Infiltrative breast cancer

What is infiltrative breast cancer, and how does it differ from other malignant breasts?

This type of cancer is characterized by an extremely aggressive form of the current. Cancer cells spread very quickly through the blood and lymphatic system to the lymph nodes, muscles, liver, joints and bones, kidneys, respiratory organs. Metastases with infiltrative cancer have their own peculiarity: they can latently exist for a fairly long period of time without revealing themselves, beginning to grow and multiply sometimes ten years after the complete removal of the initial malignant formation.

We will talk about other features and characteristics of this dangerous disease in this material.

Code for ICD 10 (diagnosis code):

• C 50 - malignant lesions in the mammary gland.
  • C 50.0 - area of the nipple and areola.
  • C 50.1 is the central region of the mammary gland.
  • C 50.2 - inner-upper quadrant.
  • C 50.3 - inner-lower quadrant.
  • C 50.4 - outer-upper quadrant.
  • C 50.5 - outer-lower quadrant.
  • C 50.6 - armpit area.
  • C 50.8 - the prevalence of the process to two or more of the above areas.
  • C 50.9 - unspecified location.

[1]

Causes of the infiltrative breast cancer

Unfortunately, to date, the exact pathogenesis of the onset of infiltrative cancer has not been studied. There are some versions according to which the development of cancer can contribute to the following factors:

• increased sensitivity of receptors to estrogen or progesterone;
• participation in tumor formation of some specific genes;
• violation in the system of signaling pathways: in the regulation of the inflammatory process, chemotaxis and adhesion process.

It was also possible to determine the underlying risk factors for the appearance of pathology:

• adverse heredity, when one of the relatives of the female line suffered from a malignant disease of the breast;
• the age of a woman after 40 years;
• hormonal balance disorder in the body, prolonged intake of hormonal drugs, lack of pregnancy, frequent abortions, early puberty, late menopause, etc.

[2], [3]

Symptoms of the infiltrative breast cancer

In the vast majority of cases, the disease occurs almost without symptoms. Of course, some patients notice external suspicious phenomena, but often the tumor is detected by accident, when conducting a preventive examination.

The first signs that should alert a woman is the appearance of a tight swelling with fuzzy contours fused to nearby tissues, as well as the retraction of the nipple and areola. The swelling may vary in size, from 1 to 10 cm, but this size tends to increase rapidly.

Do not ignore the following symptoms:

• change in the volume, boundaries and shape of the gland;
• probing a densified area or node that remains unchanged during all phases of the monthly cycle;
• visible changes in the skin in the nasal region, or on the mammary gland as a whole;
• appearance of redness on the skin of the gland;
• the appearance of secretions from the milk ducts, possibly with an admixture of blood;
• characteristic "marbling" of the skin of the affected breast.

[4], [5]

Forms

• Osteo-infiltrative breast cancer (inflammatory cancer) is observed in about 5% of cases of all known forms of breast cancers. The disease is characterized by the distribution of malignant tissues in the chest in the form of infiltration and puffiness of the skin. Since an obvious node or densification can not be palpable, then this pathology is difficult to diagnose - as a rule, at the initial stages, a cancer tumor is taken for a secondary swelling of the skin due to the inflammatory process. The oedematous infiltrative form of cancer is characterized by relatively slow growth and latent flow.
• Infiltrative protocol breast cancer (carcinoma) is considered one of the most common malignant breast tumors. As it becomes clear from the title, the development of the disease begins in the inner surface of the milk ducts. In this case, the tumor most often finds its spread to other tissues and skin of the affected gland, and also gives metastases to the nearest lymph nodes. Among other things, degenerated cells often involve the fat layer of the armpit (through lymph and blood flow) into the process.
• Infiltrative lobular breast cancer occurs as a consequence of an advanced lobular cancer, and the tumor can spread in various ways. Most often, individual cellular elements are involved in the process, which, as it were, are separated from the alveoli or glandular complexes. Affected cells are arranged in the form of chains along connective tissue structures, sometimes localized near untouched intralobular ducts. Can be located and diffuse. Detection of this type of tumor in the early stages is somewhat difficult.
• The term "infiltrative nonspecific breast cancer" includes those varieties of cancer that can be found in extremely rare cases. For such neoplasms, there are also differences in the treatment and prognosis of the disease. Non-specific types of cancer include colloid carcinoma, tumors with a low degree of differentiation, and squamous cell metaplasia.

