According to sociological polls, one of the biggest fears of modern man is the fear of getting cancer. Because cancer is one of the most common causes of death. And yet, the problem is shrouded too tragic information, which is not always the case, however, prevents many in time to see a doctor.
For example, not everyone knows that in breast cancer in 50% of cases it is possible to extend the life and reach of recovery with the help of specialized medical treatment. This figure would be higher if women were not to panic and not "hiding" from doctors.
I saw it, having visited in the Department of breast tumors and reconstructive surgery, National cancer Institute, which is headed by the chief onliroul, doctor of medical Sciences, Professor Ivan SMOLANKA. Light house, friendly and attentive doctors, full of optimism, and configured on the life of the patient, in most cases, get out of bed the next day after surgery.
We asked Ivan Ivanovich to tell the readers of the "Health and Dougall on the prevention of breast cancer, as well as the possibility of medicine in diagnostics and treatment of this disease.
Up to 70% of women have benign diseases of the breast
- Ivan Ivanovich, usually any changes in the breast in women cause fear. However, they are not always associated with malignant processes. Please, tell us about benign breast disease.
- Diseases of mammary gland benign nature of 25 to 30 times more often than breast cancer. Are certain diseases occur in 55-70% of women.
One of the most common benign tumors is fibroadenoma. It is due to impairments share of breast cancer and appears as dense moving slow tumor growth. Most often fibroadenoma occurs in young women. Although older women can be affected by this pathology. Treatment is usually surgery planned. In some cases, conservative treatment and observation. However phyllode (leaf) fibroadenoma is growing rapidly, sometimes can be very large, to be reborn in a sarcoma. Therefore needed urgent surgery.
Lipoma (can be single or multiple) - soft-flexible tumors located in the tissue subcutaneous tissue of the breast. Treatment generally conducted at the large size of the tumor, which causes a cosmetic defect.
Cysts breast cancer in most cases do not require surgical intervention. For diagnostic purposes held puncture cysts, who is also medical means (using a thin needle from it take liquid, resulting in gluing of wall cyst). If after the puncture it occurs again or there will be found papillomavirus, then shows surgical treatment. In practice this is rare. In the future, is conservative treatment of hormonal imbalances that cause the formation of cysts.
Nodular of fibroadenomatosis, called mastopathy, is the reaction of the breast tissue of the various hormonal imbalances in the body. They can manifest themselves differently as swelling Breasts before menstruation, and the formation of a dense painful swelling. Cause this disease may diseases of the thyroid gland, ovaries, liver, nervous stress, etc. 80% of tumours of this type does not have the increased risk of transformation into malignant. Treatment of mastopathy should be complex: from surgical and ending conservative with the use of hormonal therapy.
Breast cancer is a disease of women in developed countries
- What is the situation with the incidence of breast cancer in Ukraine and in the world?
- Breast cancer not only in Ukraine but all over the world occupies first place among cancer women. Annual growth in the number of disease - about three percent. In Europe identified annually 180 thousand new cases of breast cancer in the US - 130 thousand.
As for Ukraine, this figure reaches 16 thousand, of them about 50% die. Unlike developed countries, our women are more likely to go to the doctor when the trouble started. Such complaints about 30%.
It should be noted that breast cancer is called a problem of developed countries.
- Why is this?
- Obviously, it is connected by that in economically developed countries low fertility, children breast-feed a very short period of time, more often artificial feeding. In these countries is significantly more women take oral contraceptives, often uncontrollably. In Asian countries, where high fertility, the number of cases of breast cancer is much smaller.
Each patient must give yourself a chance at life
- Ivan Ivanovich, you said that the Ukrainian women in many cases too late to seek help from their doctor. Probably it is connected with myths about the fatality of cancer. What chance does women with this diagnosis, to recover or to prolong life for a long time?
- Treatment of women to the doctor for specialized medical help gives her a chance on life extension, and for recovery. This is evidenced by medical statistics. I can give approximate chances of survival for 5 years at different stages of cancer. On the so-called " zero " stage, when they find individual cancer cells, the chance to survive is almost 98-99%, in cancer stage I - 90 to 95%, II And is about 80%, II B - 65%. In the case of cancer III stage - about 45% of patients. At the fourth stage, when there are distant metastases, and adequate treatment survive 15% of women. Therefore, the earlier a woman is applying for medical help, the has more chances to survive.
The cost of treatment of a cancer of advanced cases significantly increase, sometimes 25 times. If in the early stages is enough surgical treatment, in the case of advanced forms of cancer appoint a comprehensive treatment: chemotherapy, radiation, hormone therapy, immunotherapy, etc.,
But even in advanced stages patients cannot be neglected professional oncological help. Doctors through specialized methods of treatment often possible to reduce the swelling and even in such cases, it is sometimes possible to perform organ-retaining operations. Medicine is now at such a level, when even on the third and fourth stages of cancer and metastases already far outside the body (the diseased lungs, liver, bones and so on), when properly selected, complex treatment can significantly prolong the life of patients.
