Breast Cancer
Breast Cancer in Figures
Breast cancer is an uncontrolled proliferation of tumoural cells in the cells forming the milk glands and ducts, which starts with a wide variety of predisposing factors and has the potential to spread throughout the body. Breast cancer is the most common type of cancer in women and the most common cause of female cancer deaths in our country. It is thought that 1 in every 8 women will develop breast cancer at some point in her life. The incidence of breast cancer in our country is 35 per 100.000. It is the 1st leading cause of cancer deaths between the ages of 40-55. If it is caught at an early stage, the chance of treatment is high.
What can we do for early diagnosis?
Early diagnosis and treatment is the most effective way to reduce the mortality rate and achieve quality life in breast cancer.
In the 20-39 age range, monthly breast self-examination and a specialist doctor's examination once a year and imaging examinations if deemed necessary are appropriate.
In patients over 40 years of age, monthly breast self-examination, once a year examination by a specialist doctor, once a year mammography; additional examinations are appropriate if necessary.
Breast self-examination should be performed 5-7 days after the onset of menstruation in menstruating women and on certain days of each month in non-menstruating women.
What are the Risk Factors for Breast Cancer?
Age, female gender, genetic factors (%5-10), white race, dense breast tissue, history of other cancers (such as uterus, ovary), precancerous lesions in the breast, early onset of menstruation, late menopause, not giving birth, having given birth for the first time after the age of 30, birth control medications, hormone treatments, obesity, alcohol-cigarette use, not exercising, eating habits (eating too fatty...etc) are the main risk factors.
What are the Symptoms of Breast Cancer?
Palpable mass in the breast or armpit
Nipple discharge
Inward retraction of the nipple, deformity, wounds on the nipple skin, scaling
Wound on the breast skin
Redness of the breast skin, oedema
Unilateral breast enlargement, deformity
Imaging
In addition to self-examination and clinical examination, imaging methods are used for the early detection of breast cancer.
Mammography is the most basic method. The radiation dose given in mammography is very low and the benefit is more than the harm.
Breast ultrasonography is used as the first examination method in young women or as an adjunct to mammography.
Breast MRI is used for further imaging.
Biopsy
When suspicious findings are detected in the breast, a needle biopsy or surgical removal of the area is necessary to make a diagnosis.
Needle Biopsies
Needle biopsy is performed in the radiology clinic under the guidance of imaging methods. Needle biopsies can be performed under ultrasonography, mammography or MRI guidance. Pathological findings after the procedure are reported as benign, suspicious (atypical) or malignant.
Needle biopsies can be performed as Fine Needle Aspiration biopsy, cutting needle biopsy, vacuum biopsy and MR guided biopsy according to the characteristics and visibility of the suspicious area.
Marking
When it comes to the surgical removal of suspicious areas that are detected by imaging methods and cannot be found manually in clinical examination, it is necessary to mark the area beforehand so that the area can be found during surgery. The marking process is performed with wire or radioactive material.
Staging in Breast Cancer
Determination of the treatment scheme and prediction of the chances of cure are possible with the staging of the disease.
Stage 0 (carcinoma in situ):
Cancer cells are limited in the breast and have no potential to spread.
Phase I
Cancer cells have gained the potential to spread, but are confined to the breast
Stage IIA:
Increased in size and/or spread to the lymph nodes.
Phase III
It has spread to the surrounding lymph nodes or structures in the area.
Phase IV
The cancer has spread to distant organs in the body (bone, liver, lung, brain).
Surgical Treatment in Breast Cancer
The type of cancer has no influence on staging and surgical strategy. Surgically, all breast cancers are treated with the same principle regardless of their type and subtype. In early stage breast cancer, surgery is the first-line treatment unless otherwise indicated. In current surgical treatment, part or all of the affected organ is removed and axillary lymph node sampling is performed. Thus, staging is performed.
Breast Conserving Surgery
In early stage breast tumours, the tumoural tissue is removed together with the surrounding tumour-free breast tissue of sufficient width.
Mastectomy
Today, it is preferred in cases where breast-conserving surgery is not appropriate, in cases with multifocal disease in the breast. It can be performed for preventive purposes in patients with genetic risk, as well as skin-sparing, nipple-sparing mastectomy in selected patients and simultaneous implant surgery is performed.
Armpit Interventions
Sentinel Lymph Node Biopsy
Breast cancer cells most frequently spread to the axillary lymph nodes. Special dye or nuclear material is used to remove the lymph nodes that the breast tumour first reaches. If there is no disease in these nodes, no additional intervention is performed in the armpit, if there is disease, most of the axillary lymph nodes are removed.
