Presentation on the topic "Early diagnosis and prevention of breast cancer". Presentation of breast cancer breast breast cancer presentation

1 Breast Cancer Prevention and Early Diagnostics Mammologist University Clinic Onmeda, K.Med.n. Vododyuk Vladimir Yuryevich.

3 breast cancer (RMW) is a malignant tumor of the breasts of the breast 99% of patients - women in the world annually record about 1 million new cases of RMW, of which about 15 thousand - in Ukraine every 30 minutes, in our country, a new case of RMW is discovered in our country. , every hour there is one woman dies the duration of the normal life of patients with RMG in the establishment of a diagnosis in the initial stages and a properly conducted treatment - over 25 years of 12.8% of patients with RMW did not live 1 year from the date of diagnosis

4 Structure of oncological morbidity in women

5 The incidence of breast cancer depending on age

6 Prevention of RMW Primary prophylaxis - This is a prevention of the disease by studying the etiological factors and risk factors, environmental protection and a decrease in the influence of carcinogens on the human body, the normalization of family life, the timely implementation of the childbearing function, the breastfeeding of the infant, the exclusion of marriages when mutual oncological burdens, the secondary prevention - previously identification and treatment of prematubic Diseases of the mammary glands - various forms of mastopathy, fibroaden, other benign tumors and diseases, as well as disorders of the endocrine system, diseases of female genital organs, violation of the liver function Tertiary prevention is a warning, early diagnosis and treatment of recurrences, metastases and metachronic neoplasms

7 Breast cancer risk factors, age-related, constitutional factors: female sex, age over 60 years old, high growth genetic: blood relatives, patients with rchs; burdened family history; Carriers of mutant genes BRCA1 and BRCA2 reproductive: early menarh (up to 12 years), late menopause (after 54 years), lack of pregnancies, late first childbirth (after 30 years); not bored; abortions; High X-ray density mammograms hormonal and exchange: hyperstroaction, hyperprolactinemia, hypothyroidism, disorders of the menstrual cycle, infertility; Mastopathy, adhesit, ovarian cyst, uterine myoma, endometriosis; obesity in postmenopausal age, diabetes, liver disease; replacement hormone therapy; Use of oral contraceptives for more than 10 years of external environmental factors: high socio-economic status; The impact of ionizing radiation and chemical carcinogens; excess alcohol, fats, calories, animal proteins; Lack of vegetables and fruits, food fibers

8 Clinical manifestations of RMZH: - painless, dense education in the thickness of the breast - change in the outline and shape of the breast - wrinkling or tightening the skin of the breast - the sensation of discomfort or unusual pain in one of the mammary glands - sealing or swelling on the nipple, its intensity - bleeding Selection of nipples - an increase in lymph nodes under the arm with the appropriate side

9 Symptoms of RMW

10 Diagnostics of RMW: 1. Self-examination of the mammary glands 1 times a month after menstruation 2. Clinical examination in a specialized medical institution

11 Self-examination of the mammary glands

12 Screening RMW: Annual Mammography in women over 55 years old and from a higher risk group Mammography 1 time in 2 years in women older than 39 years, in the first phase of the menstrual cycle

13 Diagnosis of RMW: Clinical examination (collection of history, inspection and palpation of the mammary glands and lymphottock paths) Tool methods Research (X-raymammography, ultrasound and MRI of the mammary glands) Methods of interventional diagnostics (tab, Trepan biopsy, Excision biopsy) Morphological method of research (cytological, histological, IGH, therapeutic pathorphosis) Genetic research (BRCA1, BRCA2) Laboratory research methods ( Oncomarkers, general-clinical studies)

14 Treatment of RMW 1. Surgical treatment. -Dical operations: LAMPECTOMIMOM, KVADRATEctomy, mastectomy-plain operations: using artificial materials (expander / implant), own tissues (thoraco-dorsal flap, tram-shutter, etc.)

15 Treatment of RMW 2. Drug therapy - Hormonotherapy -Chimotherapy 3. Radiation therapy 4. Combined and combined treatment 5. Rehabilitation

16 Thank you for your attention!

17 University Clinic ONMED Diagnostics and treatment of all forms of diseases of the Odessa of Odessa, Shady 8. T

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Breast Cancer - Presentation, Report, Project Download

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Mammary cancer

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Milk iron is an organ that feeds oncologov from birth ...

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Breast Cancer - the most common malignant tumor in women throughout the life every 8th woman has a risk to get breast cancer

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Unfortunately, the main risk factors for the development of breast cancer are not preventing ... female sex age

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Age as a risk factor of RMS risk up to 30 years 1 from 2,000 to 40 years 1 out of 233 to 50 years 1 out of 53 to 60 years 1 out of 22 to 70 years 1 out of 13 to 80 years 1 out of 9 throughout life 1 of 8

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Risk factors

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RISK FACTORS Ensuring the impact of genital hormones (estrogen) Early Menarche (up to 12 years) Late menopause (after 55 years) Age Helicitality RMZH in blood relatives Mutation of genes "Predisposition" to RMG (BRCA, P53, PTEN)

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RISK RISK RISK RMS

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What are BRCA genes? Genes encoding protein responsible for reparation of DNA two-chained breaks

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Effect of BRCA gene mutation

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BRCA Mutation Risk Increased "Family" RMW is not always associated with BRCA mutation However, if the sick or blood relatives of the breast cancer arose up to 50 years of bilateral synchronous or methachronous nuclear power plant, the combination of RMG and cancer of the ovarian groceries

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Early start of screening and special screening methods

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Preventive mastectomy and ovaredectomy

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Routine Screening of breast cancer 1. Self-examination of the mammary glands from age 20 years - monthly 2. examination by the doctor Age 20-39: every 3 years Age\u003e 40: Every year 3. Mammography Age\u003e 40: Every year

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Screening system of targeted measures aimed at identifying diseases before any symptoms are the main goal: decrease in mortality

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Early detection timely detection due to a routine examination upon visit to a doctor related to other reasons Proper interpretation Symptoms and oncological alertness of explanatory work with patients

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The examination (and self-examination) of the mammary glands of self-examination is better to carry out the same day (no more than once a month): in Premopause - during the first week of the menstrual cycle after menopause - on the same day of each calendar month

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Stage 1 Inspection of linen Minor and irregular discharge from the nipple may remain unnoticed when inspection, but leave tracks on underwear

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Stage 2. General form Self-examination glands - in front of a mirror Examination - in front of the doctor's doctor omitted hands raised slopes and turns to the side Changing the size, shapes, breast contours Symmetry of both glands alone and when the position is changed or the displacement of one of the glands towards the selection from the nipple local retractions / emissions of the change Skin

