Sarcoma of mammary glands

It occurs not so often, no more than 0.6% of all cases.

To reveal it is quite simple, despite the patient's age.

For a malignant neoplasm of this type, rapid development and course is characteristic.

[1], [2], [3], [4], [5], [6], [7], [8]

Causes of the breast sarcomas

The real reasons for the occurrence of the disease, it was not revealed. But, despite this, there are special factors that can influence the development of this process. So, the negative impact has various carcinogens and even trauma to the breast. Its contribution is made by the family hereditary weighed form and radiation.

In many cases, the sarcoma appears due to the sectoral resection of the breast. This effect is produced if there is any benign neoplasm. This can be fibroadenoma, as well as spindle cell tumors.

Sarcoma may well be combined with fibroadenoma. In most cases, it has much in common with cancer of the opposite gland, vagina or rectum. In fact, this is a serious disease. In case of untimely elimination, a lethal outcome is possible. After all, sarcoma with metastases is almost not curable, this condition is typical for the last stages of the disease. To avoid negative consequences, you need to undergo an annual examination with a specialist.

[9], [10]

Symptoms of the breast sarcomas

During palpation, a tumor can be detected. In this case, its clear contours, having a heterogeneous consistency, are probed. In rare cases, one can observe the retraction of the nipple. One of the most common types of pathology is fibrosarcoma. It is capable of reaching incredible sizes. This condition is characterized by the presence of a pronounced venous pattern.

Symptoms of breast sarcoma largely depend on the tumor itself and its size. The point is that the affected area can be of considerable size. Above the tumor, swelling of the gland is observed. If the size becomes too large, the skin begins to appear thin. The veins expand, and the pathology becomes much easier to notice.

If we are talking about liposarcoma, then it is characterized by rapid growth. In addition, the tumor is able to progress. The synchronous defeat of both breasts is especially dangerous. Rhabdomyosarcoma is also characterized by rapid growth. Most often, the problem occurs at the age of 25 years.

Angiosarcoma is a tumor that grows rapidly. In addition, it does not have clear contours and is capable of constantly recurring. Most often occurs at the age of 35-45 years. As for chondrosarcoma, it is very rare. In general, it is diagnosed in women after 55 years. It is characterized by malignancy.

Sarcoma is a serious pathology. It can give significant metastases to the lungs and bones, which aggravates the general condition of the woman. Affects and lymph nodes. If the tumor becomes too large, the mammography can not distinguish sarcoma from a leaf-like tumor.

[11], [12], [13], [14], [15]

Diagnostics of the breast sarcomas

With the help of ultrasound, you can see an education that does not have clear contours. This is due to the fact that the pathology is not so common. In doing so, it has simply a huge range of histological variability. It usually contains multiple liquid cavities and is characterized by the presence of diffuse contours. There is an infiltration of tissues surrounding the neoplasm.

Diagnostic examination can be excluded by an experienced mammalogist - oncologist. First, they start palpation. This will allow you to feel the tumor itself, to reveal its contours and consistency. In addition, puffiness, hyperemia and areas of ulceration are determined.

The ultrasound data in this case is nonspecific. The fact is that in the process of research, it is possible to identify shadows in the form of knots with bumpy contours. To determine the thinning of the skin is quite simple. The subcutaneous veins on the mammary gland are clearly expanded.

For additional diagnosis is often used MRI or scintigraphy of mammary glands with technetium-99. An accurate diagnosis can be made solely with the help of a cytological study. The material is obtained by biopsy, the affected area is carefully studied. At a microscopic examination, the sarcoma is characterized by the presence of stromal elements, as well as enlarged nuclei. In this case, the epithelial component is completely absent.

[16], [17], [18], [19], [20], [21], [22]

Treatment of the breast sarcomas

Treatment of breast sarcoma can be carried out in various ways. Often resorted to surgical intervention. And it can be of two kinds. The first option is a partial mastectomy. This method is characterized by the removal of an extremely affected area, that is, the tumor itself. The volume of the operation depends entirely on the size of the neoplasm itself. Another option was called mastectomy. It is characterized by complete removal of the mammary gland along with the tumor. Sometimes a part of the muscle tissue and lymph nodes are eliminated. With this type of surgery, plastic correction can be performed in parallel.

Radiotherapy was also widely used. It is applicable in the case of partial mastectomy. The procedure allows avoiding a possible relapse. Radiation therapy is only used if the tumor does not exceed 5 cm. Radiation therapy is also used. It can be of two kinds. The first option is represented by the effect of radiation on the tumor from the outside. The second method is brachytherapy. It is characterized by the introduction of a capsule directly into the tissue with the tumor.

Naturally, chemotherapy can not be dispensed with. It involves the introduction of certain drugs that are capable of killing cancer cells. The drug is administered via a vein or by mouth. Chemotherapy is usually done in several stages. Duration of treatment is several months.

You can not do without hormone therapy. This method of treatment is very common. It can be used exclusively in aggregate in other ways. Hormones will reduce the risk of relapse. The main goal of hormone therapy is to lower the level of the hormone estrogen.

Medicinal treatment

The drug treatment is hormone therapy. This method of troubleshooting can include several types. So, there is an adjuvant (preventive) method. Its main goal is to significantly reduce the risk of recurrence of the tumor, that is, relapse. At the initial stage, hormone therapy can be prescribed after surgery, as well as radiotherapy and chemotherapy.

