Monday, June 22, 2020

Breast cancer precancerous manifestation, breast self-examination method

Breast cancer is a disease that seriously harms women's health worldwide, and it is currently on the rise in my country. Breast cancer is a malignant tumor on the body surface, which is easier to find than other malignant tumors. The incubation period is also longer and the development is slower, ranging from cancer to clinical discovery for an average of 8 years. Therefore, the early diagnosis rate, early treatment and cure rate of breast cancer are ideal.

The earliest sign of breast cancer is a small, painless mass growing on the breast. This kind of lump usually exists alone, with a hard texture and a stone-like surface. The surface is not smooth. Although the boundary with the surrounding tissue is not clear, it can be pushed without tenderness. It is often in the bath. I accidentally found myself while changing clothes. Over time, the lump will continue to grow, develop into the surface and invade the skin and adhere to the skin, causing the skin to sink in. This is the most common sign of breast cancer that is most easily found. When the mass invades deep, it adheres to the deep tissues and can no longer be pushed. If the lumps continue to develop, the breasts can shrink and harden, and the nipple can move upwards. Within a few months, the breast lumps can increase and bulge significantly. In the later stages, cancer cells invade the pleura and pectoralis major muscles, and the mass is completely fixed. The skin around the mass can be edema due to the retention of lymph fluid. Many dot-like pores are formed in the hair follicles, which makes the skin appear "orange peel-like" and then rupture. , Hemorrhage, secretion of foul-smelling secretions, and the wound does not heal for a long time.

1. Lumps

For adult women, once any mass in the breast can be touched, it must be taken seriously to rule out the possibility of cancer.

The growth rate of breast cancer is generally slow, but there are fast and slow, and it grows faster during pregnancy or lactation. The lumps are also large and small, the smaller the chance of metastasis, and the more chance of cure. Therefore, the female compatriots must be careful when checking the breasts to prevent omissions. The morphology of the mass is mostly irregular and tends to be round or oblong, which is not clear from the normal tissue and hard. The mass of early breast cancer can be pushed freely with fingers, but if it has invaded the pectoralis major muscle or chest wall, the push should be restricted.

2. Pain

Most patients begin to feel no pain, and only a few patients have local pain of varying degrees, mainly hidden pain, blunt pain, traction pain or acupuncture-like pain, mostly paroxysmal, and persistent pain only appears in the late stage .

3. Local skin changes

When the cancer tissue invades the skin, it can cause the skin to sink partially, forming a so-called "dimple" symptom; when the cancer tissue invades the surrounding subcutaneous tissue, it can produce small subcutaneous nodules, which are called "armor-like cancers" after the small nodules fuse ; When cancer invades the skin and ruptures the skin, ulcers are formed.

Four, nipple changes

There are two main changes in the nipple, one is the nipple retraction, deepening, fixed, or slightly elevated; the second is nipple discharge, which can overflow pure blood, serous blood, milky or watery liquid.

5. Changes in breast contour

Normal breasts have a complete curved profile. If there are any defects or abnormalities in this curved shape, such as bumps or depressions in the skin, it may be a manifestation of early breast cancer.

Cancer formation often undergoes a long process of evolution. Before the cancer is fully formed, there must be some morphological changes in the local tissue. As the precursor performance, it gradually accumulates from light to heavy, and finally develops into a tumor with obvious malignant characteristics. This local tissue morphology that occurs before the cancer is abnormal, but it is not enough to be diagnosed as a pathological change of malignant tumor. The pathology is called the precursor manifestation of cancer, and it is clinically called "precancerous lesion".

The concept of precancerous lesions of breast cancer is not very clear so far. In the past, through prospective clinical studies, it was found that patients with mammary gland hyperplasia later had a higher incidence of breast cancer than ordinary women. Therefore, mammary gland hyperplasia was considered to be a precancerous lesion of breast cancer. However, in recent years, most domestic and foreign scholars believe that simple breast hyperplasia does not occur cancerous, mainly on the basis of ductal epithelial hyperplasia and atypical hyperplasia. Therefore, the epithelial hyperplasia and atypical hyperplasia are regarded as precancerous Lesions. However, some people believe that all patients with benign breast disease and epithelial hyperplasia, regardless of whether they have atypical changes, because they can increase the risk of breast cancer, should be strictly monitored. Although some scholars believe that there is not enough and strong evidence that epithelial atypical hyperplasia is a signal of precancerous lesions or canceration, there is a common understanding that women with atypical hyperplasia should be regarded as high-risk groups. Long-term monitoring. In addition, some scholars believe that intraductal papilloma and large breast cysts also have a higher canceration rate. Therefore, it can be considered that the precancerous lesions of breast cancer refer to the hyperplasia and atypical hyperplastic lesions of epithelial cells of the breast lobule or duct system.

The reversible "precancerous lesions" can be cured by active and correct treatment. In addition, it takes a long period of time for precancerous lesions to evolve into true cancer, some of which can gradually become lighter; some of them develop slowly or remain unchanged for a long time, even after the death, the examination does not change, and some gradually increase, In the end, it leads to cancer, so even patients with precancerous lesions should not be overly nervous. Remember that early detection and early treatment are the key to the treatment of "precancerous lesions".

Breast self-examination method and the best time

Breast examination should first observe the development of the breast

Whether the breasts on both sides are symmetrical, whether the size is similar, whether the nipples on both sides are at the same level, whether the nipples are retracted and sunken; whether the nipples and areola are eroded, how the breast skin color is, whether there are edema and orange peel, and whether there are redness Such as inflammatory manifestations, whether the superficial veins in the breast area are engorged.

Breast self-examination method

1. Inspection: take off your coat, under the bright light, face the mirror to do bilateral breast inspection: both arms sag, observe whether the curved contours of the breasts on both sides have changed, whether they are at the same height, breasts, nipples, areola Whether the skin has peeling or erosion, whether the nipple is raised or retracted. Then keep your hands on your hips and rotate your body left and right to continue to observe the above changes.

2. Palpation: Take the upright position or supine position, put the left hand behind the head, check the left breast with the right hand, the fingers should be close together, move clockwise from the top of the breast to check, press the outer upper, outer lower, inner lower, inner upper, armpit In the next sequence, the system checks for lumps. Be careful not to miss any parts, do not press or squeeze with your fingertips. After checking the breasts, use your index and middle fingers to gently squeeze the nipple to see if there is bloody discharge. Through inspection, if you find a lump or other abnormalities, you should go to the hospital for further examination in time.

Best time to check

For women with normal menstruation, the best time for breast examination is 9 to 11 days after menstruation. At this time, the effect of estrogen on the breast is minimal. The breast is in a relatively static state and it is easy to find lesions. Lumps that appear during lactation, if clinically suspected as tumors, should be further examined after weaning.

The high-risk factors of breast cancer refer to some factors that have a higher chance of breast cancer in certain people than the normal population. Including the following:

(1) Family history of breast cancer.

(2) Early menarche, late menopause, long menstrual years or no ovulation for a long time.

(3) Infertility or never breastfeeding.

(4) Long-term use of estrogen drugs.

(5) History of breast cancer on one side.

(6) There are still different opinions on benign breast diseases.

Women who have the above-mentioned high-risk factors must regularly conduct self-monitoring and seek medical attention in a timely manner if problems are found. They should also regularly consult a doctor to check their breasts at least once a year.

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