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Stage 3 Palpation of the mammary glands Palpation is carried out by pads, (not tips) fingers, thumb in palpation does not participate in the surfactant palpation (subcutaneous formations) deep palpation palpation of axillary regions

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What needs to be done when changes are detected? 1. Do not panic - most changes are not a tumor (cysts and fibroadenomes) 2. Contact an oncologist (send a patient to the oncologist)

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According to international data, the effectiveness of screening mammography is a decrease in the relative risk of death from the RMH 15-20% (to prevent 1 death from the RMH, ~ 200 women have been examined for 10 years) Regular examination and self-examination to reduce mortality does not lead

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Mammography of Specula Focal Microcalcinates Violation of Architectonics Uneven Density Blur Blur

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Specifying diagnostics Diagnostic Mammography ultrasound, MRI Dense Milk Iron Cysts Evaluation of lymph nodes Puncture of cysts (emptying) Cytological examination Content of the cyst

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Breast biopsy

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The features of the "Russian" breast cancer are much larger than the proportion of the launched (common) cancer \u003d more mortality in comparable morbidity more often has to be treated with a common disease.

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This is no longer screening ... and not even early detection ...

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And with the diagnosis here everything is easier ...

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According to the results of the biopsy, I confirm (refute) the diagnosis + determine the histological subtype of the tumor determine the presence of targets for special types of drug therapy (endocrinetherapy, target therapy) determine the degree of malignancy we obtain material for additional research

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Survey the patient to identify remote metastases, depending on the stage of the process in the breast (T and N) and symptoms, may be needed: radiography of organs chest Ultrasound or CT organs abdominal cavity Scintigraphy Skeleton CT brain ...

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Based on the research complex determines the prevalence of the disease Biological characteristics of tactics tactics

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Tumor prevalence TNM T system (Tumor) - characterizes the primary tumor N (NODUS) - characterizes regional lymph nodes M (metastasis) - characterizes remote metastases

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Primary tumor

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Regional lymph node lymph nodes from the affected breast, in which the lymphottok N0, the lesions of lymphatic nodes, there are no N1-N2 - the defeat of only the axillary or only intragenic lymph nodes N3 - the defeat of the axillary and intrathustic lymph nodes and / or / or / or permanent lymph nodes

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Remote metastases Clinically or histologically detected swells of tumors in organs and tissues, not described in categories T and N M0 - remote metastases NO M1 - Remote metastases have

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Stage 0 (TISN0M0) Preinment Cancer Ca in Situ (CIS)

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The stage of breast cancer. Allocation of stages is based on the difference in forecast and / or approaches to treatment II III IV

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Invasive cancer

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Stage I T1N0M0.

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Stage IIA T1N1M0 T2N0M0

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Stage IIIIB-C T4N0-2

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Stage IIC T0-4N3M0.

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Stage IV T - any N - any M1

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Localized Stages I, II, IIIA Lack of remote metastases, the possibility of conducting local treatment At the first stage, the treatment approach is complex with the obligatory inclusion of local therapy. The treatment of therapy is a cure or achieving a significant time without manifestation of the disease. The forecast depends on the size of the primary tumor and biological characteristics of the tumor

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The basis of treatment - local therapy radical operation - removal of the primary tumor and regional lymph nodes radical mastectomy (complete removal of breast carrier carrier) on the holding - with a large and small breast muscles on the drink - with a small thoracic muscle in Madden - without breast muscles organ-bearing operations Radical resection - removal of the part of the breast carrier lampctomy tumor - removal of a tumor with a small indent to the surrounding tissue (usually less than 1 cm)

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Advant therapy Adewant therapy - therapy, carried out in addition to radical local treatment, for the purpose of eradication (destruction) or inhibition of micrometastase growth radiation - prevention of local recurrences (return of the tumor in the postoperative zone) Drug (systemic) - suppression of remote micrometastases and preventing local recurrences

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Factors affecting the choice of the volume of operation The size of the tumor Localization of the tumor The presence of affected lymph nodes Age Patient wishes for the patient

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The main factor that allowed to reduce the volume of operation The appearance of effective dosage and radiation treatment of preoperative (non-adecutive) postoperative (aduvante)

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Gloomy Surgeons Our plastic ...

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Migratic lymphadenectomy for everyone?

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Watchtower lymphouzel

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Drug Therapy Chemotherapy Endocrinetherapy Target Therapy

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Key points when choosing a tactics of tone treatment Clinico-morphological tumor size Degree of malignancy Number of affected lymph nodes Histological subtype Molecular biological presence of estrogen receptors and / or progesterone in Her-2 tumor Status Ki-67 Genetic

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Chemotherapy is administered by almost all patients with early RMW (with the exception of very small tumors 2/3) the gland PEAU D 'Orange "Ground" edges The absence of palpable foci is significantly less common survival

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Even-infiltrative form of RMW

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Options for the flow of edema-infiltrative cancer

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Criteria for evaluating the effectiveness of the treatment of localized forms of RMW The Purpose of therapy - COLLECTION The main indicator is the survival rate of the non-Reluznaya survival (RELAPSE-Free Survival) - the share of patients who ... total survival (Overall Survival) - the share of patients who are ...

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Metastatic (disseminated, common) breast cancer IV stage or the appearance of metastases after the previously conducted treatment of local stages

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Metastatic breast cancer Chronic disease against the background of adequate therapy The patient can have a long time to maintain a full life flowing with the periods of "exacerbations" (progression) and remissions sooner or later leads to death (if it does not occur earlier from intercurrent diseases)

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Objectories Therapy Extending Life Control Symptoms An increase in the intervals between "exacerbations" Reducing the toxicity of treatment An increase in "quantity" and the quality of life of patients

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Ideal therapy for disseminated breast cancer Individual approach, taking into account the biological peculiarities of the tumor, achieving maximum efficiency with minimal toxicity of therapy. Maximum extension of life while maintaining its satisfactory quality.

