Prognosis in breast cancer

The prognosis for breast cancer is considered by experts to be the most favorable of all oncological diseases in men and women. This has become possible due to the fact that this disease has been well studied, and sufficient measures have been developed for high-quality and timely treatment of breast tumors.

Breast cancer is the most common oncological disease among women. Moreover, this "scourge" affects residents of the European part of the globe, Americans of the Northern and Southern continents, as well as representatives of a number of Asian countries.

Every 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 this trend primarily concerns women living in large and medium-sized cities. It can be noted that the incidence of breast cancer has increased by approximately thirty percent over this period. Moreover, women over thirty-five are most susceptible to this disease.

What specific measures should be taken to prevent the likelihood of breast cancer or reduce the degree of neglect of this disease? First of all, women need to know that an annual preventive examination by a mammologist allows you to detect a breast tumor at an early stage. This increases the chances of a favorable prognosis for recovery from this disease. But in our culture, it is customary to resort to consulting a specialist if the problem has already declared itself "in full growth". Most sick women turn to mammologists or oncologists when the tumor has obvious external signs, and also affects the general well-being of the patient and shows significant symptoms of cancer. Such a situation greatly complicates treatment, while significantly reducing the favorable prognosis for getting rid of breast cancer and prolonging the life of the patient.

Therefore, any woman who cares about her health, especially living in a large city, should make it a rule to have an annual medical examination by a mammologist. This procedure does not take much time, but at the same time, it allows you to prevent the disease or significantly reduce the risks with early detection of tumor processes. After a certain critical age (usually after thirty-five years), a mammologist prescribes a special X-ray examination of the mammary gland - mammography. Such a procedure allows you to identify tumor processes in the breast at the earliest stages of their development and take optimal measures to combat the disease.

It should be noted that representatives of the stronger sex are also susceptible to breast cancer, although it should be taken into account that this problem occurs in men much less often than in women. Some oncologists believe that breast cancer does not depend on gender, age, or ethnic group to which a person belongs. There are other factors that affect the possibility of developing breast cancer.

The nature of the oncological processes in the mammary gland depends on a number of conditions, which primarily include the woman's age and her hormonal status. Young women, especially during pregnancy and breastfeeding, are susceptible to rapid tumor growth, as well as early appearance and spread of metastases throughout the body. In contrast to the above, older women can live for more than eight to ten years with breast cancer that does not metastasize.

Of course, we should not forget that the degree of recovery and life expectancy after therapy depend on the stage of the disease. Early stages of oncology (I - II) are easily treated and the probability of relapse in this case is quite low. At later stages, treatment of breast cancer without relapse is quite problematic. In medical practice, it is known that the ten-year prognosis for the survival of patients with stage I breast cancer is ninety-eight percent, and stage IV breast cancer is ten percent. Accordingly, the ten-year survival rate at stages 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 life prognosis of a patient with breast cancer:

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

Let's consider these parameters in more detail.

• The prognosis of favorable or unfavorable recovery from breast cancer is influenced by the location of the tumor in a certain quadrant of the mammary gland. 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 grow.

The most favorable prognosis is considered to be the formation of a tumor in the outer quadrants of the mammary gland. A complete cure from the disease is possible, mainly due to the fact that these foci of oncological processes can be diagnosed at early stages, as well as regional metastasis. Also in this case, when the tumor is located in the outer quadrants of the breast, more radical methods of treatment can be used, which include surgical intervention.

Low prognosis for recovery from the disease is characterized by prognosis, which is typical for tumors in the medial and central areas of the mammary gland. These foci of malignant processes are characterized by a high level of metastasis. First of all, this concerns 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 breast tumors:
  • up to two centimeters in the largest dimension;
  • from two to five centimeters in the largest dimension;
  • over five centimeters.

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

• Experts 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 infiltrative tumors is worse than for all other types of tumors listed above. Infiltrative breast cancer is most often found in young women and, in rare cases, in elderly women in the deep menopause stage. Inflammatory forms of breast cancer have the most unfavorable prognosis.

• With the possibility of radical treatment of breast cancer after the therapy, the prognosis for five-year survival of patients with stage I cancer is from eighty-three to ninety-four percent. When conducting radical treatment of patients with stage IIIB cancer (a tumor larger than five centimeters with metastases in regional lymph nodes), the five-year survival of patients is from thirty-four to forty-six percent of cases.

