Breast cancer ranks first in cancer incidence and cancer mortality among women in Ukraine. Every year 16,000 Ukrainian women develop breast cancer. Every 30 minutes a new case of breast cancer is detected in the country, and every hour one woman dies of it. Each year this terrible disease claims the lives of almost 7,500 Ukrainian women. By Decree of the President of Ukraine of 17 January 2005, the All-Ukrainian Day of the Fight Against Breast Cancer is held every year on 20 October.
In Sumy Region about 400 women fall victim to this disease every year, and incidence and mortality grow by several percent annually. In 2014, breast cancer incidence in Okhtyrka District was 76.4 per 100,000 women (region – 77.0, Ukraine – 58.7). In 2014, breast cancer was detected at an advanced stage in 6.3% of cases in Okhtyrka District (region – 7.1, Ukraine – 20.2).
In the first 9 months of 2015, breast cancer incidence in Okhtyrka District was 39.7 per 100,000 women (region – 49.6); no advanced cases were registered.
Breast cancer is a cancer that arises in the tissue of the gland, which consists of 15–20 separate lobes surrounded by fatty tissue. Each lobe, in turn, contains many smaller lobules containing dozens of alveoli that produce milk. Like other human organs, breast tissue is made up of many types of cells. The lifespan of these cells varies, but in a healthy body exactly as many cells are formed as die, and this process is tightly controlled by hormones, growth factors and other regulatory systems. However, under the influence of various external and internal factors, this regulation can fail, and then benign or malignant tumors form. In most cases benign breast tumors can be removed; they never come back in the same place, never spread to other parts of the body and do not threaten life.
In a malignant breast tumor, cancer cells can spread to neighboring healthy cells and destroy them. They can also invade blood and lymphatic vessels and be carried to other organs with the flow of blood or lymph. The process in which breast cancer spreads to other organs and forms secondary tumors is called metastasis, and the secondary tumors themselves are called metastases. The most common form of breast cancer is cancer of the ducts of this organ, so-called ductal carcinoma. A malignant tumor that arises in the lobes or lobules of the breast is called lobular carcinoma.
In the early stages these forms of breast cancer cause no pain. It should be noted that early breast cancer has practically no symptoms. Rarely, there are forms of breast cancer that mimic inflammation – mastitis-like and erysipelas-like. They cause the classic symptoms of breast inflammation: a rise in the temperature of the breast and the body, redness and swelling. Sometimes so-called Paget's disease of the nipple occurs – a malignant tumor in the area of the areola with signs that resemble eczema.
Any woman can develop breast cancer, but for some the risk is low and for others it is high. Men are not free of this risk either, but more than 99% of all breast cancer patients are women.
Any woman's lifetime probability of developing breast cancer is about 12%, which means that one in eight women will develop breast cancer during her lifetime.
The high-risk group includes women with a hereditary and family predisposition whose mothers or sisters have had the disease. If a woman has tumors in both breasts, the risk for her closest female relatives increases ninefold. Women who have never given birth, who have terminated a pregnancy or who had their first pregnancy after the age of 35 fall ill more often; in women who have had more than 3 abortions, the risk increases 8–10 times. Single women have twice the incidence of married women. Mastopathy, fibroadenoma and other breast diseases with increased cell growth raise the risk 1.5–3.5 times. Risk factors also include early onset of menstruation (before age 12) and late menopause (after age 55), diabetes, hypertension and obesity. Other causes of the disease include the way a child is fed (it is bad if a woman does not breastfeed) and various diseases of the genital organs that harm breast health. Disorders of the ovaries, thyroid gland, adrenal glands and other organs can also lead to the disease. An additional risk factor is physical injury to the breast, especially when it leaves hardened areas. Diet also plays a role: a lack of vitamins A, E and D and too much animal fat and alcohol are unfavorable. About 30% of women who smoke fall into the risk group for breast disease. Stress and an unhealthy environment also play a part. Breast cancer can occur in women younger than 30, although before the age of 25 it practically never occurs.
There are quite a lot of precancerous breast diseases, but it is worth focusing only on the most common ones. First of all, this is fibrocystic proliferative mastopathy, which shows up as lumps of various sizes in the breasts and periodic pain before menstruation. Another is intraductal papilloma, which shows up as nipple discharge. At the slightest suspicion of one disease or another, or if you have one or several of these symptoms, I strongly advise you to see a doctor for a breast examination and timely treatment. All the more so because these diseases can be treated without any negative consequences.
No one is immune to breast cancer, so every woman should stay alert. Early detection is the best protection against breast cancer. The earlier the disease is diagnosed, the higher the chances of a full recovery.
