World Breast Cancer Awareness Month or 'Pink October'

is a prime example of bringing people together for one purpose: to remind women how important it is to take care of their breast health.

And now this topic is even more coming to the forefront:

in 2020, more than 2 mln new cases of breast cancer ^1,2
of which more 72к in Russia ³

The dynamics of morbidity continues to grow: experts predict that by 2025, the absolute number of cases will increase by 2% ³

At the same time, breast cancer is getting younger. Although the majority of patients are women over 50 years old, the disease is now increasingly detected
among younger patients.

by 64%³

the incidence of breast cancer among young women has increased over the past 10 years

Although it is scary to hear such a diagnosis, it is important to remember that breast cancer detected at an early stage is curable.

9 of 10⁴

first-degree breast cancer cases are curable if diagnosed in time

Modern methods of diagnosis and therapy help to identify the disease at an early stage and prevent its progression

TARGET ORGAN

The mammary gland is affected by various hormones that manifest themselves at different times in a woman's life. Three types of hormones affect the mammary glands the most:

Estrogens are produced by the ovaries and are responsible for the formation of the mammary gland and the mature shape of the breasts. Under the influence of these hormones, the breasts enlarge before menstruation.
Progesterone is responsible for the development of glandular tissue and its receptors. The amount of the hormone increases dramatically with the onset of pregnancy for the final formation of the alveoli.
Prolactin prepares the mammary glands for lactation, is responsible for the milk production process and its nutritional value.

When hormones are in balance, the system works

But a failure in the well-adjusted system of the body can entail disorders in the breast tissue, which without timely diagnosis and therapy can develop into malignant neoplasms

Precancerous conditions of the mammary glands

Breast cancer is a disease that does not occur spontaneously: it is preceded by pathologic cell changes, which are important to detect at an early stage ⁴

Mastopathy or benign breast dysplasia can be a precursor to the development of malignant neoplasms. It develops due to an imbalance of hormones in the body.

Mastopathy is a non-inflammatory hormone-dependent breast disease

This is a condition that requires monitoring and surveillance. In some cases, it can develop into a malignant tumor. The development of mastopathy and transformation into a malignant neoplasm can be affected by sex hormones and the work of internal organs - liver, pituitary gland, adrenal glands.

Why do precancerous breast conditions develop?

Various causes can trigger the development of neoplasms:

in addition to heredity, external factors and lifestyle have a great influence.

Genetics has an important impact on health ³

But one of the key reasons is hormonal imbalance, which strikes the breast and becomes a catalyst for the development of pathological processes

Prevention and diagnosis of breast cancer

Seeing your doctor regularly and getting medical checkups is key to preventing breast cancer.

In addition, in order to maintain breast health, women are advised to lead a healthy lifestyle and monitor the condition of their breasts through monthly self-diagnosis. Prevention is aimed at eliminating provoking external factors and unhealthy habits that affect a woman's body and lead to hormonal imbalance, reducing mortality from possible causes of breast cancer.

Therefore, it is important to adhere to basic healthy lifestyle guidelines:

eat at least 400 grams of fresh fruits and vegetables daily ³
do moderate physical activity
do not exceed the daily allowance of salt - up to 5 grams per day ⁵
quit smoking

Self-diagnosis is another mandatory step in breast cancer prevention

It should be performed monthly, 5-7 days after the end of menstruation. If a woman is already postmenopausal, self-examination is carried out at a convenient time

Self-diagnosis takes place in 2 steps: visual inspection and tactile examination.

The first step involves a visual inspection of the glands for possible changes such as:
- lodging, swelling, retraction or other changes in nipple contours;
- localized redness of the skin;
- cal or total swelling of the skin, the state of 'lemon peel';
- nodules and masses in the tissue;
- nipple discharge.
The second stage is performed in the supine position:
- place pillows under one side of your back and lie down so that the gland is spread across your chest wall;
- without pressure, use the pads of 2-4 fingers of the opposite hand to feel the gland from bottom to top in a circular motion, from the nipple to the axilla. Pay attention to the lymph nodes and the supraclavicular area;
- feel the inside of the gland from top to bottom, from the nipple to the middle of the chest wall;
- repeat the process with the second breast.

