The treatment of breast cancer depends on the nature and location of the tumor and stage of disease. The doctor also takes into account the patient age, hormonal status and general condition. There are several therapies, offered alone or in combination.

1. Surgery

Surgery remains the treatment most commonly practiced.

The surgeon removes the tumor, which will be analyzed by the pathologist, to specify the size, aggressiveness, the presence or absence of hormone receptors. These data are essential to the choice of therapeutic option.

The type of surgery (total removal of the mammary gland, or lumpectomy) depends essentially on the size of the tumor clinic. In the same operation, it achieves axillary dissection on the same side as the tumor, to detect any cancer foci in the lymph nodes examined. This dissection may be limited by the methods of scintigraphic study coupled with extemporaneous histological examination performed in the operating room, and shows the absence or presence of cancer cells in lymph nodes removed first (sentinel node).

It is important to examine these nodes because they filter the lymph that flows from the breast and across the organization. They represent the first sites of tumor spread. If the lymph nodes examined were positive, there may be cancer cells during migration in the body. This risk will determine the choice of treatment after surgery. All information gathered in the “staging”.

Different types of surgeries are performed in the treatment of breast cancer. The technique used depends on several factors but primarily on the size and location of the tumor:

• Lumpectomy: removal of the tumor.
• Partial mastectomy: removal of the tumor, a portion of surrounding tissue and lining the chest muscles near the tumor.
• modified radical mastectomy: removal of the breast and the lining of the pectoral muscles (keeping the muscles).
• or radical mastectomy Halsted operation: removal of the entire breast, chest muscles, and some fatty tissue and skin. It is no longer practiced today because very mutilating.

2. Radiotherapy

Radiation therapy uses high-energy radiation to destroy cancer cells and prevent their development. Like surgery, it is a local treatment, without any action on any remote metastatic sites. It can be administered in different ways:

• either from an external source of radiation;
• or from radioactive materials implanted directly into the breast. This is known as “brachytherapy”.

Both methods can be combined. External radiation therapy is most often done without hospitalization. At the end of this conventional radiotherapy, an overlay can be performed radiotherapy to the tumor site. This additional radiation therapy can also be applied by brachytherapy. In the latter case, the patient should be hospitalized for a short period.

Radiotherapy is often used to complement surgery, either before (known preoperative radiotherapy, the aim being to reduce the size of the tumor) or after (it is then postoperative radiotherapy, the aim to prevent a recurrence of the tumor).

3. Chemotherapy

It comprises a single drug or a combination of anti-tumor (most common), it is a treatment whose interests the general circulation throughout the body (treatment called “systemic” just like hormone treatments as opposed to “local” as surgery or radiotherapy). It can be administered before or after surgery.

If it is prescribed to destroy any metastatic foci after surgery, it is called “adjuvant”. Its guidance depends on a number of factors called “prognostic”.

The main drug treatments combine the molecules of doxorubicin (anthracycline family) of cyclophosphamide or fluorouracil. Molecules from a tree, yew, also made their appearance: they are the taxanes used in metastatic breast cancer and recently in an earlier stage of the disease.

4. Hormone

Hormone therapy is a “systemic”. It aims to prevent, in some cases, tumor cells receive hormones for their development. His administration is determined based on hormone receptor in tumor tissues.

This method involves inhibiting the production of hormones implicated, either by administration of anti-hormones, or by suppressing production of these hormones (definition: surgical castration or radiotherapy, or transiently: chemical castration).

The choice between chemotherapy, hormone therapy or both, is a function of patient age, hormonal status and the detection of hormone receptors. If positive, hormone therapy is usually effective.

5. Targeted therapies

Therapies targeted specifically to attack cancer cells without touching healthy cells.One therapeutic target is based on “monoclonal antibodies”. They are manufactured specifically for antibodies recognize an antigen expressed by a tumor. These monoclonal antibodies can be directly targeting the tumor or its environment.Trastuzumab (Herceptin ®) is one of these molecules, whose mode of action is to attack the tumors overexpressing (that is to say too much) a protein (HER2). It is used alone or in combination with chemotherapy.

Other targeted therapies will block the growth of blood vessels needed for tumor development. ”Hungry,” the latter, will stop proliferating or die. These are molecules called “anti-angiogenic” such as sunitinib.

The “borderline lesions. These cancers in situ or noninvasive, should be considered separately. Treatment can range from conservative surgery to mastectomy, the choice of therapy depends mainly on the histological type encountered.

In some cases, radiation therapy may be necessary after partial surgery. In contrast, treatment of inflammatory cancer chemotherapy based on early and aggressively, then surgery and / or radiotherapy, and as appropriate, hormone.

