a tumor that is located in the breast ducts of the breast. At the same time, malignant cells have not yet penetrated into the neighboring breast tissue. But cancer cells at this stage are actively divided, and the tumor rapidly increases in size. Therefore, if certain treatment measures are not taken, malignant processes outgrow from pre-invasive to invasive cancer.

• Invasive protocol breast cancer.

With this form of cancer, the cancerous tumor has already reached the fatty tissue of the breast. Affected cells can already enter the blood and / or nearby lymph nodes. Along with blood and lymph, malignant elements of the tumor are spread throughout the body and other organs are metastasized.

According to physicians, invasive breast cancer is the most common form of invasive oncology. Among the detected cases of this disease, more than eighty percent of cases occur in this type of tumor processes.

• Invasive lobular breast cancer.

This form of invasive breast oncology is rare. In this case, there is a difference of this type of cancer from the previous, which can be detected during palpation of the breast. In the place of tumor formation, a specialist will detect not a bump, as in the above cases, but a densification. The development of this form of the tumor process receives the same as the previous species.

The symptomatology of invasive cancer at the earliest stages is unobtrusive. Therefore, in most cases, women do not even guess that their body has undergone a serious illness. But according to some signs, well-known doctors, one can get an idea that oncological processes are present in the mammary gland.

So, the symptoms of invasive breast cancer in the early stages are:

• In the appearance of a persistent cone or thickening in the mammary gland.
• In changing the shape of the breast, its shape.
• In the deterioration of the skin of the breast and its elasticity, the appearance of strong peeling of the upper skin, the appearance of wrinkles and ripples on the skin.
• In the appearance of discharge from the nipples of the chest.
• In the emergence of a strong pallor in a specific area of the skin of the breast.

If a woman observes one, several or all of the above symptoms in her breast condition, she should immediately contact a mammalogist or an oncologist for an exhaustive consultation. It is necessary to find out the cause of such changes that occur with the mammary gland, and undergo appropriate examinations.

Based on the diagnosis, the doctor should choose the most optimal treatment option for the breast. The specialist can also choose hormonal treatment, surgical intervention, chemotherapy, radiotherapy or biological therapy. A complex combination of any of the above approaches is also possible. Everything depends on the results of the preliminary examination of the breast: the size of the tumor, its location, the stage of the oncological process, the results of laboratory tests, the age period in which the patient is. The choice is also taken into account, which was stopped by the patient on a certain method of treatment.

In order to predict the prognosis for invasive breast cancer, several factors need to be considered:

• Stage of the disease.
• The size of the tumor.
• The presence or absence of metastases in the lymph nodes and vital organs.
• The nature of tumor differentiation is highly differentiated, moderately differentiated, and low-grade.

If oncological processes in the body are detected in a timely manner, that is, at an early stage, there is a favorable prognosis for curing the disease. Thus it is necessary to consider, that the tumor should not reach in the sizes of two centimeters, and treatment of a cancer of a mammary gland occurs by means of the most effective methods.

Favorable is the prognosis for getting rid of the disease if the tumor does not give metastases to the regional lymph nodes and is highly differentiated, and there are many estrogenic and progesterone receptors in it. And thus the tumor tissue shows sensitivity to herceptin - a biological preparation having antitumoral purpose, which is used for the therapy of breast cancer. This drug affects malignant cells of the breast tumor without destroying healthy tissue.

An unfavorable prognosis for the treatment of breast cancer has tumors with the following symptoms:

• lymphedema - a disease of the lymphatic system, in which the outflow of lymph from lymphatic capillaries and lymphatic ducts of the mammary ducts is disturbed; as a result, edema of soft tissues of the upper extremities and the mammary gland occurs, which significantly increases the size of the breast affected by the tumor, as well as the limb affected by the problem;
• tumor germination in nearby healthy tissues;
• a large number of foci of tumor development;
• the presence of distant metastases in lymph nodes and various organs (lungs, liver, bone tissue and so on).

