In recent years, the incidence of breast cancer has been increasing year by year, and has taken the first place among malignant tumors in urban women. One in seven women in European and American countries suffer from breast cancer. The average annual growth rate in China currently exceeds that of high incidence countries by 1 to 2 percentage points. According to the latest epidemiological statistics, the incidence rate of breast cancer in Shanghai has reached 56.2/100,000 in 2000. According to this projection, the incidence rate in China will gradually reach the western level in the next 30 years.
Symptoms
The main symptoms are breast lumps, breast pain, nipple overflow, nipple changes, skin changes, and enlarged axillary lymph nodes. As long as women have a strong awareness of cancer prevention, scientific and comprehensive mastery and familiarity with general knowledge of breast, serious self-examination and professional regular medical check-ups, I believe cancer is no longer an incurable disease.
Breast lumps
Breast lump is the most common symptom of breast cancer, and about 90% of patients come to the clinic with this symptom. Breast cancer lumps can be single or multiple and are hard, non-tender, with unsmooth surface, unclear borders and poor mobility. Some of them only show localized glandular thickening and no obvious lump with no clear boundary, and most of them are diagnosed as “breast enlargement”. However, a closer examination of the thickened area with a little skin adhesions should be noted and a mammogram should be performed.
Breast pain
Both benign and malignant breast tumors are usually painless. When the tumor is accompanied by inflammation, there may be swelling pain or pressure pain, and if the tumor invades the nerve, there may be stabbing pain.
Nipple discharge
Nipple discharge can be physiological or pathological. Physiological nipple overflow is mainly seen in women during pregnancy and lactation. Pathologic nipple discharge refers to the secretion of fluid from the ducts of the breast in a non-physiologic state. Nipple overflow can be caused by a variety of breast diseases and is more easily noticed by patients. It is one of the main reasons why about 10% of patients come to the clinic and is second only to breast lumps and breast pain in the incidence of various breast disease symptoms. Breast cancer patients have nipple discharge in 5-10% of cases, mostly dark bloody discharge.
Nipple changes
If breast cancer patients have abnormal nipple changes, they usually present as nipple erosion or nipple retraction.
(1) Nipple erosion: there is a typical manifestation of Paget’s disease of the breast, often accompanied by itching, and about 2/3 of patients may have lumps in the areola or other parts of the breast.
(2) Nipple retraction: When the tumor invades the nipple or subareolar area, the fibrous tissue and duct system of the breast may shorten as a result, pulling the nipple, making it depressed, deflected, or even completely retracted into the posterior areola.
Skin alteration
Skin changes caused by breast tumors are related to the location, depth and degree of invasion of the tumor, and usually have the following manifestations.
(1) Skin adhesion: When the cancer invades the suspensory ligament of breast around the tumor, it can contract and shorten, pulling the skin to form a depression, like a dimple, so it is called “dimple syndrome”. If you have this symptom, you should be alert to the possibility of breast cancer, but benign tumors rarely have this symptom.
(2) Skin edema: Because the subcutaneous lymphatic ducts of breast are blocked by tumor cells or the central area of breast is infiltrated by tumor cells, the reflux of lymphatic ducts is obstructed and lymphatic fluid accumulates in the lymphatic ducts, the skin becomes thicker and the opening of hair follicle is enlarged and deepened, showing “orange peel-like changes” (medically called “orange peel”). This is known as “orange peel”.)
In addition, advanced breast cancer can also directly invade the skin and cause ulcers, and if combined with bacterial infection, the smell is unpleasant. If the cancer cells infiltrate into the skin and grow, they may form scattered hard nodules in the skin around the main lesion, known as “skin satellite nodules”.
Lymph node enlargement in the axilla
Breast cancer can gradually develop and invade the lymphatic vessels and metastasize to their local lymphatic drainage areas. The most common site of lymphatic metastasis is the ipsilateral axillary lymph node. The number of lymph nodes increases gradually from small to large.
Breast cancer can metastasize to the contralateral axillary lymph nodes and also to the contralateral axillary lymph nodes through the intercommunication between the anterior chest wall and the internal breast lymphatic network, with an incidence of about 5%. In addition, advanced breast cancer may also have ipsilateral supraclavicular lymph node metastasis or even contralateral supraclavicular lymph node metastasis.
Areola abnormalities
In inflammatory breast cancer, the skin is inflammatory in appearance; the color ranges from pale red to deep red and is initially limited, but soon expands to most of the breast skin. Many patients misdiagnose it as inflammation of the breast, and this should be especially noted.