- One of the factors why the woman is afraid to go to the doctor, is the fear of losing a breast. What is now the possibility of Ukrainian medicine relatively organ-sparing surgery?
- If the woman turns in time to see a mammologist, oncologist, she, if necessary, will be performed organ-sparing surgery. However, one should not forget about the possibility of restoration of the form and volume of the breast after mastectomy (complete removal of the breast) at the expense of reconstructive plastic surgery.
Illnesses and symptoms that indicate a precancerous condition
- What are the symptoms, the diagnosis should alert the woman regarding the risk of breast cancer?
Medical science has proven that cancer begins immediately, but gradually. This disease very often preceded by a benign tumor, papillomas, chronic ulcers, polyps, leukoplakia, hyperplasia, pigmented lesions, etc., from which over time with the wrong treatment can be a real malignant tumors.
- To what one should pay attention to the woman not to miss at home precancerous condition?
- First of all, if she find yourself in a strange lump in the breast, redness, discharge from the nipple, deformation his or breast cancer, should immediately contact a specialist. In no case does not engage itselftreatmentPM
Factors affecting the development of tumors
- What are the risk factors defeat breast cancer?
- 90% of women suffering from breast cancer, women older than 40 years. Risk factors include heredity, frequent abortions, and later the birth of children and the insufficient lactation, uncontrolled use of contraceptives, injury breast cancer, disorders of sex life, Smoking, alcohol use, failure to comply with the principles of a healthy lifestyle (sedentary lifestyle, lack of vitamins, especially a, E, D), stress. Increase the risks and concomitant gynecological and endocrine diseases. Because breast - body hormone responsive to any changes in the ovaries, the adrenal glands, thyroid gland.
Methods of modern diagnostic ekoobrazovanie
- Please, tell us about modern methods of diagnostics of breast diseases.
"The success of treatment for breast cancer fully depends on early and accurate diagnosis. This can be achieved when using complex methods of diagnostics. Will tell about the main.
Clinical breast examination is to inspection and palpation (feeling of the body), which examines the extent to which a glands, shape, size, condition of the skin above the Breasts, form nipple, availability and type of discharge from him. Is superficial and deep palpation glands and lymph nodes, is determined by the presence of seals and their character.
Mammography is the most effective method of early diagnostics of pathology of the breast used to detect tumors 0.3 see for early diagnostics can be carried out women from 40 to 50 years old - 1 every 2-3 years, and after 50 years - 1 once in 1-2 years. The method is 75-95%.
Ultrasound examination of mammary gland allows you to define the structure of the tissue studied. Its advantages include safety, detection of the tumor is not available for x-ray mammography parts of the breast, differentiation cysts and solid tumors, etc. However, it should be noted that this method allows to reveal only tumors larger than 1 cm Accuracy of ultrasonography in the diagnosis of cysts is to 98-100%, in the diagnosis of breast cancer - 87%.
Ductography - x-ray examination with the introduction of contrast in the ducts of the breast. This method is required and highly informative in the presence of pathological secretion (discharge from the nipple). Ductography allows to reveal expansion in the ducts (cancer or papillomatosis), set the location of the injury and to estimate the prevalence.
Computed tomography allows you to explore the deep divisions mammary gland, lymph nodes; to identify the spread of the tumor to the surrounding tissue and metastatic affection of the chest cavity. Computer tomography helps to diagnose tumors that were not detected during mammography. Minimum diagnosed size of tumors - 3 mm
Radionuclide diagnostics is based on the introduction into the tumor radiopharmaceuticals. No accumulation of the drug in the tumor shows benign process.
Invasive diagnosis - injection-aspiration biopsy, trephine biopsy, and surgical biopsy. A biopsy is the taking of tissues and their subsequent study under the microscope, which allows you to define the cellular structure of the studied material.
Injection-aspiration biopsy is done by administering through the skin thin needle. In 85% of cytological study (assessment of the status of the body's cells and their performance) allows to make a diagnosis. This procedure does not require anesthesia, so it can be performed under outpatient conditions.
Trephine biopsy - getting under local anesthesia with the help of special needles, pile fabrics, sufficient for histological examination under a microscope. This study gives a complete histological conclusion, allows you to determine the degree of malignancy, and other characteristics, which is very important for further treatment tactics.
Surgical biopsy is the most complete histological examination, but require hospitalization and General anesthesia. This method is required in the case of suspicious neparprotami tumors detected by mammography and ultrasound. When surgical biopsy is needed to remove 1 cm of healthy tissue around suspicious about the malignancy of tumors. In benign tumors is quite a few millimeters. Under this method assesses breast cancer: morphological characteristics, the degree of malignancy, the defeat of vessels etc.
Nuclear magnetic resonance helps to get the image in different planes, to detect changes in the structure of the breast (microcalcifications and malignant carcinoma with severe vascular architectonics).
- Ivan Ivanovich, thank You for the exhaustive information. Hope it will encourage women to be attentive to yourself, and if necessary, consult a doctor for help.