Clinical manifestations of breast cancer

The clinical manifestations of breast cancer are as follows:

1. Hidden breast cancer

Refers to breast cancer that cannot be felt clinically but is confirmed by pathological examination after mastectomy. It is often discovered by X-ray examination or with axillary lymph node metastasis as the first symptom, and should be differentiated from accessory breast cancer. It is generally believed that once occult breast cancer is diagnosed, if there is no supraclavicular or distant metastasis, radical surgery should be performed. Most reports show that its efficacy is better than breast cancer with axillary lymph node metastasis.

2. Male Breast Cancer

Male breast cancer is uncommon, accounting for 1% of breast cancer incidence and 0.1% of male malignant tumors. The age of onset is 6 to 11 years higher than that of female breast cancer on average. The main symptoms of male breast cancer are painless masses under the areola. 20% of patients have nipple inversion, crusting, and discharge. The boundaries of the masses are often unclear, and there are often skin or pectoral muscle adhesions in the early stages. The rate of axillary lymph node metastasis is high. The pathological manifestations of male breast cancer are similar to those of female breast cancer. The vast majority are invasive ductal carcinomas. There is no lobular tissue in the male breast, so there are no reports of lobular carcinoma in situ in pathology. The treatment of male breast cancer is the same as that of female breast cancer, but because the breast tissue in male cases is smaller and it is easy to invade the pectoral muscles at an early stage, the surgical method should be mainly radical surgery or extended radical surgery.

Endocrine therapy is more effective than female breast cancer in late-stage or recurrent cases. The main treatment method is bilateral orchiectomy, which has an effective rate of 50%-60%. The reason for such a high effective rate is that nearly 84% of tumor tissues are ER-positive. The effective period lasts an average of 12 months. If the patient is unwilling to undergo orchiectomy or the disease relapses after orchiectomy, good results can be achieved by taking female hormones, male hormones or TAM. Therefore, additive endocrine therapy will achieve good results in patients who have shown that orchiectomy is ineffective. The effective rate of this endocrine therapy is between 30% and 50%. Chemotherapy should be started after other treatments have failed, and its medication is equivalent to female breast cancer.

3. Inflammatory breast cancer

This type is an extremely rare clinical type, with common diffuse enlargement, redness, swelling, heat, pain, and obvious edema. The onset is explosive, very similar to acute inflammation, so it is also called cancerous mastitis. The key points of diagnosis of this disease are: ① Although the local manifestations are redness, swelling, heat and pain, there is no systemic inflammatory reaction such as chills and fever; ② The body temperature and white blood cell count are mostly within the normal range; the early skin is typical purple, with patchy edema, clear boundaries, slightly raised edges, and enlarged pores like orange peel changes. The range of redness and swelling is more than 1/3 of the breast. After 1 week of anti-inflammatory treatment, the redness and swelling do not subside. Sometimes a hard and tough mass can be touched in the red and swollen breast tissue; ⑤ At the same time, a hard lymph node can be touched; ⑥ Fine needle puncture cytology and pathological sections can provide diagnosis. Surgical treatment is not advocated for breast cancer. At present, most scholars use a combination of chemotherapy and radiotherapy for inflammatory breast cancer, that is, 3 to 4 courses of chemotherapy followed by radiotherapy, and then chemotherapy after radiotherapy.