Sarcoma of the breast: causes, symptoms, treatment

Breast sarcoma it is a malignant tumor, which is non-epithelial in nature, prone to rapid (sometimes rapid) growth, metastasis and is characterized by unfavorable course.

Force expressed in malignant properties of the tumor are dealing with it, involving radical surgical treatment (performed mastectomy – removal of the breast). The effect of the surgery is supported with radiation and chemotherapy.

General data

In comparison with other malignancies of the breast sarcoma is diagnosed less frequently – on its share drops from 0.6 to 2% of all malignant diseases of the prostate.

Diagnosis women, although the same sarcoma can develop in men – in this case, it is called sarcoma of the breast. This tumor has the same type of structure of the tissues, which is observed in sarcomas, able to appear in other organs and tissues of the human body.

Please note

Breast sarcoma rarely develops in isolation. It often appears in women on the background of another neoplasms – phyllodes tumor of the breast. It is not excluded, the affinity of these two tumors is marked by a commonality of factors that trigger their development.

In addition to phyllodes tumor, simultaneously with sarcoma of the breast may develop such neoplasms as:

Reasons

Still not found out directly the true reasons why it is absolutely normal cells in the breast suddenly start to malignities (to degenerate into malignant), forming sarcoma of the breast.

Studied a number of factors, against which the disease occurred more often and progress faster. All of them can be divided into groups:

  • physical;
  • chemical;
  • endocrinology;
  • somatic;
  • infectious;
  • inflammatory;
  • hereditary;
  • bad habits.

Physical factors contributing to more rapid development of sarcoma of the mammary gland, in turn, are:

  • mechanical;
  • radiological;
  • thermal.

Mechanical factors that play the role of provocateurs and the development of sarcomas of the breast are:

  • medical manipulations associated with invasion (the introduction into the tissues of the breast, which involves a certain degree of trauma;
  • non-medical trauma this body.

“Push” breast tissue to malignant degeneration can medical manipulations:

  • diagnostic;
  • treatment.

Of diagnostic procedures the development of described pathology is provoked by:

  • needle biopsy – removal of fragments of breast tissue for their study. Biopsy the degree of trauma to the breast tissue is small (it is pricked with a needle and aspirated contents with a needle and syringe), but it is enough to trigger malignant transformation of tissue;
  • resection biopsy – removal of piece of tissue by the method of cutting;
  • plucking biopsy – the same manipulation, but the pieces of tissue otshivajutsja.

Therapeutic manipulation of the breast, which can occur sarcoma is:

  • lancing of abscess (limited ulcer), or cellulitis (diffuse suppuration);
  • removal of foreign body;
  • breast surgery

and others.

Found that surgical procedures can be the background for the development of sarcoma of a mammary gland not only because of intraoperative injury of the tissues of the gland. A contributing factor is not sufficiently radical extent of the surgery. Most often it is a sectoral resection of a mammary gland – removal of a fragment. Can be performed for other tumors of the breast such as:

  • fibroadenoma – a benign education, which grew out of the connective and glandular tissue;
  • phyllodes tumor of breast benign fibro-epithelial tumor of its tissues with high risk of malignant transformation;
  • spindle cell tumor – a tumor that consists of cells of specific forms.

Provoking moment are not just described manipulation, the risk of developing sarcoma breast cancer increases if they are rough violation of technology.

The occurrence of sarcoma of the mammary gland contribute to the injury, not related to medical manipulations and leading to the formation of such wounds as:

  • hurt;
  • puncture;
  • cut;
  • torn;
  • bitten;
  • crush;
  • gunshot.

Breast irradiation is one of the most frequent and severe instigators of the occurrence of sarcoma of the breast. This:

  • the effects of solar radiation under natural conditions;
  • radiation in solariums;
  • radioactive effects during the radiation therapy, which is assigned in other tumors (not necessarily breast cancer);
  • contact with radioactive substances because of professional necessity;
  • radiation radioactive substances in case of unauthorized access.

Development of sarcoma of the mammary gland may contribute to the thermal factor is the impact:

  • high temperatures – as a result of frequent application of local heat (in particular, hot hand warmers);
  • less low – if you regularly stay in the zone of freezing temperatures.

Aggressive chemical compounds that can enter the body in different ways (contact, inhalation of gases and vapours, and so on) have a pronounced provoking oncogenic effect and increase the risk of sarcoma of the breast. This is mainly chemicals that are used in industry. The most pronounced carcinogenic effect seen in chemicals, such as:

  • acrylic;
  • nitrile;
  • toluene;
  • benzene;
  • formaldehyde;
  • vinyl chloride;
  • mercury

and several others.

Endocrine disruptions, contributing to the development of this pathology is:

  • diabetes – the metabolism of carbohydrates due to insufficient insulin;
  • lack hormones due to destruction of the adrenal glands (most often the tumor type);
  • endocrine outages due to neoplastic lesions of the pituitary gland;
  • hyperthyroidism – increased production of thyroid hormones;
  • hypothyroidism – deficiency of thyroid hormones.

