The breast is an organ composed of glandular tissue and fat, positioned between the skin and the wall of the chest. Actually, it isn’t a single gland, but a set of glandular structures called lobules, which together form a lobe. There are 15 to 20 lobes in a breast.
Breast cancer is the most common cancer in the female population: 1 in 8 women will be affected by this disease in their lifetime.
Exceptional under 20 years old, rare between 20 and 29 years old, it becomes more common after age 30 and reaches the highest incidence between 45 and 60 years old, showing a relative increase with age.
It arises most frequently in the following:
the glandular cells of the lobules, lobular adenocarcinomas
in cells lining the walls of the ducts, ductal adenocarcinomas
There are non invasive forms, in situ and invasive forms and infiltrative ones.
Age: the probability of getting cancer increases with age; more than 80% of cases are women over 50 years old. Positive personal history: a woman who has already had a tumor is more likely to develop another.
A positive family history: around 10% of women have more than one close family member with the disease, especially in younger women. The risk of developing cancer increases if her mother, aunt, sister have already been affected by the disease
Genetic factors: some genes, such as BRCA1 and BRCA2 predispose this type of disease. These genes are responsible for about 50% of hereditary forms of breast and ovarian cancer.
Hormones: It is shown that a high level of circulating estrogen facilitates the appearance of breast cancer. For this reason, late menarche, pregnancy and menopause have a protective effect while hormone therapy after menopause increases the risk.
Previous radiation therapy to the chest
Abnormal cell: the atypical hyperplasia of mammary cells increases the risk of cancer
Race: White women are more exposed
Obesity: it is a predisposing factor
Lifestyles: a sedentary lifestyle, a high-fat diet, smoking habits, and alcohol abuse all have negative effects.
SIGNS AND SYMPTOMS:
Pain: Typically the initial forms do not cause pain. A study of nearly a thousand women with breast pain showed that only 0.4% of them had a malignant lesion, while benign lesions (such as cysts) were present in 12.3% and there was no injury in the rest of the cases.
Nodule: it is the most common symptom of cancer. If it is hard, painless and irregular, it is more likely to be malignant.
Swelling, warmth and redness of the skin
Alteration: the size or shape of the breast
Orange peel: irregularly wrinkled skin and rippling
Itching or erythema of the nipple and/or areola
Nipple discharge (if the loss is bilateral in most cases the cause is hormonal)
Self-examination is the first useful tool for raising prevention awareness in women. Every woman should learn to know their own body, checking their breasts on a monthly basis in order to perceive even the smallest of changes. It is certainly a useful method that makes woman an active participant; although it does not replace (especially in the absence of signs and symptoms) the importance of a specialist clinical examination together with instrumental examinations (ultrasound and / or mammography) depending on the age or needs of the case.
HOW TO PERFORM A BREAST SELF-EXAMINATION:
establish one day a month to perform the examination (at the end of the menstrual cycle or on a fixed day for postmenopausal women)
stand in front of the mirror, back straight, shoulders relaxed and arms hanging down the body, then continue the observation by lifting the arms up and finally resting them against the hips.
observe the symmetry, shape, size of the breast and skin appearance in these different positions. It is a good idea to examine ourselves face on and in profile.
- check that there are no irregularities in the nipple (retraction / introflections, eczema, cracked nipples), tumefaction and visible swellings (nodules that alter the breast profile), skin changes (redness, rash, orange peel retractions)
- with the arm behind your head, gently perform palpation with your hand flat. Use circular concentric movements, examining the entire breast and paying special attention to the upper-outer quadrant and the the armpit
- continue with movements of the hand from the outside towards the inside, from the top down and from the bottom upwards
- tighten the nipple gently between thumb and forefinger and evaluate the presence of any secretions
- repeat the same maneuver by lying down with your hand under your head and with a pillow under the shoulder of the examined side
Early detection of breast cancer, however, is designed to intercept the disease in its preclinical stage, i.e. before the onset of the signs and symptoms listed above; this is why it is essential to regularly undergo specialized clinical and instrumental checkups, indicated according to the age and / or the necessity of the case
The basic diagnostic program promoted by the ANT Foundation related to breast cancer provides the following:
CLINICAL BREAST EXAMINATION
clinical examination performed by a breast specialist after obtaining all the patient’s medical history (personal information, family members) with an assessment of possible risk factors.
The check-up consists of a careful clinical examination of the breast and axillary region, which follows an instrumental examination of the patient
morphological examination with ultrasound of the mammary gland which enables the identification and characterization of breast nodules. It is the preferred choice in young women or those with dense breasts, regardless of age, with a predominantly glandular component. It can be a guide for interventional procedures (cyst aspiration, fine needle aspiration for cytological withdrawal)
a radiological morphological examination generally used (in the absence of other information) with women over 45. It provides information on the gland and axilla allowing for the identification of suspicious lesions as well as those non-palpable. It has the highest sensitivity in women with prevalent breast adiposity.
At the ANT Foundation Breast Center, this course is integrated along with other instrumental examinations:
DOBI ComfortScan System: a functional test that identifies the presence of any areas of mammary angiogenesis. The scan evaluates the elective capacity of deoxyhemoglobin to pick up monochromatic red light emitted by the instrument. The oxygen-poor hemoglobin is found in greater quantities in the capillary network of a neoplasm rather than in the normal glandular tissue, a result of the compression exerted by a silicone membrane. The DOBI scan finds any abnormal temporal variation in the concentration of deoxyhemoglobin allowing it to identify any suspicious areas.
DATG (dynamic angiothermography): This technique uses an instrument that records the temperature change of the breast due to the presence of new blood vessels (angiogenesis). The basis of the idea is that every woman has her own vascularization pattern, a sort of fingerprint, which under normal conditions does not change over her lifetime; on the contrary, any alteration may indicate a suspect tumor or pre-cancerous lesion.
The MAMMARY PROJECT aims to perform early diagnoses of suspicious lesions, allowing for an intervention in the most appropriate and timely way possible
Checkups are performed by appointment at the clinics listed below. They are free of charge thanks to funds / resources / donations that the Foundation is able to devote to this sector.
ANT Institute in Bologna
private facilities within the national territory which ANT has a special agreement with regarding employees, consultants and associates.