BREAST CANCER AND NUTRITION
SUMMARY
Breast cancer is the most common malignancy in women. After lung cancer in cancer-related deaths. It comes in second place.
Malnutrition and weight loss are considered one of the most important causes of death in cancer patients. Cachexia; It is defined as a complex syndrome consisting of anorexia, weight loss, loss of adipose tissue, muscle tissue and metabolic changes in cancer patients. Determination of nutritional status in cancer patients aims to evaluate the malnutrition status of high-risk patients and prepare a comprehensive nutrition program suitable for them. Nutritional support should start at the time of diagnosis and should be included in the treatment plan at all disease stages. Nutrition should primarily be oral. Oral nutritional support is recommended for patients who cannot receive adequate nutrition orally. In patients who cannot meet their daily nutritional needs orally, enteral tube feeding should be started as early as possible. Parenteral nutrition should only be used in cases where the gastrointestinal tract is not suitable, such as severe malabsorption, high-flow fistula, dysmotility and abdominal pain. Nutrition should be supported with electrolytes, trace elements and vitamins. Because oxidative stress markers are increased and antioxidant levels are decreased in cancer patients.
Keyword: Breast cancer, Cachexia, Nutritional support, Nutrition in cancer patients
INTRODUCTION
The female breast consists of fat, connective tissue and many small mammary glands. Breast cancer usually occurs as a mass in the breast tissue, but most breast lumps are not cancerous. Breast cancer is the most common malignancy in women and ranks second in cancer-related deaths, after lung cancer. Breast cancer is rare. It is also seen in men. Breast cancer occurs in 1 in every 100,000 men. It constitutes less than 1% of all breast cancers. Breast cancer is rare before the age of 30 and increases rapidly in the reproductive years following this age. This increase continues after menopause. It continues to rise slowly. Breast cancer is more common in women over the age of 40. The most important risk factor for the development of breast cancer is advancing age as well as family history of breast cancer. Genetically transmitted forms constitute 10% of all breast cancers, and in patients in this group, the incidence of cancer is at a younger age and in both breasts. It is noteworthy that it is high.
It constitutes 30% of female cancers in the USA and 25-28% of female cancers in Turkey. The risk of developing breast cancer in a woman's lifetime is 10-12.8% or 1:8-1:10. While the incidence of breast cancer in our country was 37.3/100,000 in 2006, according to studies carried out by the Ministry of Health in recent years. It is estimated that this rate reaches 50/100,000.
SYMPTOMS AND SCREENING OF BREAST CANCER
The symptoms of breast cancer vary depending on the degree of spread of the disease in the body and from person to person. . Although breast cancer occurs painlessly at first in most women, it is also stated that the following symptoms will be observed.
- The presence of a mass in the breast
- The appearance of the breast in the shape of an orange peel,
- Retraction of the nipple regardless of congenital causes,
- Bloody or non-bloody discharge from the nipple,
- