Breast cancer, or breast cancer, is a malignant neoplasm associated with the degeneration of the glandular tissue of the mammary gland. Breast cancer is the second most common malignant tumor: its incidence rate is second only to lung cancer in men.
In women, breast cancer is more common than other tumors. Every year, up to 1 million people become ill with breast cancer. This is a disease of women, since breast cancer occurs in only 1% of cases in men.
The causes of breast cancer are still being determined. Unlike other tumors, in particular lung cancer, carcinogens (harmful environmental agents) that cause breast cancer have not been identified. However, predisposing pathological factors can be identified: absence of pregnancy and childbirth, poor heredity, smoking, early onset and late cessation of menstruation, age over 65 years, etc.
Symptoms of the disease depend on its stage: size, prevalence, presence of secondary tumor foci (metastases). Since in stages 1 and 2 the tumor is asymptomatic, in 90% of cases early diagnosis is possible with an annual X-ray examination of the breast - mammography.
At later stages, characteristic signs of breast cancer appear: pain at the site of the tumor, the appearance of a lump in the mammary gland, changes in the color and structure of the skin over the tumor, discharge from the nipple (clear or bloody), retraction of the nipple due to tumor growth, swelling above the collarbone and axillary region due to metastases to the lymph nodes.
Stage 4 breast cancer is characterized by metastasis to distant lymph nodes (in particular, swelling in the groin area), as well as to other organs: bones (pain in the back, pelvic bones, large joints), brain (headache, muscle weakness), lungs (cough, shortness of breath), liver (abdominal pain, bloating, feeling of heaviness), kidneys, etc.
Mammography and breast ultrasound are used to diagnose breast cancer. To accurately determine breast cancer, a puncture of the gland is performed under ultrasound guidance with a biopsy of the node and subsequent histological examination of the tissue.
The main methods of treating breast cancer: surgery (removal of the mammary gland and regional lymph nodes), radiation therapy, chemotherapy with additional immunostimulation, targeted therapy using monoclonal antibodies.
To prevent a tumor or detect it at an early stage, a woman should become pregnant and give birth, eliminate menstrual irregularities, strengthen the immune system, monthly examine and palpate the breasts for lumps, undergo an annual mammogram, maintain normal blood sugar levels, normal blood pressure, strengthen the immune system, avoid obesity, lead a healthy lifestyle.
Causes of Paget's cancer
The exact etiology has not yet been established. This means that researchers find it difficult to name a specific cause or describe the mechanism of the disease. At the moment, most experts adhere to the most plausible theory, which states that modified cells (they are called Paget cells) enter the nipple, implant into the tissue and grow.
This theory is based on observations that have shown that in more than 90% of cases, Paget's disease is accompanied by other forms of oncology.
There is another theory, which modern medicine is in no hurry to abandon. The transformative theory states that the disease develops due to spontaneous (as with any other oncology) degeneration of epithelial cells of the nipple into cancerous ones.
Of course, in addition to obvious physiological reasons, it is customary to identify risk factors:
- Hereditary predisposition. The presence of breast cancer in any form in close relatives increases the likelihood of the disease significantly.
- Injuries of the nipple and areola, surgical interventions.
- The presence of other forms of cancer associated with the reproductive system.
- Frequent exposure to carcinogens: addiction to smoking, alcohol abuse, working in hazardous industries.
These risk factors cannot directly provoke cell degeneration, but they increase the risk of developing cancer.
The cause is Paget's cells - cancerous elements that form a tumor on the surface of the nipple. The factors leading to the formation of the cell itself are unknown to this day.
There are a large number of factors contributing to the development of breast carcinoma. But almost all of them are associated with two types of disorders: increased activity of female sex hormones (estrogens) or genetic disorders.
Factors that increase the risk of developing breast cancer:
- female;
- unfavorable heredity (presence of cases of the disease in close relatives);
- the onset of menstruation before 12 years or their end after 55 years, their presence for more than 40 years (this indicates increased estrogen activity);
- absence of pregnancy or its occurrence for the first time after 35 years;
- malignant tumors in other organs (uterus, ovaries, salivary glands);
- various mutations in genes;
- the effect of ionizing radiation (radiation): radiation therapy for various diseases, living in an area with increased background radiation, frequent fluorography for tuberculosis, occupational hazards, etc.;
- other diseases of the mammary glands: benign tumors, nodular forms of mastopathy;
- the effect of carcinogens (chemicals that can provoke malignant tumors), some viruses (these aspects are still poorly studied);
- tall woman;
- low physical activity;
- alcohol abuse, smoking;
- hormonal therapy in large doses and for a long time;
- constant use hormonal drugs for contraception;
- obesity after menopause.
Different factors increase the risk of developing breast carcinoma to varying degrees. For example, if a woman is tall and overweight, this does not mean that her likelihood of getting the disease greatly increases. The overall risk is formed by summing up various reasons.
Typically, malignant tumors of the mammary glands are heterogeneous. They are made up of different types of cells that multiply at different rates and respond differently to treatment. Because of this, it is often difficult to predict how the disease will develop.
A reliable reason for the development of a tumor process in the nipples has not been established. Nipple cancer is formed from Paget cells, the formation of which is explained by two theories:
- Epidermotropic theory – cancer cells enter the nipple-areolar complex from the original breast tumor. This theory is confirmed by the established fact that 95% of women with breast cancer have a combination of nipple and breast cancer.
- Transformational theory - in the tissues of the nipple, due to a gene mutation, healthy cells are transformed into cancerous ones. This idea is substantiated by the results of electron microscopy of the affected area, which shows cellular connections between keratinocytes and mutated cells of the nipple tissue.
The exact etiology or causative agent of Paget's cancer has not been established. To date, scientists have developed two theories that explain the causes of this disease - transformative and epidermotropic.
Adherents of the first believe that the disease occurs due to mutations that occur directly in the epithelial cells of the nipple. According to the epidermotropic version, the lesion forms in the mammary gland, after which it migrates along the ducts and provokes the appearance of Paget's cancer.
In addition, researchers have identified the main risk factors that cause Paget's cancer - genetic predisposition, ionizing radiation, chronic trauma, and excessive insolation. It is important to note that it is not the gene responsible for the development of neoplasia that is inherited, but the tendency to the disease.
A person diagnosed with Paget's cancer does not pose a danger - he is not contagious, therefore it is impossible to become infected, for example, by airborne droplets.
The role of psychosomatics has not been proven, but history knows many cases when, after excessive psycho-emotional stress, the rate of the disease increased sharply.
As is the case with most other oncological pathologies, the reasons why a woman or man develops this disease have not yet been studied. There are, as always, assumptions about the possible influence of certain factors on tumor formation.
According to the first theory, the reasons for the development of a tumor in the nipple and areola area are the migration of atypical cells along the milk ducts and their fixation in the areola area. This theory has the largest number of adherents, since in 95% of cases Paget's cancer is combined with another form of breast cancer, namely intraductal.
In those 5% of cases when Paget's cancer of the breast is not combined with other forms of cancer, the reason for its development is said to be the degeneration of the epithelial cells of the nipple or areola into atypical ones. Pathology can also be caused by provoking factors, for example, chest injuries or surgical interventions.
There is also a genetic theory of the development of pathology, according to which people become ill with it several times more often if there have already been cases of such cancer formation in the family history. Genetic predisposition is more common in men.
Malignant cells can form in all organs of the human body. The most common neoplasm in women is breast cancer. That is why ultrasound diagnostics and mammography are included in the list of mandatory studies when conducting a preventive medical examination.
If a doctor suspects a patient has sternum cancer, the symptoms of the disease will help establish an accurate diagnosis. A tumor appearing under the breast is not only a female symptom; in rare cases, such formations can be found in the mammary glands of men.
- Hormonal changes:
- early onset of the menstrual cycle,
- late menopause,
- late birth of the first child,
- long-term use of hormonal medications (hormone replacement therapy or contraceptives).
- Heredity (malignant tumor of the mammary glands or ovaries in close relatives).
- Wrong lifestyle:
- alcohol abuse,
- unbalanced diet leading to excess weight,
- lack of physical activity.
- Breast diseases:
- mastitis,
- fibroadenoma,
- mastopathy.
Unfortunately, despite all the detailed study, doctors cannot yet identify the exact reasons leading to the development of a tumor in the sternum in women.
However, a number of factors have been discovered that contribute to the occurrence of cancer:
- Being female is considered a factor that increases the risk of developing the disease. This is explained by the fact that the female body contains a larger number of mammary gland cells. They, succumbing to female growth hormone, tend to degenerate into cancer.
- Alcohol and smoking abuse significantly increases the likelihood of developing the disease. Especially when bad habits were acquired at an early age, during the formation of the sternum and the development of the body as a whole.
- Particular attention should be paid to your health if one of your blood relatives has had a similar problem, since genetic predisposition is a significant factor that increases the risk of developing the disease.
- The likelihood of the disease occurring is significantly higher in women over 50 years of age. Statistics have revealed that most cases are diagnosed in this age category.
- Dangerous influence of radiation waves. This is dangerous for people who work with x-rays or in chemical plants.
- It is harmful to stay in the open sun for a long time, as it emits ultraviolet radiation.
- Poor nutrition (excessive consumption of fast food and smoked foods), subsequently obesity (excess weight).
- Some chronic diseases. These include diseases such as diabetes, hepatitis, hypothyroidism, and immunodeficiency.
But it is worth noting that the presence of one or even several factors does not mean that you will definitely suffer from the disease.
Cancers of the sternum include: tumors of the lungs and breast, neoplasms of the skeletal system. Together, these diseases form the concept of sternum cancer. The division into stages depends on the course of the disease and its form of neglect.
Etiology, development and manifestations of the disease
Scientists have not yet determined the exact causes of Paget's cancer. However, there are some theories. The first of them is epidermotropic. It is believed that cancer cells travel from deep layers of breast tissue to the nipple, where they attach and multiply.
This approach is based on the fact that the disease almost always develops against the background of other forms of breast cancer. In this case, the cancer cells are glandular cells formed from the epithelium lining the milk ducts.
The second theory is transformative. According to her, the development of nipple cancer is associated with causeless degeneration of the nipple epithelial cells. This assumption explains the development of Paget's tumor as an independent disease.
In addition, it has been proven that in men the disease is associated with a genetic predisposition, and in women the likelihood of its development is higher if there is a history of tumors of the uterus or ovaries. Provoking factors include exposure to traumatic agents, radiation, alcohol and tobacco abuse.
The psoriatic type is characterized by the appearance of small pinkish papules covered with scales on the nipple or areola. With acute eczematoid, rashes and small ulcers appear on the skin. Signs of chronic eczematoid are the presence of crusts that peel off, revealing weeping wounds.
In every second case, only the nipple and areola are affected. In 40% of the disease, the formation of a seal around the nipple and areola is observed. One in ten cases of Paget's cancer is discovered by chance.
The first symptoms of the disease are not specific, so they often do not alarm a person, much less force them to see a doctor. Slight redness appears on the nipple and areola and discomfort occurs in this area. Such symptoms may disappear and reappear. Corticosteroid ointments may weaken them.
Over time, the affected nipple begins to tingle, becomes painful, and a burning sensation and itching appears. Sometimes serous-hemorrhagic fluid flows from the nipple, and its configuration changes. As the disease progresses, symptoms increase.
Changes may spread to the skin of the breast. The affected area rises slightly and is clearly separated from healthy skin. There is an increase in lymph nodes in the armpit. In the later stages, destruction of the nipple and areola occurs, as a result of which blood begins to ooze from the affected area.
Clinical picture
Paget's disease of the breast is characterized by the formation of scales on the surface of the nipple and its redness. At first, this just irritates the person, and he does not turn to a specialist. Then the symptoms suddenly disappear, which leads the patient to the wrong conclusions.
When examined by a mammologist, the presence of formations in the breast that resemble balls may be detected. The process is unilateral; less often, both nipples are affected. The cancer usually does not spread to the entire breast; it can also involve the areola and dark skin around the nipple, resembling an eczema-like lesion. In this case, a rash with itching appears.
Paget's disease also occurs among the male population and manifests itself with the same symptoms, however, due to the fact that pathologies of the mammary glands are not typical for the stronger sex, it is often missed.
Men complain of itching in the areola and nipple, peeling of the skin and erosive changes. Upon palpation, the doctor detects an increase in axillary lymph nodes fused to the tissues; there may be a formation in the mammary gland.
Symptoms of a pathology such as Paget's cancer depend on its form. The disease comes in three varieties:
- chronic eczematoid;
- acute eczematoid;
- psoriatic form.
The very names of these forms speak for themselves - with psoriatic, the area of the nipple or areola is covered with plaques and scales that look similar to psoriasis. In acute eczematoid, fine-grained rashes form in the same area, which ulcerate and become weeping, and in the chronic form, these lesions become covered with crusts, under which the weeping surface remains.
Unfortunately, you can only detect the disease at the stage of its active development, since its initial symptoms may either be completely absent or be mild and not bother the person.
Most often, in the early stages, the disease is discovered by chance, during a routine examination or during a deliberate cytological examination in order to prevent oncological pathologies. Of course, very few people closely monitor their health, and even fewer people undergo preventive examinations, so the prognosis of the disease in most cases is unfavorable, since it is detected in the later stages.
Thus, the symptoms of a pathology such as Paget's cancer are not specific and therefore do not cause concern. The first symptoms that may occur if a woman or man develops this disease are:
- irritation in the nipple area;
- peeling in the nipple area;
- nipple retraction or retraction.
Typically, peeling and redness go away if a woman begins to smear the nipple with corticosteroid ointment, so she believes that she is faced with an allergy or a form of dermatitis. Retraction of the nipple is assessed as a physiological condition and also does not cause concern. If the diagnosis is not carried out, the disease develops and more significant symptoms appear:
- nipple discharge;
- changes in the skin of the breast in the area above the nipple;
- itching and burning in the nipple area;
- the nipple becomes covered with ulcers or erosions.
There may also be lumpiness in the nipple area, soreness and redness.
As with any other cancer, there is an increase in the lymph nodes located closest to the tumor. At the very latest stage, bloody discharge from the nipple may appear - the prognosis at this stage of the disease is extremely unfavorable and the life expectancy of a patient at this stage is no more than 3 months.
Classification and forms of the disease
There are different variants of Paget's disease, which are classified according to clinical manifestations and nature of the course:
- Acute eczematoid. It appears in the form of a small rash, with weeping ulcers of the nipple and areola.
- Chronic eczematoid. It occurs with the formation of crusts on the skin. If they are removed, a weeping ulcer will form.
- Psoriatic form. It is distinguished by papules covered with scales.
- Ulcerative form. Ulcers with a depression are formed, shaped like a crater.
- Tumor form. A tumor compaction forms, which is located deep in the tissues of the mammary gland.
Nipple cancer can present in different ways. In half of the patients, changes occur only in the visible part of the nipple and areola. In 40% of patients, pathological changes affect the subcutaneous tissue and a node forms under the nipple.
The modern classification gives doctors a unified understanding of Paget's cancer and its prevalence. According to the type of flow, it can be of the following forms:
- eczema-like - characterized by small rashes, crusts and weeping;
- psoriatic;
- ulcerative;
- crater-like;
- tumor.
According to the cytological data, there are five types of Paget's cancer - adenocarcinoma, spindle cell, anaplastic, acantholytic, pigmented. The TNM classification is used to indicate prevalence.
Symptoms and stages of breast cancer
The degrees of breast cancer are determined according to the generally accepted TNM system, in which each letter has a designation:
- T – state of the primary tumor;
- M – metastases to other organs;
- N – metastases to regional lymph nodes.
| Degree of tumor process | Main characteristics |
| Tx | The doctor does not have enough data to assess the condition of the tumor. |
| T0 | No tumor was detected in the mammary gland. |
| T 1 | A tumor having a diameter of no more than 2 cm in its greatest dimension. |
| T 2 | Tumor having a diameter of 2 to 5 cm in greatest dimension |
| T 3 | Tumor larger than 5 cm. |
| T 4 | A tumor growing into the chest wall or skin. |
| N |
|
| Nx | The doctor does not have enough information to assess the condition of the lymph nodes. |
| N 0 | There are no signs indicating the spread of the process to the lymph nodes. |
| N 1 | Metastases in axillary lymph nodes, in one or more. In this case, the lymph nodes are not fused to the skin and are easily displaced. |
| N 2 | Metastases in the axillary lymph nodes. In this case, the nodes are fused to each other or to surrounding tissues and are difficult to move. |
| N 3 | Metastases in parasternal lymph nodes on the losing side. |
| M |
|
| Mx | The doctor does not have data that would help judge tumor metastases in other organs. |
| M0 | There are no signs of metastases in other organs. |
| M 1 | Presence of distant metastases. |
Of course, only a doctor can classify a tumor to one stage or another according to the TNM classification after an examination. Further treatment tactics will depend on this.
Classification depending on the location of the tumor:
- breast skin;
- nipple and areola (skin around the nipple);
- upper inner quadrant of the mammary gland;
- lower inner quadrant of the mammary gland;
- upper outer quadrant of the mammary gland;
- lower outer quadrant of the mammary gland;
- posterior axillary part of the mammary gland;
- The location of the tumor cannot be determined.
Typically, doctors divide Paget's cancer into stages:
- 0 (cancer in situ) - the upper layer of the epidermis is involved in the process, but not the basement membrane;
- 1 (first) - intraductal, located under the nipple;
- 2 (second) - intraductal, extends beyond the nipple;
- 3 (third) - the basement membrane grows;
- 4 (fourth) - distant metastases are present.
It is incorrect to say that Paget's cancer is incurable. The prognosis depends entirely on the timeliness of seeking medical attention and the severity of symptoms. The five-year survival rate in the early stages, when cancer is curable, is 100%.
At the last stage this figure drops to 10%. If left untreated, life expectancy decreases and mortality reaches 100%. As a rule, death occurs from cancer intoxication and exhaustion.
The disease is divided into 4 stages.
At stages 1 and 2, the tumor gradually increases in size, spreading to the duct, lobule of the gland and beyond. In 70% of cases, clinical signs appear when the tumor reaches 3-5 cm in diameter, that is, with stage 3 breast cancer.
As the tumor increases in size, it becomes visible to the naked eye in the form of a lump, the skin over which changes color and structure. Due to germination into surrounding tissues, the mammary gland becomes hard, swollen, inactive, and painful.
There is retraction of the nipple as a result of skin germination. At the same time, erosions, scales and ulcerations appear in the area of the nipple and areola. With further progression of the tumor (stage 4), the skin over it becomes necrotic and poorly healing ulcers form.
The tumor metastasizes through lymph and blood. First, nearby (regional) lymph nodes are affected. Swelling appears in the supraclavicular and axillary region.
With stage 4 breast cancer, the tumor reaches large and even gigantic sizes, involving the entire gland. The skin over the gland becomes ulcerated. Metastases are detected in distant (in particular, inguinal) lymph nodes and in internal organs, where tumor cells enter through the blood.
With metastases to the lungs, the patient is bothered by cough and shortness of breath; in the brain - headache and neurological symptoms, in particular muscle weakness.
With liver metastases, patients complain of dull abdominal pain, a feeling of heaviness and bloating.
With metastases to the bones, pain appears in the back (spine) with numbness in the arms and legs, neuralgia, pain in the pelvic bones and large joints (most often in the knees and hips). Bone and joint pain usually appears and gradually intensifies over 3-4 weeks. At the terminal stage, when intoxication develops, anemia and encephalopathy develop.
Stage 1
At this stage, it is very difficult to feel any neoplasms in the breast, since the size of the tumor is small - up to about 2 cm. In women who have a large bust, the neoplasm is almost impossible to palpate. Oncology is sometimes confused with mastitis and other breast diseases.
Breast carcinoma of the first stage is considered to be non-invasive; it is so called because this form of neoplasm grows inside the milk ducts, but does not spread further. The lymph nodes are in normal condition and cannot be palpated.
Pathological changes at the first stage can only be determined by modern diagnostic methods.
Stage 2
At this stage, the size of the tumor can reach 2-5 cm. This size of the formation is not large.
A characteristic sign of the second stage of breast cancer is palpation of the lymph nodes. It is generally accepted that only the axillary and supraclavicular lymph nodes can be palpated, but no, the parasternal lymph nodes can also be palpated.
If the lymph nodes are affected, the patient will feel pain in the area where the lymph node is located. Enlargement of lymph nodes (hyperplasia), inflammation (lymphadenitis) and damage to them.
Breast cancer usually affects the axillary (axillary) lymph nodes first. Next are supraclavicular, subclavian. After them, the periosternal (prarasternal) ones are located along the internal thoracic vessels. It is necessary to do mammography and x-ray examinations.
Stage 3
The tumor reaches more than 5 cm.
A characteristic sign is “clustered lymph nodes.” Feels like a bunch of grapes of different sizes (small or medium). Tumor cells at this stage penetrate into the blood and lymphatic system, which forms metastases.
At this stage, bone metastasis is possible. According to the latest scientific data, bone metastases can occur in the first stages of breast cancer, but not more than 5% of cases.
Stage 4
At this stage, the size of the malignant clot does not matter; the lymph nodes are palpated in packets (clusters) on both sides, and can also be collected in separate groups of lymph nodes.
The patient’s condition is accompanied by a serious condition; ulcers, crusts, lesions, erosions, and cysts appear in the bust area. A feeling of aching in the bones appears, this indicates that they have been damaged by metastases. In the absence of proper treatment of the patient, the growth of the tumor progresses, and the state of health regresses.
Photo 1. Diagram of breast cancer.
- Stage 1 - no lesions of the nodes or adjacent skin area are observed. The diameter of the lesion does not exceed 2 cm.
