BREAST CANCER BASE

1. History : mass is often the first symptom of breast cancer patients, need to ask the prescribed period of time, location, size, fast growth, slow and has recently changed, pain, pain in nature. Nipple erosion, discharge time and discharge characteristics. Axillary for lumps, a merger of pregnancy and lactation. Menstrual history and family history.

2. Examination : First comprehensive inspection began, the attention of thoracic, abdominal, pelvic, the skeleton of the road transfer. Then breast examination, breast examination should first check the contralateral side, the affected after the investigation. The order should check carefully. As the consultation should pay attention to whether bilateral breast symmetrical shape is not abnormal, there inflammatory skin changes and orange peel-like edema. Palpation finger-touch, breast examinations, investigations arm across the head with a half breast, arm hang down outside investigation breast half, when lumps found by the three bands, recorded four quadrant position, the nature of the mass and activity described in detail. Areola and oppression, whether discharge from a liquid discharge, should record the nature of liquid. Check supraclavicular lymph nodes, attention should be given sternoclavicular papillary muscles starting Zhi outposts deep lymph nodes. Axillary lymph node examination will be hand raised in patients with upper arm with the other hand, according to the armpit, then lay down their arm, holding hands with the elbow, inspection of axillary lymph nodes, lymph node under the clavicle, a breast coverage, difficult to identify, a number of lymph node metastasis, inconsistent satiated.

3. X-ray examination : Breast camera is a common diagnosis of breast cancer, a common disease in the breast x ray films on the general performance can be divided into lumps or nodules, calcifications and skin thickening levy group, catheter video and so on. Masses of high-density, edge a burr signs in the diagnosis of great help. Burr longer than when the lesion diameter lesions called astrocytes. X-ray film showed lumps often than palpation for small, hopefully signs of a vicious one. Tablets of calcifications should pay attention to its shape, size, density, taking into account the number of calcifications and distribution of. When clustered calcifications, particularly in a concentrated within centimeters of breast cancer is a very strong possibility. Calcifications more than 10 above, the vicious great possibility.

4. Ultrasound examinations : Ultrasound imaging examination without injury and can be repeated. Right dense breast tissue than those who use ultrasonic imaging examination more valuable, but the main purpose is to identify tumor-solid or cystic. Ultrasound diagnosis of breast cancer to the correct rate of 80% to 85%. Cancer invasion to the surrounding tissue and the formation of strong echo with normal breast mass destruction and the structure above the local thickening of the skin, or depression and other images, the diagnosis of breast cancer are an important indicator for reference.

5. Thermal Image Inspection : images show the surface temperature distribution, as the proliferation of cancer cells block blood supply rich corresponding surface temperature higher than the surrounding tissue, this difference can be used to make the diagnosis. But this lack of a firm diagnosis of standard images, thermal anomaly tumor site and not Correspondingly, the rate of diagnosis worse, in recent years has fewer applications.

6. Near infrared scanning : the near-infrared wavelength of 600 to 900 µ m, easily penetrating the soft tissues. Through the use of infrared breast density different organizations show that the different gray shadow, thus demonstrating breast lumps. In addition to the infrared sensitivity of hemoglobin strong, breast vascular video showed clear. Breast cancer often increases local blood supply, blood vessels near the fits, infrared have a better image, contribute to the diagnosis.

7. CT : can be used not palpable breast lesions before positioning, the preoperative diagnosis of breast cancer staging, after breast examination, axilla and internal mammary lymph node swelling, contribute to the development of treatment programs.

8. Tumor markers examination : in the process of carcinogenesis, tumor cells, secretion, direct release of tissue composition, and to antigens, enzymes, hormones and metabolites present in the form of tumor cells or body fluids of the host, said such substances tumor markers.

(1), carcinoembryonic antigen (cEA) : non-specific antigen, in many tumor and non-tumor diseases have increased, no differential diagnosis, the breast cancer surgery preoperative screening of about 20% to 30% of blood cEA content, and advanced and metastatic carcinoma were 50% ~ 70% of emerging high-value CEA.

(2) of ferritin : serum ferritin iron in vivo reflects the storage state, in many malignancies such as leukemia, pancreatic cancer, gastrointestinal cancer, breast cancer is higher ferritin.

(3) monoclonal antibody : for the diagnosis of breast cancer monoclonal antibody newborn, 15-3 on breast cancer diagnosis rate of 33. 3% to 57%.

9. Biopsy examination : a diagnosis of breast cancer must be established before beginning treatment, although many methods, but so far only from the pathological biopsy results can do only sure diagnosis.

(1) needle aspiration biopsy : needle aspiration cytology from Gutthrie established in 1921, is the development of fine-needle aspiration cytology

Check its method is simple, fast, safe and can replace some tissues frozen sections, higher positive rate of 80% ~ 90%, which can be used for anti-cancer census. If the clinical diagnosis of malignant and benign cytology report suspicious or cancer, the need to choose surgical biopsy for diagnosis.

(2) cut biopsy : Since this method is to promote the spread of cancer, generally do not advocate this method. Only in advanced cancer to determine the pathological types may consider applying.

(3) removal of biopsy : suspected malignant tumor resection of tumor and when a certain range around the organization shall be excisional biopsy, tumor from the general requirement of at least 1 cm edge about possible complete resection. The following resection specimens from a cross-section of the preliminary examination can be judged vicious : ① medullary carcinoma of the soft texture, the cut surface gray, can hemorrhage, necrosis and cavity formation; ② carcinoma of the hard cut surface gray, contraction-like scar flu, radiating around to lend, no capsule; ③ tube within the characteristics of cancer involving multiple catheter, or even to the nipple direction infiltration, cut surface gray, sometimes out of acne-like; ④ lobular carcinoma of the soft texture, shape and more irregular, the cut surface gray, pink, sometimes tumor block this connection only see thickening of the breast.