Why do we get breast cancer? A history of complete cure for breast cancer. What are the methods of diagnosing breast cancer?

How to help yourself with breast cancer

Women who were diagnosed with a terrible diagnosis, told how to cope with the disease
October is Breast Cancer Awareness Month. Therefore, now it is most appropriate to recall this problem, which, unfortunately, can affect each of us. Within the framework of the joint special project "Today" and the Rinat Akhmetov Charitable Foundation "Development of Ukraine" - "Stop, cancer!" we will tell two stories of women who happened to hear this terrible diagnosis. Their experience will help you look at your life differently - in order to never hear the phrase "You have breast cancer."And for those who have already been diagnosed with this disease, their stories will help to change their lifestyle - to overcome this disease.

"WHY ME? NO ONE UNDERSTOOD"

DIAGNOSIS. In most ads that hang near one of the Kyiv cancer centers, they offer wigs and the delivery of cancer drugs. Almost all papers with telephones were torn off. Quite recently, one of the patients of this center, Tatyana, also wore a wig. Last year, she was at a scheduled examination by a gynecologist, and for the sake of prevention, he advised me to check with a mammologist. On ultrasound, he found small nodules in the area of ​​\u200b\u200bthe left chest and reassured that this happens to almost everyone at this age (Tanya was 39 then). He advised me to take care of myself and prescribed a hormonal cream. Tatyana regularly used it and after six months she again went for an ultrasound, which no longer showed nodules, but showed a leaf-like fibroadenoma. Capillaries and vessels departed from it, which means that it grew. This is not a very good sign, and the formation was suggested to be removed. But what woman would calmly agree to this? They agreed that it was necessary to observe, prescribed hormonal pills.
After a couple of months, Tanya realized: the seal began to be felt. The mammologist sent me to the oncology center for a consultation. She was biopsied and told, "You have breast cancer."
THE REASONS. "Why me? Nobody understood this. I didn’t have any special stresses, I led a more or less healthy lifestyle, Tatyana reflects. - When I later tried to find out why breast cancer happens, I realized that there is no one obvious reason: it can be heredity, and malnutrition, and bad ecology, and constant unrest, and injuries, and a whole lot more. The insidiousness of the disease is that nothing hurts until it comes to a severe stage. The mammologist said that one of the possible reasons for modern women may be the love of bras with underwire and pads - they squeeze the chest every day and a little bit, but injure it. The same mammologist advised to abandon deodorants. Have you ever found out what's in them? But all this through the sweat glands regularly enters the lymph and spreads throughout the body. By the way, after the operation, I completely abandoned deodorants, and now I have no smell at all. ”
OPERATION. The first time after the diagnosis, Tatyana was in a severe depression. She clearly understood that everything could end very sadly. From the emotional hole saved a little son, who had to be educated.
On the day of the operation, she was the first patient in the surgical department. When she was taken on a gurney, the nurses were talking: “How many people today? Few, 13 total. Usually there are at least 20. She had her left breast removed and all the lymph nodes in the armpit, plus an implant was placed. “Usually this procedure is divided into two,” says Tatyana. - It is necessary to remove the tumor, clean everything, let it go and only after that put the implant. But it’s cheaper for patients, and it’s easier for doctors to do everything at once.”
CHEMISTRY. After the operation, "red" chemotherapy was prescribed. “Everyone is afraid of her, because the condition during the event is terrible: nausea, drowsiness, severe malaise - as if she was very poisoned,” recalls Tanya. - These months were the most terrible: every 3 weeks the drug is injected, as soon as you move away from one injection, you need to prepare for the next one, and even monitor hemoglobin and leukocytes. After such chemistry, the hair falls out completely. Like in a movie: touched the hair - and took off the tuft. The first course cost me 6000 UAH. I ordered drugs through friends from Russia: they are very expensive in Ukraine, even cheaper in Europe.”
PSYCHOLOGY AND BELIEF. Chemistry continues now: "red" did not give the desired effect, I had to switch to other drugs, almost a thousand dollars for the introduction. “I hope they will help get rid of metastases. There is no longer any fear - only the fear that chemistry will become a constant companion of life.
The most difficult thing in all this is to find the moral and physical strength to fight. I cannot afford to relax: my family should not burden their lives with my illness. But still, it is necessary to speak out - it becomes easier. And one more thing: if you do not believe in yourself, you will not be cured.
Faith in God also gives me strength. This is especially helpful at times when you feel terrible and start to think that you may only have a couple of weeks left. I changed my attitude to everything: I realized that you can’t allow bad thoughts for a minute and you need to fight, fight, fight!
LIFESTYLE. “After the operation, I decided that everything was finally over. But it turned out that this was only the beginning. Regular trips to hospitals and polyclinics were added to the previous household issues. After all the dressings, you need to develop the left side of the body - the axillary sutures do not allow the arm to move as before. By the way, not everywhere they write that if you have had your breasts and lymph nodes removed, then you can’t give injections on the operated side, take heavy objects with it, wear watches, bracelets, rings, measure pressure and temperature on it. And all patients need to be vigilant, even if they feel well. Six months after the start of the first chemotherapy, metastases were found in my kidneys. I would have come in a year, it might have been too late.”
Tatyana radically revised her diet. “There is a rehabilitation room in the oncology center, where there is never a queue. But in vain: the doctor in this office told a lot of useful things, including about food. For example, that every woman, healthy and sick, needs to eat bacon every day - a piece of at least a matchbox, cereals on the water, garlic.
I remember how, on New Year's Eve, a roommate asked five different surgeons: "Can we drink champagne?" And everyone answered: “Of course! And champagne is possible, and red wine, and better - cognac or vodka! And when I got metastases in the summer and I began to read special books, I realized that white sugar and bread, pasta and alcohol are the first things forbidden for cancer patients! Now I eat aspic and cartilage. It's still disgusting, but it's necessary! When I see pig ears in the market, I feel bad. And I need to make a couple of pork ears with mustard or horseradish a week the norm. Moreover, the horseradish must be whole, which I have to grate myself, and even breathe it. I eat more nuts and fruits, drink vegetable (especially beetroot and carrot) and fruit juices, homemade grape juice to raise hemoglobin. In the summer it is very useful to eat berries - raspberries, strawberries, blackberries, strawberries. To cleanse the body, you first need to solve the problem with the intestines. Instead of tea, she began to drink decoctions of birch buds, chamomile, linden flowers with honey, and oats. I lean on bacon and herring, vegetables and herbs. Bread - only whole grain cereal. My morning often starts like this: I drink a glass of freshly squeezed apple-carrot-beetroot juice with a spoonful of olive oil (you can use sesame or flax seed), then I eat nuts, a banana.
How is Tatyana doing now? She still goes to chemistry, but nevertheless finds strength for both work and leisure. Constantly monitors his health and nutrition. It looks great - well-groomed skin, careful makeup, hair that has already grown and tinted, beautiful clothes and a lot of optimism: even if the disease has not yet been defeated, it must constantly be made clear that you are stronger than it.
"BE PROUD OF YOURSELF!"
Our second heroine, Lyubov I., also had to go through a nightmare. She got into a major accident 10 years ago, received many injuries and fractures. After discharge, everything seemed to go smoothly, but trembling in the legs and rapid fatigue made me go for examinations again. They did not show anything until Love herself felt a bump in her left chest. Then - a biopsy and the diagnosis of "breast cancer of the 2nd degree." The operation was urgent, they removed her breast and all the lymph nodes, "cleaned" all the bones, put a removable prosthesis. After that - 9 months of chemistry and severe rehabilitation.
NEW LIFE. “After chemo, I took pills for five years after the operation and completely changed my life. I moved to a village with clean air, forests and ponds, although I continue to work. I don’t drink a drop of alcohol, not even beer; sausage is a complete taboo. Of course, I eat rationally and at least three times a day, but no later than 18:00. I myself grow vegetables, fruits, I eat mostly rabbit meat - I also breed animals myself. I eat a lot of cereals, but I don’t boil cereals, but soak them overnight - this way the beneficial properties are better preserved. Sugar excluded, only occasionally indulge myself with cookies. In the evening I eat some soup and once a week I make myself juice from carrots or beets with green apples. In general, I try to drink a lot, I make compotes from dried fruits and jelly.
I had to forget about tanning, but I walk a lot and swim in the river every summer. I also try not to overwork myself and not take problems to heart. But the most important thing during treatment is not to dwell on the fact that you have cancer. My husband and going to the temple helped me a lot to overcome the disease - they instilled faith and hope in me and strengthened my willpower. Loving yourself sick is difficult, but it is necessary! Now I really like myself - I help the orphanage, I am the chairman of the board of trustees in a shelter for minors. They know me, they love and respect me, although only those closest to me and my immediate superior know about the disease.
I no longer have cancer cells. I stopped taking pills two years ago, in June 2012 I was deregistered at the oncology hospital, now I see my therapist: once a quarter I take tests, including for the presence of cancer cells and the level of leukocytes in the blood, I do an ultrasound of the abdominal cavity, and twice a year - an x-ray of the lungs.
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STANDARD TREATMENT FOR BREAST CANCER