- Stage 2 is divided into two. First: deep folds begin to form in areas of the skin, and a gradual decrease in elasticity occurs. The size of the tumor reaches 3-5 cm. Second: the formation of metastatic nodes occurs, which are localized on the damaged side.
- Stage 3 - the neoplasm begins to spread to adipose tissue, increasing in diameter, and reaches a size of 5 cm or more. The epidermis in the nipple area begins to retract inward. At this stage, there may be 1-2 tumor foci.
- Stage 4 - noticeable deformation occurs, involving the entire mammary gland. Many metastases appear.
Scheme of stages of cancer development.
- The circulatory and lymphoid systems are not involved in the process. This stage is characterized by a small amount of mutations; this structure of the tumor eliminates the likelihood of metastases. The dimensions of the neoplasm are about 3-5 cm.
- The tumor of the respiratory tract begins to increase and reaches a size of about 7 cm. At this stage, coughing attacks and bloody sputum appear.
- The neoplasm exceeds 7 cm in diameter, the walls and lymph nodes are easily involved in the process, and pain appears.
- Terminal phase. This concept means the last stage, it is uncontrolled, a large proliferation of tumor cells occurs, which is irreparable.
How to recognize breast cancer at an early stage? At the first stage of the disease, there are practically no symptoms, since the tumor is less than 2 centimeters in diameter. At this stage there is still no metastasis and cell proliferation in the tissue.
One of the very first symptoms of cancer is breast lumps. A tumor is then diagnosed. Discharge from the nipples begins. This process is independent of menstrual cycles. The leaking fluid may be clear, bloody, or yellow-green. Often it appears in the form of pus.
As the cancer progresses, the intensity of the discharge increases. Special gaskets are required. Pain appears in the mammary glands. Small wounds begin to form on the chest, turning into large ulcers. This process can be observed not only on the nipples, but throughout the bust.
Photos of what Breast Cancer looks like: real photos of women
- Mammography – X-ray images of the breast. Identify existing compactions in the tissue. The modern method is digital mammography.
- Determination of the level of female sex hormones - estrogens. If it is high, there is an increased risk of developing breast cancer.
- Tumor marker CA 15-3 is a substance produced by breast carcinoma cells.
| Types of cancer | Symptoms of breast cancer. Clinical signs. | Forecast |
| Non-invasive: 1. Ductal 2. Lobular |
1. The bust is soft to the touch, painful, there is slight swelling. 2. Slightly firmer than normal breast consistency, almost not noticeable. There is also aching pain in the chest. |
Mostly favorable. |
| Infiltrative ductal breast cancer | Signs of sternum cancer: Dense inflammation of irregular shape. The nipple and skin are retracted. The neoplasm is closely adjacent to the surrounding tissue. | One of the most unfavorable outcomes, as the tumor grows rapidly and subsequently, the rapid formation of metastases occurs. |
| Inflammatory form of tumor | The first sign is redness (hyperemia) of the mammary gland. When the mammary gland swells, the skin takes on the appearance of a lemon (orange) peel. The local temperature rises, the chest feels hot to the touch, spots of blue and red flowers can be seen on the bust. | In the early stages – relatively favorable. At later stages, the prognosis is not favorable. |
| Paget's disease | Peeling of the skin on the nipples. Rash and redness around the area. The skin of the breast has an uneven surface. In some cases itching and burning. | In the later stages, the prognosis is unfavorable - the average lifespan is 4-5 years. |
| Tubular | For small sizes there are no symptoms. With large tumors, thickening and retraction of the skin or nipple occurs. |
Early detection is favorable, as the tumor grows slowly. The exact prognosis depends on the size of the tumor. |
| Slimy | The skin of the breast does not hurt, the degree of swelling is small. With palpation, you can feel hard nodules. | Relatively favorable, since this pathology metastasizes extremely rarely. |
| Medullary | It does not cause pain until the tumor reaches a large size. There is a change in the mammary glands (thickening). | Quite favorable, survival rate reaches 70-90% |
| Papillary | Severe pain near the nipple; during the development of the tumor, discharge appears from this location (can be transparent, bloody or putrid). | In the early stages, relatively favorable. When polycystic disease forms in the bust, surgery is required. Another important factor is in which part the tumor is localized. |
The risk group includes women who:
- Genetic predisposition (blood relatives who had this neoplasm). The risk of getting breast cancer increases.
- First menstruation before 12 years.
- The onset of menopause after 55 years. Therefore, women after 40 years of age need an annual examination by a mammologist.
- Medical abortion.
- Late birth (after 35 years).
- Breast mastitis.
- Poor nutrition
- Ecology
Neoplasms that arise in the mammary gland can be malignant and characterized by aggressive cell proliferation, leading to metastases.
Symptoms of breast cancer
How to identify breast cancer in women, what symptoms should alert you? There are many signs of breast disease, but little attention is paid to them. This is due to the fact that they do not cause discomfort in the early stages of the pathology. Meanwhile, time is the main factor in the treatment of breast cancer.
Important! 80% of women were able to avoid death thanks to a timely diagnosis of breast cancer and timely initiation of therapy.
Symptoms of breast cancer vary, depending on the shape and size of the anomaly, the degree of spread and location.
Common symptoms of breast cancer:
- Availability of seals;
- discharge appeared from the nipple;
- the nipple has sunk inward.
- Constant feeling of pain in the back;
- transient bust asymmetry;
- peeling, irritation, redness, and itching appeared on the skin of the chest.
Breast cancer and its symptoms for each form of the disease should be considered in more detail:
- In the nodular form, the neoplasm can be recognized by a hard ball. Its diameter can be from 0.5 – 5 cm or more. With this type of disease, all of the following symptoms will appear.
- Diffuse breast cancer is divided into three types:
- Armored - with this type of pathology, a malignant neoplasm spreads along the gland in the form of a “crust”, which tightens and reduces the size of the affected breast.
- Erysipelas – the skin on the surface of the bust becomes red, a feeling of pain appears, and body temperature may rise to 40° C.
- Pseudo-inflammatory – signs similar to those of an erysipelas-like disease. Because of this symptomatology, it is difficult to correctly diagnose the pathology; the patient is prescribed therapy for those diseases that are present in the name of this form of oncology.
All three of these species are very aggressive. Cancerous cell growth occurs at lightning speed and spreads throughout the entire bust, without clear boundaries.
There are cases when the neoplasm manifests itself as metastases to the lymph nodes on the affected side. In this case, the tumor is not detected, making it difficult to diagnose cancer. In such cases, this type of pathology is called “latent oncology.”
If the formation is small in size, then no obvious manifestations are observed. A woman can feel such a tumor on her own only if it is small in size.
A malignant node, as a rule, is motionless upon palpation, and if displacement occurs, it is insignificant, does not cause pain, has an uneven surface and stone density.
In oncology, the skin over the tumor is significantly different - it becomes wrinkled and folds appear. It retracts and becomes swollen. A sign of “lemon peel” appears. In rare cases, “cauliflower” is observed - the tumor grows outward, through the dermis.
Important! If self-diagnosis reveals such signs, then the condition of the lymph nodes should be checked. You should not be concerned if they increase slightly, feel pain, or move when palpated.
One of the symptoms of oncology in this part of the body may be swelling of the arm on the side of the tumor. If there is such a recognized sign, then you should know that these are already the last stages of the disease.
To summarize everything that was listed above, it is worth indicating the main symptoms of this disease:
- Any change in shape - a decrease or increase in the size of one of them, retraction or displacement of the nipple.
- Changes in the mamma dermis - ulcers in the area of the areola, nipple. Change in color of any place on the skin - blueness, redness or yellowing. Thickening or compression of a limited area - “lemon peel”.
- A hard, immovable knot.
- In the axillary area, the lymph nodes are enlarged, causing slight pain when palpated;
- When pressing on the nipples, a discharge appears - with ichor or transparent;
Important! It is impossible to independently detect breast cancer in the early stages. Therefore, it is important to regularly visit a mammologist.
Of course, there are many more signs of oncology for this anomaly, but it is those listed that are most often noted by women.
How to identify the pathology of a disease at home interests many women.
With the development of a disease such as sternum cancer in women, signs and photos will help reveal the entire affected area and identify the causes of the disease.
Breast structure diagram.
Breast cancer (BC) is the uncontrolled growth of cells in the mammary gland of a malignant nature. It is the most common cancer among women, although men can also develop it.
The exact causes of breast cancer are unknown, but some women have a higher risk than others. For example, the likelihood of having breast cancer is higher in women with a personal or family history of breast cancer and women with certain known gene mutations.
In addition, women whose menstrual cycle began before the age of 12 years, as well as those women whose menopause began at an older age, have an increased risk of breast cancer. Women who have never been pregnant have a higher risk of developing breast cancer than those who have been pregnant.
The best prognosis for recovery from this cancer comes from early diagnosis of the disease. It is important to have regular breast checks and mammograms starting at age 45. Women who have risk factors should start getting mammograms at age 40.
Attention: the photos below are not for the faint of heart!
Because cancer cells can metastasize or spread to other parts of the body, it is important to detect breast cancer symptoms early. The sooner you receive a diagnosis and begin treatment, the better the prognosis.
Paget's cancer: symptoms and signs with photos
Like other malignant tumors, breast cancer is very difficult to detect at an early stage. For a long time the disease is not accompanied by any symptoms. Its signs are often discovered by chance.
Symptoms that require immediate medical attention:
- pain in the mammary gland that has no apparent cause and persists for a long time;
- feeling of discomfort for a long time;
- lumps in the mammary gland;
- changes in the shape and size of the breast, swelling, deformation, the appearance of asymmetry;
- deformation of the nipple: most often it becomes retracted;
- discharge from the nipple: bloody or yellow;
- changes in the skin in a certain place: it becomes retracted, begins to peel or wrinkle, its color changes;
- a dimple, a depression that appears on the mammary gland if you raise your hand up;
- enlarged lymph nodes in the armpit, above or below the collarbone;
- swelling in the shoulder, in the area of the mammary gland.
- Regular self-examination. A woman should be able to properly examine her breasts and identify the first signs of a malignant neoplasm.
- Regular visits to the doctor. It is necessary to be examined by a mammologist (a specialist in the field of breast diseases) at least once a year.
- Women over 40 years of age are recommended to undergo regular mammography, an X-ray examination aimed at early detection of breast cancer.
As mentioned above, every woman should know what the first symptoms of developing breast cancer are. Of course, knowledge does not always bring positive results. Very often, a woman is afraid of what is happening to her body, closes herself off from others and completely immerses herself in her problem, or, on the contrary, mistakenly ignores it.
In any case, those who are familiar with the main signs of cancer are more prepared for it and are safer.
- Easy palpation of the tumor, especially if you press the chest to the chest
- If you pull back the nipple, the resulting tumor will change its place
- The skin around the nipple thickens
Despite the fact that the first signs of the development of breast cancer are quite bright and understandable, only a small number of representatives of the fair half of humanity attach importance to them.