Axillary Dissection
In case of disease in the patient's axillary lymph nodes, it is the procedure of removing most of the axillary lymph nodes.
Oncoplastic Breast Surgery
Today, simultaneous or late reconstruction is performed after all breast cancer surgeries. For this purpose, either the patient's own breast tissue is reshaped and used, or her own muscle and skin plans are used to form a breast round or prosthetic materials are used. At the same time, interventions to ensure symmetry with the contralateral breast are planned.
43 Comments
Gökçen andaç
January 16, 2023Hello Hocam, my sister has a 10 * 3 mass in my sister, it has spread to the axillary lymph, she said that it is in 3 stages, the doctor asked for pathology, but this result is 1 month in the state hospital, we are looking for a place that will come out immediately in private, but we are worried about whether there will be a more troublesome situation by having a biopsy 2 times, please help us.
Op. Dr. Gülden Ballı
March 16, 2023First of all, get well soon. Repeated biopsy does not cause the disease to progress. However, if the diagnosis is confirmed, treatment should be started as soon as possible. You need to see a general surgeon as soon as possible.
G.Karataş
July 21, 2022Hello Ms. Gülden, I am 41 years old, widespread cysts have been detected in both breasts for approximately 8-10 years, drug treatment is not applied, controls are performed at 6-month intervals, colour MR is taken because mammography is insufficient due to dense breast density, sometimes fibroadenoma, sometimes solid lesion etc. It is named, there were times when needle biopsy was considered, but it was postponed to the next 6th month and abandoned (pandemic intervened, etc.). Mastitis has occurred twice, severe pain, these cysts that grow from time to time negatively affect my daily life. In the last MRI taken in August last year, T1 low - T2 High sequence lesions were diagnosed, ultrasound follow-up was recommended. I did not go to the doctor again. 2 aunts on my father's side have breast cancer, one of them passed away, the other aunt had one breast removed, the other breast was positive and is receiving chemotherapy. Since it was said that the genes were taken by the mother, it was said that it did not pose a risk. About 10 days ago, I noticed a new mass in the left breast that was painful when pressed, very hard and 4-5 cm in size. (I came out of the menstrual period 5 days ago). I was followed up in the same general surgeon at the traffic hospital, but I don't want to go to the doctor because I'm tired of finding an appointment at the hospital, waiting for days for ultrasound + mammography + MRI procedures, and getting radiation and entering the cycle I've been through many times that will be postponed again 6 months later. Since I can't afford private financially, I want to wait and follow its shrinkage on its own. Can you make a different direction as a specialist physician? Previously, a physician mentioned protective breast surgery, do you think this is necessary? Thank you for your time.
Op. Dr. Gülden Ballı
August 26, 2022Hello, first of all, get well soon. It is not appropriate to follow the current new finding in this way without evaluation. If a re-evaluation and a mass is detected in this area, it is absolutely appropriate to perform a biopsy. It is for your safety that follow-up and controls in the breast are done in this way. I think you can find an appointment at the education-research hospitals (Yeşilyurt, Bozyaka, Tepecik). On the other hand, preventive surgeries are performed in patients with gene positivity. Please do not neglect your control Have a healthy day.
Eda Gngr
July 10, 2022Hello, I have hardening in my breast for a long time. There are also pains and weakness in the body, what do you think it could be or which doctor should I consult.
Op. Dr. Gülden Ballı
August 26, 2022Hello to you. First of all, get well soon. I strongly recommend that you consult a general surgeon experienced in breast diseases. I wish you a healthy day.
nimet alaçam
June 28, 2022Hello teacher, I'm 51 years old. I have breast discharge for a long time. 1 year ago, I had a mammogram, but the last time I saw blood, I saw 1-2 drops of blood. they took fluid and sent it to pathology and the result was: in the inlenema of both smear preparations, a few squamous epithelial cells were observed on a clean ground, and no secretory material or histiocytes were detected on the smear ground that could reflect the discharge fluid from the nipple. What do you mean, please comment, teacher, thanks in advance
Op. Dr. Gülden Ballı
August 26, 2022Hello to you. First of all, get well soon. These findings are not sufficient to diagnose any disease. If your discharge continues, it may be necessary to re-evaluate, further examination, perhaps biopsy. I wish you a healthy day.
