Protocolal carcinoma of the mammary gland
One of the most common forms of non-invasive or invasive breast cancer is ductal carcinoma of the breast.
Than this tumor is characterized:
- malignant degeneration originates in the lumen of the milky ways of the gland;
- cancer cells occur directly from the gland ducts;
- ductal carcinoma more often refers to non-invasive forms of cancer, that is, it does not germinate into other tissues, besides the milky canal. However, in some cases, the surrounding healthy tissues may also suffer.
Consider this disease in more detail.
Causes of the ductal carcinoma of the breast
Women have more glandular cells than men. If we take into account the degree of hormones exposure to these cells, it becomes clear that the risk of getting breast carcinoma in women is higher. Men, too, can get sick, but their chances are estimated about a hundred times less.
The risk of carcinoma formation may increase with age, especially after 50 years.
The greatest danger of getting carcinoma is susceptible to those patients who had cases of this disease in their genus. Moreover, the closer the affected relative (mother, sister), the greater the risk of the disease.
One of the risk factors for carcinoma is the absence of pregnancy, or infertility. Successful pregnancy and childbirth reduce this risk.
Long-term treatment with hormonal drugs, prolonged intake of oral contraceptives increases the risk of carcinoma formation.
Regular use of alcohol significantly increases the chances of developing cancer, including breast carcinoma. For this reason, women, especially after age 40, should better not drink alcohol.
The proven risk factor is obesity, since excess weight in most cases implies an increased amount of estrogens in the body, which can cause the development of a cancerous tumor.
Symptoms of the ductal carcinoma of the breast
Protocolal carcinoma can not be manifested for a long period of time. Soreness or other sensations in the chest for this disease are uncharacteristic. Some patients have symptoms, but at first few people pay attention to them.
Symptoms of the early stage of ductal carcinoma of the breast are:
- The skin around the nipple or the nipple itself is drawn inward;
- discharge from the lactiferous canal, possibly with an admixture of blood;
- enlargement and consolidation of the lymph nodes from the side of the lesion, more often in the axillary region.
With the extensive spread of the process, the signs of the disease are more pronounced:
- the mammary gland swells, when infiltration appears a kind of "lemon peel";
- The affected gland can change shape, which is more noticeable when comparing two glands;
- the appearance of ulcers in the nipple;
- the appearance of metastases, mainly in the lymph nodes of the supraclavicular and axillary region.
General symptoms of cancer can appear: a feeling of fatigue, weakness, lack of appetite, headaches, irritability.
Forms
Invasive ductal carcinoma of the breast
Invasive ductal carcinoma of the breast (synonymous with infiltrative, infiltrating) is the most common type of breast cancer. This name denotes a common germination of the neoplasm beyond the milky duct.
Infiltrating ductal carcinoma of the mammary gland originates from epithelial cells that are located inside the milky canals. Further the process extends to other surrounding gland tissues, outside the milky canal.
The causes of this disease are the same as those of non-invasive cancer. Symptoms of the disease can appear already at the initial stages, or only when the intra-cellular cancer goes beyond the milky canals. In this case, it is possible to detect a characteristic sign of infiltrating carcinoma: the appearance of a hard swelling in the nipple region with uneven contours, welded to the nearest tissues. The nipple or nasal region, as a rule, is drawn inward.
With invasive carcinoma, the diagnosis reveals microcalcinates in the mammary gland: this is due to the necrosis of tumor cells with their further calcination.
Invasive carcinoma is not limited in size and speed of development: the tumor can reach large volumes at different times, depending on the aggressiveness of the tumor.
Diagnostics of the ductal carcinoma of the breast
In the diagnosis of ductal carcinoma of the breast, many different methods are used. We will tell you about the most frequently used procedures.
- Exterior examination and palpation - should be done from the seventh to the tenth day of the monthly cycle. If there is a suspicion of carcinoma, the day of the procedure does not play a role. This is a preliminary method of examination, followed by laboratory and instrumental diagnostic procedures.
- Mammography is an informative method that helps to detect carcinoma even in non-detectable tumors. Not recommended for carrying out at a young age.
- Doktografiya - X-ray procedure with the introduction of contrast - a special substance that allows you to shade the milky duct and assess its patency, contours, tortuosity, etc.
- Ultrasound examination (possibly with dopplerography) - can be used at any age. The effectiveness of the method is equivalent to mammography, but ultrasound does not always allow us to detect microcalcinates in the gland.