The course of Paget's cancer is nonspecific; researchers do not know how long it takes to develop in the body. For a long time, the course is asymptomatic, and the initial changes are imperceptible, after which the disease suddenly and rapidly progresses and leads to irreparable consequences.
In the early stages, external manifestations are minor - the patient notices spots of unknown origin around the nipple. Sometimes they itch, there is a burning sensation, peeling, inflammation - these are the very first harbingers, obvious symptoms indicating the onset of the disease.
Over time, deformation of the affected nipples becomes visible - a characteristic feature of Paget's cancer (see photos). They become too elongated or retracted; when you feel the skin over it with your fingers, it is dense.
Late complaints of the patient include:
- discharge of a mucopurulent nature mixed with dirty blood indicates the disintegration of the tumor;
- enlargement of peripheral lymph nodes, which become like dense lumps;
- intoxication - expressed by weakness, lethargy for no reason, increased body temperature, increased heart rate and breathing;
- pain syndrome.
Symptoms of breast cancer
Paget's disease - symptoms: due to the large number of forms of the disease, they manifest themselves differently and depend on the type of cancer and the individual characteristics of the body. The danger of this type of oncology is that patients do not associate the symptoms that arise with oncology and consult a doctor too late.
In the early stages, the following characteristic manifestations are:
- Slight redness of the nipple or the skin around it.
- Peeling and irritation on the skin in the area around the nipple.
- Tingling, itching, increased sensitivity, mild pain in the nipple.
All these symptoms usually do not affect the breast tissue. Symptoms may disappear and appear over time. Sometimes patients begin to use corticosteroid-based ointments, which relieve bothersome symptoms. However, the cancer does not stop progressing.
As the disease progresses, the following symptoms appear:
- Discharge from the nipple of a serous-hemorrhagic nature. Discharge occurs spontaneously and stains underwear.
- Flattening or retraction of the nipple.
- Development of infiltrate in the nipple-areolar area.
- Hyperemia, visible redness.
- Ulcers, crusts, and erosions form on the surface of the areola.
- If you remove the crusts and scales, weeping sores form in their place.
Usually changes are observed only on one side of the chest. In rare cases, bilateral symptoms are possible, on both nipples at once.
Diagnostic signs that help identify cancer and differentiate it from eczema and skin diseases:
- The affected areas of the skin are raised above the epidermis.
- The affected areas are clearly defined and separated from healthy tissue.
- On palpation, you can notice enlarged axillary lymph nodes.
- There may be copious bloody discharge from the nipple, which indicates rapid progression of the disease. Deforming cancer develops, tissues are destroyed.
Men also experience similar symptoms:
- Itching and peeling.
- Redness and hyperemia.
- Seals in the depths of tissues.
- Inverted nipple.
- Skin maceration.
As the disease progresses, a complex of symptoms characteristic of oncology becomes involved, damage to internal organs may occur due to metastases, the blood profile changes greatly, and ostosis and osteodystrophy may develop.
If you notice at least two of the described symptoms, you should consult a doctor. Most likely, the disease will turn out to be ordinary eczema (this is how other nipple diseases manifest themselves), but it is important to exclude the risk of oncology.
| Nodular form of breast cancer | A painless, dense formation is felt in the thickness of the mammary gland. It can be round or irregular in shape and grows evenly in different directions. The tumor is fused with the surrounding tissues, so when a woman raises her arms, a depression forms on the mammary gland in the corresponding place. The skin in the area of the tumor wrinkles. In later stages, its surface begins to resemble lemon peel, and ulcers appear on it. Over time, the tumor causes the mammary gland to increase in size. |
| Edema-infiltrative form | This form of breast cancer most often occurs in young women. Pain sensations are most often absent or mild. There is a compaction that occupies almost the entire volume of the mammary gland. Swelling develops on the skin; in appearance it resembles a lemon peel. Due to compaction, it is not possible to gather the skin into a fold. The swelling is most pronounced around the nipple. The edematous-infiltrative form of breast cancer is accompanied by enlarged lymph nodes in the armpit. |
| Mastitis-like breast cancer | It occurs in women of different ages, but most often in young women. Symptoms:
What does mastitis-like breast cancer look like? |
| Erysipelas cancer | This form of breast cancer, in accordance with its name, resembles erysipelas - a special type of purulent infection. Symptoms:
What does erysipelas-like breast cancer look like? |
| Armored cancer | The tumor grows through all glandular tissue and fatty tissue. Sometimes the process goes to the opposite side, to the second mammary gland. Symptoms:
What does armored breast cancer look like? |
| A special form of breast cancer, occurs in 3–5% of cases. Symptoms:
What does Paget's cancer look like? |
The signs of breast cancer in women are almost the same. And what form is discovered does not, in principle, play a special role. But as for the symptoms, they may differ slightly for different forms of cancer.
- Edema. In this case, significant thickening and compaction of almost all breast tissue occurs. In addition, the formation of emboli is possible. This form of cancer develops so quickly that the woman does not even have time to understand what is happening. Typically, this cancer occurs in young girls, mainly during breastfeeding. That is why the first symptoms of cancer, such as the presence of a small lump, can be perceived as a blockage of the milk duct, which is very typical during the feeding period. At the moment when the tumor begins to grow, the skin turns red, and the lymph nodes in the armpit area become enlarged. The picture is quite unpleasant, and besides, this form is difficult to ignore
- Erysipelatous. In most women with this form of cancer, body temperature rises, and to critical values (up to 39-40 degrees). It goes astray, but not for long, as the inflammatory process is underway. The main feature and characteristic symptom of this form is severe redness of the breast itself, and sometimes of the area adjacent to it. Such redness from the outside may resemble a flame, due to the fact that the edges of the redness are uneven and have a specific shape. If we talk about other symptoms, the tumor grows very quickly, but due to swelling and redness it is difficult to feel it on your own. Very often, redness and swelling, despite the fact that they reach large sizes, do not cause any discomfort, and there is no pain when palpated
- Mastitis-like. This form of cancer mainly occurs in young women, especially during pregnancy and breastfeeding. Its symptoms are very easy to recognize, however, the main thing is not to confuse it with milk stagnation. So, with a mastitis-like form of cancer, a woman’s temperature may rise sharply, and it is very difficult to bring it down; in the place where the tumor has formed, the area of skin noticeably enlarges and becomes dense, severe redness and swelling appear. Sometimes the entire breast, as well as the area adjacent to it, becomes dense. As for the lymph nodes, they enlarge not only in the axillary region, since with this form metastasis begins very quickly
- Paget's, or more understandably, nipple cancer. It is this form of cancer that is considered the most acceptable and favorable, since cancer cells are located only in one area. The symptoms of this cancer are very similar to those of dermatological disease, which is why this form is so often missed. The main symptoms in this case will be discharge from the nipple, as well as the appearance of eczema. When examined by a doctor, the crusts that have formed may be perceived as normal due to the fact that a healthy woman may have a small amount of discharge. If the cancer is advanced and was not recognized at an early stage, an ulcer will gradually form at the site of the nipple, which will bleed
- Hidden. This is the most dangerous form of cancer, as it can be easily confused with lymphadenitis. This is because the first signs of hidden breast cancer in women are enlarged lymph nodes, which can easily occur for other reasons. The tumor cannot be palpated, and even an experienced specialist can very rarely notice it.
There are many forms of breast cancer in women, but the main thing to remember is that, despite the abundance of various symptoms, the most important thing will be inflammation of the lymph nodes in the armpit area. In a woman, they cannot just become inflamed, and the first thing you need to think about is the breasts.
Early manifestations of Paget's disease are redness of the skin around the nipple and the formation of scaly changes in the skin of the breast areola. Such symptoms occur in a very mild form, which in most cases is not a reason to contact a specialist.
Sometimes patients note a short-term and spontaneous improvement in their health. In the first stages of breast cancer, increased sensitivity and soreness of the breast nipple, tingling and itching in the affected area may also be observed.
There are three main options for damage to breast tissue due to nipple cancer in the later stages of the disease:
- Changes are determined exclusively in the area of the nipple and areola of the breast.
- The external manifestations of oncology are accompanied by nodular breast cancer.
- Lump in the breast and histological changes in the nipple.
In approximately half of the patients, palpation reveals hardening in the mammary gland and specific discharge from the ducts. Nipple cancer is mainly accompanied by the formation of metastases in regional lymph nodes.
- The presence of “lumps” or compaction in the chest area;
- Specific discharge not related to lactation;
- You may find that the nipple has sunk inward;
- Back pain, heaviness;
- Breast asymmetry that you have not noticed before;
- The skin of the breast may wrinkle, crack, or peel;
- When you raise your hand, you will notice depressions in small areas of the mammary glands;
- Swelling of the bust;
- Itching of the nipples or the breast itself;
- Progressive weight loss;
- Increase in local and general temperature;
- Pain when touched.
The first signs of breast cancer in women: symptoms and diagnosis
If oncology is suspected, a whole range of studies are carried out. If the primary diagnosis is confirmed, additional tests are prescribed to determine the form and nature of the disease.
The following set of diagnostic tests is usually prescribed:
- Consultation with a mammologist-oncologist with visual examination and palpation.
- An MRI, which can show how much of the milk duct is affected.
- Ultrasound of the breast.
- Mammography.
- Smear-imprint.
- Cytology and histology after biopsy.
During a visual examination, the doctor may notice characteristic manifestations. Palpation allows you to detect neoplasms in the thickness of the tissue. A smear of the secretion from the nipple allows you to find Paget's cells and confirm the diagnosis.
It is important to know that mammography is wrong in 50% of cases and is practically not used to diagnose Paget's cancer. It is customary to prescribe ultrasound or computer studies. However, a mammogram can show how much tissue is affected and reveal deformation of the milk duct. It will also be useful if there is an obvious tumor in the breast tissue.
To make a diagnosis, it is necessary to clearly separate cancer from eczema, basal cell carcinoma, melanoma, dermatitis, psoriasis, scabies and some other rare diseases.
If a tumor of the nipple of the mammary gland is suspected, the specialist sends the patient for a skin biopsy. Microscopically it is possible to detect Paget's cells. If breast cancer is present, a mammogram is recommended.
If mammography does not give a positive answer, the patient is prescribed an ultrasound examination. The ultrasound method is widespread; it allows one to detect a large number of changes, while modern devices are absolutely harmless to the patient.
Even more promising is the method of magnetic resonance imaging, which makes it possible to detect nipple cancer before its manifestations. But the most reliable method is considered to be a biopsy, for which a section of tissue is taken from the entire thickness of the nipple and areola.
An ordinary general practitioner is not always able to detect this disease, since this type of pathology is extremely rare and not every doctor will think about it. Therefore, making a correct diagnosis is delayed by an average of 1 month after the onset of clinical manifestations.
Inspection
Diagnosis of malignant breast tumors begins with an examination by an oncologist or mammologist.
During the examination, the doctor:
- will question the woman in detail, try to obtain the most complete information about the course of the disease, the factors that could contribute to its occurrence;
- will examine and palpate (feel) the mammary glands in a lying position, standing with arms lowered and raised.
| Diagnostic method | Description | How is it carried out? | |
| Mammography is a diagnostic section that deals with non-invasive (without cuts or punctures) examination of the internal structure of the mammary gland. | |||
| X-ray mammography | X-ray examination of the breast is carried out using devices that generate low-intensity radiation. Today, mammography is considered the main method for early diagnosis of malignant breast tumors. Has an accuracy of 92%. In European countries, X-ray mammography is routinely performed on all women over 45 years of age. In Russia it is mandatory for women over 40 years of age, but in practice not everyone does it. X-ray mammography best detects tumors measuring 2–5 cm. An indirect sign of a malignant neoplasm is a large number of calcifications - accumulations of calcium salts, which contrast well in photographs. If they are found to be more than 15 per cm 2, then this is a reason for further examination. |
The study is carried out in the same way as conventional radiography. The woman is naked to the waist, leans against a special table, places the mammary gland on it, after which a photograph is taken. X-ray mammography machines must meet the requirements set by WHO. Types of X-ray mammography:
|
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| MRI mammography | MRI mammography is the examination of the mammary glands using magnetic resonance imaging. Advantages of MRI mammography over X-ray tomography:
Disadvantages of magnetic resonance imaging as a method for diagnosing malignant neoplasms of the mammary glands:
|
Before the examination, you must remove all metal objects from yourself. You cannot take any electronics, as the magnetic field generated by the device can damage them. If the patient has any metal implants (pacemaker, prosthetic joints, etc.), you need to warn the doctor - this is a contraindication for the study. The patient is placed in the apparatus in a horizontal position. She must remain stationary throughout the entire study. The time is determined by the doctor. |
|
| Ultrasound mammography | Ultrasound examination is currently an additional method for diagnosing malignant neoplasms of the mammary glands, although it has a number of advantages over radiography. For example, it allows you to take pictures in different projections and does not have a harmful effect on the body. Main indications for the use of ultrasound diagnostics for breast cancer:
|
The technique is no different from conventional ultrasound. The doctor uses a special sensor that is applied to the mammary gland. The image is broadcast on the monitor and can be recorded or printed. During an ultrasound examination of the mammary glands, Doppler sonography and duplex scanning can be performed. |
|
| Computed tomomammography | The study is a computed tomography scan of the mammary glands. Advantages of computed tomomammography over x-ray mammography:
Disadvantages of computed tomomammography: |
The study is carried out in the same way as a regular computed tomography. The patient is placed on a special table inside the device. She must remain motionless throughout the entire study. | |
| Biopsy - excision of a fragment of breast tissue followed by examination under a microscope. |
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| Needle biopsy | The accuracy of the method is 80 – 85%. In 20–25% of cases, a false result is obtained. | A fragment of breast tissue for examination is obtained using a syringe or a special aspiration gun. The procedure is performed under local anesthesia. Depending on the thickness of the needle, there are two types of puncture biopsy:
The procedure is often performed under ultrasound or x-ray mammography guidance. |
|
| Trephine biopsy | Trephine biopsy of the mammary glands is performed in cases where it is necessary to obtain more material for research. The doctor receives a piece of breast tissue in the form of a column. | Trephine biopsy is performed using a special instrument consisting of a cannula with a mandrel into which a rod with a cutter is inserted. The intervention is performed under local anesthesia. The surgeon makes an incision in the skin and inserts a trephine biopsy instrument through it. When the tip of the incisor reaches the tumor, it is pulled out of the cannula. Using a cannula, a column of tissue is cut and removed. After receiving the material, the wound is carefully coagulated to prevent the spread of cancer cells. During research in the laboratory, it is possible to determine the sensitivity of tumor cells to steroid hormones (which include estrogens). This helps with further choice of treatment tactics. |
|
| Excisional biopsy | Excision is the complete removal of the tumor and surrounding tissues. The entire mass is sent to the laboratory for testing. This makes it possible to detect tumor cells at the cut border and study the sensitivity of the tumor to sex hormones. | The surgeon removes the tumor and surrounding tissue during surgery. Thus, excisional biopsy is both a therapeutic and diagnostic procedure. | |
| Stereotactic biopsy | During a stereotactic biopsy, samples are taken from several different locations through a single needle. | The procedure is similar to a regular needle biopsy. It is always carried out under the control of x-ray mammography. The needle is inserted into a certain place, a sample is obtained, then it is pulled, the angle of inclination is changed and it is inserted again, this time in a different place. Multiple samples are obtained, which makes the diagnosis more accurate. |
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| Study | Description | Methodology |
| Determination of tumor marker CA 15-3 in the blood (syn.: carbohydrate antigen 15-3, carbohydrate Antigen 15-3, cancer Antigen 15-3) | Tumor markers are various substances that are detected in the blood during malignant neoplasms. Different tumors have their own tumor markers. CA 15-3 is an antigen located on the surface of the mammary gland ducts and secreting cells. Its content in the blood is increased in 10% of women with early stages of breast cancer and in 70% of women with tumors accompanied by metastases. Indications for the study:
|
For the study, blood is taken from a vein. You must not smoke for half an hour before the test. |
| Cytological examination of nipple discharge | If a woman has discharge from the nipple, it can be sent for laboratory testing. When examined under a microscope, tumor cells may be detected. You can also make an imprint of the crusts that form on the nipple |
When examining nipple discharge under a microscope, cells characteristic of a malignant tumor are revealed. |
Breast cancer treatment and prognosis
When this type of cancer is detected, surgical treatment is prescribed. Conservative therapy tactics do not produce acceptable results.
If a non-invasive form of cancer is detected, you can get by with a standard mastectomy, in which only the nipple, areola and part of the glandular tissue are removed. After such an operation, the shape of the breast can be restored.
If invasive cancer is detected, a radical mastectomy is performed. Such stringent measures are due to the high rate of spread of pathological cells. During radical surgery, the entire mammary gland and pectoral muscles are removed, and subcutaneous tissue and regional lymph nodes are also removed.
After any operation, it is customary to perform reconstructive mammoplasty. After removal of pathological tissues, hormonal therapy, chemotherapy or radiation therapy are prescribed. After cure, which is defined as the complete absence of Paget cells in tissues, preventive maintenance therapy is prescribed.
Depending on the stage of the disease, a specific treatment tactic is chosen.
Operation
Surgical intervention is considered preferable, especially when the process is accompanied by cancer of the breast or its ducts. Here, surgeons remove the breast along with some of the surrounding muscle and nearby lymph nodes.
If the process is not malignant, the operation is more gentle and is limited to the removal of the mammary gland with the sheath of the muscles located under the breast. The excised material is then sent for histology to detect neoplasm cells in them.
Sometimes a doctor prescribes radiation treatment, but not always to fight cancer cells - more often to prevent recurrence of the disease. This therapy is used after surgery; it is very effective in this case and gives a good result.
If an advanced form of cancer is detected, radiation therapy is given before elective surgery to reduce the process and make surgery easier.
Chemotherapy
This pathology can also be eliminated by chemotherapy, which is a systemic drug treatment for the disease. The goal of the method is to prevent tumor metastases and influence the tumor itself. It is advisable to use this treatment in the presence of an unfavorable factor, for example, the patient’s young age or progressive growth of the tumor, high malignant grade, or poor prognosis.
In other situations, chemotherapy is undesirable due to the additional burden on the body that has no effect on improving the patient’s life.
However, if the lymph nodes are involved in the process, the appointment of the latter is mandatory. For this purpose, combinations of drugs with the group of anthracyclines are used. In addition, local chemotherapy using various regimens is very convenient and effective.
Medicines
Treatment of nipple disease with cytostatic drugs takes place in this series of procedures. Medicines are aimed at reducing the spread of the process, reducing immunity (since the tumor is an autoimmune disease) and eliminating the clinical manifestations of the disease. The choice of drug depends on the characteristics of the pathology.
In the last century, the connection between hormone therapy and the quality of life of such patients, especially at a young age, was proven. Nipple cancer was sensitive to progesterone and estrogens. But before introducing antiestrogenic drugs into therapy, it is necessary to detect receptors sensitive to steroids in tumor cells.
- surgical;
- chemotherapy;
- hormone therapy;
- immunotherapy;
- radiation therapy.
Combination treatment using two or more methods is usually carried out.
Surgery is the main treatment for breast cancer. Currently, oncologist surgeons are trying to perform less voluminous interventions, to preserve breast tissue as much as possible, supplementing surgical methods with radiation and drug therapy.
Types of surgical interventions for breast cancer:
- Radical mastectomy: complete removal of the mammary gland along with fatty tissue and nearby lymph nodes. This type of operation is the most radical.
- Radical resection: removal of a sector of the mammary gland along with subcutaneous fatty tissue and lymph nodes. Currently, surgeons increasingly prefer this particular surgical option, since radical mastectomy practically does not prolong the life of patients compared to resection. The intervention must be supplemented with radiation therapy and chemotherapy.
- Quadrantectomy– removal of the tumor itself and surrounding tissues within a radius of 2–3 cm, as well as nearby lymph nodes. This surgery can only be performed in the early stages of the tumor. The excised tumor is necessarily sent for a biopsy.
- Lumpectomy is the smallest operation in which the tumor and lymph nodes are removed separately. The surgical study was developed during the National Breast Surgical Supplementation Project (NSABBP, USA) studies. The conditions for the intervention are the same as for quadrantectomy.
The extent of surgical intervention is chosen by the doctor depending on the size, stage, type and location of the tumor.
Radiation therapy
| Name | Description |
| Preoperative | Intensive short-term courses of radiation are carried out. Goals of preoperative radiotherapy for breast cancer:
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| Postoperative | The main goal of radiation therapy in the postoperative period is to prevent tumor recurrence. Sites that are irradiated during postoperative radiation therapy:
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| Intraoperative | Radiation therapy can be used directly during surgery if the surgeon tries to preserve as much breast tissue as possible. This is advisable at the stage of the tumor: |
| Independent | Indications for the use of gamma therapy without surgery:
|
| Interstitial | The radiation source is brought directly to the tumor. Interstitial radiation therapy is used in combination with external beam therapy (when the source is located at a distance) mainly for nodular forms of cancer. The purpose of the method: to deliver the highest possible dose of radiation to the tumor in order to destroy it as much as possible. |
- the tumor itself;
- lymph nodes located in the axillary region;
- lymph nodes located above and below the collarbone;
- lymph nodes located in the sternum area.
Chemotherapy
– drug treatment of breast cancer, which uses cytostatics. These drugs destroy cancer cells and suppress their proliferation.
Cytostatics are drugs that have numerous side effects. Therefore, they are always prescribed strictly in accordance with established regulations and taking into account the characteristics of the disease.
The main cytostatics used for malignant tumors of the mammary glands:
- adriblastine;
- methotrexate;
- 5-fluorouracil;
- paclitaxel;
- cyclophosphamide;
- docetaxel;
- xeloda.
- CMF (Cyclophosphamide, Fluorouracil, Methotrexate);
- CAF (Cyclophosphamide, Fluorouracil, Adriablastin);
- FAC (Fluorouracil, Cyclophosphamide, Adriablastin).
The main goal of hormonal therapy is to eliminate the influence of female sex hormones (estrogens) on the tumor. The techniques are used only in the case of tumors that are sensitive to hormones.
| Method | Description |
| Spaying | After removal of the ovaries, the level of estrogen in the body drops sharply. The method is effective in a third of patients. Suitable for ages 15 – 55 years. |
“Medicinal castration” with drugs:
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Medicines suppress the pituitary gland's release of follicle-stimulating hormone (FSH), which activates the production of estrogen by the ovaries. The method is effective in a third of women aged 32 to 45 years. |
Antiestrogenic drugs:
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Antiestrogens are drugs that suppress the functions of estrogen. Effective in 30% - 60% of women aged 16 to 45 years. |
Medicines that inhibit the aromatase enzyme:
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The aromatase enzyme takes part in the formation of steroid hormones, including the female sex hormones estrone and estradiol. By inhibiting aromatase activity, these drugs reduce estrogenic effects. |
Progestins (gestagens):
|
Progestins are a group of female sex hormones that interact not only with their own receptors on the surface of cells, but also with receptors intended for estrogens, thereby partially blocking their action. Medicines containing progestins are prescribed for people aged 9 to 67 years and are 30% effective. |
| Androgens are preparations of male sex hormones. | Androgens suppress the production of follicle-stimulating hormone (FSH), which activates the production of estrogen in the ovaries. The method is effective in 20% of girls and women aged 10 to 38 years. |
- mammography;
- scintigraphy;
- biopsy.
Complications of surgical treatment
After surgical resection of the mammary gland, patients are recommended to undergo routine gynecological examinations once every six months. After three years, the frequency of visits to the doctor should be once a year.
- Limited movement of the arm on the part of the operated breast, which occurs due to damage to the pectoral muscles.
- Lymphostasis after breast removal. This complication is observed after removal of regional lymphatic vessels, which leads to impaired lymph outflow.
Late consequences of mastectomy:
- Scarring of the chest tissue, which, in addition to aesthetic discomfort, provokes a violation of the motor function of the upper extremities.
- Re-formation of a cancerous tumor of the breast tissue or the development of metastases in distant organs.
- Curvature of the spine due to dysfunction of the shoulder joints.
- Weakening of the immune system function, which occurs due to the inferiority of the lymphatic system.
During the examination, the doctor detects characteristic changes in the nipple and areola. Upon palpation, lumps may be detected in the breast tissue. Microscopic examination of the nipple smear helps detect tumor cells.
Mammography is a method of examining the mammary glands using x-rays. In the presence of isolated nipple cancer, its effectiveness is no more than 50%. The image clearly shows the tumors, which are located mainly in the thickness of the breast.
When viewing a mammogram, the doctor pays attention to the nipple, changes in its shape, the thickness of the skin of the nipple-areolar area, the presence of calcifications around this area, and assesses the size of the tumor.
Some changes that are not visualized on the image can be seen using ultrasound. It is also advisable to conduct an ultrasound scan to assess the condition of the milk ducts.
MRI helps to identify changes that do not give any symptoms and distinguish between tumors of various origins. Scintigraphy is a functional imaging method in which radioactive isotopes that accumulate in Paget cells are introduced into the body. A biopsy consists of a histological examination of a piece of damaged tissue.
Scan cancer is not well treated in the first stages, but often relapses. The main method of therapy is surgery. If the tumor grows into other tissues, the breast, lymph nodes and pectoral muscles are removed.
The non-invasive form is treated with a simple mastectomy - breast resection and removal of the pectoralis minor muscle. Stage 1 and 2 therapy involves cutting out only the tumor. Subsequently, patients undergo reconstructive surgery.
After surgery, loss of sensitivity of the skin at the incision site is possible, which is associated with nerve damage during surgery. Over time, they are restored and sensitivity returns.
In addition, the incision may become infected. In this case, the wound is washed with antiseptic solutions and drainage is installed. In addition to surgical treatment, radiation therapy, chemotherapy and hormonal treatment are performed. These methods help to avoid the recurrence of cancer and the occurrence of metastases.
Traditional medicine can be used only after surgical treatment of the disease. For the treatment of Paget's cancer, agave and wintergreen are used, from which tinctures are prepared. To prepare, take 50 grams of dried plant, add 500 milliliters of vodka and leave for 3 weeks.
The prognosis of the disease depends on the stage of the disease. Complex treatment of stages 1-3 extends the life of patients for approximately 3 years. If the disease is detected at the last stage and the presence of multiple metastases, the prognosis is unfavorable. Life can only be continued for about 1 year.
It should be remembered that Paget's cancer is a rapidly progressive disease, the symptoms of which in the first stages are similar to those of other diseases. Therefore, if even the most minor symptoms appear, you should immediately consult a doctor and undergo a full examination. The earlier treatment is started, the greater the chances of a full recovery.
What traditional treatment methods can be used for breast cancer?
Traditional methods are not able to provide an effective fight against the tumor process. Self-medication delays a visit to the doctor. Often such patients turn to a specialist when there are already distant metastases in the lymph nodes. However, 70% of patients do not survive for 3 years.
The only right decision for a patient with suspected breast cancer is to see a doctor as early as possible, carry out diagnostics and, if necessary, begin treatment in an oncology clinic.
Prevention and early detection of breast cancer
Is it possible to avoid Paget's cancer? Unfortunately, scientists have not been able to develop specific recommendations that could prevent Paget's cancer. The main attention should be paid to nonspecific protective factors - work and rest schedule, normal sleep, healthy lifestyle, sufficient level of physical activity.
If possible, it is necessary to exclude exposure to unfavorable factors - ionizing radiation, chemical carcinogens, occupational hazards, premature termination of pregnancy. Since Paget's cancer is closely associated with breast neoplasia, women are recommended to breastfeed their children for at least a year - a stable hormonal background protects against troubles.
Diagnosis, therapy and prognosis for pathology
Adequate treatment takes little time only if the cancer is detected in a timely manner. However, this type of oncology does not have specific symptoms, so the vast majority of patients seek help during the active development of the disease.
In any case, treatment takes months, in especially severe cases – years. It is difficult to predict the results, since this disease is an aggressive form of oncology. Even after all preventive measures, there remains a high risk of relapse and metastasis.
It is more correct to calculate the probability of a favorable outcome separately for each patient, taking into account age, health status, and degree of damage.
Positive or negative prognosis of the disease depends on the stages of cancer and its aggressiveness. With timely detection and treatment of the pathology, a complete recovery is possible; this is influenced by many factors, including the body itself.
A poor prognosis is observed in late stages with the presence of metastases, when the process is widespread and therapy methods are aimed at maintaining the patient’s life.
Surgery is the most radical way to treat breast cancer. A complete removal of the mammary gland (mastectomy) and surrounding tissues, including lymph nodes, is performed. Gentle organ-preserving interventions are being intensively developed, in particular, cryomammotomy, in which the tumor is frozen at a temperature of minus 120 degrees, after which it is removed using a small incision. However, the clinical effectiveness of such procedures is still debated.
Radiation therapy is used after surgery to destroy cancer cells that were not removed.
Chemotherapy is carried out before and after surgical removal of the tumor. In the first case, chemotherapy is used to achieve resectability of the tumor; if this cannot be achieved (most often, with stage 3 and stage 4 breast cancer), chemotherapy becomes the main, but, unfortunately, not a radical means of treatment.
Targeted therapy is a modern approach to the treatment of breast cancer, based on suppression of the expressed HER2 gene with monoclonal antibodies. Targeted therapy for breast cancer is carried out after surgical treatment; in most cases in combination with radiation therapy and chemotherapy.
The prognosis of the disease depends on the stage of breast cancer:
- at stage 1, the five-year survival rate reaches 85%;
- at stage 2 - 65%;
- at stage 3 - 40%;
- at stage 4 - 10%.
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The absence of a bra under a see-through top - such a fashion trend, oddly enough, has caused a decline in demand for breast enlargement services among young American women. Now girls dream of becoming the owner of nipples like the famous model Kendall Jenner. You can get hold of a new thing for a very affordable amount: the price tag starts at $700.
Dr. Norman Rowe, a New York plastic surgeon, says more and more clients are asking him to create “designer nipples.” Norman says he invented the term himself. And the most popular now are “designer nipples like Kendall Jenner’s”, that is, small, quite light, but at the same time permanently erect so that they are clearly visible from under clothes.
Since December 2016, when model Kendall Jenner launched the cry to “free her breasts” on social networks, the demand for the procedure to create designer nipples has increased 4 times.
This procedure is certainly much simpler than standard mammoplasty. To implement the operation, codenamed “Like Kendall,” doctors make the areolas symmetrical - that is, they literally adjust them to the same size. After this, the color of the nipples is corrected: to make the areolas lighter, a laser is used, and if darker is needed, tattooing is used.
Well, and the most important thing is the size: the surgeon models the nipples and makes them more convex with the help of filler injections. The cost of one injection at Dr. Rove's clinic is approximately $700, and the effect of the fillers will last at least two years.
Here's the story of 28-year-old Susan, who got the nipples of her dreams in just a few minutes. After all, in the age of plastic surgery, nothing is impossible.
Not all women are blessed with pert nipples, so the opportunity to get them is very exciting for young New Yorkers who flock to Dr. Rove's on Park Avenue.
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Sexual intercourse of a woman
The sexual act of a woman is characterized by greater variety than the sexual act of a man. In a certain sense, you can say that a woman is unpredictable. And sometimes it takes significant experience living together with a man for him to begin to understand her and feel how to behave so that everything works out in bed with her. First, let us dwell on the differences between the first three phases of female sexual intercourse from male ones, associated with the differences in the corresponding genital organs.
In the arousal phase, due to the rush of blood to the genitals, the labia majora straighten, and the labia minora increase in diameter by 2-3 times, changing color from pale pink to dark red. Most women also experience an increase in size and hardening of the clitoris. Literally 10-15 seconds from the beginning of sexual arousal, lubricant begins to be released, causing the vagina to become moist, which facilitates penetration of the penis. The vagina, especially its inner two-thirds, lengthens and expands. If at this time the penis is inserted and the first frictions are performed, then the man may get the impression that the penis is “lost” in the vagina, not clinging to anything.
However, this is a deceptive impression from an under-excited woman. If you continue caresses or frictions, then due to the overflow of venous blood into the walls of the outer third of the vagina, the woman forms an orgasmic cuff (akin to the erection of the penis in a man), which tightly covers the man’s penis, and the woman’s sexual intercourse goes into the plateau phase. The diversity of a woman’s sexual intercourse is primarily due to the fact that the presence or absence of an orgasm has absolutely no effect on her ability to become pregnant (but this ability depends on her sexual constitution). Therefore, the obligatory presence of orgasm as one of the main attributes of a woman’s sexual intercourse is not a factor in her sexual life that nature would need to consolidate in the process of long-term evolution.