Prognosis for lobular breast cancer

Lobular carcinoma in situ (in another way, this disease is called "alveolar cancer", "acinar cancer", non-infiltrative lobular carcinoma) is an oncological breast disease that occurs in women most often in the age from forty-five to forty-eight years. Foci of this form of cancer appear simultaneously in several parts of the breast, in the lobules of the breast. The upper-outer quadrants of the breast are most prone to lobular cancer.

This kind of oncology of the breast is very difficult to diagnose and detect. This is because the tissue density of the neoplasm is low enough and practically does not differ from the surrounding healthy breasts. Malignant tumor cells can be detected only under a microscope, accidentally, and in that part of the gland in which an operation to remove a benign tumor has recently been performed. Or the lobular cancer is established as a parallel disease simultaneously with other forms of breast cancer.

Infiltrating lobular carcinoma (or invasive lobular carcinoma) is a later stage in the development of lobular cancer in situ. This form of breast cancer accounts for five to fifteen percent of all cases of infiltrating (or invasive) cancer. Patients suffering from this disease refer to the age from forty-five to fifty-five years.

Infiltrating lobular carcass is a tumor in the form of dense nodes that do not have clearly defined boundaries. The dimensions of such seals in diameter are from half a centimeter to three to five centimeters. Primary neoplasms appear in several segments of the breast. Then this type of cancer spreads inside the breast and forms secondary foci of malignant processes. In more than thirteen percent of cases, infiltrating lobular cancer affects two mammary glands at the same time.

A favorable prognosis for lobular cancer is difficult to give, because this form of cancer is very difficult to diagnose in the early stages of cancer development. With the advanced degree of this oncology (with the presence of distant metastases), the patient's life expectancy is two to three years after the discovery of the disease.

If neoplasms were detected early enough (at stages I-II), then the probability of cure for this form of cancer is about ninety percent of cases. The forecast is given for a period of five years after the treatment. If this form of cancer showed several secondary foci, then the five-year survival of patients after treatment is sixty percent.

Prognosis for hormone-dependent breast cancer

Before choosing a method of treatment for breast cancer, a specialist appoints the patient to undergo a full cycle of examinations. One of the diagnostic methods is to check the level of hormones in the blood. This test allows you to determine whether female hormones (estrogen or progesterone) have an effect on the growth of a cancerous tumor. If the test is positive, it is concluded that the hormones of the female body have a direct effect on the development of malignant cells. And the specialist decides on the appointment of hormone therapy for breast cancer, which is considered effective in this case.

Also hormonal treatment of breast cancer is used for patients who have advanced tumors or unfavorable prognosis for the recovery of breast cancer. A similar method of therapy is used to treat those patients who are contraindicated in chemotherapy:

• persons aged fifty-five years,
• having acute infectious diseases,
• with the presence in the anamnesis of serious violations of kidney and liver function,
• ill uncompensated diabetes,
• patients with severe cardiovascular insufficiency,
• people who have a history of severe hemodypression.

The type of hormonal therapy and the treatment of cancer depends on the type of tumor and its nature. Specialists can choose one of the following treatment methods, namely:

• the use of drugs (androgens), lowering the level of estrogens in the body;
• the use of drugs (corticosteroids) that block the possibility of combining sex hormones with the receptors of the tumor;
• use of drugs that can completely stop the production of sex hormones that trigger the development of the tumor;
• a radical method of treatment - ovariectomy - with the help of which the ovaries that produce estrogens are removed.

The following factors influence the choice of the method of hormonal treatment:

• stage of oncological disease and previously applied methods of treatment;
• the status of the patient that concerns menopause;
• the presence of other diseases that can worsen the quality of drug tolerance (eg, arthritis, osteoporosis, thrombosis, and so on)

In general, hormone-dependent breast cancer occurs in thirty to forty percent of female patients with breast cancer. Dependence of the oncological process on the state of hormones in the body means that the surface of the tumor has receptors that directly bind to female sex hormones. This interaction provokes the development of a malignant neoplasm by stimulating the growth of cancer cells.

Indications for hormone therapy, other than those mentioned above, are:

• burdened heredity or genetic abnormalities, as a result of which the probability of oncological process in the mammary gland is high enough;
• treatment of an invasive tumor in order to prevent recurrent manifestations of the disease;
• beginning of metastasis of malignant neoplasm;
• large tumor sizes, in order to reduce malignant neoplasm.