Complications and consequences

Unfortunately, infiltrative breast cancer can lead to the following complications:

• the spread of metastases (daughter tumor cells) through the lymph in the axillary region, into the parasternal, supraclavicular lymph nodes, retrosternal and mediastinal lymph nodes, into the second breast. Through the blood, metastasis can be carried out into the pleura, the lungs, the musculoskeletal system (especially in the bones of the ribs, pelvis, vertebrae, thigh bone), as well as in the liver tissue, into the appendages, adrenals, brain;
• problems with the motor ability of the shoulder area, the upper limb on the side of the lesion;
• the phenomenon of lymphostasis of the upper limb;
• relapse of a cancerous tumor (approximately after 5-10 years).

In the absence of treatment, there is a spread of proximal and distant metastases, damage to other organs and systems, decay of the tumor, and death.

[6], [7], [8]

Diagnostics of the infiltrative breast cancer

• As with any diagnosis, a patient's examination begins with the collection of information about the history of the disease. The doctor finds out information about the presence of hereditary predisposition, previous gynecological diseases, about injuries and chest diseases. Next, a visual examination of the glands, where special attention is paid to the density, size, shape, mobility, limited breasts. In addition, the doctor checks the condition of the proximal subclavian as well as the axillary lymph nodes.
• Instrumental diagnosis is mandatory. One or more research methods can be used:
  • X-ray method (mammography) is performed in two projections (mediolateral and cranio-caudal projection). This method allows to recognize tumors with a size of 0.5 cm, as well as microcalcinates (one of the reliable signs of oncology). Another method, based on the use of X-rays - galactography - is rarely prescribed. It is used for secretion from the nipple;

• ultrasound examination in the presence of a single cancerous tumor indicates a worsening of ultrasound transmission in the neoplasm zone;
• Magnetic resonance imaging with contrast agent is used mainly to detect relapses, as well as to assess the condition of the gland tissues in the presence of an implant;
• thermography - this method is based on the phenomenon of hyperthermia in the malignant zone. It is rarely used;
• a biopsy is a puncture or resection of a tumor with a material fence for further histological examination. Histology not only indicates the degree of malignancy of the tumor, but also helps determine its receptor status.
• Laboratory tests (analyzes) include the determination of tumor markers (control values of pathology) and an assessment of the level of hormones in the body. As a rule, an analysis is carried out for the content of prolactin, LH, FSH and estrogen.
• Additional examinations may include chest x-ray, computed tomography, scintigraphy, ultrasound examination of the abdominal cavity.

Differential diagnosis is performed with mastopathy, benign neoplasms, abscess, cysts, sarcoma, malignant lymphoma.

[9]

Treatment of the infiltrative breast cancer

An integrated approach to treatment should combine several therapies:

• operative and radiation treatment;
• chemotherapy and hormonal therapy.

Hospitalization of the patient is mandatory.

Non-drug therapy

Irradiation is rarely prescribed as an independent treatment. Basically, this is an additional method, which is used in an integrated approach. Radiation therapy may be prescribed after conservative or surgical treatment to exclude the re-development of the tumor process. Irradiation is used immediately after surgery or together with medicinal prescriptions, but no later than six months after the operation.

Chemotherapy and medications

Chemotherapy is one of the options for systemic breast therapy and is used in the vast majority of cases. Medicines for the treatment of cancer are prescribed without fail in the following cases:

• in the presence of metastases in the lymphatic system;
• if the tumor size exceeds 2 cm;
• if the patient is less than 35 years old;
• if the malignancy of the tumor is determined between the II and IV degree;
• with receptor-negative (non-hormone-dependent) tumors.