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Options for systemic treatment of breast cancer Chemotherapy (mono- and combinations of drugs) and / or target (targeted) therapy and / or endocrinetherapy

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Chemotherapy for metastatic breast cancer is one of the standard treatment approaches allows the most quickly (from other types of systemic therapy) to obtain an antitumor effect is able to increase survival (compared to the absence of treatment) in all groups of patients with RMZH

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The first significant steps in drug therapy RMH last century, 70s tamoxifen CMF (cyclophosphamide, methotrexate, 5-fluorouracil)

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Cytostatics active with breast cancer anthracycline doxorubicin epirubicin Mitoxantron alkulat thiophosphamide cyclophosphamide platinum preparations Cisplatin Carboplatin

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Causes of failures? Purpose of chemotherapy products - genome or apparatus dividing the tumor cell lesion of normal tissues carrying the same objectives - toxicity The instability of the tumor genome - fast production of resistance due to hypermutability Choice of chemotherapy products - empirical no predictive factors - it is impossible to predict the effect of treatment (choose the optimal mode)

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Chemotherapy should be used in patients who do not have other treatment alternatives patients not subject to endocrinetherapy or target therapy patients after progression on the background of endocrinetherapy or targeting therapy, if it is necessary to quickly obtain effect (common or fast progressive disease), together with target therapy, if its effect potentives

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Target (target) Therapy Impact on the "target" having a proved value for a tumor, but the possibility of predicting the effect is illiciable for the body (there is a target - there is an effect, no target - no effect) small or missing toxicity due to the main mechanism of the drug, and small Nonspecific toxicity

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Perfect target therapy for small-toxic treatment with the possibility of individual selection for each patient

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Target therapy

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Principle of individualization of treatment

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Endocrinetherapy (hormonotherapy) The first example of targeted therapy, which appeared long before the introduction of the very concept of "target therapy" affects the target (progesterone receptors or estrogen in the tumor) is significant for a tumor and insignificant for the body as a whole in the presence of receptors (targets) has high efficiency in the absence of targets - the effect is unlikely (

mYPRESENTATION.U.

Breast Cancer Prevention and Early Diagnostics - Presentation, Report, Project

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Breast Cancer Prevention and Early Diagnostics Mammologist University Clinic Onmeda, K.Med.n. Vododyuk Vladimir Yuryevich

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Breast cancer (RMW) is a malignant tumor of the breast gland tissue of 99% of patients - women in the world record about 1 million new cases of RMG, about 15 thousand of them - in Ukraine every 30 minutes a new case of RMG is found in our country. , every hour there is one woman dies the duration of the normal life of patients with RMG in the establishment of a diagnosis in the initial stages and a properly conducted treatment - over 25 years of 12.8% of patients with RMW did not live 1 year from the date of diagnosis

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Structure of oncological morbidity in women

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The incidence of breast cancer depending on age

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Prevention of RMG Primary prevention is a prevention of the disease by studying etiological factors and risk factors, environmental protection and a decrease in the influence of carcinogens on the human body, normalization of family life, timely implementation of a childbearing function, breastfeeding of a baby, the exclusion of marriages with mutual oncological burdensome secondary prevention - earlier Identification and treatment of prematubolic diseases of the mammary glands - various forms of mastopathy, fibroaden, other benign tumors and diseases, as well as disorders of the endocrine system, diseases of female genital organs, liver function. Tertiary prevention is a warning, early diagnosis and treatment of recurrences, metastases and methachronous neoplasms.

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Breast Cancer Risk Factors, Age, Constitutional Factors: Female Gender, age over 60 years old, High growth Genetic: Blood relatives, Patients with RMW; burdened family history; Carriers of mutant genes BRCA1 and BRCA2 reproductive: early menarh (up to 12 years), late menopause (after 54 years), lack of pregnancies, late first childbirth (after 30 years); not bored; abortions; High X-ray density mammograms hormonal and exchange: hyperstroaction, hyperprolactinemia, hypothyroidism, disorders of the menstrual cycle, infertility; Mastopathy, adhesit, ovarian cyst, uterine myoma, endometriosis; obesity in postmenopausal age, diabetes, liver disease; replacement hormone therapy; Use of oral contraceptives for more than 10 years of external environmental factors: high socio-economic status; The impact of ionizing radiation and chemical carcinogens; excess alcohol, fats, calories, animal proteins; Lack of vegetables and fruits, food fibers

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Clinical manifestations of RMG: - painless, dense formation in the thickness of the breast - a change in the outline and shape of the breast - wrinkling or tightening the skin of the breast - the sensation of discomfort or unusual pain in one of the mammary glands - sealing or swelling on the nipple, its intensity - bleeding from nipples - an increase in lymph nodes under the arm with the appropriate side

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Diagnosis of RMW: 1. Self-examination of the mammary glands 1 times a month after menstruation 2. Clinical examination in a specialized medical institution

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Self-examination of the mammary glands

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Screening RMZH: Annual Mammography in women over 55 years old and from a group of increased risk Mammography 1 time in 2 years in women older than 39 years, in the first phase of the menstrual cycle

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Diagnosis of RMW: Clinical examination (collection of anamnesis, inspection and palpation of the mammary glands and lymphoottock paths) Instrumental research methods (X-ray Mammography, ultrasound and MRI of the Milk glands) Methods of interventional diagnostics (tab, Trepan biopsy, Excision biopsy) Morphological research method (cytological , histological, IGH, therapeutic pathorphosis of the RMZH) Genetic study (BRCA1, BRCA2) Laboratory research methods (oncomarkers, general-clinical studies)

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Treatment of RMW surgical treatment. Radical operations: LAMEctomy, quadrantctomy, mastectomy Reconstructive operations: using artificial materials (expander / implant), own tissues (thoraco-dorsal flap, tram-shutter, etc.)

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Treatment of RMG Drug Therapy Hormonotherapy Chemotherapy 3. Radiation Therapy 4. Comprehensive and Combined Treatment 5. Rehabilitation

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University Clinic ONMED Diagnostics and treatment of all forms of diseases of the Odessa of Odessa, Shady 8. Volume 703 25 75

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Prevention and early diagnosis of breast cancer in women. - Presentation

1 Prevention and early diagnosis of breast cancer in women

2 Why is it important? Oncological diseases occupy second place in the structure of diseases in the Irkutsk region.

3 breast cancer in the Irkutsk region ranks third among malignant neoplasms, the first place in the structure of the incidence among the female population and the first place in the frequency of mortality in women.

4 Each 213 Woman in the Irkutsk region is sick of malignant neoplasms of the breast.

5 Annually in the Irkutsk region more than 900 new cases of malignant breast neoplasms are detected.

6 55.6% of cases of breast cancer falls at the I-II of the stage of the disease under which complete curing is possible. 45.4% of cases of breast cancer falls on the III and IV stage of the disease, when a comprehensive treatment is required, including radiation impact, chemotherapy and hormonal treatment.

7 One of the main reasons for the neglence of the disease is the absence of education, on breast cancer, which leads to late circulation for medical care and high mortality among women diagnosed with breast cancer.

8,42% of women turn to the doctor late when 3-4 stage of the disease has come. 11% are at all afraid to go to the doctor 6% engaged by self-medication every 2nd woman with breast cancer can die due to late diagnosis

9 The goal of our today's meeting is to encourage all women with great attention to their own health to reduce the number of cancer suffering from cancer and other breast diseases.

10 Cancer Healing !!!

11 Classification of diseases of the mammary glands 1. Benign diseases (mastopathy). Such breakdowns of the breast may in a certain percentage of cases be precursors of breast cancer. 2. Malignant diseases (various forms of breast cancer) breast cancer in women is the most frequent malignant tumor.

