Breast cancer

Breast cancer is a malignant neoplasm that arises from the cells of the breast. Breast cancer ranks 1st in the overall structure of cancer incidence in the female population. Also, less than 1% of all breast cancer cases occur in men.

Risk factors

The exact causes of a malignant breast tumor have not yet been determined. Breast oncology and breast cancer, in particular, affect the female body, regardless of age. There are two risk –groups: high and low.The high-risk group primarily includes persons with a combination of certain genetic and phenotypic factors.

The risk factors are as follows:

• Age. 90% of diseases are diagnosed over the age of 40.
• Genetic tendency (patients with a burdened hereditary history of breast cancer, more often from the maternal side, have a higher risk of cancer by 2 or 3 times).
• Breast cancer mutation gene: BRCA1, BRCA2 and PALB-2. Women who carry the mutant form of the BRCA gene are up to 90% more likely to develop breast cancer during their lifetime.
• Gynecological history: Early onset of menstruation, late menopause, late first pregnancy increase the risk. Women who have their first pregnancy after age 30 have a higher risk than women who have not given birth.
• Disorders of the hormonal homeostasis system.
• The presence of benign precancerous diseases of the breast (fibroadenoma, mastopathy).
• Taking oral contraceptives for more than 10 years is associated with the treatment of menopause or prescribed for contraception.Injuries to the chest.
• Excess weight.
• Diabetes mellitus, hypertension.
• Systematic smoking and alcohol consumption, drug use.
• Chest irradiation in the anamnesis.
• Regular contact with toxins and carcinogens.

Clinical manifestations:

There are three clinical forms of breast cancer: nodular, diffuse and Paget's cancer. Each of these forms has its characteristics. Common symptoms of breast cancer are:

• the formation of a "ball" or lump in the breast, different from the surrounding tissues;
• changing the size, shape and types of the breast;
• retraction, redness, ulceration and other changes in the skin of the breast (for example, the skin resembles a lemon peel);
• slight discomfort in the area of the nipples and areola, manifested by itching, burning, tingling;
• deformation of the nipple-areolar zone (change in the configuration of the nipple - its flattening or retraction);
• enlargement of peripheral lymph nodes.

If you find one of these symptoms in yourself during an independent examination, you should immediately consult a mammologist.

Screening

Annual screening of women over 40 reduces breast cancer mortality by 20-30%. Diagnostics of breast cancer in our clinic in Kyiv includes:

• Clinical breast examination (CBE) by practicing clinicians.
• Mammography (including digital and 3D).
• Magnetic resonance imaging (MRI) for high-risk patients.

Punch and excisional biopsy with urgent examination.

Stages

TNM Classification (tumor, nodes, metastases):

1. Stage 0: cancer in situ (the tumor is already visible on an X-ray examination).
2. Stage I: the tumor up to 2 cm in diameter, a pronounced increase in lymph nodes is usually not observed, no metastases.
3. Stage ІI: the tumor reaches 2-5 cm in diameter, spreads to the axillary lymph nodes; the examination may reveal distant metastases.
4. Stage ІII: the tumor often exceeds 5 cm in diameter, but it may be smaller, metastases are found in the axillary, internal thoracic and subclavian lymph nodes; there may be metastases in distant organs and systems;
5. Stage ІV: the boundaries of the tumor outside the breast, multiple metastases in the body.

Treatment:

The specialists of the Dobrobut Clinic in Kyiv form the optimal tactics for treating breast cancer based on the stage of the tumor, its location, size, patient's condition, etc.

Treatment for stage I-III breast cancer usually involves surgery and radiation therapy, often in combination with systemic therapy (hormone therapy and/or chemotherapy). The choice of treatment depends on the condition of the tumor and the patient.

Surgical treatment for breast cancer includes mastectomy (complete removal) or breast-conserving surgery (removal of a malignant tumor) in conjunction with radiation therapy.

Preoperative chemotherapy is sometimes used to reduce the size of the tumor before removing it and using radiation therapy; thus, it allows some patients who require a mastectomy to perform organ-sparing surgery.

The indications for postoperative radiation therapy after complete breast removal are:

• primary tumor ≥ 5 cm.
• affected ≥ 4 axillary lymph nodes.

Dose planning and targeting of radiation therapy for breast cancer is strictly individual.Radiation therapy significantly reduces the frequency of local recurrence in the chest wall and regional lymph nodes, prolongs the healthy period and reduces mortality from this disease.

For patients with invasive cancer, chemotherapy is usually started shortly after surgery. If systemic chemotherapy is not required, hormone therapy plus radiation therapy is usually started shortly after surgery and continued for many years. These therapies help to delay or prevent relapses in almost all patients and increase their life expectancy in some patients.

Cost of breast cancer treatment in Ukraine:

The exact cost of breast cancer treatment depends on many factors. The treatment program may include monotherapy or a complex of procedures that doctors select depending on the stage of the disease.

For example, the cost of an operation for breast cancer depends on the category of its complexity, the volume of intervention, the need for mammoplasty, the price of anesthesia, the presence of concomitant pathologies, and the time spent in the ward after the operation. Also, the cost of breast cancer treatment will depend on the experience of the doctor and his academic title.

Therefore, the price of breast cancer treatment is formed strictly individually and depends on the characteristics and desires of the patient.

The advantages of carrying out the service with us:

• The Dobrobut Clinic in Kyiv employs highly qualified specialists who regularly attend refresher courses.
• In practice, modern methods of treatment are used.
• The list of necessary diagnostic and treatment procedures is determined strictly individually.
• The main goal of our center is to maximize the patient's quality of life.

How to sign up?

You can sign up for a preliminary examination and get acquainted with the prices on our website https://dobrobut.com/ or using the round-the-clock contact center, whose contacts are listed on the clinic's website.

Bibliography

1. Breast Cancer, Mary Ann Kosir, MD, Wayne State University School of Medicine
2. Breast Cancer: Medication Use to Reduce Risk
3. Breast Cancer — Health Professional Version
4. Breast Cancer Risk and Prevention