(breast cancer)

1. Surgical excision of the tumor

2. L educational therapy

3. Prophylactic lymphadenectomy or removal of regional lymph nodes

4. Xchemotherapy

5. Hormone therapy

6. Immunotherapy

7. Gene therapy (under research)

PSEUDOSCIENTIFIC TREATMENT (deception)

1. Preparation GA-40 (lectins bought)

2. Urinotherapy

3. ASD 2 (remedy for worms in animals)

4. Hemlock

5. Fly agaric

6. Cosmoenergetics

7. Soda

8. Castor oil

9. Celandine

WHAT ADDITIONALLY HELPS TO STOP BREAST CANCER AND SAVE LIFE

A GUIDE to Natural Ways and Substances to Fight Breast Cancer.

More than 200 0 scientific studies in different countries. The studies were carried out in vitro, in a mouse model, in humansabout the century.

The guide shows how to diets, physical activity, regime and psychological exercises can reduce the risk of developing breast cancer (breast cancer) and death from this disease.

ATTENTION!

YOU CANNOT OBTAIN INFORMATION FROM YOUR DOCTOR'S DIRECTORY FOR ADDITIONAL TREATMENTS FROM YOUR PHYSICIAN BECAUSE THEY WILL ONLY OFFER YOU AN APPROVED STANDARD TREATMENT PROTOCOL.

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CAUSES OF BREAST CANCER
The most significant causes of breast cancer are considered to be the following:
* Inflammatory diseases of the ovaries and uterus
*obesity
*hypertonic disease
*atherosclerosis
*liver disease
*hypothyroidism
*mastopathy or breast cancer in blood relatives
*smoking

*not a healthy diet

* solar radiation

*stress

*aging

*hormonal imbalance

* hormone therapy (hormonal contraceptives)

*absence of children or the appearance of the first child after 30 years

*mastopathy

SYMPTOMS (signs) of BREAST CANCER
* Any visually noticeable change in the original contours of the breast: an increase in the size of one of the mammary glands, retraction or change in the position of the nipple, retraction of any part of the breast
* Any change in the skin in the area of ​​the mammary gland: the appearance of a small sore in the area of ​​the areola or nipple; yellowing, blueness or redness of any area of ​​the skin; wrinkling and/or thickening of a limited area of ​​breast skin (“lemon peel”)
* The appearance in any part of the gland of a dense, almost motionless nodule
* An increase in the axillary region of the lymph nodes, which, when palpated, can give painful sensations
* When pressed, clear or bloody discharge from the nipple may occur
*Breast cancer often mimics the symptoms of other breast diseases. Examples include erysipelas (an inflammatory disease of the skin with soreness and redness of the breast area), or mastitis (an inflammatory lesion of the breast, with pain, fever and redness of the breast skin)

STAGES OF BREAST CANCER
I stage
The size of the tumor is not more than 2 cm in diameter. There are no regional metastases, and there is no germination into the skin and surrounding fatty tissue.