In order to be effective with hormones, before the start of therapy the patient needs to undergo tests for the presence of receptors in the neoplasm. If there are no such receptors on the surface of the tumor, hormone therapy will prove ineffective.

The duration of hormone-dependent cancer treatment is affected by several factors:

• the patient's health status;
• type of hormonal therapy;
• the rate of achievement with this method of treatment;
• presence of side effects.

At this point in time, medicine believes this way of fighting breast cancer is one of the most effective. Such high effectiveness is caused, first of all, by a great experience in the use of hormonal therapy, which allowed us to thoroughly study the methods of hormone treatment. Due to this, the cases of survival of patients with hormone-dependent cancer increased by twenty-five percent.

The prognosis of survival in hormone-dependent breast cancer with modern methods of hormonal therapy has significantly increased. In fifty-six cases, this therapy prevents the appearance of a primary tumor in another mammary gland, and the risk of relapse is reduced by thirty-two percent.

Prognosis for recurrence of breast cancer

The recurrence of breast cancer is the onset of symptoms of breast cancer again after the previous therapy. Relapse of the disease manifests itself in the repeated development of cancer processes after a while after recovery. Usually, this occurs a few months or several years after the completion of treatment, which may include chemotherapy, radiation therapy, hormone therapy and surgery. In this case, oncological processes begin to develop in the zone of localization of the primary neoplasm, and in other parts of the breast. It is also possible the appearance of oncological processes in the second mammary gland. When relapses of the disease, new foci of malignant tumors are often observed in other organs. In this case, we can talk about metastasis, when cancer cells along with the blood and lymph flow are carried throughout the body to vital organs.

Experts believe that malignant neoplasms of the breast are one of those tumors that are most likely to give a relapse of the disease. In most cases of repeated manifestations of the disease, the tumor appears in the same place where the primary neoplasm was localized (in seventy-five percent of relapses). In twenty-five percent of cases, cancer processes occur elsewhere, which had not previously been exposed to cancer cells.

The recurrence of breast cancer is typical for the following forms of the disease:

• Low-grade breast cancer is one of the most common types of cancer, relapses of which appear after a short time.
• Invasive protocol cancer with a high probability of relapse. This is due to the fact that this form of cancer gives the formation of metastases in the axillary lymph nodes.
• Tumors larger than five centimeters give a relapse of disease five to six times more often than smaller tumors.

The appearance of relapses of breast cancer is affected by the nature of the treatment. The most persistent results are provided by complex therapy of breast cancer processes. For example, with the stage II B cancer - tumor formation of two to five centimeters in size with single metastases from the lymph nodes - the occurrence of relapse and metastasis after two to four years from the end of treatment is observed twice less often than is possible with combined therapy. If we compare these results only with surgical intervention, then the occurrence of relapses and metastases in complex therapy may be 2.2 times less often than with the surgical method of treatment.

Radical treatment of breast tumors does not always give stable positive results. In the first five years after this type of treatment, recurrences of the disease are observed from thirty-eight to sixty-four percent of cases. The appearance of the symptoms of the newly developing oncological process suggests that the cancer disease has intensified, and the prognosis for survival in this case is disappointing.

The prognosis of life expectancy in recurrence of breast cancer depends on the methods of treatment of a second malignant process and ranges from twelve months to two years (information on the average life expectancy in this case).

If we talk about predictions for recovery from recurrence of the disease and the possibility of survival after it, then it must be said that the re-emergence of a malignant process in the mammary gland itself gives a greater chance of killing the disease than the spread of metastases to other organs. In the presence of metastatic tumors in the lungs, liver and bones, the patient does not have the opportunity to recover completely.

Prognosis for low-grade breast cancer

All malignant breast tumors have different properties and structure if one observes their structure and composition through a microscope. From the definition of the properties of tumors and the nature of the course of the disease, the method of treatment and the success of the results of therapy are highly dependent.

To reveal the nature of oncological processes, a histological examination of the tumor tissue is carried out, as well as other laboratory and visualizing diagnostics. Regardless of the kind of tissue in the bowels of which a tumor has arisen, the degree of cellular atypia is evolved, that is, the similarity or difference of cancer cells with normal healthy cells of the organ.

According to the degree of cellular atypia, specialists distinguish three degrees of malignancy of tumor processes:

• I degree (three to five points) is a highly differentiated cancer. In this case, tumor cells are most similar to healthy cells in the breast tissue, both in composition and in appearance.
• II degree (six to seven points) is a medium-differentiated cancer. In this case, tumor cells no longer resemble cells of healthy breast tissue.
• III degree (eight to ten points) is a low-grade cancer. At this degree of oncological processes, tumor cells completely lost the properties and appearance inherent in healthy cells of the breast tissue. Such malignant cells already live and function in a completely separate way from other cells of the tissue from which they originated. They show aggression to the rest of the healthy cells, destroying and transforming the nearby tissue of the organ, increasing the size of the tumor.

Low-grade breast cancer is one of the most aggressive forms of cancer. This type of cancer affects not only the ducts and / or lobules of the breast, but also can grow into other organs and tissues due to the high rate of spread of metastases.

Low-grade breast cancer is the heaviest in terms of predicting the healing of the disease, since treating this degree of cancer is a big problem. Tumor cells that have undergone a strong transformation, as a result of changes in structure and properties, have acquired resistance to various types of therapy. To date, the search for new treatments for low-grade forms of breast cancer is an urgent problem of modern medical science and practice.

Prognosis for inflammatory breast cancer

Inflammatory breast cancer is one of the less common types of breast tumors. This form of cancer occurs in five to ten percent of all breast cancer cases in women. Among the strong half of humanity, inflammatory breast cancer is rare. It should be noted that this type of breast oncology refers to III In the stage of cancer and is considered very serious. Inflammatory breast cancer is characterized by a high level of metastasis, that is, rapid growth and spread in the body. In addition, inflammatory breast cancer is poorly understood if one compares information on its occurrence, course and methods of treatment with other forms of breast oncology. Sometimes, during the examination of the patient, specialists can take inflammatory cancer for simple inflammation processes in the mammary gland, because all the clinical manifestations of these diseases are very similar.

The inflammatory forms of cancer include the following:

• mastitis-like,
• rosy-like,
• "Carapial" cancer.

Over the past twenty years, inflammatory breast cancer has become more common. If in the eighties and nineties this disease was found in two percent of women, by the present time inflammatory oncological processes in the breast have grown to ten percent of the total number of cases of breast cancer.

Inflammatory breast cancer is somewhat "younger" than other cancers: the average age of patients who have this disease is fifty-nine years. In comparison with other forms of cancer, this type of breast oncology occurs earlier for three to seven years than the rest.

Inflammatory breast cancer is quite difficult to diagnose. Its clinical manifestations are similar to other inflammatory processes in the chest. These include:

• the presence of redness of any segment of the skin of the breast or the entire breast,
• occurrence of the raised or increased local temperature, thus the reddened skin of a breast at palpation seems strongly warm,
• the periodic disappearance of reddening of the skin with its appearance again (in some cases, the course of this type of cancer),
• the appearance of changes on the skin, like an externally orange peel,
• the appearance of an increase in the entire breast,
• the appearance of subcutaneous compaction on the entire surface of the breast,
• the appearance of a tumor in the mammary gland (in half of the cases of this type of cancer), which is very difficult to test for examination by a specialist due to the increase and thickening of breast tissue.

Due to the above symptoms of the disease at the reception of a mammologist, very often this form of cancer is mistaken for breast inflammation-mastitis.

Summarizing all the previous information, we can state that the prognosis for inflammatory breast cancer is not particularly favorable. The mortality from this form of cancer is quite high, although recently the medicine has learned to treat this disease. A significant role for healing from inflammatory cancer is played by timely detection of the problem and the formulation of the correct diagnosis. Detection of tumor processes at early stages allows prolonging the patient's life and significantly improving his health status.

