Today, October 15, is World Breast Cancer Awareness Day – a malignant tumor that develops in breast tissues. According to WHO, it is the most common type of cancer among women. Denys Karpegin, a surgeon-oncologist (mammologist) at Odrex Medical House, told a UNN journalist how to recognize the first symptoms in time, what are the main methods of examination, treatment, and recovery after surgery.
What is breast cancer
Breast cancer is a malignant tumor that occurs in breast tissues due to the uncontrolled growth of cancer cells.
According to the World Health Organization (WHO), breast cancer is the most common type of cancer in the world among women: every fourth woman with cancer has breast cancer. In 2022, more than 2.3 million new cases of this disease were recorded.
Despite the alarming statistics, breast cancer is not a death sentence. If detected at early stages, the survival rate reaches 90–95%, at the second stage – up to 80%. That is why it is so important to undergo regular examinations: self-examination of the breasts, visiting a mammologist once a year, and after 40 years – mammography every 1-2 years.
How breast cancer manifests: early signs and symptoms
You need to be meticulous about yourself. We all know our bodies well, if some lumps appear in the breasts that were not there before, you don't need to wait, you must immediately go to the doctor and investigate it. No self-treatment, let's say a week or two will not affect anything, but two or three months of delay can change the stage of the disease
He noted that dangerous changes can be considered:
- lump;
- skin retraction;
- change in skin color;
- nipple retraction;
- nipple discharge;
- pain.
It's one thing if, roughly speaking, a week before menstruation both mammary glands swell and hurt - this is related to hormones. But if, for example, we understand that in some place, regardless of the cycle, it hurts, well, this is a wake-up call that needs attention
Regarding discharge, the doctor noted that if it is colostrum, gray, white - this is not a cause for concern. But if it is bloody - it requires immediate examination.
How breasts are checked for cancer: diagnostic methods
We have three main ones depending on age. This is breast ultrasound - standard up to 40 years, after 40 - mammography. It's not that you can't do, for example, mammography earlier or ultrasound after 40, you can. It's just that around 40 years old, the structure of the mammary gland begins to change and it's more informative to look at mammography after 40, and before 40 it's more informative to look at ultrasound
He adds that if mammography did not provide an answer, breast MRI with contrast can be used - this allows for a more accurate assessment of the "potential of the formations that concern us." However, this method is not used as a separate diagnostic method; it is an auxiliary one.
MRI is a follow-up examination method, it is not related to screening. MRI can lead to overdiagnosis
Is breast cancer treatable: modern approaches to therapy
The doctor noted that there are about 200 types of breast cancer. Therefore, the choice of treatment depends on both the stage of the disease and the type of tumor. Currently, the most common types are surgery, radiation therapy, and medications. Medications, in turn, can be divided into four groups: chemotherapy, hormone therapy, targeted therapy, and the most modern - immunotherapy.
You can't say that something is better, something is worse. No. For each type of cancer, there is its own treatment protocol. And usually all these three methods are combined
Regarding immunotherapy, according to Karpegin, cancer cells are present in the body of absolutely every person, but at some point, the immune system stops "controlling" them, which causes their rapid increase and tumor formation. Immunotherapy tries to cope with this if the disease was caught at a very early stage. In other words, it is a systemic disease of the entire body that simply manifested itself in the mammary gland, explains the oncologist.
Therefore, roughly speaking, surgery is just physically removing the tumor, but the immune system does not see these cells that it should recognize. Therefore, the treatment should be such that it acts on the entire body. And what kind of treatment? We select it after doing a biopsy and getting, roughly speaking, the tumor's passport. Its last name, first name, patronymic. Plus, we do a CT scan to determine the stage of the disease and, depending on the stage and type of tumor, we select the treatment that is suitable for that particular type.
At the same time, the so-called "old", proven methods also work, because they are constantly being improved. In particular, radiation therapy.
Such devices are constantly being updated, both the software and the tubes for radiation therapy, and the accuracy. If earlier there were devices that literally burned a person through, roughly speaking, now everything is selected to the millimeter, according to the body's parameters
Rehabilitation after breast cancer: recovery and psychological support
If we talk about psychological rehabilitation, we need to work with this when planning treatment. For example, in the case of surgery, we will choose oncoplastic methods. This is to improve the shape of the breasts, and at the same time rid the person of oncology. We can simultaneously insert an implant, or use our own tissues, or take fat from the abdomen, from the thighs and pump up the breasts
He adds that this moment often alleviates women's fear of surgery, as they can also get a dose of positive emotions regarding the change in their appearance, which they, for example, have long dreamed of. In the case of small breast size, the doctor says that when removing the entire gland, it is still possible to leave the skin and nipple and then inject fat from another part of the body, for example, from the abdomen, under the skin.
If more is needed, you can take a skin-fat flap from the abdomen, that is, an abdominoplasty is performed, and this flap is transplanted to the place of the removed one.
He notes that usually these operations can be combined, with the exception of cases where it is necessary to wait six months.
Now there are many companies that offer any kind of underwear with prostheses. That is, there is already a sewn-in prosthesis, but a woman should understand that over time we will be able to restore all this. And this is important for psychological support. Of course, in some cases, the help of a psychoneurologist with the use of medications is still needed. There are also yoga practices and other tools to improve mental health - the doctor emphasizes.
Regarding physical recovery, this includes physical rehabilitation after surgery, as well as wearing a compression sleeve that works like a pump. The doctor explained that this is due to the fact that usually when breasts are removed, affected lymph nodes in the armpits are also removed. This can cause fluid accumulation, which requires certain care.
There are three types: prophylactic, therapeutic, and therapeutic, which is already for those cases when the arm is swollen. Plus, vascular drugs that help small vessels remove this edematous fluid from the tissues.
Regarding postoperative restrictions, the doctor noted that some of them are outdated. Currently, among such, only the restriction "do not lift more than 2 kg for 2 months after surgery" is relevant.
Everything is individual. Well, that is, it's still a Soviet myth that you can't sunbathe, that saunas are forbidden, vitamins are forbidden. There is no evidence base for this. And on the contrary, it has already been proven that there is no connection with metastasis. On the contrary, vitamin D deficiency, and it is normally produced in our skin under the action of ultraviolet light. On the contrary, its deficiency is a risk factor. Therefore, everything should be in moderation. Both physical activity and sunbathing.
He also added that the sugar restriction is also a myth, because all cells, including metastatic ones, feed on glucose, but it is always in the blood, regardless of how much sugar a person eats.
Well, of course, a healthy lifestyle should be. There are risk factors: overweight, sugar, diabetes - these are all risk factors. Such people are more likely to get cancer. But definitely not because of this.
• 11951 переглядiв
• 23252 переглядiв
• 24778 переглядiв
• 2964 переглядiв
• 4446 переглядiв
• 20690 переглядiв