IIa stage
The size of the tumor is 2-5 cm in diameter, germination in the tissue does not occur at all or there is partial adhesion to the skin. There are no metastases.
The main symptoms of stage IIa breast cancer are:
“wrinkle symptom” - the appearance of shallow wrinkles on the skin of the mammary gland when captured in a fold; wrinkles are perpendicular to the crease,
"site symptom" - the appearance of a site with reduced elasticity on the skin of the mammary gland; this area of ​​​​the skin does not straighten out after even a short infringement.

IIb stage
The size of the tumor is 2–5 cm in diameter. The presence of no more than 2 metastases on the affected side of the chest. Initial manifestations of umbilization are possible.

III stage
The size of the tumor is more than 5 cm in diameter. There is no germination into the skin and surrounding fatty tissue.
Symptoms of stage III breast cancer:
a symptom of umbilization - retracted skin over the tumor;
symptom of "lemon peel";
swelling of the skin, possibly retraction of the nipple.
For this stage, no more than 2 metastases are allowed.

IV stage
The tumor spreads, affecting the entire mammary gland. There may be extensive ulceration, metastases.

Metastases
Breast cancer metastasizes to various tissues and organs. The defeat of metastases occurs through the milk passages, through the capillaries and vessels. In breast cancer, metastases spread to the axillary, subscapular, sub- and supraclavicular lymph nodes. Distant metastasis occurs in soft tissues, skin. Metastases can affect the liver, lungs, ovaries, as well as the pelvic and femoral bones.

According to statistics in Russia, breast cancer is very common, and of all oncological diseases, it ranks first. This female disease mainly occurs in adult women over 55 years of age. But due to the deterioration of the environment in cities, due to poor nutrition, the breast tumor has become younger, and now there are cases in young girls from 30 to 45 years old. Basically, the tumors themselves are benign and are quickly treated in the first stages.

The reasons

As with any oncology, scientists and doctors still cannot find the exact cause of the development of malignant neoplasms. But there are several factors that increase the chance of this disease.

Of course, first of all, the healthy state of the reproductive system affects. Are there any disruptions in the menstrual cycle of a woman and how exactly do they go. How many births there were, and how late they began in a woman. As well as the duration of breastfeeding during pregnancy.

Like, and a malignant tumor of the mammary gland directly depends on the level of the hormone in the blood, as well as how exactly estrogen itself affects the mammary gland. And the higher the level of the hormone itself relative to the normal value, the higher the chance of getting sick. Let's take a closer look at all the causes of breast cancer.

Genetics

In the last century, scientists discovered two genes that are responsible for the mutation of breast cancer cells. Therefore, the presence of the BRCA1 and BRCA2 gene significantly increases the risk of developing breast cancer.

At the same time, cancer itself manifests itself quite early from the age of 40. Breast cancer appears in two milk sacs at once. There is a possibility of other tumors appearing in the uterus, intestines or lungs. Several foci and tumors appear at once throughout the mammary gland.

At what age does cancer appear most often? Usually these are women over 50 who are overweight and have nutritional problems.

NOTE! Both of these genes also affect male organs - they increase the chance of prostate cancer.

Prevention

Usually, many women, in the presence of these genes, turn to drastic measures and resort to surgery. Removing the mammary glands really reduces the chance by 95%. There are those who remove the ovaries, as they are also at risk.

External factors

As with other tumors, malignant female education is affected by ecology, radiation, exposure, ultraviolet radiation, nutrition and air pollution with carcinogens and mutagens.

Obesity greatly affects the occurrence of cancer, since the fat layer itself produces a lot of female hormone in the blood, which simply falls on the mammary glands in nuclei.

Radiation, the general radiation background in the city, when exceeding the norm, greatly increases the risk, since all Alpha, Betta and Gamma rays can change the structure of the DNA of cells, and they, in turn, mutate.

There were cases when, during radiotherapy for the treatment of other oncology, a woman developed breast cancer, and small tumors appeared throughout the area. Fortunately, they were immediately removed before entering the metastasis phase, but the fact itself is there.

Other factors influencing the appearance of breast cancer:

1. Improper hormone therapy, when women self-medicate without the knowledge and without consulting a doctor.
2. If a girl has a very early period before the age of 11.
3. Menopause in old age.
4. Numb women.
5. First pregnancy after 30 years.

As many people know, during menstruation, the female body experiences a large surge of estrogens, because of which the mammary gland is endangered, but only if the menstruation proceeds for a long time. Simply put, the longer the tarragon peaks, the worse.

Do oral contraceptives affect breast cancer? In fact, there is no direct danger and evidence for this. Some doctors say that if used incorrectly before the age of 20, there is a risk of cancer. Someone says that they are dangerous for a woman in combination. But in some cases, these drugs help the female body. So, with the correct use of these drugs, there is no danger!

Symptoms

Unfortunately, but like other types of oncology, at first, chest symptoms do not manifest themselves in any way, and stages 1, 2 are calm. Cancer itself in the early stages can only be detected by ultrasound or x-ray mammography. In particular, this should be done for women over 50 and those who are at risk.

First signs

1. Painful menstruation and sudden mood changes.
2. Nodular induration in chest area.
3. The nipples retract.
4. A hole appears on the chest.
5. The appearance of an orange peel in one area.
6. Redness in one place.
7. Ulcers or crusts may appear in one place. This is especially strong in the nipple zone.
8. The tumor can deform the breast, and it becomes different from the second.
9. The lymph nodes in the armpit are enlarged, dense and painless.
10. One breast may be larger than the other.
11. Pain in one breast outside of menstruation.
12. First, the patient develops pain in the joint, and later the entire limb swells.
13. If malignant neoplasms are close to the surface, then it is easily visible.
14. Discharge of foul-smelling pus or mucus.
15. In later stages, the temperature rises. Redness of the whole chest.

If the first 12 symptoms can characterize other diseases, then the latter definitely indicate cancer.

NOTE! If there is at least one of the signs, then you should contact a mammologist or an oncologist. Yes, the disease itself most often proceeds very slowly and the tumor is not aggressive in the initial stages, but there are also cases when the cancer developed several months before the last fatal stage.

