Thursday, April 19, 2012

Benign and malignant breast tumors


Morphology of cancer

The breast is a steam organ whose main function is to create and secretion of milk. Two main body of the breast and nipple. The body is built from the breast milk glands, milk channels, connective tissue and fat. The back of the breast is on the front of the large pectoral muscle. The shape and size of the breast are individual and variable, dependent on the shape and development of the mammary gland and adipose tissue. Breasts are almost always symmetrical, usually the right breast is slightly smaller than the left.

Mammary gland occupies the central and largest part of the body and the breast is immersed in the fat tissue. It is a functional part of the breast and is composed of 12 to 20 slices, grape types, which are composed of many smaller režnjića. At least the structural units of the gland acini philosophy behind the secretory canals that connect the higher grade and high secretory mammary ducts which has 12 to 20, for each slice at a time. All ducts discharging to the nipple.

The nipple is a cylindrical or conical shape and a stack of milk secretory channels whose open end at the top. No fat in the nipple. Immediately beneath the skin warts are circular smooth muscle fibers associated with the same muscle bundles of the areola of the breast. Their contraction leads to erection nipples, a rhythmic contractions stimulate the secretion of milk during breastfeeding.
Nipple areola skin structure is circular in shape around the nipples, rosy brown color. During pregnancy and breastfeeding becomes much darker. In the areola are tiny sebaceous glands and sweat glands and specific Morgagnijeve that are seen as small white bumps. Their secretion protects the skin areola.

Of great importance are the lymphatic vessels of the breast. They are built from a network of lymph capillaries, which are connected to all major courts and eventually formed three major secretory lymph times. The main axillary lymph path that ends in the lymph nodes of the armpit. The second time the chest or internal, which ends in a chain of lymph nodes along the sternum and the surface of lymphatic vessels within the lymph nodes in the breast. The upper path is the smallest lymph and reaches the subclavian nodes. Lymph from all of these roads are flowing into the subclavian lymph trunk, and finally ends up in the lymph venous circulation. Lymphatic vessels spread malignant breast tumors.
Estrogens stimulate breast development. They stimulate the growth of mammary glands and fat storage, which increases the weight of the breast. More breast growth during pregnancy and Glandular tissue is only then fully developed for milk production.

Changes in the menstrual cycle, breast

During and after periods of mammary gland covering from the changes that have occurred in the secretory (second) phase of the menstrual cycle. The smallest volume of the breast can be seen between the fifth and seventh days of the cycle (a cycle runs from the first day of menstruation until the first day of next menstruation - that is, the first day of the cycle is the first day of menstruation). In the secretory phase (after 16 days) increases the number of acini and ducts of the mammary gland diameter, which generally increases the volume of the breast and stores it for use in the synthesis of milk in case of pregnancy. Just before your period comes to degenerative changes in the walls of the acini and ducts. There is an island of tissue between režnjića, are carried out some changes under the action of estrogen and progesterone, which she feels as premenstrual tension, and sometimes breast tenderness.

Benign breast changes
Inflammatory changes of the breast (mastitis)

The breast is the most infections is subject to immediate postpartum mastitis and occurs mainly in this period.Otherwise it is very rare. The most common culprits are bacteria, streptococci and staphylococci. It is treated with antibiotics. There are some specific types of inflammation that is characterized by the creation of lumps in the breast, and this process can mimic breast cancer.
The breast may appear a kind of inflammation which is basically a reaction to foreign material - silicone or paraffin. And this inflammation is manifested by creating lumps. If, during a breast reconstruction using silicone gel, it may be that he "leaked" from the bag and creates a breast tumor-like creation, called silica. It can penetrate along the lymphatic capillaries in lymph žlede and causes a condition called silicone lymphadenopathy.
Women with diabetes often occur in the breast inflammatory changes.

Fibrocystic breast disease

This disease is actually a large group which, among others, include the following changes: cysts (macro and micro), adenosine, fibrosis, epithelial hyperplasia, epithelial calcifications, and more.
Microcysts are very common, especially in women later in life. These extensions meškasta milk ducts larger than 3 mm.
Makrociste are usually multiple and are found in both breasts, but they may be individual, usually 2 - 3 cm in diameter. Are filled with opaque liquid, and sometimes can be found dried blood or secretions. Cysts result from the spread of milk ducts under the influence of sex hormones, and lack of regressive changes after menstruation.
Adenosine is a benign proliferation and growth of mammary gland ducts without generating output.
Various studies have shown that fibrocystic disease is a major risk factor for cancer.

