Breast sarcoma
Breast sarcoma is a malignant neoplasm that develops from mesenchial tissues, it is characterized by rapid growth, dissemination, and an unfavorable course. Smooth, striated muscles, adipose, bone, and nerve tissue serve as the basis for the occurrence of sarcoma. Its presence in the mammary gland is manifested by a lumpy dense tumor, the skin over the inflamed area is thinning, the networks of subcutaneous veins are expanding. The size of the tumor can be up to 15 cm. Breast sarcoma is a rare disease, according to statistics, the number of cases is up to 2% of cases. Both women and men develop sarcoma in the same way, it is characterized by rapid metastasis and growth, a very malignant course, an unfavorable prognosis for life.
The content of the article:
Classification of types of breast sarcoma
Causes of breast sarcoma
Symptoms of breast sarcoma
Diagnosis of breast sarcoma
Treatment of breast sarcoma
Prognosis for breast sarcoma
Breast sarcoma
Classification of types of breast sarcoma
The development of sarcoma most often occurs against the background of a leaf-shaped breast tumor, there is no epithelial and glandular tissue in its structure. There are several types of sarcoma behind the morphological type. Most often, in 30% of cases, fibrosarcoma is diagnosed, which arises from connective fibers, in a short time a tumor of this type can grow to huge sizes. Liposarcoma is characterized by rapid progression and ulceration, these tumors from adipose tissue often appear synchronously in both mammary glands. The difference between rhabdosarcoma consists in a high degree of malignancy, germination into surrounding tissues, rapid growth with infiltration of tissues. Mostly young patients under the age of 25 get sick. The tendency to relapse is characterized by angiosarcoma formed from vascular endothelial cells, it is diagnosed among middle-aged patients. Osteosarcoma and chondrosarcoma are diagnosed very rarely, they have an increased degree of malignancy, are detected in women after 55 years. Also, according to histological classification, there are alveolar soft tissue sarcoma, epithelioid, leiomyosarcoma, malignant fibrous histiocytoma, malignant hemangiopericytoma, schwannoma, mesenchioma, light cell and synovial sarcoma. The type of sarcoma and the degree of its malignancy is determined on the basis of a histological conclusion. Breast sarcoma can metastasize to the skeleton and lungs hematogenically, penetration into regional lymph nodes is very rare.
Causes of breast sarcoma
Modern oncology still cannot name the exact causes of breast sarcoma. It is believed that genetic predisposition, injuries and breast surgeries, the influence of chemical carcinogens and ionizing radiation can become provoking factors for the development of the disease. Breast sarcoma is sometimes combined with cervical and vaginal cancer, fibroadenoma, rectal cancer.
Symptoms of breast sarcoma
The first symptom indicating the development of sarcoma appears in the form of a dense nodular neoplasm with a bumpy surface and clear contours. Due to the growth of the tumor, the skin above it becomes very thin, acquires a purplish-bluish hue with a prominent subcutaneous venous pattern. An increase in the volume of the breast leads to breast asymmetry, soreness appears, ulcers on the skin above the tumor. Rare symptoms of breast sarcoma may be retraction or deviation of the nipple, skin retraction. At an advanced stage, the tumor can disintegrate and bleed. The rapid growth of sarcoma provokes a pronounced inflammatory reaction, similar to an abscess.
Lymph nodes are affected by sarcomas of a high degree of malignancy or with rhabdomyosarcoma, malignant fibrous histiocytoma and synovial sarcoma. Also, the possible penetration of metastases into the lymph nodes is affected by the proximity of the tumor to the lymph node and the appearance of an ulcerative process on the skin above the tumor.
Depending on the degree of malignancy, sarcoma can develop at different rates, from slow, progressive to violent, abrupt. Tumors with a relatively favorable prognosis sometimes develop within a few years, and highly malignant sarcomas can develop in rapid leaps in a few months.
Diagnosis of breast sarcoma
Since this pathology does not occur often, and the range of sarcoma variants is quite wide, the exact criteria for how to diagnose sarcoma have not been developed. For consultation for examination, you need to contact an oncologist or a mammologist.
The method of palpation reveals a mobile tumor with a coarse-grained heterogeneous consistency. Visually, there is hyperemia and swelling of the skin, local ulceration foci. The thin, almost transparent skin above the tumor focus and dilated veins on the mammary gland are clearly visible.
Overview mammography and ultrasound of the mammary glands can give a non-specific picture in the form of shadows with lumpy contours that push the surrounding tissues aside. Additionally, MRI or breast scintigraphy with technetium-99 is performed.
The final diagnosis is established after examination of tumor tissue samples, which are obtained using a fine needle or trepan biopsy. Under the microscope, sarcoma is presented in the form of stroma elements, cellular atypia, and the absence of an epithelial component.
During the cytological examination, the presence of cancer cells is confirmed in the separated material from the ulcer above the tumor. Histological examination determines the type of neoplasm and establishes the prognosis of its development.
Treatment of breast sarcoma
Breast sarcoma is surgically removed. The most radical of them is mastectomy, when the affected mammary gland is removed along with fiber, pectoral muscles and affected regional lymph nodes. Sometimes they perform operations, preserving muscles and lymph nodes. If the neoplasm has not spread to the adjacent tissues, organ-preserving operations such as resection, quadranectomy are performed. Such manipulations preserve part of the gland and in the future, with the help of modern plastic surgery techniques, it is possible to completely restore the breast, restore its attractive appearance thanks to implants or its own tissues. But the larger the lesion area, the more radical the operation is carried out.
Breast sarcoma can recur into surgical scars, as well as remotely metastasize into bone and lung tissue.
In the pre- and postoperative period, a course of chemotherapy is carried out, thereby reducing the risk of the spread of malignant cells into adjacent tissues. The effectiveness of the operation is significantly increased, and the likelihood of recurrence of the inflammatory process is reduced.
In addition to surgery, radiation therapy is used, which allows you to control the growth and development of sarcoma before surgery, and in the postoperative stage, radiation prevents recurrence.
Treatment of breast sarcoma is carried out depending on the characteristics of the course of the disease of each patient.
Prognosis for breast sarcoma
The most important prognostic factors associated with relapse—free and overall survival for soft tissue sarcomas are the histological type of sarcoma, the degree of its malignancy, and the size of the tumor. Each histological type is characterized by a wide range of neoplasms with varying degrees of aggressiveness, the potential for penetration of metastases, local invasion. The best prognosis for the patient’s life is observed with a highly differentiated type of sarcoma and the absence of metastases in the lymph nodes.
Breast sarcoma is a very life—threatening disease for the patient and the prognosis for breast sarcoma for life depends on whether it is detected in a timely manner, how high-quality the treatment will be. Therefore, if the slightest symptoms are detected, it is necessary to immediately consult a doctor. Procrastinating and self-medicating in this case is dangerous.
