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Early stage breast cancer

A precursor or cancer?

Every year in Germany around 70,000 women develop breast cancer and more than 6,000 develop breast cancer precursors. How often these precursors degenerate into breast cancer is unclear.

This means "breast cancer precursor":

A breast cancer precursor is usually understood to mean a duktales C.arcinoma in situ - short: DCIS. That means: there are abnormally changed cells in the milk ducts of the female breast. These cancer cells do not break through the confines of the milk duct. They do not grow into the surrounding tissue, do not distribute themselves in the body and do not form metastases.

So DCIS is not a life-threatening disease. However, it cannot be predicted whether and when DCIS will develop into breast cancer.

This means "early stage breast cancer":

When pathologically altered cells cross natural tissue boundaries, the tumor is referred to as breast cancer. One speaks of "early stage breast cancer" when:

  • Breast cancer is detectable but has not spread to other organs.
  • the cancer cells have not or only slightly spread to the nearby armpit lymph nodes.

Experts speak of one localized stage. Then breast cancer can usually be treated well.

Detect breast cancer

To diagnose breast cancer, professionals recommend the following tests first:

  • medical questioning and palpation examination
  • for women over 40 years: chest x-ray (Mammography)
  • for women under 40 years of age: breast ultrasound

Further imaging examinations can follow. In order to reliably detect breast cancer, a sample is taken from the abnormal areas of the breast. Those skilled in the art refer to a tissue sample as biopsy. A team of doctors in the laboratory examines whether these samples contain cancer.

Plan the treatment

The nature of the cancer can be determined in the laboratory. There is breast cancer that grows slowly, but there are also breast cancer that progresses quickly and aggressively. In some it grows depending on the hormone, in others it does not. The treatment is based on this.

treatment

For early-stage breast cancer, the goal of treatment is to get rid of the cancer completely. Several methods are used for this: surgery, radiation and drugs against cancer.

There are two ways to operate in the early stages:

  • The cancer is removed, the breast is preserved.
  • Cancer and breast are removed, the breast can be rebuilt.

Reliable studies show that breast-conserving surgery with subsequent radiation gives the same good results as breast removal: after 5 years, the same number of patients were alive. Breast removal is recommended, for example, if the cancer could not be completely removed from the breast, if re-irradiation is not possible or if you expressly wish it.

For early-stage breast cancer, additional treatments may be considered:

  • Radiation is recommended after breast-conserving surgery. High-quality studies show for a period of 10 years: Without radiation, 35 out of 100 women relapsed, with radiation only in 19.

  • Different drugs reduce the risk of relapse in some women: anti-hormones, chemotherapy or antibodies can be used individually or in combination.

The laboratory tests whether anti-hormones can work. These Anti-hormone treatment lasts at least 5 years. In good studies, 25 out of 100 women on anti-hormone treatment had a relapse after 10 years. Without anti-hormones it was 38.

A chemotherapy After surgery, for example, experts recommend when anti-hormones don't work, the cancer is growing aggressively, or women are younger than 35 years. In summary, good studies for a period of 15 years show: Without chemotherapy, about 54 out of 100 women under the age of 50 had a relapse. With chemotherapy there were 41.

If the cancer responds, experts recommend one antibody or a combination of chemotherapy with antibodies before and / or after surgery. In studies, about 36 out of 100 women who had chemotherapy had a relapse. With the additional antibody it was 26.

All of the drugs used can sometimes cause considerable side effects. Some can be treated preventively.

Which treatment is best for you depends on your personal situation and the type, size, and characteristics of the cancer. Your treatment will be tailored and planned specifically for you.

What you can do yourself

  • Diagnosing breast cancer is not an emergency. Take your time before deciding on any treatment. Talk to people you trust or other people who are affected in peace.

  • To visually compensate for a missing or too small breast, there are various medically prescribed aids such as breast prostheses or special bras.

  • Exercise, for example, reduces tiredness and feelings of stress. Many sports clubs and fitness studios offer group training for cancer patients. You can also ask your medical team if rehabilitation sports are an option for you.

  • You and your relatives can receive psycho-oncological care at any time.

April 2019, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians