Breast cancer

This section contains statistical data on morbidity and mortality from breast cancer, given the international clinical (TNM) and histological classification of the who. The substantiation of the role of the so-called dishormonal hyperplasia in the pathogenesis of cancer, given the SYNOPTIC table of the main pathogenetic factors that are important in the formation of the "groups of risk" populations healthy women that are subject to routine inspections. Describes the use of Mamma - and thermography, isotope scanning microalbumin marked 131I, data needle and trephine biopsy, clarification of tumor spread through the lymphatic collectors with pneumocystography, razgromnoy venography and indirect scintigraphy. Special attention is given to the analysis of results of complex and combined treatment of primary tumors, based on the assessment of the biological properties of the tumor and the body. See remote results of the treatment of breast cancer, described the organization of the follow-up of patients after radical treatment of and rehabilitation after mastectomy.
Intended for oncologists, surgeons and gynaecologists.

Table of contents

Chapter I. the Morbidity and mortality from breast cancer
Chapter II. Clinical and morphological characteristics of dishormonal hyperplasia and precancerous diseases of the breast
Dishormonal hyperplasia nodular type
Dishormonal hyperplasia of the diffuse type
Chapter III. Pathogenic forms of breast cancer and the formation of "risk groups"
Chapter IV. The growth and spread of primary breast cancer
Chapter V. Clinical, morphological and clinical and histological classification of breast cancer
Clinical and histological classification in stages
International clinical classification
Classification rules
Classification by categories
Grouping by stage
Histological classification (international classification of tumors № 2)
Chapter VI. Clinical and instrumental diagnosis of primary breast cancer
Clinical diagnostics
Needle biopsy and trephine biopsy
X-ray diagnosis
Radioisotope diagnostics
Thermal diagnosis
Excisional biopsy
Chapter VII. Detection of metastases in regional lymphatic collectors and distant organs
Diagnosis of lymph node metastasis
Diagnosis of metastatic lesions of bones
Diagnosis of metastases in the lung and pleura
Diagnosis of liver and abdominal organs
Chapter VIII. Anatomical and biological characteristics of the tumor and the body of patients with breast cancer
Biological and anatomical properties of the primary tumor
Biological properties of the organism cancer patient
       Tests of specific and non-specific immunity
Chapter IX. Major therapeutic measures in breast cancer
Operative treatment
Radiation treatment
Chemotherapy
Hormonotherapy
Immunotherapy
Chapter X. Combined and complex treatment of patients with breast cancer
Treatment of primary cancer
Treatment restoregeometry recurrence and distant metastasis after mastectomy
Chapter XI. Breast cancer in men
Chapter XII. Remote results and rehabilitation of patients after treatment for breast cancer
Remote results
Some questions of rehabilitation
List of literature

Preface

Among malignant tumors of various localizations breast cancer occupies a special position, not only because of growing absolute number of cases and incidence rate currently holds the frequency the second place among other neoplasms, and in some Western European countries is one of the main causes of mortality for women aged 45 to 55 years. In addition to the practical aspects, the problem of breast cancer in modern medicine has moved beyond the development of a specific diagnostic and therapeutic measures and, in essence, can be regarded as widely and comprehensively investigated biological model of malignant growth. This could be an example not only managed to map the data of experiments on animals with the course of cancer in humans, but also to assess the impact on the development of cancer functional, exchange and hereditary constitutional characteristics of the organism in General and its relation with the environment and external carcinogenic factors.
At the same time the diagnosis and treatment of cancer of the body there are great difficulties and contradictions associated, in our opinion, first of all with the existence of several pathogenic form of the disease, different pace of development and progression, and therefore require different therapeutic approaches. Development of this direction has just started and we can expect significant improvement of remote results of treatment.
As in recent years have convincingly shown that breast cancer refers to a slowly developing and hidden current diseases, which has the property suddenly accelerate the growth and progress under the influence of many endogenous and exogenous factors, clinical diagnostics apparently tumor is usually late, because by that time most of the patients there are already metastases to distant organs. Therefore, especially important was the problem of detection of cancer and precancerous breast changes among the contingent of so-called healthy women. Such inspections allow us to identify early, including pre-clinical (napoliroma) form tumors, without lymph node metastases, treatment which gives a better prognosis. To perform such tasks was necessary to create new organizational forms of preventive examinations, the use of x-ray and other objective methods of diagnostics.
On the other hand, the problem of treatment of developed and common forms of breast cancer, in General, remain far from being resolved in recent years have progressed, due to application of radial and rapid local-regional influences in the complex with different combinations chemohormonal drugs multidirectional action, mutually reinforcing each other. However, many medical proposals, recommendations and techniques described in the literature, make it difficult to use the entire Arsenal of medical products for treatment of cancer, not only because of their large number, the difficult to explain to the practical doctor in the whole flow of information, but mainly because of differences and even contradictions in assessing the effectiveness of these methods. That is why, despite the publication of a number of interesting publications on individual and General issues of diagnostics and treatment, there is a need to synthesize the work addressed to practitioners, which will reflect the totality of problems of pathogenesis, diagnosis and treatment of breast cancer at the present stage.
This task is extremely difficult, although 50-year experience of Oncology research Institute. Professor N. N. Petrova USSR Ministry of health, the origins of this work is based on the treatment of more than 10 000 new cases of breast cancer, has been analyzed and published in a wide print many years head of the clinic, member-correspondent of the Academy of medical Sciences of the USSR S. A. Holdiny. However, in recent years new data, greatly enhances our understanding in questions of pathogenesis and immunology of cancer, which allows not only in a slightly different way to present the prospects for improving treatment outcomes, but also to approach the practical decision of problems of the prevention of tumors.
In this book, addressed to practitioners, the focus is on three key issues: 1) the pathogenesis and pathogenic forms of breast cancer, 2) the peculiarities of detection of tumors at different stages of development, including the search early forms using modern instrumental and x-ray methods, 3) the results of application of the complex operative-radiation and drug (chemohormonal) treatment.
The author hopes that such material will allow in short to familiarize the reader with the basic clinical and pathogenetic problems of this cancer localization, attracting in recent years great attention not only medical oncologists and biologists, but also representatives of other professions.