Breast Cancer Description and Stages

Structure is present both in breast lymph nodes and lymph vessels. Mammary glands in each structure there are blood vessels and so and lymphatic vessels. Transported via lymphatic vessels is called a colorless liquid lymph. Lymphatic vessels carry lymph to the lymphatic system called lymph nodes stations. Lymph nodes are small structures like some bean seeds which are spread throughout the body. Their role is to filter out certain substances in lymph and help the body fight infections and certain diseases. Groups of lymph nodes are found near the breast in axils (under arm), above the collarbone and rib cage (chest).

The most frequent type of breast cancer Ductal Carcinoma is, that develop from the ducts. Breast cancer that develops from the lobes or lobules is called lobular carcinoma is the most common type of breast cancer affecting both breasts. Inflammatory breast carcinoma is one of the rarest types of cancer, where breast shows signs of inflammation (redness, local heat and swelling). Age and breast cancer in this family (the family) influence the risk of developing breast cancer.

Risk Factors

Risk factors are all those factors that increase a person's risk of developing cancer.

Risk factors for breast cancer are:

- Old age

- Early menarche (First menstruation)

- Women who have children or have their first child at an older age

- This breast cancer or Benign tumors (Cancer) family

- This breast cancer in mother or sister

- Radiotherapy to the chest done / Breast

- After conducting discovery mammography a denser the breast tissue

- Use of hormonal preparations (such as estrogen and progesterone)

- Consumption alcohol

- Caucasian.

Breast cancer is often caused by mutations (defects) genetic legacy. Genes are bearers of information inherited from both parents. Transmitted hereditary breast cancer accounts for approximately 5 to 10% of all cancers. Certain types of modified genes responsible for breast cancer are more common in certain ethnic groups.

Women who have altered genes that cause breast cancer and who had past cancer one breast have an increased risk of developing cancer in the other breast. Also, these women there is increased risk of ovarian cancer and an increased risk of developing other cancers in other location.

Also, men who have altered genes responsible for breast cancer have an increased risk of developing this disease.

To detect gene "defects" exist the possibility of conducting Genetic tests. These genetic tests are sometimes recommended that other family members at increased risk of developing cancer.

Investigations which aim to examine your breasts to detect (find) and breast cancer diagnosis. Your should notice any changes after breast examination.

These tests and procedures may be used for this purpose:

- mammography: Radiological exploration of the breast

- biopsy: Is a method which is drawn cells or tissue from the tumor for examination under a microscope by the pathologist, in order to detect changes due to cancer, in case of detection of unusual formations in the breast is required to incisions to remove a portion of that formation.

There are four types of biopsies:

- Excisional biopsy: This method completely removes the faction or unusual tissue

- Incision biopsy: this method removes only part of the formation or unusual tissue

- Intraregional biopsy: this method removes some of the faction or tissue using a needle biopsy unusual

- With a needle biopsy or by aspiration biopsy: This method removes either part of the formation or unusual tissue or fluid using a thin needle biopsy

- Test estrogen receptor and progesterone: This method measures the amount of estrogen and progesterone receptors in the tumor tissue, the detection of breast cancer are examined in the laboratory of tumor tissue to detect estrogen and progesterone way influence malignant cell growth. After conducting this investigation, the results may indicate hormone therapy effective in stopping the proliferation of cancer.

Staging of Breast Cancer

After the diagnosis of breast cancer are investigations to detect if cancer cells have spread within the breast or elsewhere in the body.

Detect if the process of tumor spread within mammary gland or in other parts of the body is called staging. The information obtained in pursuance of the staging process determines the stage of disease. Knowing the stage is very important to institute appropriate therapy.

For breast cancer using the following stages:

Stage 0

There are two types of carcinoma in situ:

- Ducal carcinoma in situ is a noninvasive tumor, a precancerous stage in which the proliferation of cells lining the surface layer altered mammary gland ducts. These modified cells are confined to the ducts, without scattering to the other tissues of the breast. Although currently there are no known predisposing factors for ductal carcinoma in situ transformation into an invasive tumors, in some instances, ductal carcinoma in situ may become invasive tumors and can spread to other tissues

- carcinoma lobular tumor in situ stage in which cells have changed as a starting point lobules from mammary gland. In rare cases, lobular carcinoma in situ may become an invasive tumor, although this lobular carcinoma in situ in the mammary glands causes an increased risk of developing breast cancer and the other mammary glands. Breast tumor size may be the size of a pea, a peanut, nuts or lemon.