12 MAX The level of morbidity (cancer MZH) 55 - 60 years Max The incidence rate (benign diseases of the MZ) 40-45 years of the incidence of the pathology of the mammary glands depending on the age

13 What is cancer? Healthy Cinema Cells is a group of diseases (more than 200 species) when cells are uncontrolled and grow. Form metastases in other organs

14 Do we know the cause (s) of the occurrence of breast cancer? Unfortunately no

15 breast cancer - risk factors lifestyle adverse environmental personal genetic

16 An important risk factor in the development of breast cancer: the level of hormone estrogen at various stages of female development throughout the life of estrogen - is absolutely necessary for normal female development and puberty.

17 Early menstruation up to 12 years Early risk Late menopause after 55 years Increased risk of children. First child after 30 years Increased risk. Primary infertility Increased risk breastfeeding Feeding for 12-month reduced risk. Personal risk factors that depend on estrogen levels :

18 Other Personal Factors: Age - 55 years old and older If there was already cancer breasts Some mastopathy more dense breast structure The history of breast cancer in the family

19 What is a healthy lifestyle? Lifestyle

20 healthy lifestyle Refusal from harmful habits - smoking and excessive use of alcohol, proper nutrition, physical education classes Proper Sun behavior Attentive to its body - Preventive inspections, application of self-examination techniques

21 Smoking is the main reason for the development of lung cancer, larynx, nasal cavity, throat and trachea. Lung cancer refers to the type of cancer, which is difficult to treat. ....... ... You will refuse smoking about 87% of cases of the disease light cancer caused by smoking. The cigarette contains about 4000 components, 60 of which are carcinogens, i.e. Cancer.

22 Alcoholic beverages increase the risk of developing colon tumors, liver cancer, stomach and breast. .......... You will reduce the use alcoholic beverages. Women S. high degree The risk of breast cancer is recommended complete refusal to eat alcoholic beverages. Women with a high degree of risk of breast cancer is recommended complete refusal to eat alcoholic beverages.

23 Long-term stay in the Sun is the cause of skin cancer, and also increases the risk of cataracts, other problems with eyes and can suppress the immune system. ...... .. ... You will avoid long stay in the sun. During the period of solar activity (especially at noon), try to keep the shade. During the period of solar activity (especially at noon), try to keep the shade. Cove your head and wear sunglasses. Cove your head and wear sunglasses.

24 Incorrect power leads to most cancers. Eating fresh fruits and vegetables, solid cereals reduces the risk of lung cancer, oral cavity, intestines, stomach and rectum. The use of a large number of animal fat increases the risk of prostate cancer and rectum. If possible, reduce the use of fried foods: boil, bake, prepare for a pair. Refuse chips, sweet carbonated drinks, etc. ...... .. .... You will eat right.

25 at least 30 minutes per day are actively physical activities. Try not to type extra kilograms. ......... ... you are physically active.

26 Participate in vagrants, own self-examination techniques, immediately consult a doctor if you have a long cough, inexplicable weight loss, weakness, fatigue, changes popy spots, violation of food, discomfort in the rectum. If there are any seals and tumors, you need a counseling oncologist. Avoid the advice of people far from medicine. The effective method of preventing breast cancer is the use of self-examination techniques. ...... .. ... You carefully treat your health

27 It is easier to warn you than treat! Breast cancer successfully cured on early stages - More than 75% of Russia's success. Women from 20 years old: Monthly breast self-sawing. Women after 40 years every year: Mammography and inspection of the breast by a specialist

28 Take care of yourself !!!

29 How to keep breasts, or what is useful for the breast 1. Sex life. The chest reacts to trouble in personal life very sensitive. She really likes "massage", during which she strains and slightly increases. 2. Pregnancy is a normal pregnancy that has come when it is supposed, that is, up to 30, - the key to a healthy chest. 3. Long breastfeeding breasts is very beautiful and very sexy. However, its main purpose is to feed a little man. If the milk iron did not fulfill this task if its cells never produced milk or produced it too short time, in the exchange of substances inside the cell, not too favorable shift occurs. 4. Convenient bra refusing a bra - risky and, in general, an unnecessary step, because even a small breast without a bra quickly saves and loses its attractiveness. Comfortable underwear is absolutely necessary for sports. 5. Simple exercises breast rests on a peculiar muscle pillow, which form a large and small breast muscle. Strengthen these muscles and make breasts at least a little more very much possible. 6. Cold shower Cold water is an excellent tonic: after all, it causes the cells of smooth muscles to shrink and pulls up a natural "bra." 7. Daily care area decolte is an exclusively delicate zone, and it is necessary to care for it no less carefully than the skin of the face.

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2018 female health blog.

Breast cancer occurs in 1 woman out of 10.

Mortality due to breast cancer is 19-25% of all malignant neoplasms in women.

Most often occurs in the left breast.

Most often, the tumor is located upper-outer quadrant.

1% of all cases of breast cancer makes breast cancer in men.

The greatest risk factors are the female sex, the cases of a family disease of breast cancer.

Treatment.

Treatment of RMG - combined (surgical, radiation, chemotherapeutic, hormone therapy).

Surgery.

The operation may be radical or palliative.

In most cases, a modified radical mastectomy is applied. Operations with the preservation of the breast make it possible to correctly estimate the prevalence of the tumor process and improve the cosmetic result: however, the possibility of conservation of the gland is not available in all patients.

Removal of all the affected breasts is necessary due to the multipocheticity of the disease. Approximately 30-35% of patients find precancerous or cancer damage in areas adjacent to the affected primary tumor.

The removal of the axillary lymph nodes is necessary to determine the defeat of the nodes and the stage of the disease.

Types of operations:

LAMPECTOMIMOM (sectoral resection), the lymphaderectomy of the axillary lymph nodes and postoperative irradiation are used for small tumors (less than 4 cm) and during inttracotum carcinomas.

- Simple mastectomy(Madelena surgery) includes the removal of the breast with the near-block space together with the removal of lymph nodes.

- Modified radical mastectomy(Patty Operation). Remove the skin around the gland, milk gland, small chest muscles, fatty fiber with the lymph nodes of the axillary, subcupatic and subband regions. URO

- Radical Mastectomy on Holt. Together with all the tissues listed above, the larger chest muscle is removed.

- Extensive radical mastectomyincludes the removal of mediastinal lymph nodes. The operation is shown at large or medially located tumors with the presence of intrabrudal (parastinal) metastases. High risk of intraoperative mortality.

- Operations for the reconstruction of breasts are performed simultaneously with the mastectomy or the second step after the full healing of the primary operating wound.

Radiation therapy

- Preoperative. Patients with RMW after establishing the diagnosis receive a course of preoperative radiation therapy on the milk gland and the regional metastasis zone.