Benign breast tumors

The main features of benign tumors of any localization are have a capsule of connective tissue and the capsule does not allow uncontrolled infiltration of tumor cells into surrounding tissue, tumor growth in a way that only a "push" the surrounding tissue, but does not destroy surrounding tissue structures; not give distant metastases .Benign tumors can cause problems if you reach a huge size. After many years of evolution, a small percentage of benign tumors can be transformed into malignant cells. Because the typically benign tumors regularly monitored or removed immediately.
Benign tumors are usually observed as nodules of various sizes in the breast.
There are several types papilomatoznih changes in the breast. Individual papillomas are epithelial tumors that develop within the expanded dairy and clean channels. Fortunately the women from the third to fifth decade of life. It usually occurs in women leak small amounts of nipple fluid, discolored, or bloody. Sizes are only a few millimeters in diameter, and rarely can grow up to several centimeters. Their localization is just below the nipple areola. Very rarely transform into malignant tumors. However, in young women may appear multiple papillomas, often in both breasts, and these tumors are prone to malignant. Sometimes these benign changes inflicted difficulties doctors to distinguish them from malignant cancers.
Adenomas occur in young women as lumps in the breast. Adenomas are benign tumors composed of glandular breast tissue.
Fibroadenoma is the most common benign tumor of the breast. The highest incidence is in the third decade of life of women. It is believed that estrogen, a hormone of the ovaries, plays an important role in their creation.Fibroadenomas have a capsule, usually in a single breast. They belong to fibroepitelne benign tumors. At the time of diagnosis and surgery are usually about 3 cm in diameter. Sometimes the young girls can grow rapidly and reach large sizes, and over 10 cm in diameter, so. giant fibroadenoma. Fibroadenoma surgically removed because there is a risk of malignant alteration.
Tumor Filoides (phyllodes tumor) is fibroepitelni tumor. It occurs most often in women in their fifties. According to its characteristics similar to fibroadenoma. It reaches a diameter of 1 to 2 cm larger. The tumor may be benign and malignant. There is a direct correlation with tumor size, degree of malignancy. In some studies, it was announced that they are mostly large tumors (greater than 8 cm) malignant and give metastases. Most commonly the skin over the tumor "stretched" thin and sometimes necrotic. Often these tumors can be multiple and bilateral, and cases of malignant tumor metastases usually given in the lungs and skeleton.

Lipomas are tumors that are composed of normal adipose tissue in the capsule.
Adenolipomi addition of fat and contain glandular elements.
Hemangiomas are composed of elements of the blood vessels.
Leiomyomas are smooth muscle origin. Commonly found in the nipple areola.
Less common benign tumors in the breast are: Schwannomas and neurofibromas (of nervous origin), Myoepitheliomas, granular-cell tumors, fibromatosis, and others.

Malignant tumors of the breast

Objectives of the organism occurs only a single cell (fertilized egg) because the cells in its genome contains information about sharing and further routing to a specific function. When complete growth and development, genes that are responsible for sharing the specific mechanisms of "locked". However, in the course of life, some influences from the environment, but also from the body, interfere with this mechanism, the genes for the division begin to divide without control and the resulting tumor. The tumor usually arises from a single cell that divides out of control, and each of her daughter-cell has that feature.
The characteristics of malignant tumors that have no capsule, but invasive growth, destroying healthy tissue in its vicinity. Malignant cells that reach the bloodstream or lymph to travel to distant organs, where they settled again and start creating division in this area secondary tumors called metastases.

- Non-invasive carcinoma (carcinoma in situ)

This term is used to change that has transformed malignant cells, but these cells are located only at the level of the epithelium. Normal epithelial tissue lining the mammary ducts and acini with luminal side. Basal membrane, which is the border of the epithelium to the deeper tissues, preserved and deep tissue is not affected. In this situation, the cancer can be maintained for years, and only later begin to invade. But, if I may regress, so the real malignant tumor never occurs. These tumors do not give any symptoms. Carcinoma in situ is usually discovered accidentally, when breast tissue is removed for other reasons (eg, after removal of cysts or other benign changes).Two basic types of carcinoma in situ are ductal and lobular on the basis of their origin.

- Invasive cancers

The real cancer with all the features of malignant tumors. By place of origin and specific histological features there are several types. As the basic types are: ductal, lobular and medullary, and Paget's disease (Morbus Paget) with special features.
Rare malignant tumors of the breast skin tumors (especially malignant melanoma), malignant tumors of fat and connective tissue, blood and lymphoid tissues, carcinosarcoma, and some tumorolike lesions.


Risk Factors

- Breast cancer in the family: mother, sister, grandmother, aunt, especially before the age of forty

- Women in the industrial region

- A long reproductive period - women who receive early menstruation and / or enter menopause late (longer exposure to estrogenic hormones)

- The presence of other malignancies

- Long-term use of oral contraceptives (birth-control pills)

- Obesity in postmenopausal

- Nonparturition or the birth of their first child after thirty years

- Mostly fat diet

- Smoking and alcohol consumption

- Pre-breast radiation

Symptoms of malignant tumors

The tumor usually discovered by accident the woman herself. Commonly observed in breast lumps, or changes in skin cancer - skin like orange peel with steps and / or feeding nipple. Somewhat less in discharge from the nipple, clear, or bloody gnojav. T is more pronounced veins on the breast drawing - due to pressure on the veins of breast tumors, they tend to swell and so empty. Unfortunately, these are, in fact, already well-developed symptoms of cancer.

The most common place of localization of cancer is the upper outer quadrant of the breast, over 50% diagnosed.In second place was the center of the breast, up to 20%, then the upper inner quadrant, and least frequently occurs in the lower quadrants, between 5 and 10% of all diagnosed cancers. The tumor is usually localized in only one breast, while the left is somewhat more involved. In a few cases may be affected both breasts.