Variety

First of all, the doctor conducts a complete examination and finds out what he is dealing with: the size of the tumor, the degree of damage to nearby tissues, the classification and lymph nodes, the level of aggressiveness, the presence of metastases in the blood.

1. non-invasive- to put it simply, it is a tumor that does not go beyond its tissue and structure. With an early surgical intervention, there is a chance to save most of the breast.
2. invasive- This is a different form, which occupies several tissues and structures in area. A more aggressive and dangerous type of cancer.
3. Squamous cell breast cancer- usually occurs much more often than adenocorcinoma. Mutation of the squamous epithelium occurs.
4. Adenocarcinoma or glandular breast cancer- is reborn from the glandular epithelium. It is more common in the lower chest.

nodular breast cancer

This type is currently the most common in women over 40 years old. The tumor in the first pair is located in the upper outer quadrants of the chest. Further, the cells themselves grow and penetrate into the nearest tissues, muscles, fat layer and even skin.

nipple cancer

In another way, this pathology is also called Paget's disease. First, the nipple itself becomes denser, and then increases in size. Later, jams, dry crusts appear. In general, the disease itself is very slow and metastasizes late.

Diffuse breast cancer

This type of cancer grows much faster than the previous one, the tissues themselves are more aggressive, due to which the tumor quickly spreads throughout the mammary gland. The breast grows in size, has severe redness and swelling. True, it is rare in 5% of cases in all breast oncology.

Hormone sensitivity

As we said, cancerous tumors in the breast are usually more sensitive to female hormones:

1. Estrogen -ER+
2. Progesterone - PgR+
3. Epidermal growth factor HER+

This means that if you reduce the amount of hormones, as well as use drugs that reduce the sensitivity of the tumor itself, then you can reduce the growth rate of malignant tissues or even slightly reduce the neoplasm itself.

But there are also types of cancer that begin to develop without hormonal replenishment and do not react in any way to the amount of female hormones in the blood. Then doctors have to resort to chemotherapy to shrink the tumor. The therapy itself has more side effects.

In general, the stages of breast cancer are very similar to other malignant tumors. Let's take a closer look.

Survey

First of all, you will need to take a general and biochemical blood test, and in case of any deviations, the doctor may require you to donate blood for tumor markers. But this is done extremely rarely, since usually with a direct suspicion of a tumor in the mammary gland, the therapist already sends for examination to an oncologist and mammologist.

This x-ray examination should be done for all women once a year after 50 years, patients at risk once every six months, especially those who have the BRCA1 and BRCA2 genes.

Immunohistochemical diagnostics

Doctors are trying to figure out how tumor cells react to female hormones. If breast cancer itself is hormone-dependent, then certain drugs are prescribed that reduce sensitivity, as well as reduce the amount of estrogen in the blood.

ultrasound

For older women, this examination is not very suitable, and is usually used in young girls. In the early stages, there is a strong error and a chance not to detect a tumor.

Cytological examination

Using a special device, the doctor takes a tissue sample for examination. Cancer cells have a different structure, and based on the study, it is possible to determine how much tissues differ from normal ones. You can see the aggressiveness and growth rate of cells.

Other studies

It is usually prescribed in the later stages of cancer, when there are metastases to other organs, so it is easier for doctors to see the affected area and prescribe a specific type of treatment.

Therapy

Like any cancer treatment, it depends on the stage of breast cancer and the age of the patient. The earlier breast pathology was detected, the easier it is for doctors to treat breast cancer. Therapy is usually aimed at removing the tumor and part of the breast, or removing the entire organ. There are quite a few methods of therapy, let's analyze them all.

Operation with partial removal

NOTE! The doctor necessarily prescribes additional therapy in the form of radiation in order to kill the remaining cancer cells. When part of the gland or cancer is removed, the healthy halves themselves are sewn together.

Mastectomy

You probably already guessed that this is a complete removal of the mammary gland with lymph nodes.

Irradiation

Radiation therapy is a fairly effective method, after partial removal of the tumor. Then the doctor prescribes radiotherapy to destroy the remaining cancer cells, which can later turn into cancer.

Chemotherapy

It is used both before and after surgery. Before surgery, this therapy helps to reduce the size and growth rate, and after it is used to destroy the remaining lesions.

hormone therapy

Elderly women may have their ovaries removed to prevent them from releasing excess estrogen into the blood, plus blockers are prescribed that reduce the sensitivity of the tumor to the female hormone.

Use: tamoxifen, exemestane, anastrozole, letrozole.

Palliative Care

At stage 4, when the tumor has spread to all corners of the body, it is no longer possible to cure the disease, and the doctors have the task of improving the quality of life of the patient, reducing pain, intoxication and the impact on the organs of the tumor itself. For this, radiation, chemotherapy, narcotic drugs, painkillers are used.

Stage 1 breast cancer treatment

Usually a small part of the gland with a tumor is removed. Since there is no severe damage to nearby tissues, the operation is usually quite successful with few consequences. If the patient is at risk, then radiotherapy is additionally prescribed.

Stage 2 Breast Cancer Treatment

Here, treatment with drugs that reduce the growth rate due to hormone blockers is added. Plus there is chemotherapy before surgery, and after. The tumor itself is removed with the surrounding tissues. After the operation, the patient undergoes a constant examination for the occurrence of relapses.

Stage 3 Breast Cancer Treatment

Step 1 - chemotherapy, followed by surgery to partially or completely remove the mammary gland. Step 2 - a complex of chemotherapy and radiotherapy is given.

NOTE! Remember - Early detection of cancer leads to a better prognosis and easier treatment.

Rules of conduct after surgery

1. After the operation, you can not sleep, so it is better to distract the patient with something.
2. You can get up and walk slowly if possible.
3. You can not touch the bandage and remove it from the chest.
4. Be careful with the PVC tube, which brings out the excess ichor. It is removed after 8-11 days.
5. If a doctor advises chemotherapy or radiation, then listen to him, as this will kill the remaining cancer cells.
6. You can not swim for 3-4 weeks.
7. The stitches are removed after two weeks.

