How do you recognize breast cancer?
introduction
Breast cancer (also known as breast cancer) is the most common cancer in women.
Around 70,000 new patients fall ill in Germany every year.
In rare cases, men can also develop breast cancer. With them, however, the diagnosis is usually made much later, which leads to a worsening of the prognosis, because, as with most other types of cancer, an early diagnosis and an early initiation of therapy improve survival time many times over.
As a rule, breast cancer means a malignant degeneration of the breast tissue that should be surgically removed.
However, not every structural change in the breast (lump) is a definite indication of the presence of breast cancer. If a lump in the breast tissue is palpable, it is usually due to a benign cause. It is particularly often a so-called cyst (i.e. a fluid-filled cavity in the glandular lobe), which, however, does not significantly increase the risk of breast cancer.
However, a clear diagnosis can only be made by the gynecologist after a closer examination, imaging (ultrasound, mammography, MRT) and possibly taking a tissue sample (breast biopsy).
In order to be able to notice a change in the breast tissue at an early stage, it is advisable to palpate your own breast regularly or have your partner palpate it. The most suitable point in the woman's cycle for this is about one week after the start of the menstrual period. At this time, the breast tissue is particularly soft due to hormones.
In addition, women between 50 and 69 years of age have the option of using mammography screening every two years, during which the breast is x-rayed for structural changes. This examination is voluntary and is covered by the statutory health insurance.
There are therefore numerous procedures with the aim of diagnosing breast cancer as early as possible and initiating treatment. As a patient, however, one must never forget that a palpable lump in the breast or a conspicuous mammography image alone do not constitute evidence of malignant breast cancer, but that this always requires further diagnostics.
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Symptoms of breast cancer
In the early stages of breast cancer, symptoms are usually hardly noticed. However, above a certain tumor size, a nodular change in the breast tissue can often be felt.
But not every lump in the breast has to be malignant. In the majority of cases, this is just a benign cyst (a fluid-filled cavity in the lobule of the gland). In the case of more advanced breast cancer, however, significantly more symptoms can be described, some of which are also visible from the outside. Among other things, a new size difference between the right and left breasts or a retracted nipple (nipple) can become noticeable.
A discharge of secretion or blood from the nipple also indicates a change in the mammary gland tissue. If the cancer has already spread via the lymphatic system, there may also be a palpable enlargement of the lymph nodes in the armpit region.
But even if all these symptoms are present, breast cancer has not yet been proven.
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node
Breast cancer can often be felt from the outside as a kind of lump, but not every palpable lump indicates the presence of breast cancer. In most cases, the cause of the lump is simply a harmless, non-malignant cyst that doesn't even require therapy. But sometimes it is also a malicious change.
However, no reliable statement can be made about the malignancy of the nodule by just touching it. However, its movability can provide a first indication. If a lump can hardly be moved, this can indicate that it is growing in and growing into the surrounding tissue, which would rather suggest a malignant process. A precise differentiation between benign and malignant, however, is only possible with a mammography in combination with a tissue removal.
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Pain
Pain is not a typical sign of breast cancer. In most cases, this is just a hormone-related, cycle-dependent pulling in the breast.
During the cycle there is an increase in the concentration of estrogen (estrogen is the female sex hormone), which causes fluid to be stored in the breast tissue and the breasts to increase in size and weight.
This can cause stretching pain, which should, however, show improvement with the onset of the menstrual period, before which the estrogen level drops again. Even if the pain is not cycle-dependent, this is by no means a sure sign of breast cancer.
Only a very advanced tumor that displaces the surrounding tissue can cause chest pain. Affected women usually describe these as suddenly occurring and increasing in strength. But even this pain is only suspect in combination with other symptoms typical of breast cancer.
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How Sure Is Breast Cancer To Be Detected By Ultrasound?
Ultrasound is not suitable as the sole means of detecting breast cancer. It is initially used in women under 40 to rule out benign changes. These can be shown particularly well in the ultrasound. However, if breast cancer is suspected, a mammogram must also be performed. Since tumors under 5mm and small calcifications that speak for a tumor cannot be detected using ultrasound, it is only useful as an additional diagnostic tool, but not as a sole diagnostic tool.
Read more on the subject at: Ultrasound of the breast
How Sure Is Breast Cancer To Be Detected By Mammography?
An X-ray examination of the breast (mammography) is the only method that allows early detection of breast cancer. Even the smallest calcifications and small tissue changes can be shown during the examination. However, it is often impossible to distinguish between benign and malignant changes. Even with younger women, the images are less meaningful due to the higher tissue density of the breast. In spite of everything, mammography can detect 85-90% of all breast cancer patients.