In this regard, some women (according to various sources, 10-15% and even 22.4%) are frigid and do not experience orgasm under any circumstances.
Sexopathology in some cases considers frigidity as a sexual disorder, and in others - as sexual coldness in the absence of any deviations in the mental and physical sphere of a woman. Apparently, the first option should be associated with the fact that in some cases a woman had or has (for example, during erotic dreams) orgasms, and then disappeared and are not achieved during sexual intercourse. In this case, frigidity is the result of either a defect in the woman’s upbringing or the incompetence of her sexual partner.
The second option may be associated with truly innate sexual coldness, i.e. with a woman’s inability to experience orgasm at all (so-called constitutional frigidity). In both cases, frigid women have sex life without internal motivation, mainly out of a sense of marital duty and to avoid conflicts with their husbands. In this case, the woman has to pretend that she is allegedly experiencing an orgasm, which greatly contributes to male self-confidence.
On the other hand, women have objective indicators by which a man can find out whether they have an orgasm or not. So, immediately after orgasm, some women experience so-called “sexual flushing.” This is a measles-like rash that appears on the chest, appears suddenly, lasts for a few minutes and gradually disappears. This redness does not happen to every woman. But the second sign is common to all women: their orgasm is always followed by an erection of the nipples. Despite the heaving of the hips, the thrusting of the pelvis, the passionate moans - since there is no erection of the nipples, then there is no orgasm.
The second factor influencing the variety of sexual intercourse of women capable of experiencing orgasm is its multivariance. Multivariance is manifested both in the place of orgasm and in its type (or nature of occurrence). Depending on the location, a woman’s orgasm can be: clitoral (40-56%); vaginal or vaginal (33-37%); tsvirkalny or uterine; perineal; mixed (27%). In the latter case, a woman's orgasm can be simultaneous, affecting several of her organs, or sequential, when it first occurs in one place and then continues in another. More than half of women of this type note the appearance of orgasm first in the clitoral area, about a third - in the vaginal area, and the rest - in other places.
In appearance, a female orgasm can be: single, like a male orgasm (10%); wavy (84%); multiple or multiorgasmic (about 5%); protracted (no more than 1%). A single orgasm is pulsating with a single peak, similar to a male one, jerky, but often longer than a male one by 20-30%. The specificity of such an orgasm is the rhythmic contraction of the muscles of the vagina, uterus, pelvic floor, perineum, diaphragm and even the abdomen. Many women describe that their orgasm begins with a short-term feeling of delay in all mental processes, a peculiar feeling of weightlessness, ending with a push in the clitoris area with irradiation into pelvis, and the appearance of a feeling of warmth spreading throughout the whole body.
In this case, there is a feeling as if something is being squeezed out of the body, which has given rise to an incorrect judgment about the existence of female ejaculation. Then comes an involuntary rhythmic contraction of the muscles of the vagina, pelvis, etc., felt throughout the body and reminiscent of a pulse, which is why it is called “pelvic beat.” It is accompanied by a feeling of non-existence, stunning ecstasy, unusual voluptuousness. In this case, the respiratory rate reaches 40 per minute, blood pressure sometimes rises to 200 mm Hg. Art. and higher, and the pulse is up to 140-170 beats per minute.
The number of beats varies for different women: from 3-4 to 12-15. Then comes the phase of calming, but unlike male sexual intercourse, the woman does not experience depression, but a simple calming of the body occurs with a return flow of blood from the genitals and the disappearance of the orgasmic cuff, lightening of the reddened areas of the skin, a decrease in pulse and blood pressure.
How to properly perform sexual intercourse
In this case, the woman’s arousal gradually subsides to a normal state, which sometimes takes up to 10-20 minutes.
It should be noted that some women experiencing uterine orgasm actually experience the release of some amount of fluid. In this case, first the so-called Christeler's plug, which is a clot of mucus, is pushed out of the cervix, and then the secretions of the cervix and Bartholin's glands are thrown out. Usually all this fluid is not much, but some women in one sexual act gain, as one tabloid newspaper puts it, the amount of “a small cup of coffee.” Therefore, such women always have problems with the cleanliness of bed linen if no measures are taken in advance (do not place napkins as thick as a towel).
There is another source of fluid for women - the bladder. In a very small number of women, it is possible that a combination of muscle tension during orgasm leads to squeezing out the contents of the bladder, which can also be perceived as female ejaculation. There is only one way out - to empty the bladder immediately before sexual intercourse. With a wave-like orgasm, from 5 to 15 waves of tension in the muscles of the genital organs occur with the simultaneous appearance of orgasmic sensations. Each wave can last from a few to several tens of seconds. In this case, the strength of sensations, as a rule, increases from wave to wave.
Sometimes there is only one wave of orgasm.
Then they talk about a dome-shaped orgasm. Moreover, at different times, depending on the time of previous abstinence, mood, well-being, etc. the same woman can experience both a dome-shaped and a wave-shaped orgasm. But in all these cases, to fully satisfy a woman, intense frictions are required during orgasm (which can be done both by the man and, naturally, by the woman or by them together). This is its difference from a single orgasm and a man’s orgasm, where such frictions are not required.
Multi-orgasmic women are able to experience several orgasms during one sexual act, just like multi-orgasmic men. Like men, during orgasm they experience rhythmic contraction of the muscles of the genital organs, perineum, pelvis and even abdomen. But the arousal curve at the end of sexual intercourse ends not in depression, but in calming, which usually takes some time.
To fully satisfy a multi-orgasmic woman, intercourse must continue until she has experienced a full series of orgasms. This can be 8-12, and sometimes up to 20 orgasms in up to 20 minutes. Such women are called superpotent, and they are found very rarely and only among people with a strong sexual constitution. A prolonged orgasm can be considered as a long dome-shaped orgasm, stretching for 1-3 or even 4 hours. All this time frictions must be carried out.
Obviously, not every man can satisfy a woman with such an orgasm. As a very rare variant of the norm for a woman with a strong sexual constitution and a very sensitive nervous system, one can distinguish a continuous orgasm with rhythmic contraction of the muscles of the genital organs, which occurs immediately after the start of friction of the penis in the vagina and continues until its end, i.e. until the end of the man's sexual intercourse.
With such an orgasm, sexual intercourse should not be prolonged, otherwise it will cause a woman great muscle strain and fatigue instead of satisfaction. In addition, it should be taken into account that if, when inserting the penis into the vagina, touching the woman’s genitals, or even just at the thought of sexual intercourse, a convulsive contraction (spasm) of the muscles of the genital organs begins, then this is no longer an orgasm, but vaginismus - a type of sexual disorder for which you need to see a doctor. Interesting variations are observed with mixed orgasm. Most often this is a clitoral-vaginal or vaginal-clitoral orgasm, at the beginning of which shocks and sensations begin first in the clitoral area and then move to the vagina or vice versa. But there are some other varieties.
For example, an orgasm can begin in the clitoral area, like a man's, with several quick and rhythmic contractions of the abdominal muscles, and then turn into a dome-shaped or even wave-shaped vaginal orgasm that lasts several minutes.
Women with this type of orgasm have a more sensitive clitoris and a vagina that is not at all sensitive before orgasm. Therefore, they need a long foreplay with caressing the clitoris without insertion of the penis until orgasm (immission at this time is simply unpleasant for them). The absence of immission for a man in this case is also very useful, since it helps to save his strength to carry out intense frictions during a woman’s prolonged orgasm.
Of course, the above examples of the forms of sexual intercourse of a woman and the varieties of her orgasm by no means exhaust the variety of sexual manifestations of these unpredictable creatures. And if a man has a certain and sometimes long-term sexual experience with one or even several women, then when he meets a new partner, this experience will most likely only harm the achievement of harmony in their intimate relationships. Because every woman is a complete mystery not only for the man who is interested in her, but, what is most offensive, for herself. And they both have to solve this riddle again. Knowledge of issues of sexual constitution can be very useful to them here.
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Are you here: articles Sex technique How to recognize a true female orgasm
How to recognize a true female orgasm
Women have become adept at faking orgasms. Yes, so cleverly that you cannot distinguish a simulation from a genuine orgasm. But we men don’t need simulations, we need to get a real assessment of our sexual efforts. This is the only way we will know whether we are doing everything right, or whether we need to try better. There are physiological signs of a true female orgasm that will tell whether the woman received pleasure or whether she faked an orgasm.
Plateau is a harbinger of orgasm
A female orgasm is necessarily preceded by a special state - a plateau. What is the Plateau? This is the period of maximum sexual arousal for a woman. Orgasm occurs only after a woman has reached a plateau.
Based on its external manifestations, a plateau can be confused with an orgasm. During friction, a woman screams, writhes, and wriggles. And after reaching a plateau, it subsides. But this is the calm before the storm. She slowly continues the friction. Then it gradually accelerates. She starts screaming and moaning again. And then, in joyful convulsions, he experiences a real orgasm.
Contraction of vaginal muscles
At the moment of orgasm, the vagina grips the penis especially tightly. You can feel the grip. And, accordingly, it gives the man special pleasure. If, at the height of a female orgasm, you feel more pleasant sensations inside the “pussy,” it means she’s cumming for real. In some cases, during orgasm, the vagina may even push the penis out or, conversely, suck it in deeper. Do not be afraid. These are normal manifestations of a true orgasm.
In a slender woman, orgasmic spasms can be felt simply by placing your hand on her stomach. Sometimes these contractions are so strong that they move like waves throughout the woman’s body, resembling convulsions. The same convulsions that simulators love to imitate. But if there were no convulsions inside the vagina, then all other convulsions are questionable.
Female ejaculation
For some women, orgasm is also accompanied by the release of large amounts of fluid from the vagina. Do not confuse it with intimate lubricant released during sex. And this is not the partner’s sperm leaking out. The vagina is indeed capable of secreting some fluid during orgasm. By analogy with the male orgasm, this liquid is called ejaculate.
Sexual intercourse of a woman
After orgasm, a woman is left with a “lake” between her legs. The more female ejaculate, the stronger the orgasm.
The moment of ejaculate release can be felt. A man feels as if his partner peed on him during sex. This is especially clearly noticeable in the “cowgirl” position, when the woman sits on top with her legs spread and nothing prevents the ejaculate from flowing onto her partner.
"Erection" of nipples
An orgasmic spasm inside a woman’s body may not manifest itself at all on the outside. The absence of screams and convulsions does not mean the absence of orgasm. And orgasm can be diagnosed by female nipples. If the orgasm was genuine, then the internal spasm will reach the chest and make the nipples stand upright.
However, the tips of the breasts can stick out seductively simply from strong excitement, or even from cold. Therefore, nipple erection can be considered a secondary sign of orgasm.