In this stage, the tumor is 2 centimeters or smaller and does not spread outside the breast

Stage IIA

At this stage:

-Tumor is detected in the mammary gland, but is detected in the axillary’s lymph nodes (lymph nodes under the arm)

-Tumor is 2 centimeters or smaller and has spread to axillary’s lymph nodes

-Tumor greater than 2 centimeters but not exceeding 5 centimeters not spread to the lymph nodes.

Stage IIB

In stage IIB breast tumor can be:

-Greater than 2 cm but not exceeding 5 centimeters and has spread to axillary’s lymph nodes

Greater than 5 centimeters, but not spread to the lymph nodes.

Stage IIIA

-Tumor is detected in the breast, but the tumor is detected in the axillary’s lymph nodes are a conglomerate mass, attached to each other or are attached to other structures

-Tumor is 5 centimeters or smaller and has spread to lymph nodes that are a conglomerate mass, attached to each other or are attached to other structures

-Tumor greater than 5 centimeters and has spread to lymph nodes that can form a conglomerate mass, attached to one another or are attached to other structures

Stage IIIB

In stage IIIB, the tumor can be any size and:

, Has spread to tissues near the breast (skin or chest wall including the ribs and muscle tissue of the thorax)

-Can spread to lymph nodes within the breast or under arm.

Stage IIIC

In stage IIIC, tumor:

, Has spread to lymph nodes and lymph nodes under clavicle near neck

-Can spread to lymph nodes within the breast or the armpit (axillary) and to tissues near breast.Cancer stage IIIC breast is classified as stage IIIC can work and can not stage IIIC work.

In operable stage IIIC, tumor:

-Is found at 10 or more lymph nodes under the arm

-Is found in lymph nodes near the neck under clavicle and the same body part with breast tumor

-Is found in lymph nodes within the affected breast and axillary’s nodes satellites. In inoperable stage IIIC, the tumor has spread to lymph nodes near supraclavicular and neck on the same side of the body like breast cancer.

Stage IV

In stage IV, the tumor had spread to other organs in the body, most often in the bones, lungs, liver or brain.

Typology

Inflammatory Breast Cancer

Signs of inflammatory breast cancer are present in the breast affected inflammatory signs:

- Redness, swelling and local heat. Local redness and warmth occur because cancer cells block lymph vessels in the skin. The affected breast may look pinched skin (as in chicken wind), so-called "orange skin (like orange peel). Inflammatory breast cancer is included in stage IIIB, IIIC or stage IV.

- Inflammatory breast cancer skin at this level is that a nipple is orange peel and cord (facing inwards).

Recurrent breast cancer

recurrent breast cancer is that cancers recur after his treatment. This may present recurring in the breast, chest wall or in other parts of the body.

Therapeutic Options

Currently there are different types of treatment for patients with mammary cancer.

Currently you can use different types of treatment for patients with breast cancer.

For treating patients with breast cancer using two approaches:

- Standard treatment (treatment that is used currently) and new treatments are in clinical testing phase. Before starting treatment, patients are able to choose between standard treatment and new therapies by including patients in clinical trials.

- Treatment is in clinical testing phase aims to improve current treatment options and obtaining information on new therapies for cancer patients. If the findings of a study indicating that treatment has been tested are more effective than standard therapy, new treatment can replace standard treatment.

Clinical trials are ongoing in various parts of the country. Additional information about clinical trials can be obtained from Doctors oncologists. Choosing the most suitable type of patient treatment is a decision typically involves both patient and family and medical team.

Standard treatment

Currently using four types of standard treatment:

Surgery

Most patients with breast cancer require surgery to remove cancerous tissue from the breast. Also during surgery can remove a part or all of the breast affected lymph nodes to be investigated under a microscope to detect malignant cells at this level.

Conservative breast surgery is a surgery that is distant from malignant breast tissue but not entirely remove the breast, including the following techniques:

-Lumpectomies: is surgery that removes tumors (a piece of tissue) with a small area of normal tissue around it, partial mastectomy: is surgery that removes a portion of the breast with a small area of tissue normally around her. This procedure is also called segmental mastectomy.

Dotted lines are identified in the breast tumor area that will be removed and some groups of lymph nodes to be removed.

Also, patients treated by conservative surgical therapy is removed and some lymph nodes for biopsy. This method is called lymph node dissection. This procedure can be performed during conservative surgery or after. Lymph node dissection is performed through a separate incision.

Other types of surgery include:

Total Mastectomy

is surgical which removes the entire mammary gland tumor that contains cancer. This method is also called simple mastectomy. Some axillary’s lymph nodes are removed for biopsy during or after surgery.

