BREAST CANCER
DEFINITION: For cancer refers to an uncontrolled proliferation of cells , this may be benign if it remains confined to the site of development , malignant if it invades surrounding tissues or spread through remote metastases. Tumors can be benign breast ( fibroadenomi , papillomi intra duttali , adenoma and phyllodes tumors) or maligni ( carcinomas). In the following descriptions we will consider mainly breast cancer.
ETIOLOGY : Breast cancer is a disease characteristic of Females (although there are cases of male breast cancer) and there is a genetic predisposition identified. The use of estrogens (not the birth control pill) seems to favor the onset of the disease. Pregnancies and prolonged breastfeeding are protective elements instead. In case of positive familiarity and the previous occurrence of a contralateral breast cancer there is increased risk of 5 times.
SYMPTOMS: The initial stages of the disease are asymptomatic , therefore is a useful prevention through targeted examinations ( echo / rm mammography or breast). Subsequently a lingo can appear at the level of a breast quadrant. Other signs may be a more advanced nipple retraction or skin associated with the presence of enlarged lymph nodes armpit. A particular picture is that of inflammatory carcinoma characterized by extensive skin redness and edema to differentiate with mastitis.
DIAGNOSIS : In this disease is of great importance prevention. Mammography should be carried out in conjunction with ultrasound as a routine. Currently MRI of the breast is giving the best results. The first diagnosis is through clinical specialist subsequently completed with the findings above, which in most cases are sufficient to establish a diagnosis to therapy that addresses.
TREATMENT: The treatment is variable in relation to individual cases and to the type of tumor found. Surgical treatment should be solely by the removal of the tumor , the Quadrantectomy ( removal of a quadrant of the breast) until the mastectomy (removal of the entire breast) , in cases of cancer will proceed by removal of the axillary lymph nodes of the first , II and III level. Chemotherapy may be useful both in the preoperative phase that in the next. Hormonal therapy has proven useful when there are specific receptors in cancer cells. Radiation therapy is very useful especially in the postoperative period to sterilize from residual neoplastic foci.
COMPLICATIONS: The main complications of breast cancer not being able to give compression of neighboring organs are given by distant metastases mainly to the bones , liver and lungs.
INTERVENTION FOR BREAST CANCER
Breast cancer recognizes hereditary causes ( so it is important to undergo an ultrasound / mammography or breast MRI after 30 AA or above in the presence of a positive family history).
Indications for surgery
The indication for intervention is always in the presence of operable breast cancer. In more advanced cases , fortunately very rare today , it is possible to perform a preventive chemotherapy in order to reduce the mass of the tumor.
Results
The results of both aesthetic and prognostic be the better will be treated as early pathology. To date there are genetic tests to be performed on tumor samples postoperatively able to give precise indications about treatment and prognosis.
The intervention
The operation is performed under general anesthesia ( quadrantectomy and mastectomy with axillary lymph node removal). In the first case consists in removing one quadrant of the breast and in the second the entire breast along with underarm lymph nodes generally. Remembering always that you're fighting against cancer, Quadrantectomy leaves the best aesthetic results while with the mastectomy, more disfiguring, can be done in the same surgery a breast.
Conclusions relating to the intervention- Duration intervention: 60 /100 my ( in relation to the type of intervention)
- Type of anesthesia: General
- Dressings: 3
- Length of stay: 3 gg.
- Resumption of normal activities: 10 gg.