Cold lips
Another minor sign of orgasm, or rather a sign of lack of orgasm, can be the cold lips of a woman during final kisses. This means the lips on the face 😉 Kiss the woman. And if in response she kisses as if reluctantly with tense, cool lips - a formal kiss - then perhaps she did not experience an orgasm. And if the lips are soft, warm and pliable, then most likely there was an orgasm.
Calm and relaxed after sex
A true orgasm is the peak of sexual pleasure, during which a huge amount of “pleasure hormones” endorphins enter the blood. Scientists have measured that endorphins released during orgasm are 200 times stronger than morphine. Yes, sex is like a drug.
However, we will not conduct a chemical analysis of women's blood to determine the content of endorphins in it. But you can easily see what mood a woman is in after sex, or in the morning.
Orgasm can calm even the most evil vixen. So if in bed she gives orgasm after orgasm, but the rest of the time she constantly nags her partner, getting irritated at any reason, it means she is a good actress, and she clearly lacks endorphins. And vice versa: if after sex a woman is happy and complacent, and in the morning she is cheerful and cheerful, there is every reason to consider her a super-lover!
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Women's calendar.
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Sexual intercourse
SEXUAL ACTUAL
In order for conception to occur, it is necessary for the egg and sperm to meet and merge, that is, fertilization occurs, the egg attaches to the uterus (implantation) and turns into a fetus (pregnancy).
Sexual intercourse is the act of sexual intimacy between a man and a woman, as a result of which fertilization occurs. A man and a woman are attracted to each other by instinct, desire and sexual attraction. In a man, desire is expressed explicitly - in the form of an erection, while in a woman it is less obvious, which is expressed in a number of changes. Erections can be caused by various forms of physical, mental or sensory stimulation. It affects the nerve center located in the spinal cord. During an erection, the erectile bodies of the penis (corpora cavernosa, corpus spongiosum and glans penis) fill with blood and the outflow veins close. The penis increases in size, rises and becomes hard, allowing it to enter the vagina. A woman, under the influence of desire, also experiences blood flow into the vaginal area. A lubricating fluid appears on its walls, which facilitates sexual intercourse. The vagina changes shape: the upper part becomes oval, and the lower part narrows to better embrace the male penis as it enters.
CHROMOSOMAL DIVISION
After ejaculation, sperm enter the uterus and travel up the fallopian tube.
Female orgasm: 4 phases of sexual intercourse and one prerequisite
If there is a mature egg in it, released by the ovary on the same day or a day earlier, fertilization occurs. When the head of the sperm penetrates the egg, its membrane undergoes a number of changes to prevent the penetration of other sperm. At this point, the 23 male chromosomes of the sperm combine with the 23 female chromosomes to form a zygote. At this moment, the process of cell division - mitosis - begins. The zygote moves along the fallopian tube and after a few hours is split into two smaller cells, and so on sequentially continues.
Penis in
relaxed
condition
MALE GENITAL ORGANS IN A STATE OF Arousal
Secretion
lubricating fluid
FEMALE GENITAL ORGANS IN A STATE OF Arousal
The cells duplicate to form identical copies. The beginning, or prophase, is characterized by the disappearance of the cell nucleus, while the chromosomes tend to the center and the centrioles move to both ends. In metaphase, the centrioles become fixed to give rise to the next stage, anaphase, in which the chromosomes separate. In telophase, with the appearance of nucleoli, the formation of a nuclear membrane at each end, narrowing, and then division of the cytoplasmic membrane along the central zone, the cell is divided into two identical parts. Four days after fertilization, the embryo has 32 identical cells, which are arranged in the form of a ball - a morula.
The penis is erect
Ejaculation occurs when the penis is erect. This occurs due to the powerful contraction of the perineal muscles, which push the sperm accumulated in the seminal vesicles to exit through the urethra. The sperm is ejected in several decreasing portions. The volume of each portion is 2-4 cc, that is, from 100 to 400 million sperm. Some of them are capable of fertilization within a few hours after release. Erection and ejaculation can occur unconsciously during sleep. Such nocturnal ejaculations often occur during adolescence and are completely normal.
SEXUAL INTERACT: DETAIL OF THE HIGHLIGHTED AREA (CUT TOGETHER)
Woman and sexual intercourse: what a woman feels
Believe me, not every woman can quickly get aroused and achieve orgasm. Today there is a lot of useful advice on this matter, including folk remedies for stimulation. Let's look at them in more detail.
Caressing the lower abdomen is considered the best, and this is not surprising. During such caresses, you need to lightly press on the lower abdomen. A small pad placed on the back side gives a good effect. As you move, the pad begins to apply slight pressure, resulting in direct stimulation of the uterus. Contractions of the uterus cause arousal in a woman and speed up orgasm, but the main thing here is not to overdo it. This technique is most effective for an excited woman who has not yet approached orgasm.
Sexual intercourse (30 photos)
To make the sensation more intense, press your lower abdomen several times before orgasm.
As a folk remedy for arousal, it is sometimes recommended to inject a solution of alum into the vagina. On the one hand, alum increases the sensitivity of the vagina due to its narrowing, but, on the other hand, it greatly dries out the mucous membrane. Moreover, a woman can mistake a burning sensation in the genitals for arousal, but with every minute the sensations will become less and less pleasant. By introducing alum into the vagina, a woman runs the risk of getting an inflammatory process. That is, it is better to forget about this method of excitation.
Another popular method of arousal is to insert a tampon into the anus in advance. Please note that there is a rational grain in this method: when the anus is compressed, the vagina also narrows, and the sensitive endings of the vagina receive more stimulation. Most often, this method is used by women who have given birth. Yes, it’s a good way to get excited, but you still don’t need to get carried away with it. Otherwise, it is not difficult to overstretch the anal muscles.
Light stimulation with warm water, for example, a bath with sea salt or herbs, will help you “awaken” the sensitive points of the genital organs elecampane. In such a bath you can experience real relaxation! A warm bath with salt or elecampane helps to increase body temperature and blood flow, but there is no need to talk about strong arousal. Another recipe from traditional doctors - an exciting cocktail of milk and a few drops of iodine (usually the ratio is 1 glass of milk/2-3 drops of iodine). Quite unpleasant in taste, this cocktail causes contraction of the uterus and increased muscle tone, but it has virtually no effect on orgasm.
An interesting folk method of arousal is to insert a carrot into the vagina about an hour before contact. Naturally, the carrots need to be peeled and washed well. The effect is as follows: carrot juice contains carotene and has a tonic effect on the woman’s genitals. In addition, the process itself causes mechanical irritation of the vaginal walls and, as a result, a rush of blood.
To increase arousal, have sex in a cold room, such as with an open window. When the temperature in the bedroom drops to 17-19°C, the blood will begin to flow more strongly to the body and increase sensitivity. You can also turn on the radio, but it should be tuned not to a music station, but to the gap between radio stations, that is, to noise. Strong waves of “noise” imperceptibly excite the female body. The main thing in this method is to take into account the partner’s sensitivity to extraneous sounds and monotonous humming. And finally, you can try to have sex on certain days of the month - this will become a “habit” for your body and it will “prepare” for these days in advance. True, the effect of temporary abstinence should not be overestimated.
More than half of the male population of planet Earth considers it to be the most attractive part of the female body. Some people like big breasts, some have average breasts, others are delighted with flat breasts. Only now, chasing the optimal bust size, both men and women forget about such an important attribute - nipples.
It would seem that what else new can you learn about them - so much has been written, discussed and shown. But no, every year there are more interesting and unusual facts about nipples. WANT.ua has collected the most interesting facts. You'll like it!
"FAVORITE COLOR AND SIZE"
It turns out that nipples and areolas can be of absolutely any color and size: dark, light, red, pink, invisible, large, small. And this is quite normal.
If you have snow-white skin, and your nipples stand out on the shape of your breasts because they have a very dark color, this is not yet a sign of an incurable and fatal disease. The skin of the areola contains two pigments - red and brown. Whichever one predominates, that color will be your nipples. And yes, The areola often darkens during pregnancy.
PIERINGS AND NIPPLES
There are so many horror stories surrounding nipple piercings. But most of them don't actually happen. Yes, nipples are not happy with piercings, since it is a rather painful procedure and there is a risk of infection, mastitis, or nipples will not accept jewelry or precious metals. You should also not forget about the risk of transmitting hepatitis and AIDS through non-sterile objects - but this can be said about all manipulations with the skin (piercing, scarring, tattoos).
Experts note that piercing does not reduce the sensitivity of the nipple, since the sensitivity of the nerve endings from the puncture is distributed over the rest, maintaining the same excitability.
Just be prepared that the nipples can significantly increase in size as a result of the piercing; they take a very long time to heal (but the hole, even if you have had the piercing for years, heals in 1 day). An interesting thing - tattooing of the areola and nipple, which improves the shape and makes them contrast.
NIPPLES AND SPORTS
We are in no way scaring you or promoting a couch potato lifestyle, and if this hasn’t happened to you, thank God. But take note of this rule: before training, lubricate your nipples with cream or Vaseline, and also choose the right one that will not rub your nipples.
HAIR IS NORMAL
Yes, yes, yes - this is not “Ewwww!” - This is fine. There is no need to be afraid or ashamed of this. Most women have hairs on or around their areola that are noticeable only to them. The areola contains hair follicles. If the hairs bother you too much, you can carefully trim them with nail scissors., but in no case do not pluck them - new hairs will grow harder and thicker, if they do not go under the skin at all (and we know from epilation of legs and bikini line how unpleasant this is) and will not cause inflammation. Another option is to use a laser at a beauty salon.
You should start to panic when there is a lot of hair and its number continues to grow exponentially.
This means that your female body contains a lot of androgens - male sex hormones, which often indicate the presence of certain diseases (for example, thyroid diseases). In this case, it is better to consult a doctor.
INTRACTURED NIPPLE
In about 15% of women, the nipples do not stick out, but seem to be pulled inward. This is due to the length of the milk ducts, which prevent the nipples from becoming puffy. This is normal and does not pose a health risk. The only thing is that such women may have a problem with it, but they quickly adapt. You need to pay attention to inverted nipples when they were normal and one day they retracted.
In general, you should be wary of any changes in your breasts, especially if this change is accompanied by itching, strange discharge and pain.
Do not delay your visit to the mammologist - the sooner the disease is detected, the easier it will be to cure it.
MORE THAN TWO
There are people who have more than two nipples - the third, fourth and subsequent ones are called accessory nipples. Don't be alarmed, they don't function as usual, they won't grow extra breasts and some even mistake them for ordinary moles.
Interestingly, a specially trained man was hired to stimulate the nipples.
COLLECTOR OF GYPSUM NIPPLES
A truly concerned artist lives in Norway. His name is Ian Hoglin. He simply adores women's bodies, breasts and nipples. He collected the latter - he made copies of 99 nipples of 99 women, deduced his classification, attached them to a wooden stand and closed the lid.
According to him, nipples should not excite, they should evoke admiration for a woman as a keeper of the hearth who gives new life.
IDENTITY
An interesting fact is that nipples are the only part of the female body that is copied on the male body. Male and female nipples are completely identical.