Removal of lymph nodes is performed through a separate incision. It delineates the entire breast area dotted lines will be removed. Also, some lymph nodes may be removed

Modified radical mastectomy

it is a surgery that removes the entire cancerous tumor, mammary gland, which contains a large number of axillary’s lymph nodes, the tissue that lines the chest muscles and sometimes remove a part of the chest wall muscle

-Modified radical mastectomy: the dotted lines delimit the entire breast and lymph node area to be removed. Also part of the chest wall can be removed muscle

-Radical mastectomy: a surgical procedure that removes the entire tumor containing cancerous mammary gland, the muscular wall of the chest below the breast and all axillary’s lymph nodes. Sometimes this procedure is called Hallstead radical mastectomy.

Although, after surgery the entire tumor is removed to see the doctor during the surgery, the patient will need radiation therapy, chemotherapy or hormonal therapy following surgery in order to destroy remaining cancer cells. Therapy administered after surgery in order to increase the chance of cure is called adjuvant therapy.

If patients with mastectomy breast reconstruction is taken into discussion (surgical intervention for breast reconstruction after mastectomy form). Restoring the breast can be done simultaneously with mastectomy or later. This can be done by themselves or tissue implant using implants filled with saline or silicone gel. Some medical organizations recommend the use of silicone gel implant clinical trials only.

Radiotherapy

Radiotherapy is a treatment option for cancers that are used X rays high intensity or other types of radiation to kill cancer cells. There are two types of radiation. External radiation therapy uses a machine outside the body to generate X-rays to be directed to areas where it is located tumor. Internal radiation therapy uses a radioactive substance encapsulated in needles, caps, wires, or catheters that are placed inside or near the cancer. The type of radiation, used depends on the stage and type of cancer to be treated.

Chemotherapy

Chemotherapy uses drugs to stop cancer cell growth, both through their destruction by stopping and division (multiplication). Systemic chemotherapy is administered orally or by injection into a vein or muscle, the drugs reach the bloodstream and thereby destroy cancer cells throughout the body. When chemotherapy is placed directly into the spinal column, an organ inside the abdomen, the drugs act specifically on cancer cells in those areas (regional chemotherapy). Mode of administration and type of chemotherapy used depends on the type and stage of tumor being treated.

Hormone therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action, thus stopping cancer cell growth. Hormones are substances produced by endocrine glands in the body and released directly into the bloodstream. Presence of growth hormones can cause certain types of tumors.

If investigations show the presence of cancer cells in places where certain hormones to attach the cells to produce the effect (the receptor), medicines, surgery or radiotherapy are used to reduce the production of hormones or to block their local influence.

Hormone therapy is often recommended to tamoxifen in breast cancer patients in the early stages and those with metastases (cancer has spread to other body parts). Hormone therapy with tamoxifen or estrogen acts on all cells and can increase the risk of developing endometrial cancer. In patients receiving therapy Tamoxifen recommended annual pelvic examination to detect early signs of cancer. Any metrorrhagia (non-menstrual bleeding) should be disclosed to the treating physician as soon as possible.

Currently, there is ongoing testing of new types of treatment in clinical trials.

These comprise the following:

- Sentinel node biopsy followed by surgery. Sentinel lymph node biopsy is removed sentinel lymph nodes (the first lymph node to reach malignant cells metastasize when the tumor) during surgery. Near a radioactive substance are injected tumor and / or blue dye. Radioactive substance or dye enters the lymphatic vessels and thus reach the lymph nodes. The first lymph node that captures the radioactive substance or dye is removed for biopsy. The lymph tissue is examined under a microscope by the pathologist to detect malignant cells. If no malignant cells seen, no need to remove and other lymph nodes. After sentinel lymph node biopsy, the surgeon removes the tumor and the actual (mastectomy or conservative surgery)

- High-dose chemotherapy associated with stem cell transplantation. High-dose chemotherapy associated with stem cell transplant is a method which is given high doses of chemotherapy and replacing blood cells forming elements have been destroyed by anticancer treatment. Stem cells (immature blood cells) harvested from blood or bone marrow the patient (before the start of antineoplastic therapy) or from a donor and are preserved by freezing. After courses of chemotherapy, the stem cells are thawed and administered through an infusion patient. They develop and restore the body's blood cells.

Clinical trials conducted have shown that high doses of chemotherapy followed by transplantation stem cells is more effective than standard chemotherapy in treating breast cancer. Doctors have now decided that high doses of chemotherapy should be used only in clinical trials. Before participating in these trials, patients should seek specialist advice oncologist about the side effects, including taking into account the death that may occur after high dose chemotherapy.