Breast cancer is slow growing, and can pass the whole decade until it grows enough to be clinically apparent.Sometimes the pain can occur in the breast in the early stages, but mainly absent. Later, the above symptoms occur.

Paget's disease or cancer Pedžetov (Morbus Paget) is only characterized by early manifestation of symptoms such as redness of the skin around the nipple with a feeling of burning and itching. Morbus Paget's carcinoma of the breast milk of large channels, is a rare and comprises only 1-2% of all breast cancers.

When a woman notices a lump in the breast or skin changes, should immediately be told the doctor. The most important thing is not to panic, because over 80% napipanih lumps quite harmless. The doctor will first do a clinical breast examination, which involves observation and palpation of the breast. The next step is Mammography - X-ray of the breast with which to detect changes that can not be felt. Furthermore, it can be done using ultrasound breast tumors that differ from the cysts. Some of the more sophisticated methods as magnetic resonance imaging and Computerised Tomography by which we can see the finest of change, but do not routinely because they are very expensive, but are used only for obscure cases. If it is determined that it was a cyst, it is aspiration biopsy, and that means using a thin needle enters the cyst and the cyst fluid extract is then examined.When there is discharge from the nipple, and he examines. If it is a tumor (benign or malignant) on surgically removed, and then determines the type of cells and definitely diagnosed.

Some statistics show that every eight women at risk to get breast cancer. A year die from the disease an average of 35 100 000 women.

Symptoms of malignant tumors

The tumor usually discovered by accident the woman herself. Commonly observed in breast lumps, or changes in skin cancer - skin like orange peel with steps and / or feeding nipple. Somewhat less in discharge from the nipple, clear, or bloody gnojav. T is more pronounced veins on the breast drawing - due to pressure on the veins of breast tumors, they tend to swell and so empty. Unfortunately, these are, in fact, already well-developed symptoms of cancer.
The most common place of localization of cancer is the upper outer quadrant of the breast, over 50% diagnosed.In second place was the center of the breast, up to 20%, then the upper inner quadrant, and least frequently occurs in the lower quadrants, between 5 and 10% of all diagnosed cancers. The tumor is usually localized in only one breast, while the left is somewhat more involved. In a few cases may be affected both breasts.
Breast cancer is slow growing, and can pass the whole decade until it grows enough to be clinically apparent.Sometimes the pain can occur in the breast in the early stages, but mainly absent. Later, the above symptoms occur.
Paget's disease or cancer Pedžetov (Morbus Paget) is only characterized by early manifestation of symptoms such as redness of the skin around the nipple with a feeling of burning and itching. Morbus Paget's carcinoma of the breast milk of large channels, is a rare and comprises only 1-2% of all breast cancers.
When a woman notices a lump in the breast or skin changes, should immediately be told the doctor. The most important thing is not to panic, because over 80% napipanih lumps quite harmless. The doctor will first do a clinical breast examination, which involves observation and palpation of the breast. The next step is Mammography - X-ray of the breast with which to detect changes that can not be felt. Furthermore, it can be done using ultrasound breast tumors that differ from the cysts. Some of the more sophisticated methods as magnetic resonance imaging and Computerised Tomography by which we can see the finest of change, but do not routinely because they are very expensive, but are used only for obscure cases. If it is determined that it was a cyst, it is aspiration biopsy, and that means using a thin needle enters the cyst and the cyst fluid extract is then examined.When there is discharge from the nipple, and he examines. If it is a tumor (benign or malignant) on surgically removed, and then determines the type of cells and definitely diagnosed.
Some statistics show that every eight women at risk to get breast cancer. A year die from the disease an average of 35 100 000 women.

Something about breast cancer

The treatment of malignant tumors council makes a decision. If the tumor without distant metastases can be primarily treated surgically. If it is an aggressive form of cancer or very advanced, first to take the intercept of the tumor or lymph nodes from the armpit to determine tumor type, and applied radiation or chemotherapy, which aims to reduce the size of the tumor and prevent the dissemination of the tumor during surgery, to be Only then joined the operation. Signs of an aggressive tumor of the skin island of the breast, swelling hands on the same side, like skin cancer using orange and others.

The volume of the removed breast tumors depend on tumor size. Carcinoma in situ treated by removal of the tumor into healthy tissue. Small cancers, and 2.5 cm, are removed along with 3 to 5 cm of healthy tissue and this is so. sparing surgery. If the tumor is larger, removes the entire breast (radical mastectomy). During surgery to remove lymph nodes and the breast and reviewed to determine whether the tumor began to spread. All this information and the council shall consider the prognostic category, the so-called. TNM status, which describes the tumor size, lymph nodes (axillary usually), and metastases. After the operation is applied to neutralize the radiation scattered malignant cells during surgery, and found that radiation reduces the chance of recurrence by 30%.

Upon completion of treatment for the breast reconstruction.

For early detection of breast self-examination is most important! It is recommended to start with self but with twenty years of age, once a month. The best review is done between the fifth and tenth day of the cycle because the breasts are at their lowest volume, can be easily felt any changes.

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