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

• stage I – if the tumor size is less than two centimeters and there is no lymph node involvement or distant metastases – the five-year survival rate is eighty-five percent of cases;
• stage II – with a tumor size of two to five centimeters and the presence of affected lymph nodes in the armpits, there are no distant metastases – the five-year survival rate of patients is sixty-six percent;
• stage III – if the tumor size is over five centimeters, has grown into nearby breast tissue, has affected the lymph nodes not only in the armpit area but also further away, and there are no distant metastases – the five-year survival rate for 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 – the 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 ten years after the end of therapy.

There is data on the life expectancy of patients with breast cancer in the metastatic stage. At the present time, the disease in this form is incurable. Therefore, the average life expectancy of most patients who have received treatment since the discovery of metastases is from two to three and a half years. From twenty-five to thirty-five percent of such patients can live for more than five years, and only ten percent of patients - more than ten years. Although, information on the life expectancy of patients who have not undergone treatment at stages III and IV of cancer is about two years and seven months. Which may cast doubt on the very fact of the possibility of curing these stages of breast cancer by means of modern medicine.

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Prognosis for invasive breast cancer

Malignant tumors in the mammary gland have several stages of their development. Specialists dealing with this problem distinguish several stages that oncological processes in the breast go through. Invasive breast cancer is one of them.

Invasive breast cancer is a tumor that has grown into the breast tissue. In this case, with the help of blood and lymph flow, malignant cells spread throughout the body from the tumor formation area. In the armpits, lymph nodes begin to be affected and enlarge. Cancer cells penetrate the main human organs - the liver, lungs, skeletal system and brain - where metastases begin to form at an accelerated rate.

Invasive breast cancer is divided into certain types:

• Preinvasive ductal carcinoma of the breast.

This oncological disease is a tumor that is located in the milk ducts of the breast. At the same time, malignant cells have not yet penetrated into the neighboring tissues of the mammary gland. But cancer cells at this stage actively divide, and the tumor quickly increases in size. Therefore, if certain treatment measures are not taken, malignant processes develop from preinvasive to invasive cancer.

• Invasive ductal carcinoma of the breast.

In this form of oncological processes, the cancerous tumor has already reached the fatty tissue of the mammary gland. The affected cells can already penetrate into the blood and/or nearby lymph nodes. Together with the blood and lymph, the malignant elements of the neoplasm are carried throughout the body and subject other organs to metastasis.

According to doctors, invasive ductal breast cancer is the most common form of invasive oncology. Among the identified cases of this disease, more than eighty percent of cases are of this type of tumor processes.

• Invasive lobular breast cancer.

This form of invasive breast cancer is quite rare. However, there is a difference between this type of cancer and the previous ones, which can be detected during palpation of the breast. At the site of tumor formation, the specialist will find not a lump, as in the above cases, but a seal. The development of this form of tumor process is the same as the previous types.

The symptoms of invasive cancer at the earliest stages are barely noticeable. Therefore, in most cases, women do not even suspect that their body has been subjected to a serious disease. But according to some signs known to 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 include:

• The appearance of a long-lasting lump or compaction in the mammary gland.
• In changing the shape of the breast, its outlines.
• In the deterioration of the condition of the skin of the mammary gland and its elasticity, the appearance of severe peeling of the upper skin layers, the appearance of wrinkles and ripples on the skin.
• In the appearance of discharge from the nipples of the breast.
• In the occurrence of severe pallor in a certain area of the skin of the mammary gland.

If a woman notices one, several or all of the above symptoms in the condition of her breasts, she should immediately contact a mammologist or oncologist for a comprehensive consultation. It is necessary to find out the reason for such changes that occur with the mammary gland and undergo appropriate examinations.

Based on the diagnostics, the doctor must select the most optimal treatment option for the mammary gland. The specialist may 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 mammary gland: the size of the tumor, its location, the stage of the oncological process, the results of laboratory tests, the age of the patient. The choice that the patient has made for a certain treatment method is also taken into account.

In order to predict the prognosis for invasive breast cancer, several factors must be taken into account:

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

If oncological processes in the body are detected in a timely manner, that is, at an early stage, there is a favorable prognosis for recovery from the disease. It should be taken into account that the tumor should not reach two centimeters in size, and breast cancer treatment occurs using the most effective methods.

The prognosis for recovery from the disease is considered favorable if the tumor has not metastasized to regional lymph nodes and is highly differentiated, and also contains many estrogen and progesterone receptors. And at the same time, the tumor tissue is sensitive to Herceptin, a biological drug with an antitumor purpose, which is used to treat breast cancer. This drug affects malignant cells of the mammary gland tumor without destroying healthy tissue.

