Mammary gland cancer is the most common malignancy for women. It is not only the most common tumor, but also the one that is mist likely to result in death. For every 100 thousand women, 40 women suffer from breast cancer worldwide.
Mammary gland cancer is increasing even in developed countries. This is primarily due to:
Nevertheless, due to early diagnosis and the latest treatments, mortality from this disease in recent years have been reduced by one third. The main thing is the timely diagnosis and access to health care and quality treatment.
At the moment, we know a lot of risk factors that increase the possibility of developing breast cancer. Controllable factors include:
Uncontrollable risk factors:
Some precancerous conditions greatly increase the risk of breast cancer. Among them:
Breast cancer can be also found among the male population, but comparatively seldom (1% of cases). The main risk factor for them is ginecomasty, this can be qualified as a precancerous condition.
Ideally it necessary to detect breast cancer at the initial stage when there are no symptoms. The main symptom of the disease is the presence of breast tumor formation - first movable and then soldered to surrounding tissues. With the use of modern diagnostic techniques the tumor can be detected with a diameter up to 0.5 cm.
For the detection of tumors in the breast following techniques can be used:
About 80% of patients go to the doctor with complaints about the palpable presence of tumor in the breast. More seldom the tumor is detected during preventive examination or diagnosis of the other diseases.
With the development of the disease additional symptoms can be observed. The most frequent (classical) clinical signs of breast cancer:
In the case of Paget's cancer around the nipple there are cracks, sealing, flushing. The crusts are formed that get wet and fall away. Granular surface appears instead. Subjectively, the disease is manifested through itching in the nipple area.
To confirm the diagnosis the next medical tests are held:
Bilateral mammography is conducted to clarify and estimate the tumor size and its location.
The main method of treatment for breast cancer is surgery. Other therapeutic methods are used in combination with surgery or instead of it, if there are contraindications to surgery.
Sectoral resection, quadrantectomy. While this kind of operations, only selected areas of the breast are removed. They are used in case of a small tumor size (2-3 cm) and it’s not soldered to surrounding tissues. It should necessarily be combined with radiation therapy for the residual breast tissue.
Conservative operation are not carried out if:
Radical mastectomy is a removal of the entire breast, subcutaneous fat, the lymph nodes and pectoral minor muscle. Sometimes a large pectoral muscle is also removed.
Radiation therapy is held as an adjunct to surgery to reduce the risk of disease recurrence.
Chemotherapy. With high probability the tumor metastasizes by the time of diagnosis, even if the cancer has been diagnosed at an early stage. Chemotherapy is administered to suppress the growth of the metastasis.
Survival rates, absence of tumor recurrence, but also appearance are very important for young and middle age women. Therefore, the reconstructive surgery is often held after breast surgery. Breast reconstruction after mastectomy can be done with the patient’s own tissues or using the implants.
The five-year survival rate for untreated patients is only 22%. If the disease is detected early, the patient has received adequate treatment; there are good chances of a full recovery. Usually if recurrence is not observed during the first 5 years after treatment, this indicates that there is no metastasis, and disease will not return.
On average, breast cancer treatment prolongs the life of a woman for 10-15 years. The most favorable prognosis is characteristic for the first stage of the disease - a 15-year survival rate is 75%. If there are metastases in the lymph nodes, long-term remission in approximately 40% of cases can be achieved.
But the fourth stage of breast cancer is not a sentence either. Qualified treatment will give a woman a good chance to prolong life for a few years. Even at the last stage of cancer 10-year survival is 10%.
More and more of the new treatment methods are gradually introduced. These methods can considerably lengthen patients’ life including the advanced stages of the illness.
Targeted therapy. Here, the medications are used that have a selective impact on the tumor cells. In this case, though, the division of the normal cells is normally not inhibited.
HER-2 positive cancer presupposes the implementation of the monoclonal antibodies (Trastuzumab, Pertuzumab). These drugs proved the high efficiency during the clinical studies for the metastatic mammary gland cancer while monotherapy as well as while combined with chemotherapy.
Latest medications Palbociclib and Everolimus are used for the targeted therapy of the HER-2 negative hormone-dependent mammary gland cancer. They selectively inhibit the tumor growth by blocking the proteins that contribute to the accelerated division of the tumor cells.
Angiogenesis inhibitors is the new group of drugs for mammary gland cancer treatment. Mode of action of these medications is to inhibit the new blood vessels growth that feed the tumor.
Oncoplastic surgery. For a woman, effectiveness of the surgery for the disease treatment is as much as important as her aesthetic look. Surgeries combining removal of mammary gland section while preserving shape and size of the breasts are being gradually introduced.
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