Postoperative complications

Immediately after surgery

• Bleeding from wounds
• Suppuration
• Lymph secretion
• Limostasis

Late Complications

• Violation of posture due to the removal of 1 breast. For this, exercise therapy and a combination of various exercises that correct this are prescribed.
• Post-mastectomy defect - after one gland is removed, the woman feels uncomfortable. To do this, an internal implant is installed or a special weight is hung, which helps to balance the second breast.
• When the nipple and areola are removed, it is usually replaced with a similar tissue from the labia, or from the second nipple. Sometimes the tissues themselves are sewn together and the areola of the nipple is tattooed.
• Lymphatic swelling of the arm - then the doctor prescribes a series of exercises to reduce swelling and improve blood circulation.

Psychotherapy

After the operation, a woman usually experiences post-mastectomy depression. At the same time, there is a decline in mood, constant melancholy, sexual problems due to the lack of one breast. During this period, it is imperative to go to courses with a psychotherapist who will help you cope with this stage in life. Later, an implant will need to be inserted in order for the woman to feel complete.

In men

Strange as it may seem, but males can also visit breast cancer. The fact is that some have a rudiment in the form of a mammary gland. It's underdeveloped, of course, but it's there. Usually breast cancer in men occurs with gynecomastia. This happens with severe obesity, when there is an excess of female hormones or due to some pathologies.

At the same time, the tumor itself grows very quickly and is very aggressive. Mucus and pus may come out of the nipple in the later stages. The treatment of this pathology is very difficult.

Forecast

Carcinoma is detected at stages 2 and 3. The tumor is not aggressive and grows slowly at the very beginning. That is why the survival rate varies from 50 to 70% on average in all cases.

• 1st degree - 90%
• 2nd degree - 70%
• 3 Degrees - 35%
• 4 Degrees - 5% of women live for another 5 years.

Prevention of breast cancer

• Women over 55 should visit a mammologist every year.

Breast cancer (carcinoma)- the most common malignant tumor of the mammary glands.

The disease is characterized by a high prevalence. In developed countries, it occurs in 10% of women. Europe is leading the way. Japan has the lowest prevalence of breast cancer.

Some epidemiological data on breast cancer:

• most cases of the disease are registered after the age of 45 years;
• after 65 years, the risk of developing breast carcinoma increases by 5.8 times, and compared with a young age (up to 30 years) it increases by 150 times;
• most often the lesion is localized in the upper outer part of the mammary gland, closer to the armpit;
• 99% of all patients with breast carcinoma are women, 1% are men;
• isolated cases of the disease in children are described;
• mortality in this neoplasm is 19 - 25% of all other malignant tumors;
• Breast cancer is one of the most common tumors in women today.
  At the moment, there is an increase in the incidence worldwide. At the same time, in a number of developed countries there are downward trends due to well-organized screening (mass examination of women) and early detection.

Causes of breast cancer

• female;
• unfavorable heredity (the presence of cases of the disease in close relatives);
• the onset of menstruation before the age of 12 or their end after 55 years, their presence for more than 40 years (this indicates increased estrogen activity);
• no pregnancy or its onset for the first time after 35 years;
• malignant tumors in other organs (in the uterus, ovaries, salivary glands);
• various mutations in genes;
• the effect of ionizing radiation (radiation): radiation therapy for various diseases, living in an area with an increased radiation background, frequent fluorography for tuberculosis, occupational hazards, etc .;
• other diseases of the mammary glands: benign tumors, nodular forms of mastopathy;
• the action of carcinogens (chemicals that can provoke malignant tumors), some viruses (so far, these points have been poorly studied);
• tall woman;
• low physical activity;
• alcohol abuse, smoking;
• hormone therapy in high doses and for a long time;
• constant use of hormonal contraceptives;

Usually, malignant tumors of the mammary glands are heterogeneous. They are made up of different types of cells that multiply at different rates and respond differently to treatment. In this regard, it is often difficult to predict how the disease will develop. Sometimes all symptoms grow rapidly, and sometimes the tumor grows slowly, without leading to noticeable disturbances for a long time.

The first signs of breast cancer

Symptoms that require immediate medical attention:

• breast pain that has no apparent cause and persists for a long time;
• feeling of discomfort for a long time;
• seals in the mammary gland;
• change in the shape and size of the breast, swelling, deformation, the appearance of asymmetry;
• nipple deformities: most often it becomes retracted;
• discharge from the nipple: bloody or yellow;
• changes in the skin in a certain place: it becomes retracted, begins to peel off or wrinkle, its color changes;
• a dimple, a depression that appears on the mammary gland, if you raise your hand up;
• swollen lymph nodes in the armpit, above or below the collarbone;
• swelling in the shoulder, in the region of the mammary gland.

• Regular self-examination. A woman should be able to properly examine her breasts and identify the first signs of a malignant neoplasm.
• Regular visits to the doctor. It is necessary to visit a mammologist (specialist in breast diseases) at least once a year.
• Women over the age of 40 are advised to regularly undergo mammography, an x-ray examination aimed at early detection of breast cancer.

How to examine your breasts on your own?

Inspection of the mammary glands should be carried out on the 5th - 7th day of the menstrual cycle, preferably on the same days.

visual inspection

• Are the right and left mammary glands symmetrical?
• has one mammary gland increased compared to the other (it is worth remembering that normally the sizes of the right and left mammary glands may differ slightly)?
• does the skin look normal, are there any suspicious areas with a changed appearance?
• do the nipples look ok?
• nothing else suspicious seen?

Feeling

First, one mammary gland is felt, then the second. Start from the nipple, then move the fingers outward. For convenience, you can feel in front of a mirror, conditionally dividing the mammary gland into 4 parts.

Moments to pay attention to:

The general consistency of the mammary glands - has it become denser since the last examination?

• the presence of seals, nodes in the tissue of the gland;
• the presence of changes, seals in the nipple;

The condition of the lymph nodes in the armpit - are they enlarged?

If changes are found, contact one of the specialists:
With the help of self-examination, it is possible to detect not only breast cancer, but also benign neoplasms, mastopathy. If you find something suspicious, then this does not indicate the presence of a malignant tumor. An accurate diagnosis can only be established after examination.