Medicines can be used in the following combinations:

• scheme with cyclophosphamide, methotrexate, 5-fluorouracil;
• scheme with adriamycin and cyclophosphamide;
• scheme with 5-fluorouracil, adriamycin and cyclophosphamide;
• combination of anthracyclines and taxanes.

The additional use of such drugs as trastuzumab and bevacizumab may improve the effectiveness of chemotherapy.

Hormone therapy is rarely used as an independent treatment, but its effect in combined and complex courses of therapy is undeniable. Most often resort to such types of hormone therapy:

• with use of preparations-competitors of estrogens;
• with the use of agents that reduce the production of estrogens.

Among the antiestrogenic agents, the most common drug is Tamoxifen. It is a competing with estrogens substance, providing control of cellular receptors.

The second group of drugs includes drugs that inhibit aromatase, which helps to lower the level of endogenous estrogens. Typical representatives of this group are Anastrozole and Letrozole.

[10], [11], [12], [13]

Operative treatment

In infiltrative breast cancer, the following types of surgical treatment can be prescribed:

• standard radical mastectomy (breast muscles are retained, there is the possibility of further primary gland plasty);
• Mastectomy with preservation of the areola and the possibility of further primary breast plasty;
• organ-preserving operation with further irradiation
• radical resection (tumorectomy with lymphodissection), in combination with radiation and drug treatment.

Radical mastectomy with preservation of the chest muscles is performed at early stages of tumor development or at its central position. During the operation, the fiber is removed in the axillary, intermuscular, subclavian and subscapular area. Immediately with this operation can be carried out and plastic breast.

Patients with inoperable forms of cancer undergo palliative surgery aimed at alleviating the condition and lengthening life expectancy.

Homeopathy

Homeopathic remedies are often used by medical specialists to improve the effectiveness of rehabilitation of patients after surgery, to prevent relapse, to strengthen and strengthen the body's immunity. Appointed drugs for oral administration:

• Galium-Hel;
• Psorinocheel;
• Lymphomyositis;
• Phosphor Homaccord.

Drugs take 10 drops 6 times a day. At the end of 2 months, 10 drops are administered to the administration 4 times a day, and after 2 months - 3 times a day. In addition, injectable injections of such drugs as Nux vomica-Homaccord, Hepel, Berberis-Homaccord, Helidonium-Homaccord, which favor the removal of toxic substances from the body, can be prescribed additionally.

Diet

Changes in the diet of patients with an infiltrative form of breast cancer are aimed at supporting normal body weight, strengthening the defenses of the body, ensuring the full flow of nutrients into the body. Making up the daily menu, it is recommended to adhere to the following rules:

• follow the calorie content of food, do not overeat;
• use more cereals, plant foods, fiber;
• when choosing bread, give preference to dark varieties;
• limit the use of animal fats, preferring vegetable;
• use in sufficient quantities of foods rich in calcium and vitamin D;
• avoid drinking alcohol;
• limit the use of sweets, sugar, artificial additives;
• red meat is best replaced with white.

In addition, it is recommended to follow the drinking regime - to drink pure still water in sufficient quantities. Unsweetened green tea is also useful.

[14], [15], [16], [17]

Alternative treatment

The methods of alternative treatment are most often addressed in such cases:

• when treatment with traditional methods does not bring the expected result;
• when it is required to strengthen the effectiveness of traditional methods of treatment.

Of course, a miracle of alternative means should not be expected, but they will not be superfluous in many cases.

Often alternative recipes include treatment with herbs that contain poisonous substances. This must be taken into account so as not to harm your body - it is important to strictly adhere to the dosage specified in the prescription.

It is also not recommended to take several alternative medicines at the same time - go to other tinctures or decoctions when you finish the course of the previous medications.