Neoadjuvant method. It is used only if the tumor has a huge size. Moreover, it involved lymph nodes as well. Apply also a medical type. It is widely used in foci of cancer. Its action is aimed at reducing or completely eliminating the affected area. This method is used in the event that a person can not be operated.

The main differences between all methods of treatment are the objectives of each method. In general, they are all aimed at the speedy recovery of the patient. Each technique has its pros and cons. The choice of one or another method depends on many factors. So, not only the hormonal status of the neoplasm, but also the menopausal status of the patient itself is taken into account.

As for certain medications, they can be determined after receiving the results of the hormonal status of the patient. A special role here is played by the level of estrogen, progestin. Most often, estrogen receptors are preferred. In general, those that are able to actively block estrogen receptors are used. For this purpose, Tamoxifen is used.

Common drugs are those whose goal is to suppress estrogen production in postmenopausal women. Among these drugs include Femaru, Arimidex, Aromazine. Preparations destroying estrogen receptors - Faslodex.

Tamoxifen is the main drug used in hormone therapy. Most often it is prescribed to patients who are in premenopause. Especially if the early stage of cancer was diagnosed. Possible application in the period after the operation, as well as radiotherapy and chemotherapy.

Chemotherapy

Chemotherapy can be prescribed both in the period after the operation and before it is carried out. The main goal of this method is to reduce the tumor itself. This method will make the removal more convenient and preserve the mammary gland.

If chemotherapy is used after the operation, its main goal is to prevent metastasis, as well as suppress the growth of tumor cells in the future. During the chemotherapy, only international protocols are used. Naturally, they were approved by well-known oncological communities. In this case, we mean ASCO, NCCN, ESMO.

As an independent method, chemotherapy practically does not give any results. It should always be used in conjunction with other methods of eliminating tumors. As for adjuvant treatment, this method is used only as an effect on the infraclinic microscopic tumor metastases.

In chemotherapy, schemes are widely used, in the composition of which there are preparations of anthracycline series. It is important that they are combined with cisplatin. The most important of them are CYVADIK (Cyclophosphane + Vincristine + Adriamycin + Dakarbazine), AR (Adriamycin + Cisplatinum), PC (Cisplatinum + Cyclophosphamide).

[23], [24],

Operative treatment

Operative treatment of breast sarcoma involves two main approaches. It is for them to determine the further way of plastic correction of the appearance of the mammary glands. One of the most important methods is lumpectomy. It is characterized by partial removal of the mammary gland, namely the affected area. The second method is mastectomy. This method involves the complete removal of the breast with possible plastic correction. Mastectomy is performed in cases where the patient is the owner of a small breast, and the tumor thus grows into the integuments or chest wall. The method is also used when the tumor is located on the large breast and occupies a large part of it. Surgical treatment is the main way to eliminate the pathological neoplasm. An adequate technique is to remove the tumor within a healthy tissue. It is important that in the surrounding tissues there is no tumor growth. Reducing the volume of surgical treatment in the presence of a tumor in any way does not affect the survival rate or the frequency of relapses.

For axillary lymphadenectomy, its characteristic indications. So, it is used exclusively with enlarged lymph nodes. Sometimes it is advisable to use it in the radical removal of the primary tumor. Especially if the amputation does not guarantee a sufficient distance to the line of resection. The same requirement is advanced even with a metastatic lesion, when the lymphatic apparatus is involved in the process.

Prevention

Prevention consists in the elimination of precancerous neoplasms. In addition, a woman should clearly observe a normal physiological rhythm. In this case, we are talking about pregnancy and the period of breastfeeding. The number of abortions should be reduced to a minimum. When diagnosing an important role is assigned directly to a systematic survey. And it can carry an independent character. Ignore the annual check-ups with the doctor clearly is not worth it. This issue is especially acute at the age of 40 years. It is necessary to go through mammography once every 2 years after 40 years. If a woman has severe heredity, then it is recommended to undergo a survey from an early age.

The easiest way to prevent breast sarcoma is to have a self-examination. The woman herself is able to feel the mammary glands. True, it should be understood that this procedure is not so effective. But, despite this, it is she who will reveal the tumor at an early stage. Self-examination should be done at least once a month. First you need to examine the chest in front of the mirror. To cause concern is the tension of the skin, the appearance of formations, as well as changes that resemble the "lemon peel".

After that, a feeling is carried out. If any seals have been found, or if the inhomogeneity is found, it is worthwhile to see a doctor. Particular danger is the allocation. To deal with these problems will help the oncologist.

One of the most effective prevention methods is screening. This procedure is a planned examination of people to identify their pathologies in the early stages. The procedure is completely painless. At the age of 20 to 40 years, screening is necessary every month. Every year it is recommended to do ultrasound. Starting from the age of 40, an independent examination should be conducted every month.

[25], [26], [27], [28]

Forecast

The prognosis of breast sarcoma depends on the differentiation of tumor size. Many factors influence the further course. Thus, the size of the tumor, as well as the histogram of the sarcoma, is taken into account. An important role is played by the degree of differentiation. The main survival rates are noted mainly with highly differentiated sarcomas. Naturally, a favorable prognosis is observed in the absence of metastasis.

Sarcoma in some cases can lead to local recurrence in the area of scars. A similar situation develops in the mammary gland. It is not excluded metastasis in the bone and lung tissue. All this entails grave consequences. The profitability of the forecast depends entirely on the stage at which the problem was found. Naturally, the harder the case, the less chance of a positive outcome. Therefore, it is recommended that you constantly conduct research and not ignore them. After all, from simple procedures depends on a carefree life.

[29], [30], [31]