• Mammography - X-rays of the breast. Existing seals in the tissue are revealed. The modern method is digital mammography.
• Determination of the level of female sex hormones - estrogens. If it is high, there is an increased risk of developing breast cancer.
• Oncomarker CA 15-3 is a substance that is produced by breast carcinoma cells.

Consultation with an oncologist for the treatment of breast cancer

Symptoms and appearance of different forms of breast cancer

Nodular form of breast cancer	A painless dense formation is palpated in the thickness of the mammary gland. It can be round or have an irregular shape, it grows evenly in different directions. The tumor is soldered to the surrounding tissues, therefore, when a woman raises her hands, a depression forms on the mammary gland in the corresponding place. The skin in the area of ​​the tumor is wrinkled. In the later stages, its surface begins to resemble a lemon peel, ulcers appear on it. Over time, the tumor leads to an increase in the size of the breast. Lymph nodes are enlarged: cervical, axillary, supraclavicular and subclavian. What does nodular breast cancer look like?
Edema-infiltrative form	This form of breast cancer is most common in young women. Pain is often absent or mild. There is a seal that occupies almost the entire volume of the breast. Symptoms: compaction of the mammary gland; redness of the skin, which has uneven edges; increased temperature of the skin of the breast; during palpation, the nodes are not detected. What does erysipelas-like breast cancer look like?
shell cancer	The tumor grows through the entire glandular tissue and adipose tissue. Sometimes the process goes to the opposite side, to the second mammary gland. Symptoms: reduction of the mammary gland in size; restriction of mobility of the affected mammary gland; compacted, with an uneven surface, the skin over the focus. What does breast cancer look like?
Paget's cancer	A special form of breast cancer occurs in 3-5% of cases. Symptoms: crusts in the nipple area; redness; erosion - superficial defects of the skin; wetting of the nipple; the appearance of shallow bleeding ulcers; nipple deformity; over time, the nipple is finally destroyed, a tumor appears in the thickness of the mammary gland; Paget's cancer is accompanied by metastases to the lymph nodes only in the later stages, so the prognosis for this form of the disease is relatively favorable. What does Paget's cancer look like?

Breast cancer grades

• T is the state of the primary tumor;
• M - metastases to other organs;
• N - metastases in regional lymph nodes.

Of course, only a doctor after an examination can attribute a tumor to one or another stage according to the TNM classification. From this will depend on further tactics of treatment.

Classification depending on the location of the tumor:

• breast skin;
• nipple and areola (skin around the nipple);
• upper inner quadrant of the breast;
• lower inner quadrant of the breast;
• upper outer quadrant of the breast;
• lower outer quadrant of the breast;
• posterior axillary part of the mammary gland;
• the location of the tumor cannot be determined.

Breast Cancer Diagnosis

Inspection

During the examination, the doctor:

• ask the woman in detail, try to get the most complete information about the course of the disease, the factors that could contribute to its occurrence;
• will examine and palpate (palpate) the mammary glands in the prone position, standing with arms raised and lowered.

Instrumental diagnostic methods

Diagnostic method	Description		How is it carried out?
Mammography- a section of diagnostics that deals with non-invasive(without incisions and punctures) by examining the internal structure of the mammary gland.
X-ray mammography	X-ray examination of the breast is carried out using devices that generate low-intensity radiation. Today, mammography is considered the main method of early diagnosis of malignant neoplasms of the breast. Has an accuracy of 92%. In Europe, X-ray mammography is mandatory for all women over the age of 45 on a regular basis. In Russia, it is mandatory for women over 40 years old, but in practice it is not carried out by all. With the help of X-ray mammography, tumors with a size of 2-5 cm are best detected. An indirect sign of a malignant neoplasm is a large number of calcifications - accumulations of calcium salts, which are well contrasted in the pictures. If they are found more than 15 per cm 2, then this is a reason for further examination.		The study is carried out in the same way as a conventional x-ray. The woman is stripped to the waist, leans against a special table, puts her mammary gland on it, after which a picture is taken. X-ray mammography devices must comply with the requirements established by WHO. Types of x-ray mammography: film- use a special cassette with a film on which the image is fixed; digital- the image is fixed on the computer, later it can be printed or transferred to any medium.
MRI mammography	MRI mammography is a study of the mammary glands using magnetic resonance imaging. Advantages of MRI mammography over X-ray tomography: there is no x-ray radiation, which negatively affects tissues, is a mutagen; the opportunity to study the metabolism in the breast tissue, to conduct spectroscopy affected tissues. Disadvantages of magnetic resonance imaging as a method for diagnosing malignant neoplasms of the mammary glands: high price; lower efficiency compared to X-ray tomography, the inability to detect calcifications in the gland tissue.		Before the study, you must remove all metal objects from yourself. You can not take any electronics, as the magnetic field that the device generates can disable it. If the patient has any metal implants (pacemaker, joint prostheses, etc.), you need to warn the doctor - this is a contraindication to the study. The patient is placed in the apparatus in a horizontal position. She must be in a stationary position during the entire study. The time is determined by the doctor. The result of the study are digital images that show pathological changes.
Ultrasound mammography	Ultrasound examination is currently an additional method for diagnosing malignant neoplasms of the mammary glands, although it has a number of advantages over radiography. For example, it allows you to take pictures in different projections, does not have a harmful effect on the body. The main indications for the use of ultrasound diagnostics in breast cancer: observation in dynamics after the tumor was detected during x-ray mammography; the need to distinguish a cyst filled with fluid from dense formations; diagnosis of breast diseases in young women; control during the biopsy; the need for diagnosis during pregnancy and lactation.		The procedure is no different from conventional ultrasound. The doctor uses a special sensor that is applied to the mammary gland. The image is transmitted to the monitor, can be recorded or printed. Dopplerography and duplex scanning may be performed during an ultrasound examination of the mammary glands.
Computed tomomammography	The study is a computed tomography of the mammary glands. Advantages of computed tomomammography over x-ray mammography: the ability to obtain images with layered tissue sections; the possibility of clearer detailing of soft tissue structures. Disadvantages of computed tomomammography: The study is worse than x-ray mammography, reveals small structures and calcifications.		The study is carried out in the same way as a conventional computed tomography. The patient is placed on a special table inside the apparatus. It must remain motionless throughout the study.
Biopsy- excision of a fragment of breast tissue with subsequent examination under a microscope.
Needle biopsy	The accuracy of the technique is 80 - 85%. In 20 - 25% of cases, a false result is obtained.	A fragment of breast tissue for research is obtained using a syringe or a special suction gun. The procedure is performed under local anesthesia. Depending on the thickness of the needle, there are two types of puncture biopsy: fine needle; thick-needle. Manipulation is often performed under the guidance of ultrasound or x-ray mammography.
Trepanobiopsy	Trepanobiopsy of the mammary glands is performed in cases where it is necessary to obtain more material for research. The doctor receives a piece of breast tissue in the form of a column.	Trepanobiopsy is performed using a special tool consisting of a cannula with a mandrel, into which a rod with a cutter is inserted. The intervention is performed under local anesthesia. The surgeon makes an incision in the skin and inserts a trepanobiopsy instrument through it. When the tip of the incisor reaches the tumor, it is pulled out of the cannula. With the help of a cannula, a column of tissues is cut off, and it is removed. After receiving the material, the wound is carefully coagulated to prevent the spread of cancer cells. During a study in the laboratory, it is possible to determine the sensitivity of tumor cells to steroid hormones (which include estrogens). This helps in the further choice of treatment tactics.
Excisional biopsy	Excision - complete removal of the tumor with surrounding tissues. The entire mass is sent to the laboratory for analysis. This makes it possible to detect tumor cells at the border of the incision, to study the sensitivity of the tumor to sex hormones.	The surgeon removes the tumor with surrounding tissues during the operation. Thus, excisional biopsy is both a therapeutic and a diagnostic procedure.
Stereotactic biopsy	During a stereotactic biopsy, samples are taken from several different locations through a single needle.	The procedure resembles a conventional needle biopsy. It is always carried out under the control of x-ray mammography. The needle is inserted in a certain place, a sample is obtained, then it is sipped, the angle of inclination is changed and it is inserted again, this time in a different place. Multiple samples are obtained, making diagnosis more accurate.