- Postoperative. Patients who suffered the removal of tumors and axillary lymph nodes and did not pass the preoperative radiation therapy should receive final radiation therapy on the area of \u200b\u200bthe breast and lymphatic nodes (when metastases are detected).

- Bond postoperative. Patients with RMW should receive postoperative exposure in the presence of any of the following risk factors:

the size of the primary tumor is more than 5 cm

metastasising in more than 4 axillary lymph nosexol reaches the resection line, penetrates into the chest fascia and / or the muscle, or spreads from lymph nodes to the axillary fatty tissue.

Patients with a high risk of remote metastasis can receive radiation therapy before completion of adjuvant chemotherapy or it can be carried out together with irradiation. Postoperative irradiation of the axillary depression increases the risk of edema of the upper limb.

Chemotherapy

Slows out or warns recurrence, improves the survival of patients with metastases in the axillary lymph nodes, as well as in part of patients without axillary metastases.

Chemotherapy is most effective in patients in premopause with metastases in the axillary lymph nodes (there are a decrease in 5-year-old mortality by 30%).

Combined chemotherapy of monotherapy preferred, especially in a group of patients with metastatic breast cancer. Reception of drugs with six courses for six months is the optimal method of treatment in efficiency and duration.

Hormonal therapy

Suppression of ovarian functions by irradiation or ovaredectomy leads to ambiguous results; In some subgroups of patients, there are prolonged periods of improving the state.

Positive answer to hormonal therapy. Probustin under the following conditions:

long period without metastasis (more than 5 years);

elderly age, the presence of metastases in the bones;

regional metastasis and minimum metastasis in the lungs;

histological confirmed malignant 1 and 2 degrees;

prolonged remission as a result of previous hormone therapy.

Estrogen Antagonist Tamoxifen delays the onset of relapses, improves survival and preferable for patients in postmenopausal.

ҚР Densaulқ Saktau Ministers
S.D.Asfenendiyov Atynda азақ лттяқ
Medicine University
Ministry of Health RK.
Kazakh National Medical University
Named S.D.Asfenendiyov
Department of Oncology, Mammology and Rade
Therapia
Mammary cancer

Plan

Breast anatomy: blood supply,
lymphotok, etc.
Ethiology of breast cancer.
Epidemiology of breast cancer.
. Risk factors for breast cancer
Histological classification (WHO 2002)
TNM Breast Cancer Classification
Clinical picture RMH.
Breast cancer forms.
Diagnosis of breast cancer
Differential diagnosis of RMW
Treatment:

Women's dairy gland is located on
Front breast wall between III and IV
ribs. From the medial side she
adjacent to the sternum or covers part of it,
outside closes the edge of big breast
muscles and comes to the front
axillary line.

Topographic Anatomy of the Breast

In topographic
Anatomy milk
glare accepted
divide
Quadrant (Figure 2):
Fig. 2 quadrants
Breast:
Upper
Lower storey
Verkhnevennnyy I.
Nizhnevnutrnia

Breast fabric is represented by complex alveolar-tubular glands collected in small slices, of which large

Breast fabric is presented complex
Alveolar and tubular glands collected in small
Slings from which large shares are formed. Dolki.
glands can lie separately from its bulk
(Then they are called extensions). Milk size
Share ranges from 1-2 cm long and 1.5-2 cm in width
(small mammary glands) up to 5-6 cm long and 3-4 cm in
Width (big glands).
The number of stakes in the gland is from 6-8 to 20-24 shares. Each share
It has output milk duct.
Some ducts before reaching the surface of the nipple
Can be connected, their number usually ranges from 12 to 20
Shares on the nipple. Shares are located in radial
direction on the attitude towards the nipple can be laid
one to another (Fig. 3).

Blood supply of breast
carried out by the branches of the inner chest and
axillary arteries (lateral and top
Breast), as well as branches of intercostal arteries.
About 60% of blood she gets from the inner
chest artery and about 30% - from lateral
chest artery. Vienna of the breast
accompany artery and wide
Anastomozing with the veins of others
regions.

Lymphatic system

Lymphatic system
Lymphatic breast system with oncological
positions is very important because
First of all, it is distributed by tumor
Cells. It is this process that underlies the development
Metastasis RMW in regional lymph nodes.
Knowledge of the characteristics of the structure of this system, and
Consequently, the patterns of lymphogenic
Metastasising RMW is crucial in
evaluating the degree of propagation of the tumor process, then
there are stages of the disease, which ultimately reflects
On choosing a method of treatment.

Distinguish the following paths of lymphs from the breast

1. Migrate. Normally, on this path flows around
97% Lymph. It is usually represented by 1-2 vessels,
Blowing into the axillary lymph nodes. Number of these nodes
May be average 18-30.
2. Plug path. On him Lymph is given away from
Lymphatic plexuses of the upper and rear departments
glands.
3. PARASTNAL PATH. Lymphotok occurs
mainly from the inside of the gland (more from
deep departments) through the chest wall in parastinal
Lymph nodes I-V intercostal.

4. Intercostal path. Lymphotok is carried out from the rear
and external breast departments through vessels,
which are performed muscles II-IV intercorery and further
Anastomozing with a paraspinal mancher in front
or with lymph vessels bodies of vertebrae from behind,
Conditioning their metastatic defeat.
5. Increased path. Lymph outflow occurs
vessels taking start from the central and medial
Departments of the gland and triggering the breast wall in the sternum.
6. Cross Path. Lymph movement occurs on
skin and subcutaneous lymphatic vessels chest
Walls to the opposite axillary nodes.
7. The path of gerot. Lymph outflow occurs in the vessels
epigastric area related anastomoses with
lymphatic mediastinum and liver vessels,
which may occur metastasis.

Ways of outflow of lymphs from the breast

Thus, the lactic iron has many lymphottock paths,
Main main of them. Abundance of lymphatic vessels and
The variety of paths of possible outflow of lymphs are factors
contributing to very frequent and sometimes early metastatic
The spread of breast cancer.

Breast Cancer (RMW):

About 4000 annually
thousand new cases
RMW in RK
Every year in the world more than 1
million new cancer cases
MRJ

Epidemiology of breast cancer

Breast cancer occurs in 1 woman out of 10.
Mortality due to dairy cancer
The glands are 19-25% of all malignant
New formations in women. Most often
It is found in the left breast. Most
Often the tumor is located upper-outer
quadrant. 1% of all cases of milk cancer
The glands is breast cancer in men.
The greatest risk factors - female sex, cases
Family disease breast cancer.