Özge Kavaklı
March 25, 2022Brads5 is a definite cancer test subject
Op. Dr. Gülden Ballı
April 20, 2022Without a biopsy result, no disease can be called cancer. However, a BIRADS5 mass is often diagnosed as a malignant disease.
Mustafa
December 22, 2021There is an irregularly contoured hypoechoic solid lesion measuring 11 × 8 × 8 × 7 mm at a distance of 5-6 cm from the areola at the left breast 2 o'clock level, you can open it to us, sir, good or bad. Thanks in advance
Op. Dr. Gülden Ballı
December 24, 2021Hello, first of all, get well soon. In order to comment on the disease, we need to know all the details. Such as your age, family history, the result of manual examination by a specialist and all other examinations. The mass described here may require a biopsy after detailed evaluation. For this reason, we recommend that you quickly see a general surgeon specialised in breast cancer. If you would like to continue your diagnosis and treatment process with us, you can contact my assistant on 0(546)4328384 for appointment and all details. I wish you a healthy day.
Hülya UYUMUŞ
December 11, 2021Merhaba Hocam Yaklaşık 19mm×11mm büyüklüğündeki kitle ER(%10) PR(%3) cerbB2(+3) ki67 (%15) p53(%1) AR(%50) E.cadherin (diffüz) panCK ile pozitif boyanma izlenmistir P63 _CD10 _Kromogranin _ sinaptofizin_ CD56 ile boyama izlenmemistir Tani :Intraduktal komponeti belirgin invaziv duktal karsinom Hocam benim de raporumu inceleyebilir misiniz? Teşekkür ederim
Op. Dr. Gülden Ballı
December 11, 2021Hello, first of all, get well soon. In order to comment on the disease, we need to know all the details. In oncological diseases, evaluation only by looking at the pathology result may cause misinterpretations. Please send all your examinations (Mammography, Ultrasound, Biopsy; body screening tests, if performed) to info@guldenballi.com.tr. I wish you a healthy day.
Kadir
December 7, 2021cerb-B2 (+3)
Op. Dr. Gülden Ballı
December 9, 2021Hello. The value you specified is an immunohistochemical marker used in breast cancer. We kindly ask you to send us detailed information so that we can help you with your question. with our regards.
Arzu Ayaz
January 5, 2022Hello good evening doctor, I had an operation from the left breast two years ago, they removed 14 cm of fibroanedom from the place we call 2 cm, but after 3 months it came out again, but it came out again in the right breast in 6 months, the parcels that came out were called grape vineyard koplike, I was again taken memgraphy, but they gave utrasound to 4 February, I wonder if you look at the memngrafileei, I wonder if you can look at my armpit veins, I am worried about the fog along my armpit veins, doctor, can you help me thank you.
Op. Dr. Gülden Ballı
January 10, 2022Mrs Arzu, first of all, get well soon. Fibroadenomas are benign breast masses, but your current picture suggests complicated Fibroadenomatosis or Filloides disease. It would not be correct to make a judgement only with mammography; it would be appropriate to have a general surgical examination and ultrasound, and if necessary, evaluation with MRI. You can send your mammograms to info@guldenballi.com.tr. I wish you a healthy day.
Op. Dr. Gülden Ballı
January 10, 2022Mrs Arzu, first of all, get well soon. Fibroadenomas are benign breast masses, but your current picture suggests complicated Fibroadenomatosis or Filloides disease. It would not be correct to make a judgement only with mammography; it would be appropriate to have a general surgical examination and ultrasound, and if necessary, evaluation with MRI. You can send your mammograms to info@guldenballi.com.tr. I wish you a healthy day.
ezgi kocabıyık
November 20, 2021hello doctor lady, when a mass was detected in my mother's breast, a thick needle biopsy was performed first. the result came out clean. our doctor said let's take them all and have peace of mind. when he took them all and sent them, the result was bad, it was called tumour. as a result of the biopsy, it says 1 mm away from the borders. do you think it should be operated again or should it be decided whether to perform surgery as a result of pad screening mammography. thank you in advance
Op. Dr. Gülden Ballı
November 20, 2021Hello Mrs Ezgi, first of all, get well soon. Surgical intervention for your mother's tumour is sufficient as a limit. However, underarm gland sampling is necessary. The PET examination taken before this may be guiding us, but it does not exclude the need for underarm sampling. Therefore, you should definitely consult your general surgeon. If you have any difficulties in the process, we would be honoured to help you.
