Oncological diseases - an actual problemmodern medicine. Until now, no medicine has been found that could stop the growth of malignant cells with 100% efficiency. In hospitals, doctors continue to put terrible diagnoses to their patients.
There are quite a lot of oncological diseases.Any organ and any tissue of the human body can be suddenly enveloped in the pathological process. One of the possible places of localization is the nipple on the female breast. Such an oncological disease in medicine is called Paget's disease.
General information about the disease
The first information about Paget's disease appeared inXIX century. It is known that in 1856 the French anatomist and surgeon S. Velpeau discovered pathological changes of the nipple-areolar complex. In 1874 J. Paget, who is a British surgeon and pathologist, studied the disease in more detail. That's why his name was called a malaise.
G.Paget in the study of the disease revealed a link between pathological changes of the nipple-areolar complex and carcinoma of the breast. Such a conclusion he made based on the results of 15 observations. Specialist noticed in women superficial inflammatory changes. During the year, all patients developed breast nipple cancer. J. Paget also suggested that superficial inflammation affects adjacent tissues, and degenerative changes in them eventually cause the development of neoplasia.
Modern data on the disease and the symptoms of the disease
Information about the disease in 2011 collectedClinic "Mayo" (USA). The specialists determined that initially in almost all cases the nipple undergoes pathological changes. With further progression of the ailment, the surrounding skin is involved in the process. Also, according to the information provided by the clinic, it can be noted that the collection of an anamnesis of breast cancer Paget before a true diagnosis can take from 6 to 8 months.
What are the symptoms of thisoncological disease? Women who have nipple cancer, note the change in the sensitivity of this area. In most cases, patients complain of itching, burning sensation. Because of clothes on the nipple and in the areola area, redness occurs. The affected surface may even begin to bleed. In the late stages there are abundant spotting from the nipple (with cancer this is a common phenomenon). The nipple retracts. Most often, its flattening is observed because of the growth of a malignant tumor.
Prevalence and causes of the disease
In the structure of all existing dairy neoplasiathe cancer of Paget's cancer has a share of 0.5-5%. Fortunately, this is a rare disease. In young people, as a rule, it does not come to light. Most pathology is diagnosed in adult women in postmenopause (50-60 years). The average age of sick people is 54 years.
The causes of the development of Paget's cancer can not be called. As in the case of other cancers, they have not yet been studied. However, there are suggestions. Earlier, a theory was put forward, according to which, cancer developed because of migration of atypical cells along the basal membrane of the ducts into the epidermis of the nipple.
Variants of pathological changes
Nipple cancer can progress in one of the possible variants:
- At the first variant the current of pathological processes is observed only in the area of the nipple and areola. Other changes are not detected.
- In the second variant of oncologicalthe disease shows a suspicious symptomatology in the area of the nipple-areolar complex. What visible signs can indicate a nipple cancer? Photo diseases, which can be seen in various textbooks and medical articles, reflect redness, peeling, ulceration. In addition to these symptoms, a feeling is felt, a new growth in the chest.
- With the third option, skin changes are notare observed. A clinical examination reveals a tumor in the mammary gland, and in the course of a histological examination, Paget's cancer is detected (as an accidental finding).
Nipple cancer: signs depending on the form of the disease
With oncological disease, there may be a variety of symptoms. Depending on the clinical picture, Paget's cancer can be classified as follows:
- chronic eczematid;
- acute eczematid;
- psoriatic form;
- pigmentary form.
What does the nipple look like for breast cancer? The answer to this question depends on the form of the disease. With chronic eczematid, a woman has a nipple eczema for a long period of time. On it and around it crusts are formed. When they fall off, the wetting surface becomes noticeable in their place. With acute eczematid, there is hyperemia. Fine graininess on the surface, mocculation, ulceration is also characteristic for such a disease as Paget's disease (or nipple cancer). Symptoms in psoriatic form on the skin are manifested as sloughing scales, and with pigment form - in the form of spots that go beyond the areola.