The incidence of breast cancer

According to WHO in 2008 in 59 countries in the world
1050446 breast cancer cases are registered,
The incidence (global standard) was 35.7,
Mortality - 12.5.
In 17 countries of the European Union (Mair per 100,000 population) in
2008 marked very high indicators
The incidence of breast cancer. So, in France -
95.1, Italy-94.4, in the Netherlands-90.3, Germany-84.9,
relatively low - in Slovakia-46.9, Lithuania-43.7,
Latvia-44,1, Estonia-47.2.
In the CIS countries according to 2008, high
Indicators of incidence per 100,000 population
Registered in Russia-42.9, Belarus-37.9, Georgia26.5, Armenia-31.7, Moldova-24.8, Kyrgyzstan-20,
Azerbaijan-12.2 (M.I.Davydov and E.M. Asksel, 2008)

In the Republic of Kazakhstan in the period 1970 - 2009
The incidence of 100,000 population increased from 10.6
up to 20.5 and in the structure of oncolicity
The second rank place, mortality - 8.0.
In 2009, high incidence - in
G. Almaty-33.2, Pavlodar -33.1, Northskazakhstan -29,1, East Kazakhstan-28.3
regions, low - in Yuko -10.7, Kzylordinskaya11, Atyrauskaya-12.4, Zhambylskaya - 13.2 regions.
The specific gravity of the I-II stage among patients with
RMW amounted to 71.1%, IV stage - 6.4%
(J.A. Arzkulov, GD Skequazina, Igisinov S.I.,
2010).

Front proportion pituitary

Ttg.
Shield
Iron (thyroxin,
triiodothironine)
FSH
LG
ovary
Laktotropic
hormone
prolactin
LG-probating
Fsegystrogen
Breast
ACTH
adrenal
(norepinephrine, karting,
estrogen)

Factors contributing to the emergence of precancerous diseases and breast cancer:

I Factors arising from violation
Reproductive
Organism systems:
Menstrual violation (early start
monthly (up to 12 years), late menopause (over 50 years old),
Dysmenorrhea, lack of ovulation);
Violation of sexual function (no, irregular,
Frigidity, non-physiological prevention methods
from pregnancy);

Violation of the childbearing function (no
or small amount of childbirth, late first
Birth -starsche 30 years old, a history of
infertility, frequent abortion - more than 5 times);
Violation of the lactation function
(insufficient lactation, alactation, refusal to
breastfeeding);
Hyperplastic processes I.
Inflammatory diseases of ovaries and uterus
(chronic adnexites, ovarian cysts,
Myoma uterus, endometriosis).

II endocrine-metabolic factors due to related or preceding diseases:

Liver diseases (hepatitis, cirrhosis);
Thyroid disease (hypothyroidism);
The presence of disease triads (sugar
diabetes, hypertonic disease, obesity);
Domor monomal hyperplasia dairy
glands;
Previously transferred mastitis.

III. Exogenous factors:
Injuries;
Ionizing radiation;
Chemical carcinogens.

Pathogenetic forms of RMW

Hypothyroid shape - 5%
Ovarian form - 40-50%
Hypertensional adrenal shape -
40 %
Involutionary (senile) form -
5-10 %
Cancer pregnant women

Preiodine Diseases Classification of Domoronal Hyperplazies

1. Diffuse mastopathy:
a) diffuse mastopathy with the predominance of ferrous
component (adenosis);
b) diffuse mastopathy with the predominance of fibrous
component;
c) diffuse mastopathy with the predominance of cystic
component;
d) mixed form - fibrozno-cystic mastopathy.
2. Nodular mastopathy
3. Benign tumors:
a) adenoma;
b) fibroadenoma;
c) sheet fibroadenoma;
d) intrapritic papilloma (illness
Mint);
e) cyst

In the occurrence of breast cancer, the following hormonal, metabolic and immunological changes occur more often:

1. Lack of progesterone and excess estrogen;
2. Lack of estriol.
3. Violation of the daily rhythm of secretion
Prolactin or increase its secretion.
4. Absolute or relative excess
cortisol, especially in combination with a decrease
The excretion of 17 ketosteroids.
5. Increasing the level of secretion of androgens (
Testosterone, dehydrootestosterone).

6. Improving the level of total
Gonadotropins.
7. Increased blood levels of insulin or "
Detained "type of its secretion.
8. Hyperholesteremia and hyperitriglyceridemia.
9. Increased lipoprotein levels in blood
Low density and decreased lipoproteins
High density.
10. Increased level in blood
Somatostaninov.
11. Reducing the level of thyroxine levels and
triiodothyronine.
12. Reducing cellular activity
Immunity

The group of elevated oncological risk on the occurrence of breast cancer includes women having 5 or more of the above

To a group of increased oncological risk
on the emergence of breast cancer
belong women with 5 or more
The above factors, as well as the presence
Domoronal hyperplasia (mastopathy)
Breast.
Women belonging to the group of oncological risks,
necessary
Reveal by applying the following methods:
1. Method of self-examination - the essence of which
lies in the fact that each menstruatory
Woman monthly after the end of menstruation at 7-8
day and woman postmenopausal age on the 1st
Every month should conduct self-examination
Milk glands:

a) inspection in front of the mirror, paying attention to
Symmetry, state of nipples and skin changes; b)
palpation of both mammary glands in vertical and
horizontal positions from the center to the periphery. For
the availability of changes in the skin, nipple, some seals in
breast woman should turn to
mammologist. Self-examination method
Promotion through the media and television.
2. Ankit-polling method that represents
Questionnaire questionnaire comprising all known factors
contributing to the emergence of precancer and cancer
Breast. The questionnaire must fill out a woman
Applying to the doctor about any disease.
It is advisable to fill it in the viewing office
Polyclinics, as well as during preventive
inspections (mass and individual).

Self-examination of the breast.
Self-examination of the breeding stores - simple, not
requiring costs and special equipment
Method of diagnosing pathological conditions
Breast. More than 80% of tumors in
Women's breasts discover
Alone. The best way to master
Self-examination techniques - women's training
medical worker during clinical
inspection (a woman can spend
self-examination fluid technique, most importantly,
so that she did it regularly and everybody one
and in the same way).

3. Mammography - informative method in
diagnosis of breast pathology. WHO
(1995) recommends to carry out women up to 40
years 1 time in 2 years older than 40 years and persons
Increased risk - annually.
4. Ultrasound procedure - Most
Informative harmless method of detection
Breast pathology. It should be
spend annually all women older than 30
years.
5. Determine the level of estrogen,
Processorone, kartalisol

Pathological anatomy
RMH.
IN
Dependencies
from
Forms of growth
RMW shares:
1. Supplies
2. Diffused:
A) Etcheninftrate
B) Mastitito-like
C) Rozhist-like
D) armor
3. Pacific Cancer
Pedge disease:
A) Eczema-like
B) psoriatic
C) ulcery
D) tumor

Nodal cancer
right
dairy
gland S.
Metastases B.
Regional
Lymphatic
nodes.

