The growth and spread of primary breast cancer

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Neoplasms of the breast belong to highly aggressive malignant tumors prone to rapid and steady dissemination. Suffice it to recall that at the beginning of treatment almost 2/3 of patients can detect metastases in regional lymphatic collectors, and more than half of treated die at different times after mastectomy from distant metastases, hidden existed even before the start of treatment. Metastasis contribute not only dishormonal nature breast cancer and the effect of different exchange and biological factors on growth of primary tumor and engraftment metastatic complexes, but also a developed network of lymphatic and blood vessels, the existence of several regional lymphatic collectors, carrying vessels which are directly connected with venous system and thoracic duct. Although the lymph nodes in the beginning undoubtedly play a barrier role, replacing them tumor tissue, development of blockade and lymphostasis quickly lead to the retrograde flow of lymph vessels, which are tumor complexes and separate cells. This may explain the universal character of metastasis, typical of breast cancer, especially in the defeat of the axillary lymph nodes.
The growth and spread of cancer in the breast usually occur in four ways: 1) by the milk ducts and moves by intraepithelial growth; 2) through the lymphatic capillaries parenchyma, lymphatic vessels vnutriposelkovykh and mitakovich plexus, perivascular and perineurally lymph gaps; 3) lymphatic and krovenosny vessels breast tissue, subcutaneous tissue and skin due to germination of their tumor; 4) through the blood vessels as a result of penetration of tumor cells in clearance due to the reduction of the links between endothelial cells and their opening with the formation of cracks in the wall of the vessel, which is proved by numerous experiments (Roberts, 1961).
In addition to these characteristics of the primary tumor growth, metastasis is set to architectonics of the vascular bed. Around the cancer site is usually a dense network of lymphatic capillaries, sharply winding or having blind appendages, often filled with tumor cells and emboli. In addition, on the periphery of the lesion can be detected process strands of tumor cells, like rays outgoing from the tumor, or their round slot (vnutrimatern metastases), located at a distance of 7-10 cm from the primary tumor (Semiglazov C. F., 1970; ihsanova With. So, 1971). The appearance of blood, or the so-called pericentromeric, metastasis is parallel to the development of distant lymph and blood of dissemination. On the other hand, almost half of the patients can see the manifestations of local protective reactions, mainly from mesenchymal tissue. To them in the first place belongs lymphoplasmacytic infiltration around the lesion, hyperplasia and sinus histiocytosis lymph nodes. The occurrence of local reactions prevents the development of dissemination outside the body (Semiglazov C. F., 1970).
The study of lateral and regional lymph vessels and their role in the metastasis of breast cancer is devoted to numerous studies, which found that an outflow occurs in the following areas (Fig. 8).