Adjuvant therapy with monoclonal antibodies

Monoclonal antibody therapy is an anticancer treatment that uses antibodies synthesized in the laboratory from a single cell type Immune system. These antibodies can identify substances in some malignant cells or normal substances that help malignant cells to develop. Antibodies attach themselves to these substances and kill malignant cells, preventing their development or metastasis. Monoclonal antibodies are administered to the patient by infusion.

Monoclonal antibodies can be used alone or to carry drugs, toxins or radioactive substances directly to malignant cells. These antibodies are also used also in combination with chemotherapy as adjuvant treatment. Trastuzumabum (Herceptin) is a monoclonal antibody that inhibits proliferation of tumor cells that express excess HER2 protein by blocking tumor cell growth induced by the HER2 protein. Approximately 25% of patients with breast cancer can be treated with combination chemotherapy trastuzumabum.

Ductal carcinoma in situ

Treatment of ductal carcinoma in situ may include the following:

Conservative-surgical therapy with or without radiotherapy or hormone therapy association

-Total mastectomy with or without combination hormone therapy

-Inclusion in clinical trials using hormone therapy associated with conservative surgical therapy with or without radiotherapy.

Lobular carcinoma in situ

Lobular carcinoma in situ treatment may include the following:

-Lobular carcinoma biopsies needed for diagnosis in situ and clinical examinations followed by mammography regularly to detect any changes from an early stage

-Administration of tamoxifen to reduce the risk of developing breast cancer

Prophylactic bilateral mastectomy,. This therapeutic method is sometimes used for women who have high risk of developing breast cancer. Most surgeons felt that this type of treatment is too aggressive for such patients

-Inclusion in clinical trials investigating the effectiveness of drugs in preventing breast cancer.

Therapeutic options based on disease stage

This chapter refers to specific therapeutic methods still in testing stage clinical trials, but some might not be very new therapies mentioned. For more information on the ongoing clinical trials talk to your doctor.

Stage I, Stage II, Stage IIIA, and operable stage IIIC

Treatment in Stage I, Stage II, Stage IIIA, and operable stage IIIC includes the following:

- Conservative surgical therapy used to remove the primary tumor and a portion of normal tissue around the tumor, followed by removal of lymph nodes and radiotherapy

- Modified radical mastectomy with or without surgical reconstruction of the breast

- Inclusion in clinical trials investigating the sentinel lymph node biopsy followed by surgery.

Adjuvant therapy (treatment given after surgery in order to increase the chances of healing) include the following:

- Radiotherapy lymph nodes near the breast and chest wall following modified radical mastectomy

- Systemic chemotherapy with or without hormone therapy

- Hormone therapy

- Inclusion in clinical trials that use trastuzumabum (Herceptin) combined with systemic chemotherapy.

Stage IIIB inoperable Stage IIIC

Treatment of Stage IIIB and inoperable stage IIIC may include the following:

- Systemic chemotherapy

- Systemic chemotherapy followed by surgery (total mastectomy or conservative surgical therapy), followed by removal of lymph nodes and radiotherapy

- Adjuvant systemic therapy (chemotherapy, hormone therapy or both)

- Inclusion in clinical trials investigating new anticancer drugs, new combinations of drugs and new methods of treatment administration.

Stage IV and metastasis breast cancer

Treatment of stage IV and metastasis breast cancer may include the following:

- Hormone therapy and / or chemotherapy with or without trastuzumabum (Herceptin)

- Radiotherapy and / or surgery to relieve pain and other symptoms

- Inclusion in clinical trials investigating new chemotherapy and / or hormone therapy. Also in clinical trials are investigating combinations between trastuzumabum November (Herceptin) and other anticancer drugs

- In clinical trials are investigating new therapies associated with high dose chemotherapy Stem cell transplantation.

Therapeutic options in inflammatory breast cancer

Inflammatory breast cancer include the following:

- chemotherapy systemic

- Systemic chemotherapy followed by surgery (total mastectomy or conservative surgical therapy), and lymph node removal followed by radiotherapy

- Adjunctive systemic therapy (chemotherapy, hormone therapy or both)

- Inclusion in clinical trials investigating new anticancer drugs, new combinations of drugs and new methods of treatment administration.

Therapeutic options for recurrent breast cancer

Recurrent breast cancer (cancer that recurs after treatment) in the breast or chest wall may include the following:

- Surgery (radical mastectomy or modified radical mastectomy), radiation or combination thereof

- Systemic chemotherapy or hormone therapy