Histological classification (WHO 2002)

A. Non-invasive Cancer (Carcinoma in Situ):
Intra-prototype (intracanalicular) cancer in situ;
Dolk (lobular) cancer in situ;
B. Invasive cancer (infiltrating carcinoma)
Infiltrating ducting cancer;
Infiltrating lobby cancer;
Mucous cancer;
Medullar cancer;
Papillary cancer;
Okulyard Cancer;
Apocryan cancer.
C. Special forms:
Cancer Pedge
Inflammatory cancer

Classification of RMG in Stages:

CIS - Cancer "On the spot."
I Stage (T1N0M0 - tumor up to 2 cm in diameter without metastases;
The stage has two substandy: ІІА stage (T0-1N1M0; T2N0M0) -
tumors up to 5 cm in diameter, can be moving metastases in
arms of lymph nodes; IIB Stage (T2N1M0, T3N0M0) -
Tumor from 3 to 5 cm in diameter with presence of moving metastases
in arms of lymph nodes, or a tumor of more than 5 cm in
diameter without refinery metastases;
III Stage (T1-4N2M0) - a tumor of any rosemers with availability
fixed multiple metastasis in the axilation area;
ІV stage (any T and N at m1) - a tumor of any sizes with
the presence of remote metastases (bones, liver, lungs, brain and
etc.)
The classification of stages has an exceptional value when
Solving the tactics of the treatment of patients, as well as for the forecast.

A grouping of breast cancer in stages is given in the table.

The main histological form of cancer
Breast is adenocarcinoma, from
90% of them is a protocolous, 10% - Dolk
adenocarcinoma.
Select 3 degrees of differentiation:
G1 is a high degree of differentiation;
G2 is the average degree of differentiation;
G3 - Low degree of differentiation;

Ways of metastasis of RMH.

The propagation of tumor cells occurs:
1. Local growth, spreading into breast fabrics,
Infiltrating skin.
2. Lymphogenic metastasis:
Pectoral path - under muscle lymph nodes;
A connector path is connectible L \\ nodes;
The parastinal path is an invioxual L \\ nodes;
Related path - mediastinal l \\ nodes;
Cross Path - to another milk gland;
3. Hematogenic metastasis - in bones, lungs, liver, head
Brain and others.

Ways of Flock Lymph in
Regional lymphatic
Breast nodes with
By consideration of quadrants.
Lymphatic vessels I.
Regional lymphatic
Breast nodes

Clinical picture of RMW:

1. Symptoms of nodal cancer MZ:
Tumor tumor node in mzh;
Skin retraction over the tumor;
Symptom platform;
Symptom of lemon crust over the tumor;
Symptom of scaby nipple;
Symptom Craise (Pacific Effusion and Area);
Symptom of Pribrama - when filming behind the nipple tumor
shifts together with the nipple;
Symptom of deformation of the breast;
Hyperemia and skin ulceration over the tumor;
Blood selection from the nipple when pressing the node.

2. Symptoms of diffuse cancer MZ:
Increase in the volume of the breast;
Symptom of the citric crust of diffuse character (
Even-infiltrative form);
Dark red skin with a blue tint
(mastic-like form);
Bright red skin hyperemia with uneven
Festonymous edges (Rozhist-like);
On the skin of the breast, the ulcent nodes,
covered with crust (armored form);

3. Symptoms of RMG type PEDGET:
Availability on the nipple or arole erosion or
ulceration with granular bright red bottom and
rolling edges, scales, cracks, not
healing for a long time;
The feeling of burning, itching and tingling in
affected area;
Constant moonlessness not covered
Cork.

Journal forms of RMW

RMH: nodal form with
Growing skin

Mastito-like shape of cancer of the left breast.

Lymphatic skin edema ("Lyonda crust") - a late symptom of the disease. Increase or seal of axillary lymph nodes

Lymphatic skin edema ("Lona crust") - late
Symptom of the disease. Increase or seal
axillary lymph nodes even with a small
Movable tumors with clear contours should cause
Suspected of breast cancer. With ultrasound characteristic
Excess formation height over width, uneven
edges, the presence of acoustic shadow, heterogeneous inner
structure.

Infiltrative cancer shape
dairy
Even-infiltrative
cancer.

Breast cancer with ledge of the skin and decay

Breast Cancer Metastasis in L / in Sorgius with a decay

Breast Cancer Symptom "Lemon Cork"

Cancer of the right breast.
Symptom "platform" - symptom
Tightening the skin as
Spray Cooper
Leather ligaments tumor.
Cancer right dairy
glands. Yazwnonecrotic form

Left breast cancer.
Even-infiltrative form.
Symptom of "Lemon Cork" Eveniness, skin infiltration
Breast.
Rog-breed breast cancer.
Pronounced hyperemia leather left
Breast, outwardly reminds
erysipelas Breast

Pancar cancer
Rozhist-like cancer

Redness of the skin of the breast. With a malignant tumor of the breast indicates the defeat of most of the breast.

Specifies O.
launched tumor.

Carcinoma Pedget
Pedge cancer.

Cancer Pedge

Cancer breast. Eleknoginfiltrative form

Breast cancer mastic-like form

Mammary cancer. Disintegration of the tumor

Mastito-like form

Nipple skin irritation
Peeling. Ensure
When cancer Pedgeta
Overall form

Diagnosis of RMW

1. Poll. Finding out the complaints from the history of the disease
The presence of factors should be clarified
promoting the development of RMW (violation
Reproductive system, endogenous and
Exogenous factors).
2. Manual research methods
MZ inspection are carried out in positions standing with
lowered hands divorced on the parties and
Head of the head. The presence should be identified
All clinical symptomscharacteristic of for
RMW.

Palpation is carried out superficially and deep
in vertical and horizontal positions
Falangs of fingers in the direction from the nipple to
periphery. For cancer, the presence of a nodal
Education with stony density,
Drop Surface, when pressed it
There is bleeding from the nipple.
Determine the mobility of the tumor, mutual communication
Its with skin. Committed palpation zones
Regional metastasis.

3. Special research methods
Determination of estrogen receptors and
Progesterone, tumor markers qi - 67, HER2.
Mammography - should be held for 8-10 days
menstrual cycle. There are straight and indirect
Signs.
. Pravy signs - the presence of star shadow,
The radiation of the contours of the shadow, microcalcinates on
limited plot - 15 calcinates per 1 cm2
Related signs - infiltration and thickening
skin, deformation of the structural pattern of MZ,
Hypervascularization and extension of veins, packer.

