Breast cancer is a health problem that no woman wants to
think about. However, dismissing the possibility of developing a disease leads
to losing sight of the development of real symptoms; breast cancer develops
through several signs.
Ignoring these signs does nothing except put lives in
danger. Surgeons affirm that like any other type of cancer, early diagnosis, as
well as treatment, is very important against breast cancer, they say
"Regarding the early diagnosis of breast cancer breast, routine medical
examinations should not be neglected.
In addition, after reaching the age of 20, each woman must carry out monthly self-examinations for early detection. This makes it easier to detect breast cancer before it reaches advanced stages.
1-Presence of breast nodules
The most visible sign of breast cancer is palpable masses in
the breast and armpits. Cancerous masses are distinguished from other masses by
their texture, irregular contours, and hard surface.
The most effective way to identify them is by manual
examination when the body is lying on a bed. Place one hand under your head.
Examine your chest using the index and middle fingers of the other hand.
Repeat the procedure for both breasts. Examine your breasts in circular motions, following a pattern that starts from the nipples and moves toward the surrounding area. Repeat this exam for your armpits as well.
2-Breast discharge
In case there is discharge from a breast or mammary duct
without applying pressure on the nipples, it is necessary to look for the
reason behind it.
Such breast discharge may be caused by breast cancer or by “intraductal papilloma,” which are lesions that increase the risk of breast cancer.
3-Nipple deformities
If you notice retractions, inversions, or any other deformation in your nipples during self-examination in front of a mirror, it would be best to seek medical advice immediately.
4-Changes in the skin of the nipple
Other symptoms identified during mirror examination, such as peeling of the skin around the nipple, should also be analyzed by a specialist.
5-Deformation or lumps in the breasts
The ideal method for identifying breast lumps is self-examination in front of a mirror. Place your hands on your hips and notice if your breasts are symmetrical or if there are breast lumps.
6-Sores or redness of the skin of the breasts
Sores or redness that suddenly appears on the skin of your breasts, unless caused by physical impact injuries, are among the primary symptoms that should be taken seriously.
7- Edema, swelling, or retraction of the skin of the breasts.
“It is certain that not all edema and swelling are symptoms
of breast cancer. These are also signs frequently encountered by women during
periods of menstruation or pregnancy.
"However, if these signs are accompanied by retractions of the skin of the breasts and a texture that resembles that of orange peel, you should consult a doctor without wasting time.
Make breast self-exams a habit!
While the incidence rate of breast cancer increases each
year, mortality rates from the disease have declined significantly. The most
important reasons lie in recently developed diagnostics and treatment methods.
Breast cancer is now detected early through mammography and
ultrasound screening methods, and patient-specific approaches increase
treatment success rate.
According to Kulkuf, Stressing that it is important for women to increase the frequency of such screenings, especially after the age of 40, adds that women should adopt breast self-examination as a habit to make diagnoses as early as possible, she says: "All women over the age of 20 should do a monthly self-exam and young girls should be encouraged to make it a habit.
Diagnosis
A simple cyst on ultrasound is very unlikely to be cancer.
The negative predictive value of breast ultrasound is high, even higher if
combined with mammography, of the order of 97%.
However, some publications have demonstrated significant
variation between radiologists in their ability to differentiate benign solid
lesions from malignant lesions, which means that ultrasound alone cannot be
sufficient to exclude cancer when a lesion is suspicious at first glance.
mammography or physical examination. Only a biopsy can do this.
Biopsy is therefore recommended for any suspicious lesion,
clinically or on imaging. Surgical biopsy (open biopsy or excision) is only
performed if percutaneous guided biopsy modalities are not available.
For patients with a very suspicious lesion, an ultrasound of
the armpit looking for enlarged lymphadenopathy allows a needle biopsy of this
node to be carried out immediately.
If this examination reveals cancerous cells, the surgeon
will immediately proceed with a complete dissection of the armpit and not
simply excision of a sentinel lymph node.
The diagnosis of a complex cystic lesion or a solid mass in
the breast is made by biopsy and aspiration of the lesion, usually fine needle
biopsy, the breast being an easily accessible organ.
In expert hands, this procedure is relatively painless and
has few complications. The mass is immobilized between the fingers and the
liquid is aspirated with a 22 or 24-gauge needle. If the liquid removed is
clear, and not bloody, the risk of cancer is very low.
Everything that is taken is sent for pathological analysis,
especially blood-tinged liquid: 7% will be cancers. If the puncture does not bring
back fluid, we try to obtain cells for cytological analysis.
The sensitivity and specificity of fine needle aspiration
biopsy are very variable (65 to 98%, 34 to 100%) and seem to depend mainly on
the experience of the physician and cytopathologist.
Percutaneous fine needle biopsy does not distinguish between
in situ and invasive carcinoma and provides a significant rate of inadequate (4
to 36%) or false negative (0 to 32%) specimens, especially in inexperienced
hands.
Some studies demonstrate that fine needle biopsy in expert
hands appears almost as reliable as a core needle biopsy in making a diagnosis
of palpable breast carcinoma, with a sensitivity of 85 to 90% and 96 to 98%.
The current consensus is that these two techniques would be
comparable in terms of sensitivity, but that core biopsy would be more
specific.
The triple diagnosis refers to the combination of 3
examination techniques for the evaluation of a solid mass in the breast:
physical examination, mammography, and fine-needle biopsy.
Very few cancers are missed in this way, i.e. 0.7%, when
these 3 examinations suggest a benign lesion and the sample is of sufficient
quantity. When one of these tests suggests cancer, the patient will then have
to undergo a core biopsy or an excisional biopsy.
Ideally, any mass suspicious on physical examination or ultrasound should undergo a core biopsy under ultrasound or stereotaxy.
Conclusion
Early detection of breast cancer is crucial for successful
treatment. Regular self-examinations, coupled with breast screening like mammography
and ultrasound, significantly improve the chances of early diagnosis.
Biopsy remains the definitive method for confirming
suspicious lesions. With prompt diagnosis and appropriate intervention,
mortality rates from breast cancer have seen a decline, emphasizing the
importance of proactive healthcare measures.