With inflammatory breast cancer, which is detected late enough and which corresponds to stage III oncology processes with a strong metastasis, the average life expectancy of the patient is from four to sixteen months. Such adverse predictions are due to the fact that inflammatory forms of cancer are characterized by strong aggressiveness and a high level of resistance to any kind of treatment.

If inflammatory breast cancer is detected at an earlier stage, the life span of patients after treatment is from three years.

Prognosis for breast cancer Paget

Paget's disease or Paget's breast cancer is called an oncological disease that affects the nipples of the breast or the area of the breast that is located around the nipples. The overwhelming majority of patients with Paget's disease (no less than ninety-five percent) have breast cancer. In the case of detection of breast neoplasia, Paget's cancer appears between 0.5% and 5% of the detected abnormalities.

Paget's disease is a disease of the elderly. Such health problems among all cases of such an oncology are most often recorded in patients who have crossed the 50-year age limit. In very rare cases, Paget's cancer occurs in young people under the age of twenty. The disease is observed in both women and men, and the average age of the disease in the female is sixty-two years, and the male population is sixty-nine years old.

Symptomatic of this disease includes the following manifestations:

• Appearance of reddening of nipples.
• Scale formation on the skin of the nipples.
• Appearance of a sensation of tingling of the skin of the nipples.
• The onset of itching and / or burning of the nipples and the sucking area.
• Appearance of high sensitivity of nipples and areola.
• The occurrence of pain in the nipples and nearby tissues.
• Appearance of discharge from the nipples.

When examined from an oncologist or mammologist, a specialist can detect a pineal gland in the mammary gland. Similar manifestations of this disease are characteristic for half of cases of Paget's disease. In the early stages, nipple cancer can appear only in this area, but then spread to the mammary gland. Sometimes Paget's cancer affects the areola - the dark skin around the nipple and does not penetrate further into the breast tissue. In such manifestations of the disease, the areola is covered with affected skin, which is externally similar to eczema and is accompanied by the same symptoms - itching and rash. In very rare cases, the cancer of the nipples affects both mammary glands.

So, we summarize the variants of lesions of the breast in Paget's cancer:

• Affecting only the nipple and areola.
• Having nipple changes and areoles when a tumor node appears in the mammary gland.
• The presence of a tumor node in the mammary gland, which is established by palpation and other methods of examination, for example, ultrasound. Histological examination of breast tissue samples reveals the presence of Paget's cancer of the nipple and breast areola, which is a surprise for both the patient and specialists.

Paget's cancer of the breast is also found in the stronger sex, although in much lesser cases. This is because the oncological processes of the breast are not characteristic of the male body. The course of the disease occurs in the same way as in female patients: it is possible to observe the manifestation of erythema, scaling and itching of the skin in the nipple and areola, erosion affecting the duct of the breast.

The prognosis for breast cancer Paget depends on the stage of the cancer, as well as the biological aggressiveness of the disease and the speed of its spread in the body. The incurability of the disease and rapid lethal outcome are available when a combination of the last stages of cancer with high aggressiveness of the cancer process. The most favorable predictions, respectively, are obtained with the early detection and treatment of a disease with a low biological activity of the oncological process.

It is impossible to give a general prognosis that would be as accurate as possible without seeing the results of the patient's examination and not being able to observe the development of the disease. Individual criteria for the life expectancy of a patient are influenced by many criteria. Known medical practices the factors from which a prognostic picture of the patient's health condition is formed are the same for both breast cancer and breast cancer Paget. The most important of them are:

• stage of oncology process development,
• age of the patient,
• the number of metastases affected by lymph nodes,
• the presence or absence of unfavorable morphological criteria,
• presence or absence of multiple lesions (especially if there is a lobular infiltrative cancer),
• degree of malignancy of oncoprocess,
• overexpression of c-erb 2neu,
• and-DNA.

So, summarizing all of the above, we can say that a favorable prognosis for breast cancer is established at the earliest stage of the oncological process with minimal biological aggressiveness of the tumor and a low rate of its spread. In this case, the disease can be cured completely, avoiding recurrence of the disease. In other cases, with advanced stages of breast cancer, for example, in stage III without metastases, the life expectancy of patients is six to ten years after the treatment.