Aylin gülüm
November 20, 2021Hello good day my name is aylin I have lymph nodes in my breast what should I do
Op. Dr. Gülden Ballı
November 20, 2021Hello Mrs Aylin, lymph nodes in the breast are usually benign. However, it is necessary to evaluate whether this is caused by another disease. A general surgical examination and existing examinations should be reviewed. Get well soon
Fatih Karakaş
November 2, 2021My wife's breast was diagnosed with mastitis, what can we do?
Op. Dr. Gülden Ballı
November 7, 2021Hello Fatih bey, first of all get well soon. It would not be appropriate to make a recommendation without examination and necessary examinations. It is appropriate to continue the general surgery doctor's examination and treatment-follow-up in competent hands at the first opportunity. If you are in Izmir, we are ready to do whatever it takes to help you in our clinic. You can reach my assistant on 0(546)4328384 for appointment and all details. I wish you a healthy day.
ilknur albayrak
May 6, 2022Hello Mrs Gülden, I have a pain in my left breast for about 6 months and it hits my left arm a lot, sometimes I can't stand the pain, what should I do?
Op. Dr. Gülden Ballı
May 26, 2022Hello. First of all, get well soon. You should definitely be examined first, and you should not neglect to have the examinations appropriate to your age and recommended by your physician.
AYGÜL AYDEMİR
January 21, 2021MRB I HAD PAIN AND A LOT OF GROWTH IN MY CHEST, MY BACK PAIN AND MY CHEST BEES INCREASED, MY SIMPLE CYSTS WITH A DIAMETER OF 5MM CAME OUT, HOW CAN I BE TREATED?
Op. Dr. Gülden Ballı
January 21, 2021Hello Aygül Hanım, breast cyst complaint is a common discomfort in women. First of all, do not worry. What to do can be decided after your age, risk factors and examination. However, make an appointment with a general surgery doctor experienced in breast surgery and have your controls done. If you want to meet with us, you can contact my assistant on 0 (546) 4328384 and make an appointment. Get well soon
Zübeyde Onarın
December 27, 2020Hello doctor, there is a 4-5 day pain in the left breast, what do you think I should do? It is very risky to go to hospitals in the pandemic. Thank you in advance.
Op. Dr. Gülden Ballı
January 8, 2021Hello Zübeyde Hanım, breast pain is a common complaint in women. First of all, do not worry. Most of the time there is no significant problem. However, make an appointment with a general surgery doctor experienced in breast surgery and have your controls done. If you want to meet with us, you can contact my assistant on 0 (546) 4328384 and make an appointment. Get well soon
Arife BILGIC
December 12, 2020Does Brads 4 definitely mean cancer?
Op. Dr. Gülden Ballı
December 12, 2020Cancer risk is increased in BIRADS-4 lesions compared to normal. However, not every patient has cancer. This needs to be confirmed by examination, imaging and biopsy. Get well soon
duygu gller
May 31, 2022hello biradas 3 came out, but my doctor said that I need to have a biopsy, but does a biopsy need to be done at this stage?
duygu gller
June 5, 2022available left lymph adenomegaly with reactive lymphadenomegaly with a size of 14 mm in the right axillary area and 16.5 mm in the left axillary area
Yüksel Arslan
August 27, 2022They said that the Bı-rads 0 would need additional tests. After 10 days, can there be a delay for this situation?
Op. Dr. Gülden Ballı
September 2, 2022Hello. First of all, get well soon Further investigation required However, in order to assess the urgency of the emergency, it is necessary to see the examination of the current situation and the tests performed.
Op. Dr. Gülden Ballı
June 24, 2022As I mentioned in previous comments, diagnosis and treatment decision requires detailed evaluation. Therefore, follow the recommendations of your physician. We wish you a healthy day.
Op. Dr. Gülden Ballı
June 1, 2022Hello. First of all, get well soon Biopsy decision, It is a decision to be made after a detailed evaluation of all your risk factors, examinations and tests. Please follow the recommendations of your physician. We wish you a healthy day
Burcu
September 23, 2022What is an egg-sized mass growing under the nipple?
Op. Dr. Gülden Ballı
October 6, 2022Hello. First of all, get well soon. I recommend that you have a general surgery examination as soon as possible and have the appropriate examinations for your age.
çilem akgün
November 20, 2020Well, if the cancer cells have gone up to the bone marrow, does it end with chemotherapy or what are the consequences?
Op. Dr. Gülden Ballı
December 12, 20204. Treatment response in stage 4 disease varies according to the patient. It is not possible to give an opinion without evaluating all your examinations. Get well soon