07/12/2022
Breast Cancer

Breast cancer symptoms and diagnosis – 2022

breast cancer

Breast cancer symptoms and diagnosis

A palpable nodule in the breast is the most frequent sign that is consulted, generally not painful, although retraction of the nipple or alterations of the skin of the breast are also frequent.

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Symptoms

A palpable nodule in the breast is the most frequent sign that is consulted, generally not painful, although retraction of the nipple or alterations of the skin of the breast are also frequent.

If you notice any of these symptoms, you should consult your gynecologist or surgeon to assess it and start a more in-depth study if you consider it appropriate.

Diagnosis

When there is a suspicion of breast cancer either by physical examination (both by the patient and by a doctor) or by a routine mammogram, a study is started to confirm or rule out that suspicion. Imaging tests will guide the diagnosis, but a certain diagnosis of breast cancer always requires confirmation with a biopsy.

Imaging tests that study the breast:

Mammograms

These are X-ray images that detect abnormal areas in the breast. They are not 100% reliable, so they can give suspicious images that are not ultimately malignant (false positives) or fail to diagnose a malignant tumor (false negatives).

Ultrasound

A technique that uses ultrasound to produce an image and that can distinguish cystic lesions (fluid-filled, usually not tumorous) from solid lesions (more suspicious). Many times this technique complements mammography. Ultrasound can also assess the status of the nodes in the armpit, which are the first site of spread of breast cancer.

Nuclear magnetic resonance (NMR)

It is a radiological examination that uses the action of an electromagnetic field to obtain images. It may be necessary in women with dense breast tissue, women with a BRCA gene mutation, or women with silicone prostheses.

If breast cancer is suspected, the next step is to take a tissue sample from it for analysis.

Biopsy

Consists of extracting a sample of the tissue from the suspicious area to analyze it microscopically and be able to determine its benign or malignant characteristics, as well as the type of tumor cells, their degree of aggressiveness and some other parameter. of interest when making treatment decisions.

The biopsy can be done by direct palpation or guided by ultrasound, this can be done with a fine needle (PAAF) or with a thick needle (BAG) to obtain a larger amount of tissue. Occasionally, a biopsy may be necessary in the operating room.

Sometimes, when the suspicious area is only seen on imaging tests (and there are no abnormalities on physical examination), the suspicious area is marked with a needle guided by some imaging technique so that it can be identified later by the surgeon.

Tests that will assess whether there is spread of the disease to other organs

After confirming the diagnosis of breast cancer with a biopsy, other radiological tests are performed to ensure that there are no metastases in other organs. These scans are usually recommended for stages II or higher. In patients with small tumors and negative nodes (stage I), these studies are not necessary.

Chest x-ray

Normally performed before surgery and serves to rule out lung involvement by the tumor.

Abdominal ultrasound

Image of the abdomen, obtained using ultrasound. It is used to assess the liver and other abdominal structures.

Bone scintigraphy

It is a test that detects areas of increase or decrease in bone metabolism and is used, among other things, to assess whether the tumor has spread to the bones.

Computerized axial tomography (CAT). It is another radiological technique that serves to rule out distant involvement of the breast (lymph nodes, liver, lungs, bone).

 

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