Diagnosis of cancer
With suspicions of malignant processes,proceeding in the mammary gland, doctors prescribe a mammogram. This is a non-invasive breast examination, for which x-rays can be used, ultrasound. In the course of it can be detected neoplasms. Another method of diagnosis - magnetic resonance imaging. Thanks to it, specialists identify changes in the nipple that are clinically impossible to detect.
Those women who are suspected of having nipple cancerbreast, a clinical picture of Paget's disease is observed, a nipple biopsy and areola are prescribed for the entire thickness. This study will allow you to make an accurate diagnosis, confirm or deny the presence of cancer.
Features of treatment of pacifier cancer
Treatment is determined by a specialist depending on thethe received results of diagnostics. When the biopsy is negative, a dynamic observation of the patient is carried out. If the disease makes itself felt, manifests symptoms, a second biopsy is performed.
When confirming the Paget's disease is performedsurgery to remove the tumor and surrounding tissue or completely the entire breast. Later, additional treatment is appointed, which allows to finally destroy the atypical cells.
More about surgical treatment
The operation is an important and necessary step in thecombined therapy of such an oncological disease as breast cancer of the nipple. Experts for a long time could not come to a single conclusion as to which treatment methods are most effective. Various studies have been carried out. At the University of Michigan, the results of treatment of 36 patients were analyzed. All were performed organ-saving surgical interventions. Later, the patients were observed on average 113 months. 11% of women developed a relapse.
Also, a South Korean study was conducted. The results of treatment of 104 women with nipple cancer were analyzed. Mastectomy specialists were assigned to 92 patients, 12 people performed organ-saving operations. Later, 3 relapses after mastectomy and 1 after the second treatment were revealed. Studies have shown that organ-preserving surgery does not increase the likelihood of a woman developing a relapse. This method of treatment is prescribed to patients with resection of the nipple-areolar complex.
An effective method of treating cancer is radiationtherapy. Its task is to destroy the cells that make up the pathological focus. Radiation therapy copes with it, however, as a result of treatment, not only the tumor, but also healthy cells suffer. Because of the negative effects on the body, there are side effects:
- local - radiation burns are formed, fine-focal hemorrhages appear due to increased fragility of blood vessels;
- systemic - patients complain of nausea, vomiting, weakness, fast fatigue.
Chemotherapy for nip cancer
Chemotherapy means an introduction to the bodyspecial antitumor drugs that inhibit the growth of malignant cells and have a harmful effect on them. Such treatment of nipple cancer is designed to solve the following problems:
- prevention of metastatic disease;
- effective effect on the tumor for subsequent application of local treatment options (surgical or radiation).
Chemotherapy, like radiation therapy,accompanied by side effects. In 80% of cases, nausea and vomiting occur. Also, because of chemotherapy, hair begins to fall out, nails become more fragile, appetite deteriorates, taste habits change.
Such treatment helps in the presence ofhormone-dependent tumors in the body. However, Paget's cancer did not for a long time concern such neoplasms. In 1949, it was first suggested that the ailment could react to hormonal therapy, but under certain conditions. Later studies have proved this. Hormone therapy with a disease such as nipple cancer has proven effective in the presence of a receptor for progesterone and estrogen in a malignant neoplasm.
At present, if necessary,hormonal therapy patients are prescribed "Tamoxifen", "Zitazonium", "Nolvadex". They are considered a "gold standard" in such treatment. However, there is one condition in which these drugs can be used: the tumor must have receptors for steroid hormones (> 10 fmol / mg protein). The need for hormone treatment is determined by specialists.
Prognosis for nipple cancer
Oncological diseases are very serious and dangerous ailments. Not an exception and breast cancer nipples. What will be the result of treatment? The forecast depends on a combination of factors:
- stage of the disease;
- age of the sick person;
- number of affected lymphatic vessels;
- degree of malignancy;
- the presence of unfavorable morphological factors.
Doctors know a lot of cases when cancerthe nipple people were dying. Lethal outcome, as a rule, is possible at later stages, in neglected cases and with biological aggressiveness of malignant neoplasm. Thus, if you have suspicious symptoms, you should not delay a visit to a doctor. The earlier you are examined by a specialist, the sooner he will put the correct diagnosis and prescribe the necessary treatment.