Breast sarcoma

It does not occur very often, in no more than 0.6% of all cases.

It is quite easy to detect, regardless of the patient’s age.

Malignant neoplasms of this type are characterized by rapid development and progression.

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Causes breast sarcomas

The real reasons for the occurrence of the disease have not been identified. But, despite this, there are special factors that can influence the development of this process. Thus, various carcinogens and even trauma to the mammary gland have a negative impact. Family history of a hereditary burdened form and radiation also contribute.

In many cases, sarcoma appears due to sectoral resection of the mammary gland. This action is performed in the presence of 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 fatal outcome is possible. After all, sarcoma with metastases is practically incurable, this condition is typical for the last stages of diseases. To avoid negative consequences, you need to undergo an annual examination by a specialist.

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Symptoms breast sarcomas

During palpation, a tumor can be detected. Its clear contours are felt, having a non-uniform consistency. In rare cases, nipple retraction can be observed. One of the most common types of pathology is fibrosarcoma. It can reach 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 fact is that the affected area can be quite large. Swelling of the gland is observed above the tumor itself. If the size becomes too large, the skin begins to visibly thin. The veins expand, and it becomes much easier to notice the pathology.

If we are talking about liposarcoma, then it is characterized by rapid growth. In addition, the tumor can progress. Particularly dangerous is the synchronous defeat of both breasts. Rhabdomyosarcoma is also characterized by rapid growth. Most often, the problem occurs before the age of 25.

Angiosarcoma is a tumor that grows quickly. In addition, it does not have clear contours and is capable of constantly recurring. Most often, it occurs at the age of 35-45 years. As for chondrosarcoma, it is observed extremely rarely. It is mainly 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 worsens the general condition of the woman. Lymph nodes are also affected. If the tumor becomes too large, mammography is not able to distinguish sarcoma from phyllodes tumor.

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Diagnostics breast sarcomas

Using ultrasound, it is possible to notice a formation that does not have clear contours. This is due to the fact that the pathology is not very common. At the same time, it has a huge range of histological variability. Usually, it contains multiple fluid cavities and is characterized by the presence of blurred contours. Infiltration of tissues surrounding the neoplasm occurs.

An experienced mammologist-oncologist can conduct a diagnostic study. First of all, they begin palpation. This will allow you to feel the tumor itself, identify its contours and consistency. In addition, swelling, hyperemia and ulceration areas are determined.

The ultrasound data in this case are non-specific. The fact is that during the examination it is possible to detect shadows in the form of nodes with lumpy contours. It is quite easy to determine the thinning of the skin. The subcutaneous veins on the mammary gland are clearly dilated.

For additional diagnostics, MRI or mammary gland scintigraphy with technetium-99 is often used. An accurate diagnosis can only be made with the help of a cytological examination. The material is obtained by biopsy, the affected area is carefully examined. When examined microscopically, sarcoma is characterized by the presence of stromal elements, as well as enlarged nuclei. At the same time, the epithelial component is completely absent.

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Treatment breast sarcomas

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

Radiation therapy has also become widespread. It is applicable in the case of partial mastectomy. The procedure allows avoiding possible relapse. Radiation therapy is used only if the tumor does not exceed 5 cm. Radiotherapy is also used. It can be of two types. The first option is 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 is also necessary. It involves the administration of certain drugs that can kill cancer cells. The drug is administered intravenously or orally. Chemotherapy is usually carried out in several stages. The duration of treatment is several months.

Hormonal therapy is also necessary. This method of treatment is quite common. It can only be used in combination with other methods. Hormones will reduce the risk of relapse. The main goal of hormone therapy is to reduce the level of the hormone estrogen.

Drug treatment

Drug treatment consists of hormone therapy. This method of eliminating the problem can include several types. Thus, there is an adjuvant (preventive) method. Its main goal is to significantly reduce the risk of tumor recurrence, that is, relapse. At the initial stage, hormone therapy can be prescribed after surgery, as well as radiation therapy and chemotherapy.

Neoadjuvant method. It is used only if the tumor was huge. Moreover, it involved the lymph nodes. The therapeutic type is also used. It is widely used for cancer foci. Its action is aimed at reducing or completely eliminating the affected area. This method is used if a person cannot be operated on.

