Breast diseases—breast cancer

The regular self-examination of the breast and also at regular intervals by a specialist (surgeon, gynecologist) is essential. In recent years, the incidence of breast cancer has been reduced significantly, ultimately also because of the good education about the importance of preventive medical check-ups. Breast cancer is still the most common cancer in women .

Any lumps or hardenings in the breast, change in size of the breast, retraction of the nipple or sudden (bloody) secretion The nipples must be clarified . In many cases, the tumors are harmless and must be continuously monitored by palpation (breast examination), mammography, ultrasound or MR (magnetic resonance imaging). Imaging reveals certain characteristics of a lump that can tell whether it is a benign or non-benign tumor. The classification is based on the 4 eyes principle (2 independent radiology specialists, specializing in the diagnosis of mammograms) according to BI-RADS. If there is the slightest doubt as to whether a tumor is benign, a tissue sample (true or shure cut biopsy) must be taken. This is a procedure without significant effort, but it is possible to specify the tumor with regard to its biological properties. This is essential for planning how to proceed.

Breast cancer

Breast cancer (breast cancer) is the most common malignant tumor in women, with around 5,000 new cases per year.

Risk factors for developing breast cancer include childlessness, breast cancer in close relatives, obesity, smoking and alcohol consumption.

Since the chances of recovery from breast cancer in the early stages, with a nodule size of less than 1 cm, are around 95%, the preventive examination is of particular importance.

From the age of 40, a woman should have a mammography carried out at regular intervals in order to detect every new lump as early as possible and to be able to initiate further diagnostic steps. In addition to the regular check-ups at the doctor's, the monthly breast scan by the woman also plays a major role in the early detection of breast cancer.

If a lump is discovered in the breast, a number of diagnostic steps are available to distinguish a benign (e.g. a cyst, a fibroadenoma, etc.) from a malignant lump. The basis of the diagnosis is mammography and an ultrasound of the breast. The focus shown in the mammography is classified according to BIRADS (Breast imaging reporting and data system = breast cancer assessment category) and in this way radiological criteria are used to predict the disease.

To clarify unclear nodules, an MR mammography and tissue removal, either open surgery or ultrasound-targeted with a fine needle under anesthesia or local anesthesia, can be performed.

The treatment of breast cancer consists of surgical removal of the tumor. Breast-conserving surgery can be performed in 70-80% of cases. However, if the entire breast has to be removed, the breast can be rebuilt by plastic surgery.

Depending on the histological findings of the tumor and the involvement of the surrounding lymph nodes, an individually planned combination of surgery, radiation therapy, chemotherapy and hormone therapy can be useful.

Before the operation, the tumor and the nearest lymph node in the armpit (sentinel lymph node) are marked. If the lymph node proves to be tumor-free during the operation, the lymph nodes in the armpit need not be removed, otherwise they will be removed during the operation. Follow-up care should take place over a period of more than 5 years and consists of a physical examination of the breast, a mammography, tumor markers, abdominal ultrasound and lung x-rays (better computed tomography of the chest and abdomen) and gynecological examinations at regular intervals according to international recommendations.