Somatic pathology play an indirect role in the occurrence of sarcoma, breast cancer – they drain the reserves of the body, weaken it, it contributes to a variety of failures in organs and tissues including malignant transformation.

Particularly important are long lingering chronic diseases is:

  • hypertension – persistent high blood pressure;
  • diseases of the stomach and intestines;
  • of liver injury of various Genesis (origin), in particular hepatitis;
  • the defeat of the pancreas;
  • neoplasms of other organs and tissues

and so on.

Infectious factors that can be the impetus for the development of sarcomas of the breast are:

Most often it is the virus:

It is important

The risk of sarcoma of the breast is higher in women, if her family suffered from this disease. Medical language it sounds like “positive family onlinemath”.

Development of sarcoma of the mammary gland contribute to habits such as:

  • Smoking;
  • the abuse of alcohol.

The development of the pathology

Sarcoma is a tumor which is no epithelial or glandular tissue. But fabric varieties of this tumor is quite a lot. Sarcoma can occur from:

  • striated muscles;
  • smooth muscle elements;
  • adipose tissue;
  • neural structures;
  • bone.

In the mammary gland may develop different histological types of sarcomas – they are based on tissue structure may be the following:

  • fibrosarcoma;
  • liposarcoma;
  • chondrosarcoma;
  • angiosarcoma;
  • leiomyosarcoma;
  • rhabdomyosarcoma;
  • osteosarcoma;
  • malignant fibrous histiocytoma

and some others.

Histological variant, which occurs most often variations of sarcomas of the breast are fibrosarcoma – they diagnosed in 30% of patients with sarcoma of the breast. Some of the features of these tumors:

  • develop from connective tissue fibers;
  • are large in size;
  • even with a substantial progression not accompanied by ulceration.

Liposarcoma is a malignant neoplasm composed of degenerated fat tissue. For them, too, is characterized by rapid progression, but they often ulcerate, moreover, affect both Breasts.

Rhabdomyosarcoma – sarcoma formed from structures in striated muscles. Its main distinctive features – an extreme degree of malignancy (this aggressive tumor), the rapid growth and development, infiltration (germination) tissue. Mainly rhabdomyosarcoma are seen in young women up to 25 years.

Angiosarcoma grow from the cells of vascular endothelium. Characteristic for them are rapid growth, recurrent course. Identified predominantly in women in the age group of 35 to 45 years.

Rarely meet other sarcomas chondrosarcoma (of the elements of cartilage), and osteosarcoma extraskeletal localization (bone marrow) – they diagnose 0.25% of all sarcomas of the breast. They are characterized by a high degree of malignancy. They mostly affected women over the age of 55 years.

It is important

Tumor node, with sarcoma of the mammary gland can reach the size of 1.5 to 15 cm.

Origin of sarcoma of the breast is divided into:

  • primary – occurs in healthy tissues;
  • secondary – formed as a result of malignant transformation of benign tumors (e.g., leaf).

The symptoms of sarcoma of the breast

Symptoms of sarcoma of the breast are:

  • the presence of a node in the gland;
  • the increase in volume;
  • the skin over the tumor;
  • soreness;
  • bleeding;
  • inflammatory reaction;
  • signs of violation of the General condition of the body.

Often the appearance of a node in the breast is the earliest manifestation of sarcoma. Its characteristics are:

  • the shape – node;
  • the consistency is dense;
  • to shape – with a clear outline and a rough surface;
  • sensitivity is painless, with the progression of pathology sensitive.

The growth of the host skin over it changes:

  • thinner;
  • becomes blue-purple color;
  • on the skin over a node is visualized dilated saphenous vein.

The growth of the tumor also increases the volume of the diseased glands, by tumors observed asymmetry is one of iron more than the other, often has an irregular shape.

As progression develops the pain syndrome. The following pain characteristics:

  • localization – region formation unit;
  • distribution may be sore the whole breast;
  • the nature of pain aching, pressing;
  • in intensity to the pain syndrome of moderate severity, overall pain is tolerable;
  • the appearance – in the early stages of formation and growth of the node is not observed, joined with the progression of the disease.

In the later period appear on the skin ulceration.

Bleeding may occur in advanced cases it occurs due to collapse of the tumor tissues.

It is important

If sarcoma of the breast is growing quickly, there is often an inflammatory reaction of the body – it may seem that it develops a mammary gland abscess (limited purulent education).

Signs of violation of the General condition of the body develop with the progression of the disease. They are fairly typical, reminiscent of the pattern of worsening General health with the progression of other malignancies. This symptoms such as:

  • General weakness, lethargy, malaise;
  • the decrease in the level of disability – even when the usual amount of work;
  • hyperthermia (increased body temperature) at the level of the subfebrile is 37.3-37.5 degrees Celsius;
  • poor appetite, and subsequent disease progression – the lack of it;
  • the decrease in body mass.

The growth rate UGA can be:

  • slow;
  • progressive;
  • hopping;
  • stormy.

Rapid or abrupt development indicates a high degree of malignancy of sarcoma for several months may occur end-stage. At the same time of sarcoma with a relatively favorable course develop slowly – they may have formed over several years (sometimes many years).