Laboratory methods for diagnosing breast cancer

Breast Cancer Treatment

• surgical;
• chemotherapy;
• hormone therapy;
• immunotherapy;
• radiation therapy.

Surgery

Types of surgical interventions for breast cancer:

• Radical mastectomy: complete removal of the mammary gland along with fatty tissue and adjacent lymph nodes. This version of the operation is the most radical.
• Radical resection: removal of the breast sector along with subcutaneous fatty tissue and lymph nodes. Currently, surgeons increasingly prefer this variant of surgical intervention, since radical mastectomy practically does not prolong the life of patients compared to resection. The intervention must be supplemented with radiation therapy and chemotherapy.
• Quadrantectomy- removal of the tumor itself and surrounding tissues within a radius of 2 - 3 cm, as well as nearby lymph nodes. This surgical intervention can be performed only in the early stages of the tumor. The excised tumor must be sent for a biopsy.
• Lumpectomy- the smallest operation in terms of volume, during which the tumor and lymph nodes are removed separately. The surgical study was developed during the studies of the National Breast Surgery Augmentation Project (NSABBP, USA). The conditions for the intervention are the same as for quadrantectomy.

The volume of surgical intervention is chosen by the doctor depending on the size, stage, type and location of the tumor.

Radiation therapy

• directly the tumor itself;
• lymph nodes located in the armpit;
• lymph nodes located above and below the collarbone;
• lymph nodes located in the sternum.

Chemotherapy

Cytostatics are drugs that have numerous side effects. Therefore, they are always prescribed strictly in accordance with established regulations and taking into account the characteristics of the disease.

The main cytostatics used in malignant tumors of the mammary glands:

• adriblastin;
• methotrexate;
• 5-fluorouracil;
• paclitaxel;
• cyclophosphamide;
• docetaxel;
• xeloda.

• CMF (Cyclophosphamide, Fluorouracil, Methotrexate);
• CAF (Cyclophosphamide, Fluorouracil, Adriablastine);
• FAC (Fluorouracil, Cyclophosphamide, Adriablastine).

hormone therapy

Methods of hormone therapy:

How does a doctor choose tactics for breast cancer treatment?

Features that the doctor should consider:

• the size of the neoplasm;
• the presence of metastases in the lymph nodes;
• germination in neighboring organs, the presence of distant metastases;
• laboratory data characterizing the cellular composition, the degree of malignancy of the tumor.

What alternative methods of treatment can be used for breast cancer?

Alternative methods are not able to provide an effective fight against the tumor process. Self-medication delays the visit to the doctor. Often such patients turn to a specialist when there are already distant metastases in the lymph nodes. At the same time, 70% of patients do not survive for 3 years.

The only right decision for a patient with suspected breast cancer is to see a doctor as early as possible, carry out diagnostics and, if necessary, start treatment in an oncology clinic.

I am the mother of a large family: ten children, seven of which are adopted. I went to create such a family, for a long time and consciously. And the disease, oddly enough, gave me strength.

Ten years ago, my beloved husband and I already had two daughters and a son, and we began to go from the church as volunteers to the boarding school. We are not businessmen and not billionaires - an ordinary Russian provincial family. I then worked in a team, was engaged in the decoration of apartments, and my husband worked with plumbing all his life. Of course, we could not buy expensive sweets for children in the boarding school, and I baked pies. Every Saturday I started ten liters of yeast dough and sculpted three hundred and fifty pieces. I really wanted to somehow convey to them the feeling of home warmth. We also played sports games with children, relay races, sometimes we took them to our home, took them for a walk in the park. We observed the life of children not only on holidays, but every weekday and saw emptiness inside them: boarding school teenagers are a pack of wolves, where everyone is trying to survive. Although the material situation there is quite good - better than in many provincial families. The girlfriend said: “Calm down, it’s just a cyst, put on a downy scarf, and everything will resolve from the heat” They are dressed, shod and not hungry - they simply lack love. Therefore, often these children grow up as consumers and live from holiday to holiday, when sponsors come. Watching them, my husband and I realized that if we want to really help someone, it is better to take the child to ourselves. And we decided to adopt four brothers at once, since such children have very little chance of being adopted.