Early diagnosis is especially important in the case of breast cancer before it’s to spin off the disease responds best to treatment.

The doctor will perform a complete physical examination, and conduct a detailed investigation of personal or family history of the patient.

1. Clinical examination

The doctor observed whether the skin covering the breasts will change in some areas, asking the patient to put his arm in different positions.

A careful palpation of the breast can say many things about the medical nature of a lump. Its size, its consistency, so it rolls under your finger, etc..

2. Mammography

A radiograph can provide the physician with important information about a lump or swelling in the breast.

This examination can reveal tumors too small to be detected by palpation (microcalcifications, for example).

In addition to the mammogram, the doctor has other methods to aid in diagnosis.

3. MRI

Magnetic Resonance Imaging, is a means of investigation in the diagnosis and therapeutic monitoring of cancer.

Providing a visualization of anatomical sections extremely thin, it allows to differentiate diseased tissue and healthy tissue to perform a “mapping” very accurate three-dimensional tumors.

4. Ultrasound

It can produce images from the echo of high-frequency sound waves (ultrasound) sent in the breast.

Ultrasound is often more effective in young women who have dense breasts.

5. Samples

• The aspiration cytology or biopsy: vacuuming using a needle and syringe some fluid or tissue size, we will know if it is a cyst (and not a cancer) or a solid mass (which can be cancerous or not).
• Biopsy to confirm the diagnosis. This technique involves removing part or all of a lump or a suspicious area, and to examine anatomical and pathological microscope. It is usually performed under local anesthesia.

6. Analysis

If breast cancer is found, the pathologist may specify the type. Other laboratory tests, more specialized, are sometimes performed on cancerous tissue, to better understand the cells that form them.

If the biopsy shows cancer, it is necessary to conduct tests on the tumor (dose estrogen receptor and progesterone). These reviews are intended to determine whether hormones feed the tumor and facilitate its growth (hormone-dependent tumors). This information gives the physician the opportunity to decide the value of hormone therapy, either immediately or subsequently.

7. Staging

It also has a number of tests to determine whether the disease has spread to other parts of the body. They are the “staging”.

Will be performed blood tests, chest radiograph, bone scan and laboratory tests, including tumor markers (CA15-3).

Breast cancer can swarm into the lungs, liver, bones or brain, the doctor may order tests specific for these organs. All of these tests allows the physician to assess the extent or stage of disease. It evaluates the size of the tumor, the existence of a clinically node-negative, then the presence of distant metastases of the breast. This is the “TNM” which allows the physician to develop a therapeutic strategy.

8. The Treatment Planning

The treatment strategy developed by the physician depends on the TNM

T: tumor size. Of T0 (primary tumor) to T4 (tumor extending to the chest wall or skin)
N: lymph node
M: the presence or absence of metastases

Finally, the record allows for a classification of cancer: Stage I to Stage IV. Are also taken into account in developing a treatment, patient age, hormonal status (menopause or not), his general condition and certain tumor characteristics (expression of hormone receptors, for example).

More detecting breast cancer early is more likely 16122/guérison16117 / are important. More detail on breast cancer screening.

1. Symptoms of Breast Cancer

The breasts are in women, a great diversity of size, shape and texture. A woman sees her breasts also change throughout his life.

These changes may be related to many factors: age, menstrual cycle, pregnancy, birth control pills or other hormones. A swelling or induration within or armpit or any other abnormal change and persistent should lead them to consult his doctor.

Each woman should also be regularly examining the breasts by a physician, whether generalist, a gynecologist or doctor.

Breast cancer can occur with other symptoms such as:

• a change in size or shape of a breast;
• a discharge from the nipple;
• a change of color or texture of the skin of the breast or areola.

The pain is usually not a 9212/signe16117 / breast cancer. However, any change affecting the breast should be reported immediately to a doctor. Symptoms may be caused by cancer or by a number of other conditions.

2. Breast cancer: mass screening

Research has proven that it is possible to detect breast cancer long before it is palpable, and that mammography combined with clinical examination could reduce mortality from this cancer.

Since the Cancer Plan, breast cancer has a systematic organized screening test is supported 100% by Social Security. Women 50 to 74 are invited every two years to visit a certified radiologist of their choice.

After a clinical examination (palpation), this practice a mammogram (breast X-ray). If the snapshot is normal, it will be read by another practitioner. If an abnormal image is detected, the radiologist practice exams complementary expansion of shots, ultrasound, and if the judge is required to practice a levy under local anesthesia for analysis of cells under a microscope.

Breast cancer in humans. Breast cancer in men is 1% of all cancers and 0.5% of male cancers. His event is so unique it is often ignored, at least neglected. However, as in women, the chances of recovery are more important than screening, diagnosis and treatment are early.

