notes by dr Claudio Italiano
You have noticed that in your breast there is an hard area inside, but also your mother had a breast injury (!); we are talking about a lump, as if it were a ball as a nut, that if you touch it hurts, it is hard, it seems like glued inside the breast, under the skin and does not move: go immediately to your doctor and talk to him!
Request exams, for ex. a mammogram, an ultrasound or even a breast resonance if
there are doubts, even if your doctor agrees.
Then go to a specialist center: do
not be satisfied if a doctor told you not to worry and repeat an ultrasound
examination or mammogram in 6 months; if you have doubts proceed and do
something, take another opinion!
I know one of my patients who had breast pain,
right after the cycle; she had performed a mammographic investigation that
documented a nodule under the nipple, but her doctor only prescribed controls.
Having come to the Policlinic and having visited with a specialist, this had
decided to intervene: it was evidently an early tumor.
Moral of the story: the
patient had spared her breast from amputation, even if the axillary lymph nodes
were already taken from the tumor. Just in time!
See the resonance, that the lady had performed, look at the arrow, and reflect! That's an early cancer !
The incidence of breast cancer in Italy is about 36,000 new cases a year and the age group is that of women over the age of 60 with a frequency about 10 times higher in these women than in younger women. Breast cancer typically appears after age 45.
The most mature women
Women who did a biopsy of a dysplastic nodule, ie with a tendency to develop
cancer
Women who often undergo chest radiographs (eg, tuberculosis)
Obese women, smokers, alcoholics
Women with ovarian cancer
Women who use post-menopausal estrogenic therapy (low risk)
Women with premature menarche
Women with late menopause over 55
Women who did not have pregnancies
Postmenopausal obesity
Women who have had children after the age of thirty
see >> Benign mammary lesions and
cancer
- fibroadenoma
- the adenosis (hard, flat knot, of variable size),
- papillomas (hard, single or multiple knots, generally small),
- the cysts (rounded, single or multiple forms, full of liquid, with the typical
consistency of the balloon filled with water).
- Benign tumor nodules.
Surely at the clinic or by the surgeon or gynecologist.
The prevention of breast cancer is based on counseling by the Center of
reference, ie taking charge, whose objectives are:
Determine the exact nature of the problem
Solve a situation of existential and / or relational uneasiness
Execution in the time of diagnostic / therapeutic protocols
Do not lose patient and patience!
Get excellent results in a short time
No control in women under 40;
From 40 to 50 years the diagnostic test with a preventive purpose, for example a
mammogram every 12-18 months, clinical examination + mammary ultrasound;
In the elderly woman with more than 50 years participation in screening programs
or a periodic check every 24 months.
The above expressed is certainly related to hormones that act on the breast, ie
estrogen and progesterone
Breast cancer can be hormone-dependent, that is, to be affected by hormonal
action, which is especially possible in the premenopausal phase of a woman's
life. Estradiol, a prototype of estrogens, induces the growth of the mammary
ducts and epithelial cells that coat them internally, stimulating the formation
of new blood vessels and the permeability of the surrounding tissue. The action
of estrogen explains the increase in breast volume during the menstrual cycle
and the possible appearance of breast pain in women in whom estrogen stimulation
is excessive.
• Progesterone is produced by the ovary after ovulation and its most important
action on the breast is to promote growth and differentiation of the berries
(the structures in which milk is produced) and to prepare them for the secretory
function, ie milk production.
• Prolactin is a hormone promoter of breast growth along with estrogen.
In the daily practice of senology the "mammary nodule" is a very frequent expression, it must evoke suspicion but not concern. Certainly you must contact the specialist or the surgeon or gynecologist or simply your doctor to make a diagnosis of nature, to know what it is. A nodule should not be misleading, it is not necessary immediately to think of the worst because the breast is a glandular structure made of many berries that can give the idea of nodules, More acini form the lobules and these lobes, held together by connective tissue. When the breast is young, if it is small and thin, or if the fat tissue is scarce, you may have the sensation of many small balls (nodules) of various sizes. On the other hand, if the young breast is rich in connective tissue and fat tissue, its nodular structure differs little. The nodular structure, on the other hand, is very evident during pregnancy, because the growth of the berries, which are the site of the formation of the elements of the mother's milk, occurs above all. In menopause the tissue that forms the gland is progressively disappearing and in its place the fat tissue increases (even the glandular nodules are reduced, but nodules of fat can appear). Therefore during the course of the breast the breast undergoes a continuous transformation of its nodular structure: every month, in relation to the hormonal cycle, over the years, according to fertility and maternity.
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