The characteristic peculiarities of any kind of sarcoma are:

  • hematogenous (through the blood) path of metastasis (usually lungs and bones);
  • a rare defeat of the regional lymph nodes.

Diagnosis

A provisional diagnosis of sarcoma of the breast is put on the basis of patient complaints, anamnesis, results of additional research methods. The final diagnosis of certain histological forms of the disease can only be made after histological and cytological examination.

Data of physical examination:

  • during the inspection – identified the symptoms of lemon peel and platforms, the deformation of the prostate, swelling of the skin of the breast, ulceration. Also the General condition of the patient;
  • palpation (feeling) in the affected breast is determined by the elastic krupnoporistoj mobile tumor heterogeneous texture.

In the diagnosis of sarcoma of the breast used the following instrumental methods of investigation:

  • mammography – comprehensive breast examination;
  • fine-needle biopsy carried out otsyrevanie fragments of tissue sent to a laboratory for subsequent examination under a microscope;
  • scintigraphy breast – intravenously administered pharmaceuticals with radionuclides, their radiation is fixed with a special gamma camera that produces the characteristic color picture on which to draw conclusions about the condition of the tissue of the breast.

During mammography are involved in such methods of examination as:

  • x-ray mammography;
  • ultrasound mammography in the time to identify the tumor site, along with its size, shape, contour, and condition of surrounding tissues;
  • tomosynthesis is the creation of a two-dimensional image of the breast in which tumor detected;
  • magnetic resonance (MRI) mammography – as a result of its implementation receive a tomographic image of the breast, which analyzes on the subject of tumor.
  • optical mammography – a study of the condition of the breast with the use of optical equipment.

Laboratory methods used in diagnosis of the disease described it:

  • General analysis of blood – about the cancer defeat signals a significant increase in ESR. With the progression of pathology of the possible signs of anemia – a decrease in the number of hemoglobin and red blood cells;
  • histological study – the study under a microscope of tissue biopsy structure;
  • Cytology – the study under the microscope the cellular structure of biopsy.

Differential diagnosis of

Differential diagnosis is carried out:

  • between the individual forms of sarcoma of the breast;
  • between sarcoma and other pathologies.

It is necessary to distinguish sarcoma of the breast from such pathologies as:

  • phyllodes tumor of the breast;
  • her cancer is sporadic and hereditary form of cancer;
  • abscess – limited ulcer;
  • tuberculosis center (infiltration).

Complications

The complications that often accompany sarcoma of the breast is:

  • infection of the ulcerations of the skin with subsequent formation of pyoderma – purulent lesions of the superficial layers of the skin;
  • abscess – a limited abscess in the progression of suppurative infectious process;
  • phlegmon – diffuse purulent lesion, which occurs for the same reasons as the abscess;
  • germination in neighbouring organs and tissues in the chest wall;
  • cancer intoxication – develops at the expense of falling into the bloodstream and spread throughout the body of waste products of tumor cells and degradation products of dead cancer cells;
  • cancer cachexia – the exhausted condition of the patient, which develops in the terminal stage of the described pathology;
  • metastasis – transfer of malignant cells to other organs and tissues.

Treatment of sarcoma of the breast

In the treatment of sarcoma of the breast is applied the combined treatment – surgery and chemotherapy.

The transaction volume can be in the form:

  • mastectomy – removal of entire breast;
  • less radical resection, which removes the tumor from adjoining tissues.

If lymph nodes revealed metastases, also performed lymphadenectomy – removal of lymph nodes. Especially this operation is relevant when the decay of the tumor.

Chemotherapy is carried out in the postoperative period, using etracycline antibiotics.

Radiation therapy may also be involved in the treatment of sarcoma of the breast, but in those cases, if there is any doubt whether an effective radical surgical intervention.

Prevention

As immediate causes the occurrence of sarcoma of the breast is unknown, specific prevention methods are not. The risk of this disease can be reduced by following these recommendations:

  • the precise execution of invasive medical manipulations connected with examination and/or treatment of diseases of the breast;
  • avoidance of trauma to the breast;
  • avoiding contact with radioactive substances, and if such a need arose – the use of personal protective equipment;
  • dosed sunbathing;
  • avoidance Solarium;
  • radiation therapy according to indications and under control;
  • avoiding exposure to the breast too high and too low temperatures;
  • avoiding contact with chemicals and carcinogens;
  • the prevention of any abnormalities that contribute to tumor development and endocrine disruptions, somatic pathologies, infectious pathologies, and if they have already developed their timely diagnosis and adequate treatment;
  • avoiding harmful habits;
  • healthy lifestyle – proper regime of work, rest, sleep, nutrition, sexuality, exercise.

The prognosis in sarcoma of the breast, survival rate

The prognosis in sarcoma of the breast is different – it depends on:

  • tissue type of the tumor;
  • its size;
  • the duration of the disease.

This tumor is prone to postoperative recurrence, and distant metastasis to lungs and bones.

Kovtonyuk O. V., medical columnist, surgeon, consultant physician