To examine the breast and find even small lumps, you do not need any highly sophisticated equipment or expensive laboratory tests. So-called palpation is enough (palpation is a method of diagnostic examination by feeling a particular part of the body). Very small lumps in the breast can be found by palpation. That is why it is extremely important for women to know how to examine their own breasts. Breast self-examination should start at the age of 20. It should become a habit. The best time for self-examination is the first week after your period ends, when the breast is softest. Do it every month (or at least once every 2–3 months). Women in menopause should choose one day of the month, for example the first. Pay attention to the underwear that touches the breasts. Slight nipple discharge may go unnoticed but will leave stains on the bra: yellow, brown, reddish, watery or greenish. When examining the nipples, check whether their shape and color have changed, whether they are pulled in or weeping, and whether there are any sores or cracks. When examining the skin, note changes in color, redness of the whole surface or of separate areas, rashes, chafing, and changes resembling “orange peel”. Check whether the skin folds easily, whether it forms a groove over a bulging area when squeezed with the fingers, and whether there is swelling, retraction, sores or areas of wrinkled skin. When looking in a mirror, pay attention to the shape and size of the breasts (whether one has become larger or smaller, whether the surface is uneven) and whether the breasts are at the same level (whether they rise evenly when you raise your arms and put your hands behind your head, and whether one of them is fixed or pulled up or to the side). Repeat the examination while turning to the right and to the left.
Examination technique:
- It is most convenient to do the examination in the bathroom. Soapy fingers make it easier to feel the breasts. If the examination is done in another room, use creams and lotions.
- Feel the surface with the pads of the fingers, not the fingertips. Otherwise a lump in the breast will be pushed deeper.
- Feel with three or four fingers held together, depending on the size of the breast. The thumb is not used for palpation. If the breast is large, support it with the opposite hand.
- Feel methodically (in squares or in a spiral) with circular, pressing, springy movements of the finger pads. Chaotic, unsystematic examination and grabbing movements are wrong.
- First do a superficial palpation, when the finger pads do not press into the depth of the breast tissue; this makes it possible to find small lumps directly under the skin that cannot be felt with deeper pressure. Then do a deep palpation, when the finger pads, with circular pressing movements, gradually reach the surface of the ribs.
- Examine the armpit, where lymph nodes may be enlarged. The front chest wall outside the breast is also examined because there may be additional lobules in which the same changes can occur as in the breasts.
- Feel the nipple and the area under the nipple, because there may be a tumor under the nipple.
- Most often (in 50% of cases) a tumor is found in the upper outer quadrant of the breast.
- At the end of the examination, gently take the nipple between your thumb and index finger and press it, noting the nature of any discharge or its absence.
When palpating the breasts, note how they feel to the touch and remember these sensations. Since the breasts have a lobular structure, you will feel a slight graininess or stringiness under your fingers, which is not a sign of disease. If you find any lumps, tumors, suspicious areas, tenderness or other worrying symptoms, the strong recommendation is to see a doctor – a family doctor, a local general practitioner, a surgeon or a gynecologist, whose duties include breast examination. If necessary, these specialists will refer the woman to a breast specialist or an oncologist, who in turn will order an ultrasound or X-ray examination. Any breast examination to clarify the diagnosis should be ordered only by a competent doctor. Only a doctor can correctly interpret the results and recommend additional diagnostic tests if needed. Currently, mammography is considered the most informative method of diagnosing breast cancer. Women under 35 should approach mammography with great care and not have it without medical indications. Mammography is an X-ray of the breast performed on special machines where the X-ray dose is extremely low. Based on statistical data, breast specialists around the world have concluded that such examinations are safe. Usually 2 X-ray images of each breast are taken – one from above and one from the side. Mammography can detect breast tumors before they become clinically apparent, that is, before the first symptoms appear. The first mammogram should be done at the age of 45; it is considered the baseline and is used for comparison with later ones. After 45, women should have a mammogram every other year, and after 60 – every year. Women under 45 are advised to have a breast ultrasound rather than a mammogram. During pregnancy and breastfeeding, ultrasound is also the main method of breast examination. In a number of cases ultrasound is more effective than mammography: when examining dense breasts in young women, in women with fibrocystic mastopathy, and in detecting cysts. Ultrasound is also used to monitor benign breast lumps that have already been found, to see whether any changes have occurred. No negative effects of ultrasound waves on the human body have been found. All breast examinations are carried out in the first half of the menstrual cycle (days 6–12 from the first day of menstruation). The exception is when a patient has a lump suspected of being cancer; in that case the examination is done urgently.
Breast cancer is treated at the Sumy Regional Clinical Oncology Center with surgery, radiation therapy, chemotherapy and hormone therapy. The choice of method depends primarily on the size and location of the tumor, the results of laboratory tests, including histological and cytological examination of the tumor tissue, and the stage of the malignant process.
Statistics show that breast cancer is cured in 95% of women whose disease is detected at stage I (a tumor up to 2 cm in diameter), in 80% of women with stage II disease (a tumor 2 to 5 cm in diameter, with or without involvement of regional lymph nodes) and in 50% of those with stage III disease (a tumor over 5 cm in diameter, with involvement of regional lymph nodes).
Breast cancer cannot be cured with alternative medicine. As world medical experience shows, no country in the world has so far documented a single case of a malignant tumor being cured with alternative medicine. Alternative treatment only wastes time, prevents the use of effective “conventional” medicine and turns early stages of cancer into late, incurable ones.
Remember: tumors and even breast cancer can be fully cured, especially if you see a specialist at an early stage!