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

As for certain medications, they can be determined after receiving the results of the patient's hormonal status. The level of estrogen and progestin plays a special role here. Most often, preference is given to estrogen receptors. Those that are able to actively block estrogen receptors are mainly used. Tamoxifen is used for these purposes.

Common drugs are those that aim to suppress estrogen production in postmenopausal patients. These include Femara, Arimidex, Aromasin. Drugs that destroy estrogen receptors - Faslodex.

Tamoxifen is the main drug used in hormone therapy. It is most often prescribed to patients in premenopause. Especially if early stage cancer has been diagnosed. It can be used in the period after surgery, as well as a course of radiation and chemotherapy.

Chemotherapy

Chemotherapy can be prescribed both before and after surgery. 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 surgery, its main goal is to prevent metastasis and suppress tumor cell proliferation in the future. During chemotherapy, only international protocols are used. Naturally, they have been approved by well-known oncological societies. 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 combination with other methods of tumor elimination. As for adjuvant treatment, this method is used only as an effect on infraclinical microscopic tumor metastases.

In chemotherapy, regimens that include anthracycline drugs are widely used. It is important that they are combined with cisplatin. The most important of them are CYVADIK (Cyclophosphamide + Vincristine + Adriamycin + Dacarbazine), AR (Adriamycin + Cisplatin), PC (Cisplatin + Cyclophosphamide).

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Surgical treatment

Surgical treatment of breast sarcoma involves two main approaches. They determine the further method 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 complete removal of the mammary gland with possible plastic correction. Mastectomy is performed in cases where the patient has small breasts, and the tumor has grown into the skin or chest wall. The method is also used when the tumor is located on a large breast and occupies a significant part of it. Surgical treatment is the main way to eliminate the pathological neoplasm. An adequate technique is to remove the tumor within healthy tissue. It is important that there is no tumor growth in the surrounding tissues. Reducing the volume of surgical treatment in the presence of a tumor does not affect the survival rate or the frequency of relapses.

Axillary lymphadenectomy has its own characteristic indications. Thus, it is used exclusively for enlarged lymph nodes. Sometimes it is advisable to use it for radical removal of the primary tumor. Especially if amputation does not guarantee a sufficient distance to the resection line. The same requirement is put forward for metastatic lesions, when the lymphatic apparatus is involved in the process.

Prevention

Prevention consists of eliminating precancerous neoplasms. In addition, a woman must strictly adhere to a normal physiological rhythm. In this case, we are talking about pregnancy and breastfeeding. The number of abortions should be reduced to a minimum. When diagnosing, an important role is given to systematic examination. Moreover, it can be independent. It is clearly not worth ignoring annual check-ups with a doctor. This issue is especially acute after the age of 40. It is necessary to undergo mammography once every 2 years after the age of 40. If a woman has a severe heredity, it is recommended to undergo examination from an early age.

The easiest way to prevent breast sarcoma is self-examination. A woman can feel her breasts on her own. However, it should be understood that this procedure is not as effective. But despite this, it will allow you to detect a tumor at an early stage. Self-examination should be done at least once a month. First, you need to examine your breasts in front of a mirror. Skin tension, the appearance of formations, as well as changes that look like a “lemon peel” should cause concern.

After this, palpation is performed. If any lumps or irregularities are found, you should consult a doctor. Discharge is especially dangerous. An oncologist will help you deal with these problems.

One of the most effective methods of prevention is screening. This procedure is a routine examination of people to detect pathologies at early stages. The procedure is completely painless. From 20 to 40 years of age, screening should be done every month. It is recommended to do an ultrasound every year. Starting from 40 years of age, self-examination should be done every month.

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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 is taken into account, as well as the histotype of the sarcoma. The degree of differentiation plays a significant role. The main survival rates are observed mainly in 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 occurs in the stump of the mammary gland. Metastasis to bone and lung tissue is not excluded. All this entails serious consequences. The favorable prognosis depends entirely on the stage at which the problem was detected. Naturally, the more severe the case, the less chances for a positive outcome. Therefore, it is recommended to constantly conduct research and not ignore it. After all, a further carefree life depends on simple procedures.

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