I went to the guardianship. I remember very well the first conversation with their employee: “Do you have any children of your own? Three? Are you crazy, these are children from drunkards, alcoholics and prostitutes - you don’t understand what you are messing with, ”that woman told me. I began to explain to her that we are Christians, we have a good non-drinking family, and we just want to help. “If you are so kind, organize a foster family.” I asked what is it? But she only answered: "If you want, you will know." I went home and cried.

There was no Internet then, so I collected all the information from acquaintances and friends. When all the documents for the adoption of four children were already ready, I found a bump in my chest. The girlfriend said: "Calm down, it's just a cyst, put on a downy scarf, and everything will resolve from the heat." I made such lotions several times, but in the end I only did harm - another bump popped up under my arm. And then I ran to the hospital. The gynecologist immediately sent me to a mammologist, who went for an ultrasound scan and oncology. The diagnosis was quickly made - breast cancer. I felt like it wasn't happening to me. I am a very active person, I had my own motorcycle, skateboard, I never got sick with anything. I didn’t even know my blood group, I was only in the hospital in the maternity hospital.

The doctor, without looking into my eyes, says: “Baby, everything is not very good with you. You need to cut off the entire chest and as quickly as possible. I remember how I came to the hospital for tests, and the doctor, without looking into my eyes, said: “Baby, everything is not very good with you. You need to cut off the entire chest and as quickly as possible. It was like a bolt from the blue. You know, when I was young, I always thought that my breasts only bothered me. As a teenager, I played football as a striker and tightened my chest with an elastic bandage so that it would not shake when I ran. And by nature, I'm more of a kid. And suddenly, at thirty-six, I began to realize that breasts are something important for a woman. I was able to ask the doctor only one question: “What will happen there?” I remember how she looked up at me and said: "The scar." It was December 1, 2010. On December 6, I was admitted to the hospital.

I asked my husband what to do with adoption. He replied that for now this topic is closed. Adoption papers are valid for two years.

On December 16, my husband and I celebrated our fifteenth wedding anniversary. Before the illness, we thought to celebrate in a restaurant. But I was in the hospital after the operation and did not know if I would survive. The day before, I told my husband that he should never be left alone - this is an unnecessary sacrifice. The temperature rose at night, I could not sleep. I asked God, “Why did this happen to me? What did I do wrong?" Probably, this question is asked by all people who survived cancer. I began to reevaluate my whole life. I began to remember that before the operation I dreamed of my car. I looked at women in mink coats and thought: “Someone has everything. And now I will take more children, and I will only have pots, snot and lessons. Do I need it? But that night, everything appeared in a different light. I realized very clearly: today you are, tomorrow you may not be. And no one wants your cars or fur coats. We invented some unnecessary tinsel for ourselves. I lived for thirty-six years very happily, my husband never offended me, he never raised his voice at me, I have very kind and loving children. And I was not afraid to think about death - I am a believer. But it became a shame for me to leave this life, knowing that I could help someone else. I could convey to someone else that life is a gift that is given to us for free. I remember, I kept remembering the movie "Schindler's List", the episode where the hero took off a golden cufflink and said: "I could save one more person with it." I also wanted to have time to do something worthwhile. In the morning I stopped rebelling, bargaining with life and death. I accepted everything: as it will be, so it will be. I calmed down, fell asleep, and in the morning I felt healthy. I lay and looked out the window at the pine branches covered with snow. It was like a Christmas story.

In the morning, a sister came and said: “We have women in the corridor after the operation, who do not have enough space in the ward. You are Oryol, local, maybe you can be discharged? And you will come to us for procedures. The ward neighbors began to resent: “What a disgrace? They throw us out with stitches!” And I almost danced a polka butterfly for joy and went home.

I asked God, “Why did this happen to me? What did I do wrong? Then there were twenty-five sessions of radiation and six sessions of chemotherapy. Before the procedures I bought a wig. Until the fourth chemo, I continued to work as a pastry chef in a children's camp - I got a job there for the summer to distract myself from heavy thoughts. At first, I was embarrassed at work about my wig: it was somehow ridiculous to put on a chef's hat over it. And then she spat, took a three-liter jar in front of everyone, turned it over, put a wig on the jar and a chef's hat on her head. And she said at the same time: “The best cook is a bald cook!” Everyone was mad at me and treated me very well.

After the fourth chemo, I was completely weak. I climbed to the third floor for fifteen minutes, out of breath. I thought that nothing helped me, and I was dying. Once, at an appointment with an oncologist, I saw an advertisement for the Women's Health mutual aid group. I dialed the number and from the first minutes of the conversation I felt that on that wire the woman was asking me very precise and correct questions. I was talking to a man who himself went through all this. It was incredibly inspiring. I came to the group and saw fifteen women there, each of whom had gone through all this. Someone was also wearing a wig, someone with short growing hairs. I looked at them with square eyes and endlessly asked questions: “Will I also have such hair?” “Yes, they will definitely be like that, and curly! Grow up three weeks after the last chemo." I confessed to one woman: “I don’t know what’s wrong with me, I can hardly move my legs. I'm probably dying." And she says: “Sveta, yes, it’s your leukocytes that have fallen. This means that the chemistry is doing its job. It is very good!"

Family of Svetlana Kuzmenko.Photo: from personal archive

I remember I came home after the women's group and told my husband. “Pash, if after the treatment I live at least another five years, and we don’t take children, I will regret it every day and feel that I lived these days uselessly.” And my husband supported me. I went through two more chemos and we called the oblast care coordinator. A few months later we took two brothers. A little less than a year after the first adoption, three more brothers were taken. And in March of this year - two more brothers. And we have already prepared documents for one girl.

I confessed to one woman: “I don’t know what’s wrong with me, I can hardly move my legs. And she says: “Sveta, yes, it’s your leukocytes that have fallen. This means that the chemistry is doing its job.”