Breast cancer is the leading female cancers with 50,000 new cases per year.  Some factors increase the risk of developing breast cancer.

1. Risk factors for breast cancer

Many diseases have a unique and identifiable cause, such as a virus or bacteria.

Cancers, however, are diseases called “multifactorial”, the causes are multiple.Genetic abnormalities responsible for malignant transformation, due to various disturbing elements.

The work of epidemiologists is to identify and assess these risk factors. Scientific work has shown that certain factors increase the risk of developing breast cancer.

2. Age

Two thirds of breast cancers occur after age 50.

The disease is rare in women under 35 years old and quite outstanding below 20 years.

3. Family history

The risk of having breast cancer is doubled in a woman whose mother or sister had the disease.

If the cancer occurred in the mother before menopause, the risk in girls is even higher.

The existence of familial forms of breast cancer has long been known. Research has shown recently that genes predisposing to breast cancer and / or ovarian cancer are transmitted in families and give to women who are carrying a significant risk of developing breast cancer.

Most of these genes have been identified, which allows for genetic counseling in these families.

4. Heredity and breast cancer

It is estimated that 5-10% of breast cancers are linked to genetic predisposition.Through the study of familial cases, basic research has identified two susceptibility genes: BRCA1 and BRCA2. Alterations in these genes are responsible for more than 80% of hereditary forms of breast and ovarian cancer and 65% of hereditary forms of breast cancer alone.

Mutations in BRCA1 and BRCA2 are associated with a predisposition to breast and ovarian cancer, those of the BRCA2 gene induce rather high risk of breast cancer at an early age.

5. Personal history

Having had cancer in one breast means that the risk of having a second in the other breast is 4-5 times higher than average.

About 15% of women treated for breast cancer eventually develop cancer in the other breast. This risk is above average among women with early menarche were or that menopause is delayed, or in those who had their first child after age 30 years, or are childless.

The 9852/recherchesO-16117 / recent evidence suggests that the 16,084 / alimentation16117 / may affect the development of certain cancers. Breast cancer and appears most frequently in women with a diet high in fat.

6. Breast Cancer: breastfeed to protect themselves

Several studies have shown, women who breastfed see the risk of breast cancer decline. The protective effect is even more important than the cumulative duration of breastfeeding is long.

Have breast fed for 12 months of life is associated with a decrease of 4 to 5% risk of breast cancer. That’s what came to demonstrate different teams of scientists studying data on several tens of thousands of women around the world. It appears that there is an inverse association between cumulative duration of lactation (the sum of past periods to nurse one or more children) and the risk of breast cancer.

Thus, women who breastfed 18 months, the risk of breast cancer is lowered further (-6 to 7%).

The biological mechanisms behind protective phenomenon are still poorly understood.However, researchers believe they depend on changes in hormonal impregnation.

Breastfeeding in fact leads to a decrease in activity of the ovaries (not ovulating) and thus exposure to female hormones. Now it is established that these hormones play an important role in the risk of breast cancer.

The benefits of breastfeeding are numerous and well recognized by the scientific and medical community. However, the benefits brought by the mother’s diet in the prevention of allergic diseases and asthma are also discussed. While some studies observe no preventive effect, others find that breastfeeding reduces the risk of asthma in children.

Asthma is a disease that takes a lot of momentum in the developed countries.Thus, all tracks and all measures to reverse this trend should be carefully investigated.

To determine the effects of breastfeeding on the subsequent onset of asthma in children, an analysis has combined all studies on this subject. The findings show that breastfeeding during the first three months of life, especially among children from families atopic or allergic exerts a protective effect against asthma.

It is therefore likely that the exclusion of non-maternal allergen or immunomodulatory effect of breast milk is able to reduce the risk of asthma.

It remains to elucidate the exact mechanisms, but these results are in favor of promoting breastfeeding.

1. The case of a mother with asthma

Meanwhile, another team of researchers looked at whether maternal asthma was a significant factor influencing the protective effect of breastfeeding. They show that this relationship depends on the presence of maternal asthma and the age of the child. Thus, children under three years who were breastfed are less wheezing than those who have not been, the mother is asthmatic or not. However from 6 years, children who were breastfed for a prolonged period have more often asthma if the mother is asthmatic. Indeed, 42% of children aged 6 -13 years old have asthma if they were breastfed for more than four months by a mother with asthma, against 16% of children breastfed by a non-asthmatic mothers.

The age of the child, and asthmatic status of the mother are important factors. Breastfeeding has a protective effect on the occurrence of wheezing in young children, but it is associated with an increased risk of asthma in children over 6 years when the mother has asthma.