What is Invasive Lobular Carcinoma?

Invasive breast cancer is a malignant tumor in which cancer cells have penetrated the basement membrane of mammary ducts or lobular acinars and invaded the stroma. The vast majority of invasive breast cancers are adenocarcinomas, which originate from the subcutaneous cells of the mammary gland, especially the ductal lobular units of the peripheral ducts. There are many morphological phenotypes of invasive breast cancer, and they are clearly divided into different types of histopathology according to their unique prognosis or clinical characteristics. Some studies indicate that tumors with high histological grade respond better to certain chemotherapy regimens than tumors with low histological grade. Invasive breast cancer is sometimes found to invade peripheral nerves in invasive breast cancer, but it is not an independent prognostic factor.

Basic Information

English name: invasive breast cancer
Visiting department: Thoracic surgery, breast surgery
Multiple groups: 55 to 59 years old women

Common locations: Mammary gland
Common causes: unknown
Common symptoms: Breast lump, nipple discharge, abnormal nipples, areola, swelling of axillary lymph nodes

Causes of invasive breast cancer

The etiology of breast cancer is multifactorial. A family history of breast cancer is a high risk factor for breast cancer. In addition, it also involves diet, fertility, hormone disorders, and mutations in related genes.

Clinical manifestations of invasive breast cancer

Early breast cancer often does not have the typical symptoms and signs, and is not easy to attract attention. It is often found through physical examination or breast cancer screening. The following are typical signs of breast cancer.

Breast lump

80% of breast cancer patients are first diagnosed with a breast mass. Patients often find breast masses unintentionally, mostly single, hard, irregular edges, and less smooth surfaces. Most breast cancers are painless masses, and only a few are accompanied by varying degrees of faint or tingling pain.

2. Nipple discharge

The non-pregnant period of blood, serum, milk, pus from the nipple, or stop breastfeeding for more than six months still have milk outflow, called nipple discharge. There are many causes of nipple discharge. Common diseases include intraductal papilloma, breast hyperplasia, duct dilatation, and breast cancer. Unilateral and single-hole bloody discharge should be further examined, if accompanied by breast masses, more attention should be paid.

3. Skin changes

There are many signs of skin changes caused by breast cancer. The most common is that the tumor invades the Cooper ligament, which connects the breast skin and the deep pectoralis fascia, shortens and loses its elasticity, pulls the skin of the corresponding part, and causes "dimple sign" That is, a small depression in the breast skin, like a small dimple. If the cancer cells obstruct the lymphatic vessels, there will be "orange peel-like changes", that is, many small dot-like depressions in the breast skin, just like orange peel. In the advanced stage of breast cancer, cancer cells infiltrate into the skin along the lymphatic, glandular or fibrous tissues and grow, forming scattered hard nodules in the skin around the main cancerous foci, the so-called "skin satellite nodules."

4. Nipple and areola abnormalities

Tumors are located at or near the depth of the nipple and can cause nipple retraction. The tumor is far away from the nipple, and the large duct in the breast is invaded and shortened, which can also cause the nipple to retract or raise. Nipple eczema-like cancer, known as Paget's disease of the breast, is manifested by itching, erosion, ulceration, scabbing, scaling, and burning pain of the nipple skin, causing the nipple to retract.

5. Axillary lymph node enlargement

About a third of breast cancer patients have axillary lymph node metastases. Ipsilateral axillary lymphadenopathy may occur early, and the enlarged lymph nodes are hard, scattered, and pushable. As the disease progresses, the lymph nodes gradually fuse, and adhere to and fix with the skin and surrounding tissues. In the later stages, metastatic lymph nodes can be felt on the clavicle and on the contralateral axilla.

Invasive breast cancer examination

In the breast clinic, the doctor will first perform a physical examination to check the bilateral breasts after understanding the medical history. They will also combine imaging examinations, including mammography (mammography of mammography), color ultrasound, and if necessary, magnetic resonance examinations of the breast ( MRI). Mammography is the main method of breast cancer screening recommended internationally in recent years. It can be found that breast cancer can not be detected by clinical examination. It is usually used for women over 40 years of age. Sensitive, with limited radiation damage and relatively low breast density, abnormal signs are easy to find on mammograms. Breast color Doppler ultrasound is not harmful to the human body, and it is ideal for young women and dense breast examinations. MRI can find multifocal and multicenter small lesions, and it is also an imaging method for early diagnosis. Finally, the diagnosis will be based on cytopathology (in conditional hospitals) and histopathological diagnosis. Biopsy will be performed on the basis of abnormalities found in clinical examinations. Puncture or surgical methods can be used. Take treatment. If the patient has a nipple discharge, some examination methods for nipple discharge can also be developed, such as bronchoscopy, mammography, cytology smear, etc.

Diagnosis of invasive breast cancer

Early detection and early diagnosis of the disease are the key to improving the efficacy. The diagnosis and differential diagnosis of breast cancer should be combined with the patient's clinical manifestations and medical history, physical examination, imaging examination, histopathology and cytopathology examination (in conditional hospitals).

Most of the patients came to the hospital for finding a breast mass by accident, and a few patients were found to have breast masses or suspicious lesions through regular physical examination or screening. Touching the mass can be confirmed by needle aspiration biopsy or surgical resection biopsy. If the tumor is not detected clinically, suspicious lesions are found by imaging examination, biopsy can be performed with the help of imaging examination. Pathological examination is the gold standard for breast cancer diagnosis.

Treatment of invasive breast cancer

Doctors will use surgery, radiotherapy, chemotherapy, endocrine therapy, bio-targeted therapy, and Chinese medicine adjuvant therapy as appropriate according to the stage of the tumor and the physical condition of the patient. Surgery plays an important role in the diagnosis, staging and comprehensive treatment of breast cancer. Radiotherapy is the use of radiation to destroy the growth and reproduction of cancer cells, to control and destroy cancer cells. Surgery and radiotherapy are local treatments. Chemotherapy is a treatment method that uses anti-cancer drugs to inhibit cancer cell division and destroy cancer cells, referred to as chemotherapy. Endocrine therapy is to use drugs or remove endocrine glands to regulate the endocrine function of the body and reduce the secretion of endocrine hormones to achieve the purpose of treating breast cancer. Molecular targeted therapy is one of the most active research fields in recent years. Compared with chemotherapeutic drugs, it is a new type of anti-tumor therapy with multiple links of action. Traditional Chinese medicine treats tumors by emphasizing the principles of regulation and balance, restoring and enhancing the disease resistance inside the body, so as to achieve the goal of yin-yang balance treatment of tumors. Chemotherapy, endocrine therapy, targeted therapy and traditional Chinese medicine treatment are all systemic treatments. During the treatment, doctors will take into account the local treatment and systemic treatment of patients, strive for cure for patients with early and mid-term breast cancer, extend life expectancy and improve quality of life for patients with advanced stage.

Surgery for breast cancer involves breast and axillary lymph nodes. Breast surgery includes breast-preserving surgery (breast-conserving surgery) and total mastectomy. Axillary lymph node surgery includes sentinel lymph node biopsy and axillary lymph node dissection. Breast-conserving surgery has strict surgical indications. At present, all breast cancer patients cannot perform breast-conserving surgery. Breast cancer patients who are not suitable for breast-conserving surgery also need to have their breasts removed, and doctors can use plastic surgery techniques to reconstruct the breasts. Breast reconstruction can be performed using autologous tissue or prosthesis. The breast reconstruction can be performed at the same time as the tumor removal operation, or it can be performed when the results of the review are normal after the treatment is completed.