ONCOLOGY

BALL IN THE BREAST

Many women one day discover a lump in their breast. Often the cause is benign. However, in all cases, you will consult your doctor and try to notice certain signs.

It is important to know if this lump appeared in the two weeks preceding the rules and especially if it regresses after them. In this case, the responsibility of the hormones and probable and one can suggest a benign tumor, in particular a cyst.

If several balls appear on both sides while the breasts become very painful, it may be a simple hormonal adjustment without real lesion: it is the premenstrual syndrome, a phenomenon occurring frequently or constantly, with each cycle, in some women. They know it well but must nevertheless be attentive to any change; new or larger or more painful lump, or regressing less markedly after menstruation.

A lump made up of a benign tumor is more or less firm, mobile, very smooth and regular.If it is a cyst, it is in fact a pocket of liquid, somewhat elastic in consistency, often becoming painful. before the rules.

The lump that constitutes cancer is hard, irregular, not very mobile, and even adherent to the skin or the nipple. If we pinch the skin of the breast at the level of the ball, it takes on an orange peel appearance.

These data are only indicative: a cancer can present the appearance of a benign tumor and vice versa.

The doctor will first carry out a systematic examination allowing him in particular to look for other manifestations of hormonal imbalance as well as risk factors for breast cancer. Her clinical examination will first include inspection, looking for breast deformity, skin or nipple retraction. Palpation will allow him to locate the ball and define its characteristics: location, size, shape, contour, mobility, firmness. He will look for other balls in both breasts, as well as the presence of lymph nodes in the axillary hollows and in the supraraxillary hollows. most often, the doctor will have recourse to a breast assessment to establish the exact diagnosis of the nature of the lump.

Different decisions will be taken depending on the case:

– If we judge that the lump is a simple glandular condensation of hormonal origin without real lesion, we establish a drug treatment to correct the hormonal imbalance and we will check that the lump has completely disappeared.

– if the lump is a cyst, it is punctured and the liquid is replaced by air, which makes it possible to X-ray its interior wall: a cystography.

– if the lump is diagnosed as a benign solid tumor such as an adenoma or fibro-adenoma, confirmation should be sought with a cytopuncture. When the benignity is not called into question, the ablation of the ball is not obligatory, but a monitoring is indicated at least during the first years.

– If there is the slightest doubt or if the lump is bothersome or if the patient’s anxiety cannot be calmed, this tumor should be surgically removed and carried out microscopically, a biopsy resection .

– if at the end of the senological examination the diagnosis of cancer is made or suspected, the attitude will depend on the possible therapeutic choice: more or less extensive ablation of the tumor which will then of course be analyzed, or on the contrary sample by puncture with a large needle, drill-biopsy, to allow precise microscopic analysis even if one decides to treat this cancer without breast surgery.

Copyright photo : public domain

Bibliographie : Breast Tumours de S.R. Lakhani et International Agency for Research on Cancer

BRONCH CANCER

Bronchial cancer is in most industrialized countries the leading cause of cancer death.

It can be estimated that 95% of bronchial cancers are the direct consequence of smoking and pollution. the risk increases with the number of cigarettes consumed, their tar and nicotine load and the inhalation of smoke.

A rare cancer before the age of 40, it can nevertheless appear before this age if smoking is early and intense.

The warning signs are numerous but rarely evocative:

– accentuation of the cough, dry and quintuous or productive, which does not always worry the smoker because it is so commonplace and habitual;

– appearance of shortness of breath on exertion;

– lingering or recurring bronchial or pulmonary infection after a first antibiotic treatment;

– sputum tinged with blood, this symptom should always lead to a consultation with the doctor;

– unexcited weight loss or fatigue, change in voice.

Such symptoms occurring in a smoking patient will lead the doctor to prescribe a biological assessment to look for inflammatory signs by increasing the sedimentation rate, as well as an x-ray of the lungs. this one can already show an evocative image, as it can be normal. Anyway, and even if the radiography is not evocative, the only notion of smoking associated with abnormal signs, justifies a specialized consultation. the pulmonologist will perform a bronchial endoscopy. this examination allows using a flexible optical system to directly explore the trachea and the large bronchi. It is usually performed under local anesthesia. Hospitalization is not necessary. Biopsies of suspicious areas will usually allow an accurate diagnosis.

Once the diagnosis is made, it is up to the pulmonologist, in conjunction with the attending physician, to guide the treatment after an assessment of the general condition of the patient and of the local and general extension of the tumor.

Whenever possible, the patient is referred to the thoracic surgeon and the tumor is extirpated by a lobectomy, removal of a lobe; or pneumonectomy, removal of the lung.

This intervention can only be considered if the patient’s respiratory state allows it, if the mocal extension of the tumor is not too great and if there is no distant metastasis already. Thus, surgical removal of the tumor is far from always possible. It is then necessary to resort to other therapies, but the chances of recovery are then much lower.

Nevertheless, the use, in combination or alone, of chemotherapy or radiotherapy has made it possible to obtain an improvement in the survival time and sometimes even cures, but these are always heavy and difficult treatments, which are the responsibility of specialized teams.

Thus, despite real progress in thoracic surgery, chemotherapy and radiotherapy, bronchial cancer is far from being a cancer that is always curable. early screening attempts by systematic chest x-rays did not produce the expected results because the appearance of suggestive radiological signs is often the result of already advanced tumors.

Cytological examination of the sputum, looking for malignant cells, might help detect cancer at an earlier stage. However, applied regularly to all subjects at risk, this examination is currently economically insurmountable compared to the expected benefit.

the best way to reduce bronchial cancer mortality is still the fight against smoking and pollution.

Copyright photo :  domain public de cancer.gov http://visualsonline.cancer.gov/details.cfm?imageid = 2348

Bibliography : Illustrated Anatomical Segmentectomy for Lung Cancer by Hiroaki Nomori and Morihito Okada

Leave a Reply

Your email address will not be published. Required fields are marked *