Tumors with the following symptoms have an unfavorable prognosis for breast cancer treatment:

• lymphedema - a disease of the lymphatic system in which the outflow of lymph from the lymphatic capillaries and lymphatic vessels of the mammary gland ducts is disrupted; as a result, swelling of the soft tissues of the upper limbs and the mammary gland itself occurs, which significantly increases the size of the breast affected by the tumor, as well as the limb affected by the problem;
• tumor growth into nearby healthy tissue;
• a large number of tumor development sites;
• the presence of distant metastases in the lymph nodes and various organs (lungs, liver, bone tissue, etc.).

Prognosis for lobular breast cancer

Lobular carcinoma of the breast in situ (otherwise this disease is called "alveolar cancer", "acinar cancer", non-infiltrative lobular cancer) is an oncological disease of the breast, which occurs in women most often in the age period from forty-five to forty-eight years. Foci of this form of cancer appear simultaneously in several areas of the breast, in the lobules of the mammary gland. The upper-outer quadrants of the breast are most susceptible to lobular cancer.

This type of breast cancer is very difficult to diagnose and detect. This is because the density of the tumor tissue is quite low and is practically no different from the surrounding healthy breast tissue. Malignant tumor cells can only be detected under a microscope, by chance, and in the part of the gland where a benign tumor was recently removed. Or lobular cancer is diagnosed as a parallel disease simultaneously with other forms of breast cancer.

Infiltrating lobular carcinoma (or invasive lobular carcinoma) is a more advanced stage of lobular carcinoma in situ. This form of breast cancer accounts for five to fifteen percent of all cases of infiltrating (or invasive) cancer. Patients with this disease are between forty-five and fifty-five years of age.

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

It is quite difficult to give a favorable prognosis for lobular cancer, since this form of cancer is very difficult to diagnose at the early stages of the development of oncological processes. At an advanced stage of this oncology (with the presence of distant metastases), the patient's life expectancy is two to three years after the disease is detected.

If the tumors were detected early enough (at stage I-II), then the probability of recovery from this form of cancer is about ninety percent of cases. In this case, the prognosis is given for a period of five years after the treatment. If this form of cancer has shown several secondary foci, then the five-year survival rate of patients after the treatment is sixty percent.

Prognosis for hormone-dependent breast cancer

Before choosing a method of treatment for breast cancer, a specialist prescribes a full cycle of examinations for the patient. One of the diagnostic methods is checking the level of hormones in the blood. This test allows you to identify whether female hormones (estrogen or progesterone) affect the growth of a cancerous tumor. If the test is positive, then a conclusion is made that the hormones of the female body have a direct impact on the development of malignant cells. And the specialist makes a decision on prescribing hormonal therapy for breast cancer, which is considered effective in this case.

Hormonal treatment of breast cancer is also used for patients with widespread tumors or forms of breast cancer with unfavorable prognosis for recovery. A similar method of therapy is used to treat those patients for whom chemotherapy is contraindicated:

• persons over the age of fifty-five,
• having acute infectious diseases,
• with a history of serious renal and hepatic dysfunction,
• suffering from uncompensated diabetes,
• patients with severe cardiovascular insufficiency,
• persons with a history of severe hemodepression.

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

• use of drugs (androgens) that reduce the level of estrogens in the body;
• the use of drugs (corticosteroids) that block the ability of sex hormones to bind to tumor receptors;
• the use of drugs that completely stop the production of sex hormones that provoke the development of tumors;
• A radical treatment method is oophorectomy, which removes the ovaries that produce estrogen.

The choice of hormonal treatment method is influenced by the following factors:

• stage of cancer and previously used treatment methods;
• the patient's status regarding menopause;
• the presence of other diseases that may worsen the quality of drug tolerance (for example, arthritis, osteoporosis, thrombosis, etc.)

In general, hormone-dependent breast cancer occurs in thirty to forty percent of women with breast cancer. The 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 hormonal therapy, in addition to those indicated above, are:

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

In order for hormone treatment to be effective, the patient must undergo tests for the presence of receptors in the tumor before starting therapy. If there are no such receptors on the tumor surface, hormone therapy will be ineffective.

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

• the patient's health status;
• type of hormonal therapy;
• the speed of achieving results using this treatment method;
• presence of side effects.