Download the self-diagnosis handout

Regular breast self-examination is a simple but important practice of conscious care for your health

Она позволяет внимательно изучать особенности своей груди и своевременно замечать любые возможные изменения, что играет ключевую роль в ранней диагностике рака молочной железы. В нашем видео вы узнаете, как правильно проводить самообследование и массаж молочных желез, на какие  изменения нужно обращать внимание и что еще важно делать для профилактики заболеваний этого органа.

At the same time, the basis for early diagnosis and prevention remains dispensary — it includes a number of instrumental studies that help to make sure that there are no changes in the breast.

Under the age of 40, breast ultrasound is the baseline examination method. Mammography remains the gold standard of breast cancer screening for women over 40 years of age. The diagnostic method helps not only to detect malignant neoplasms, but also to diagnose pathologic changes that precede them.

Outside of cancer diagnosis, mammography also helps detect arterial calcification, which increases the risk of cardiovascular disease and atherosclerosis.

Рассказываем женщинам разного возраста о профилактических мерах для заботы о здоровье груди

Prevention before age 20

Instrumental diagnostics — only when indicated by a specialist, for prevention it is enough to adhere to the basic principles of healthy lifestyle and regular self-examinations

Prevention in age 20-39

Breast ultrasound — once a year or more often as indicated
Consultation with a geneticist and oncomammologist in case of hereditary predisposition

X-ray mammography is not recommended before age 40 because the breasts are dominated by dense glandular tissue that is poorly viewed

Prevention in age 40-49

Mammography — once every 2 years
Family history for cancer screening

5-7% of cases of malignant neoplasms are related to heredity

Prevention in age 50-69

Mammography — once every 2 years
Breast ultrasound — once a year
Additional examinations — as indicated in case of cancer in the family history

Prevention in age 70+

Mammography — once every 2 years

Up to the age of 75, it can be done free of charge as part of a routine checkup under the MHI, and at older ages - by doctor's appointment. More frequent examinations are not recommended, as X-rays may aggravate existing age-related changes or chronic diseases

BREAST PATHOLOGY DIAGNOSIS

If there are any changes in the mammary gland, the specialist may refer the patient for a number of additional examinations

Monitoring by radiation methods, as well as the joint work of the therapist, mammologist, gynecologist, oncologist and ultrasound specialist help to timely identify pathological changes, including mastopathy, and take preventive measures.

The patient itinerary for a neoplasm diagnosis may consist of the following steps:

Blood tests — including cancer markers to detect cancer in its early stages
Breast ultrasound — if neoplasms are suspected
Mammography — to determine the size, shape and other characteristics of the tumor
Biopsy — to determine the nature of cells and their features
PET-CT — a method for diagnosing tumors and metastases
MRI — is an optional study and may be ordered for nipple involvement

Whether to continue observation or to treat pathological conditions with drugs - only the doctor decides after examination and tests.

And most importantly remember that health is beautiful

Sources cited:

Data from the International Agency for Research on Cancer GLOBOCAN cancer incidence and mortality estimates, 2020. Data on the study population from the Surveillance, Epidemiology and End Results Registries database for 2004-2011.
Sung H, et al. CA Cancer J Clin. 2021; 71: 209–249; 2. Iqbal J, et al. JAMA. 2015; 313:165-173.
Rozhkova N. I. 'Prevention of breast cancer', online conference. Prevention of oncologic diseases of organs of female reproductive system. 05.06.2024 г.
[Electronic resource]. https://krymsk-crb.ru/patients/novosti/455-profilaktika-raka-molochnoj-zhelezy-2. GBUZ “Krymskaya CRB”. Ministry of Health of Krasnodar Krai. (Date of reference: 25.09.2024).
[Electronic resource]: https://www.who.int/news-room/fact-sheets/detail/salt-reduction (Date of reference: 06.09.2024)