• Infusion of potato color. One tablespoon of dried flowers are poured 500 ml of boiling water and insist for at least 3 hours in a thermos bottle. Filter and wring out, store in a glass jar in the refrigerator. Take three times a day for half an hour before a meal of 160 ml. The duration of the first course of treatment is 14 days. Treatment can be continued after a one-week break. The total duration of treatment is six months.
• Infusion of birch mushroom. Grated mushroom is insisted for 2 days in warm boiled water at the rate of 1 part fungus - 5 parts water. After 2 days, the infusion is filtered and taken three times a day, half an hour before a meal. Keep in the refrigerator for no more than 4 days.
• A good effect is the tincture of the plant from the golden mustache. Mix 30 ml of tincture (45 sprouts for 1.5 liters of 40% alcohol) and 40 ml of unrefined sunflower oil, drink in one gulp. So repeat three times a day for 20 minutes before eating. Systematic reception is as follows: 10 days of treatment - 5 days break, then 10 days of treatment - 10 days break. So take the medicine for 3 months.
• Before and after surgery recommended to take infusion of 100 g nettle, 100 grams of plantain, 50 grams of vegetable fat, 50 g of wolf, 50 g of spores, the same rue, the herbs of St. John's wort and acacia. One tsp. Collect 250 ml of boiling water. Insist half an hour and use 1 glass twice a day.
• Nettle honey. Grind in a coffee grinder identical parts of leaves of a nettle and a walnut. Three tablespoons of the crushed raw material is mixed with ½ kg of liquid honey. Such honey can be added to dishes and drinks.
• Good helps with sea buckthorn oil. It is taken up to 5 times a day for 1 tbsp. Spoon, gradually dissolving in the oral cavity.
• Tincture of wormwood. To prepare the tincture, take 20 grams of dried herbs 200 ml of vodka, stand for one week, then put on a small fire and evaporated by 1/3. Cool and use 1 tsp. Three times a day before meals.
• It is also recommended to take fresh pomegranate juice at 200 ml per day - this can slow down the development of tumor cells.

Treatment with alternative methods is recommended to be coordinated with the treating doctor. If during treatment you become worse, discontinue treatment and immediately consult a doctor.

[18], [19], [20], [21]

Prevention

Preventive examinations and breast ultrasonography should be performed annually, starting from the age of 20.

In addition, monthly self-examination of the breast is important, which is carried out by the woman herself on about 6-10 days of the monthly cycle.

After 50 years of age, mammography is recommended (once every 2 years, and after 60 years - every 3 years).

At the increased risk (adverse heredity or transferred diseases of mammary glands) the listed actions are carried out more often. For example, to prevent the recurrence of cancer, patients should visit the doctor for a comprehensive examination once every six months during the first two years (hereinafter - once a year).

Also, with hereditary predisposition, it is recommended to periodically take a blood test for oncomarkers, starting at the age of 25 years.

In order to maintain breast health for many years, the woman is recommended to adhere to the following preventive principles:

• maintain a normal body weight, especially after 40 years of age;
• Do not smoke or abuse alcohol;
• avoid a sedentary lifestyle, be active, walk more often outdoors, exercise;
• Do not deprive yourself of the joy of motherhood and do not stop breastfeeding ahead of schedule;
• use enough vitamins that are in plant foods - vegetables, fruits, herbs, berries, nuts and seeds;
• there is less harmful food and red meat;
• conduct monthly self-examination of the mammary glands.

[22], [23], [24],

Forecast

According to statistics, about half of patients die from infiltrative breast cancer. The average five-year survival rate is about 75%, depending on the stage of the disease on which the disease was found. Also, success in treatment directly depends on the presence of metastases and lesions of the lymphatic system.

The earlier a malignant tumor is diagnosed, the more favorable the prognosis.

After surgery, especially careful monitoring of the health condition is required, since the risk of relapse may be present for about another 10 years.

The length of the patient's incapacity for work after the surgery is dependent on the scale of the intervention and the amount of radiation chemotherapy performed. The shortest period of stay of a woman on inpatient treatment is from 18 to 21 days.

The doctor must decide on the patient's further ability to work. In most cases, the woman returns to the old way of life in 5-6 months.

Infiltrative breast cancer is a common and dangerous disease. Do not forget that you can begin to prevent tumors at any age. Make useful changes in your life today, so that in the future there is no reason to worry about your health.

[25], [26], [27], [28], [29]