At the present time, medicine considers this method of fighting breast cancer to be one of the most effective. Such high efficiency is caused, first of all, by extensive experience in the use of hormonal therapy, which allowed us to thoroughly develop the method of treatment with hormones. Thanks to this, the survival rate of patients with hormone-dependent cancer has increased by twenty-five percent.

The survival rate for hormone-dependent breast cancer has increased significantly with modern hormone therapy. In fifty-six cases, this therapy prevents the possibility of the primary tumor appearing in the other breast, and the risk of recurrence has decreased by thirty-two percent.

Prognosis for recurrent breast cancer

Recurrence of breast cancer is the reappearance of breast cancer symptoms after treatment. Recurrence of the disease is manifested in the repeated development of oncological processes some time after recovery. Usually, this occurs several months or several years after the completion of treatment, which may include chemotherapy, radiation therapy, hormonal therapy and surgery. In this case, oncological processes begin to develop both in the area of localization of the primary tumor and in other areas of the breast. Oncological processes may also appear in the second mammary gland. Relapses of the disease often involve the emergence of new foci of malignant tumors 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 mammary gland are among those tumors that are most prone to relapses. In most cases of recurrent manifestations of the disease, the tumor occurs in the same place where the primary neoplasm was localized (in seventy-five percent of relapses). In twenty-five percent of cases, oncological processes occur in a different place that was not previously exposed to cancer cells.

Recurrence of breast cancer is typical for the following forms of this disease:

• Poorly differentiated breast cancer is one of the most common types of cancer, which relapses after a short period of time.
• Invasive ductal carcinoma is highly likely to relapse. This is also due to the fact that this form of cancer causes metastases to form in the axillary lymph nodes.
• Tumors larger than five centimeters cause relapses of the disease five to six times more often than tumors of smaller sizes.

The occurrence of breast cancer relapses is affected by the nature of the treatment. The most stable results are achieved with complex therapy of breast cancer processes. For example, at stage II B cancer - a tumor formation measuring from two to five centimeters with single metastases to the lymph nodes - the occurrence of relapse and metastasis after two to four years from the end of treatment is observed twice as rarely as is possible with combination therapy. If we compare these results only with surgical intervention, the occurrence of relapses and metastases with complex therapy can be 2.2 times less frequent than with surgical treatment.

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

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

If we talk about prognoses for recovery from relapse of the disease and the possibility of survival after it, it must be said that the recurrence of a malignant process in the mammary gland itself gives a greater chance of stopping 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 fully recover.

Prognosis for poorly differentiated breast cancer

All malignant tumors of the mammary gland have different properties and structure if their structure and composition are observed through a microscope. The method of treatment and the success of the therapy results depend greatly on the determination of the properties of the tumors and the nature of the disease.

To identify the nature of oncological processes, a histological examination of the tumor tissue is carried out, as well as other laboratory and visual diagnostics. Regardless of the type of tissue in which the tumor arose, the degree of cellular atypia is distinguished, 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:

• Stage I (three to five points) - highly differentiated cancer. In this case, the tumor cells are most similar to healthy breast tissue cells in both composition and appearance.
• Stage II (six to seven points) – moderately differentiated cancer. In this case, the tumor cells no longer resemble the cells of healthy breast tissue.
• Stage III (eight to ten points) – low-differentiated cancer. At this stage of oncological processes, tumor cells have completely lost the properties and appearance inherent in healthy cells of the mammary gland tissue. Such malignant cells already live and function in a completely separate way from other cells of the tissue from which they arose. They show aggression to other healthy cells, destroying and transforming nearby organ tissue, 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 is also capable of growing into other organs and tissues due to the high rate of metastasis.

Low-differentiated breast cancer is the most severe in terms of prognosis for recovery from the disease, since the treatment of this stage of cancer is a big problem. Tumor cells, having undergone a strong transformation, as a result of changes in structure and properties, have acquired resistance to various types of therapy. At the present time, the search for new methods of treating low-differentiated 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 rare types of breast tumors. This form of cancer occurs in five to ten percent of all cases of breast cancer in women. Among the strong half of humanity, inflammatory breast cancer is quite rare. It should be noted that this type of breast cancer belongs to stage IIIB cancer and is considered very serious. Inflammatory breast cancer is characterized by a high level of metastasis, that is, the speed of growth and spread in the body. In addition, inflammatory breast cancer is poorly understood when comparing information about its occurrence, course and treatment methods with other forms of breast cancer. Sometimes, during the examination of a patient, specialists may mistake inflammatory cancer for simple inflammatory processes in the mammary gland, since all the clinical manifestations of these diseases are very similar.