Dotography - indication is bloody
Selection of nipple. Used verses 0.5-1.5
ml. Signs of cancer - the presence of intra-prototype
defect filling, irregularity of the wall of the ducts,
Amputation of ducts.
Ultrasound procedure
Computed tomography - with diffuse forms
Cytomorphological study (strokes from
Point or imprint, scraping, TrepaBiopsy,
Excision biopsy)
Thermography
Perugurgical phlebography

Radiological research methods
Breast
X-ray examination for diseases
Breast is a reliable diagnostic
method. Diagnostics various diseases dairy
glands, in particular cancer, in some cases represents
Significant difficulties.
Indisputable preference is still given
Mammography.
Mammographic research method has
high diagnostic efficiency in identifying
volume formations of the mammary glands. Method
High informative with early diagnosis
Unpalpable formations.

The radiological method is one of
leading methods in complex radiation diagnostics
oncological patients, on the basis of which
The diagnosis is established, the degree of prevalence,
Evaluation of the dynamics of the treatment carried out, the choice of tactics
Further treatment, the stage of the process is established.
Mammography allows you to clarify the diagnosis of cancer
Breast, narrow testimony to biopsy makes it easier
Differential diagnosis between
Benign and malignant processes in it.

The most informative study is digital
mammography. Two types of pathological are detected on mammograms
Changes: nodal and diffuse. With nodal forms distinguished
Locally infiltratively growing and degraded growing cancers.
The mammographic picture of the first is distinguished by a seal
Incorrectly star form with "spikulas".
The minimum node value on mammograms is 0.4 cm. In
diameter, shadow of often inhomogeneous density.
.

Characteristic is a sharp change in fabric structure
glands around the tumor. Restantly growing crayfish
characterized by round or incorrectly oval
form, sometimes consisting of connected two nodes,
Can reach 8 - 10 cm in diameter. Uniform structure,
Shadow is less intense, contours of bugs. Structure
The glands around the tumor changes little.
Diffuse forms of breast cancer are combined
one general sign - permeating character
propagation of tumor cells from which
Infiltrate breast fabrics.

Diffuse-infiltrative form of breast cancer
glands on radiographs has a kind of negrogenous
Seals in gland tissue. Borders fuzzy - "Languages
Flame. The leather gland is thickened, the nipple is drawn. Even
The form on mammograms is detected in the form of intensive
Thickening the skin and expansion of premamar space
Owing to edema, gland tissue seal
Mammograms are poorly detected.
Even-infiltrative shape gives mammograms
The picture of the combination of edema and infiltration of the gland fabric.
Differential diagnosis of these forms of crayfish from
Plasmodate mastitis are difficult. In these
Cases should be carried out aspirational thin game
Biopsy (TiaB) under X-ray control.

To galactographies (dotography) have to
resort in the presence of bloody discharge from the nipple,
less often in serous discharge. Application of MRI
The pathology of the mammary glands is limited to its complexity and
cost. However, it is necessary to take into account the fact that MRI with contrast
reinforcement allows you to solve differentially digitality difficulties, very useful in control
The effectiveness of chemistry treatment and detection
local recessed after sectoral resection of the gland.
With CT of the breast study is estimated
the state of the tissue of the breast, as well
regional lymph nodes - axillary, over-, and
Connected. Standard program includes
Scanning in the fabric and pulmonary window, so
There is an opportunity to early detect metastatic
Light damage.

Pneumocystography
Currently apply less often, as the study of the condition of the wall
cysts and detecting growth in it possible with
Modern ultrasound devices.
Computer tomography and magnetic resonance Tomography CT and
MRI - auxiliary methods in the diagnosis of primary tumors
breast, but they are extremely important in diagnosis
common processes when it is necessary to find primary
tumor with hidden cancer, evaluate the state of intrathora
lymphatic nodes, eliminate metastatic liver damage,
Light, skeleton. Thin game aspiration biopsy.
Thin-game aspiration biopsy - the easiest way
obtaining material for cytological research in outpatient
Conditions do not require anesthesia. If there is a cyst of thisProcessor
Can serve as a medical event.

Trepan-biopsy
The use of a special needle allows you to get
Required quantity of fabric for histological
study of the nature of the pathological process,
Including differential diagnosis of invasive cancer and lesions in situ, degree
Differentials of the tumor, presence in it
Estrogen receptors, progesterons. This method
Also apply an outpatient basis, but it already requires
Local anesthesia. With non-fallen tumors
Microcalcinates Introduction The needle is carried out under
Ultrasound control or mammography (stereotactic
biopsy).

Biopsy "Signal" lymph node

Immunodiagnostics of milk tumors
glands.
The most critical factor determining success
Treatment
cancec
breast, is the degree of prevalence of tumor
Process
during
Setting
diagnosis.
However, not less than 50% of breast cancer patients
In the first appeal to the doctor, invasive local growth is detected
Tumors or metastases in remote organs. IN
Communication
from
that
Actual problem is the development of the methods of early detection
Malignant breast tumors.
Early detection of metastases allows one timely
Radical treatment and increase its effectiveness. However, the definition
breast cancer prevalence has a lot
difficulties.
Micrometastases in regional lymph nodes and remote organs
Set
ordinary
Clinical
Methods are almost impossible. Therefore, it is important to identify tumor
Markers for diagnosis
cancec
dairy
glands
In the initial
Stages, as well as to assess the effectiveness of therapy and early diagnosis
Recurities and metastases.

Tumor Growth Markers unite
in the following classes:
.
Immunological
Associated
from
tumor antigens or antibodies to them;
. Hormones - Ectopic hormones (XGG,
adrenocorticotropic hormone);
. Enzymes - phosphatases, lactate dehydrogenase, etc.;
. Exchange products - creatine, hydroxyproline,
Polyamines, free DNA;
. Plasma proteins - ferrine, cerululusmin ,? Microglobulin;
. Protein products of decay of tumors.

Sa 15-3 - Breast cancer oncomarker
CA 15-3 is an important tumor-associated
The marker used in the diagnosis of carcinoma
Breast and monitoring the course of the disease.
Breast cancer is one of the central
Pobblel of modern oncology. In structure
oncological diseases of women he occupies the first
Location and second place - by mortality. For the last
Twenty years of morbidity increased by 25-30%.
CA 15-3 has a fairly high specificity
(95%) with regard to breast carcinoma
comparison with benign diseases
Breast. SA 15-3 level can be enhanced
of benign diseases of the breast, but
Exceeding the critical level of the marker in this case
It will be insignificant.

In the study of CA 15-3, it should be considered its individual
informativeness with various forms and prevalence of tumor
process. The frequency of detection of increased values \u200b\u200bof Ca 15-3 and its concentration
Directly depend on the size of the tumor, involvement in the process of lymph nodes. For
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regions.

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Ways of Flock Lymph in
Regional
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Lymphatic vessels I.
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Breast

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