Read more on the subject at: Mammography
Can you detect breast cancer from a blood test?
A blood test to diagnose breast cancer is not used. There are no markers or values in the blood that unequivocally identify breast cancer. Blood tests are used for other purposes.
An inflammatory reaction can be recognized by altered markers such as CRP, sedimentation rate and leukocytes. Even if a genetic burden is suspected, a mutation in the BRCA gene, for example, can indicate an increased risk of the disease. In addition, blood tests are used to assess the success of the therapy or growing metastases.
MRI for breast cancer
MRI (magnetic resonance imaging, breast MRI, magnetic resonance imaging) is not one of the standard procedures in breast cancer diagnosis.
It is primarily used when the other imaging methods, mammography and ultrasound, have not been able to provide a clear result. Since this method enables the body to be viewed in longitudinal and cross-sections, an avoidable tumor can be assessed particularly well in terms of its size and location.
But even the MRI is not error-free. It is very sensitive, but this leads to a decrease in its specificity. The specificity indicates how many false positives (a cancer is diagnosed, although none is present) results. MRI is only the method of first choice for early detection in very young patients with a greatly increased risk of cancer, as mammography is often not very meaningful due to the very dense breast tissue in them.
How sure is it to detect breast cancer with a breast MRI?
An MRI of the breast is also only used in addition to mammography. This is primarily due to the cost of this investigation. Recent studies have shown that MRI is superior to mammography and diagnoses more patients with breast cancer. At the moment, however, the MRI is only used for certain indications. These include patients with dense breast tissue, multiple suspicious areas in the breast, or an unclear spread of the tumor.
Read more on the subject at: MRI of the breast and MRI for breast cancer
Can you detect breast cancer despite silicone?
All screening tests can also be performed on women with silicone breast implants. The implants do not prevent the palpation examination and the most common screening method, mammography, from being carried out. The implants are always located under the glandular tissue of the breast in which the cancer is developing. Although the silicone hides the underlying structures on the X-ray, the crucial part can be shown.
In mammography, the breast must be compressed between two plates. This is often not possible with implants because there is a risk of damaging them. In order to still ensure a good overview, more than the two usual recordings may have to be made. If the findings are still too imprecise, further examinations such as ultrasound can be referred to (see also: Ultrasound of the breast) or magnetic resonance imaging (see also: MRI of the chest) can be used.
Breast cancer during pregnancy
The occurrence of breast cancer during pregnancy is possible in principle, but is still rarely the case. Due to the many changing hormone concentrations during pregnancy, there is a change in the mammary gland tissue.
The breast grows and swells, preparing itself to be able to supply the newborn with breast milk after delivery. This is the reason why a lump in the breast is often felt much later (5-15 months later) than in women who are not pregnant.
The later diagnosis can mean that more aggressive therapy methods have to be chosen or that the prognosis worsens. Most women who develop breast cancer are between 32 and 38 years old. In addition, more and more women are becoming mothers as they get older.
In combination, this means an increase in breast cancer cases in pregnant women over the next few years. Nevertheless, one should always be aware that a structural change in the breast tissue during pregnancy is usually completely normal and is not a cause for concern. If you want certainty, it is possible to ask the gynecologist for a more detailed examination.
Breast cancer in men
The occurrence of breast cancer in men is rare, but it cannot be ruled out. As a rule, a change in the tissue in the male breast can be felt at an early stage due to the significantly lower fat and glandular content, which enables a diagnosis to be made at an early stage.
In this way, therapy can be started quickly, which significantly improves the prognosis. But many men do not know that they can also develop breast cancer, which means that they do not have regular self-scanning of the breast. If there is a lump, it is usually only detected late, which explains the overall poorer survival rate of the man with breast cancer compared to a breast cancer patient.
The same applies to both men and women: Your own breast should be scanned regularly so that possible changes can be recognized and treated at an early stage.
Read more on the topic: How do I recognize breast cancer in men?
How do you recognize breast cancer in men?
In men, palpable changes can often be recognized earlier than in women. These include lumps, ulcers, nipple retractions, or discharge from the mammary gland. As with women, a mammogram and an ultrasound examination of the breast are performed for diagnosis. However, since men have denser breast tissue, these tests are not always meaningful. A reliable diagnosis is only a sample of the suspicious region (biopsy). An MRI should also be performed to show whether the cancer has already grown into the chest wall. A skeletal scintigraphy to rule out bone metastases is also useful.