Inflammatory forms of cancer include the following:

• mastitis-like,
• erysipelatous,
• "armored" cancer.

Over the past twenty years, inflammatory breast cancer has become much more common. If in the eighties and nineties this disease was found in two percent of women, then by now 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 types of cancer: the average age of patients diagnosed with this disease is fifty-nine years. Compared to other forms of cancer, this type of breast cancer occurs three to seven years earlier than others.

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

• the presence of redness of any segment of the skin of the breast or the entire mammary gland,
• the appearance of increased local temperature, while the reddened skin of the chest feels very warm when palpated,
• periodic disappearance of skin redness with its reappearance (in some cases of this type of cancer),
• the appearance of changes on the skin, similar in appearance to orange peel,
• the appearance of an enlargement of the entire mammary gland,
• the appearance of a subcutaneous lump on the entire surface of the chest,
• the appearance of a tumor in the mammary gland (in half of the cases of this type of cancer), which is very difficult to palpate during an examination by a specialist due to the enlargement and compaction of the breast tissue.

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

Summarizing all the previous information, we can state that the prognosis for inflammatory breast cancer is not particularly favorable. Mortality from this form of cancer is quite high, although medicine has recently learned to treat this disease. Timely detection of the problem and correct diagnosis play a major role in healing from inflammatory cancer. Detection of tumor processes at early stages allows to prolong the patient's life and significantly improve his health.

In inflammatory breast cancer, which is detected quite late and which corresponds to stage III of oncoprocesses with strong metastasis, the average life expectancy of the patient is from four to sixteen months. Such unfavorable prognosis is related to the fact that inflammatory forms of cancer are characterized by strong aggressiveness and a high level of resistance to any type of treatment.

When inflammatory breast cancer is detected at an earlier stage, the life expectancy of patients after treatment is three years.

Prognosis for Paget's disease of the breast

Paget's disease or Paget's carcinoma of the nipple is a cancer that affects the nipples of the breast or the area of the breast that is located around the nipples. The vast majority of patients with Paget's disease (at least ninety-five percent) have breast cancer. In the case of breast neoplasia, Paget's carcinoma occurs in 0.5% to 5% of detected anomalies.

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

The symptoms of this disease include the following manifestations:

• The appearance of redness of the nipples.
• Formation of scales on the skin of the nipples.
• The appearance of a tingling sensation in the skin of the nipples.
• The occurrence of itching and/or burning of the nipples and areola area.
• The appearance of high sensitivity of the nipples and areola.
• The occurrence of painful sensations in the nipples and surrounding tissues.
• The appearance of discharge from the nipples.

During an examination by an oncologist or mammologist, a specialist may detect cone-shaped tumors in the mammary gland. Such manifestations of this disease are characteristic of half of the cases of Paget's disease. In the early stages, nipple cancer may 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 tissue of the mammary gland. With 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 fairly rare cases, nipple cancer affects both mammary glands.

So, let's summarize the variants of breast lesions in Paget's disease:

• Affecting only the nipple and areola.
• Having changes in the nipples and areola when a tumor node appears in the mammary gland.
• The presence of a tumor node in the mammary gland, which is detected by palpation and other examination methods, such as ultrasound. Histological examination of mammary gland tissue samples also reveals the presence of Paget's cancer of the nipple and areola, which comes as a surprise to both the patient and specialists.

Paget's cancer of the mammary gland also occurs in men, although in much smaller numbers. This is because oncological processes of the breast are not typical for the male body. The course of the disease is the same as in female patients: one can observe the manifestation of erythema, peeling and itching of the skin in the nipple and areola area, erosion affecting the ducts of the breast.

The prognosis for Paget's disease of the breast depends on the stage of the oncological disease, 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 death occur with a combination of the last stages of cancer with high aggressiveness of the oncological process. The most favorable prognosis, accordingly, is obtained with early detection and treatment of the disease with 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 patient's examination results and without being able to observe the disease development process. The individual prognosis of the patient's life expectancy is influenced by many criteria. The factors known to medical practice that make up the prognostic picture of the patient's health condition are the same for both breast cancer and Paget's disease of the mammary gland. The most important of them are:

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

So, summing up all of the above, we can say that a favorable prognosis for breast cancer is stated 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 relapses of the disease. In other cases, at advanced stages of breast cancer, for example, at stage III without metastases, the prognosis for the life of patients is from six to ten years after treatment.