- Thermography - the application of infrared radiation, which helps identify areas with a deficiency of blood circulation and slow metabolism. This method is inferior to the informative mammography and ultrasound, so it is rarely used.
- MRI (magnetic resonance imaging method). Can assess the condition of tissues even without using contrast. A high-precision method, which, however, is less popular due to its high cost.
- Cytology is a method of determining malignant cells in the gland secretions, in a punctate (a material taken directly from the gland tissues through puncture).
If as a result of diagnosis the diagnosis of ductal carcinoma of the breast was confirmed, the next step should be a check for the presence of metastases in the body. Most often, computer tomography is used for this purpose.
Treatment of the ductal carcinoma of the breast
The most radical type of treatment of ductal carcinoma of the breast is removal of the tumor with a further course of irradiation. However, this is by no means the only method of therapy for a cancerous tumor.
- Organ-preserving removal. By agreeing to remove the tumor, women certainly want to keep the affected mammary gland as an organ. In some cases, it is really possible. The surgeon performs the removal of the tumor directly, without affecting the gland as a whole. After such an operation, subsequent radiotherapy is mandatory.
- Surgical treatment of ductal carcinoma of the breast can be performed in several ways: the method of lumpectomy (removal of the entire area of cancer degeneration) and the method of excision (usually a reoperation after lumpectomy, when the remains of cancer cells are detected). Often the method of excision is practiced under the supervision of ultrasound or mammography to facilitate the clarification of the location of the tumor.
- Radiation therapy - is often prescribed after surgery in order to completely rule out the re-development of cancer. Radiation therapy can be performed on the entire affected gland, or in a restricted area. The device for radiation therapy is called a linear accelerator of charged particles. The course of irradiation is usually carried out by the apparatus for five days in two for five weeks. The use of radiation therapy can reduce the risk of recurrence of cancer by 50-75%.
- Complete ectomy of the affected gland - mastectomy. Such a radical operation is prescribed for carcinoma of considerable size, as well as with a clear hereditary predisposition to oncological diseases of the breast. After complete removal of the gland, plastic surgery is performed to prosthetically remove the missing breast. Often, this procedure is carried out simultaneously with the removal.
- Chemotherapy. This method of treatment can improve the result of surgical intervention. What drugs can be used to treat carcinoma:
- tamoxifen - the blocker of estrogen receptors, inhibits the growth of malignant cells in hormone-dependent oncology;
- drugs that inhibit aromatase (arimidex, femara, aromazin) - inhibit the production of hormones, thereby suppressing the biosynthesis of estrogens in tumor tissue;
- Other chemotherapy drugs (cyclophosphamide, epirubicin, doxorubicin, methotrexate, fluorouracil) are quite toxic drugs that kill cancer cells, but in some cases, damage to healthy tissues. Particularly expressed effect of such funds on the bone marrow and digestive system.
The choice of this or that method of treatment remains with the doctor: it can depend on many factors, therefore the therapy is selected individually.
Prevention
Preventive measures consist in the timely treatment of breast diseases, the prevention of abortions, the observance of the physiological period of breastfeeding. Each woman, without exception, is recommended self-examination of the mammary glands for the appearance of seals, nodules, secretions, etc. Every year, you should undergo examination at a mammalogist or gynecologist. After 40 years of age, it is advisable to undergo periodic mammograms.
If a family member has had a breast cancer on the family, then all the other nearest family members are at risk, so they should undergo an examination every year from the mammologist on a mandatory basis.
It is desirable not to forget about the general rules for the prevention of cancer:
- to abandon bad habits (smoking, drinking);
- avoid stress;
- avoid chest injuries;
- time to treat diseases of the genital area, hormonal failures, as well as infectious diseases in the body (including chronic).
Forecast
The prognosis for ductal carcinoma of the breast can depend on various factors:
- from the size of malignant education;
- from detection of metastases in the lymphatic system;
- from the degree of malignancy according to the results of histology;
- from hormone dependence of the tumor;
- from the level of the cancer marker CA 15-3;
- from the timeliness and quality of the treatment.
Qualified and well-chosen therapeutic measures guarantee the patients a good chance of a favorable prognosis. Protocolal carcinoma of the breast can be treated: at present, most medical facilities have all the necessary equipment for treating this pathology.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"
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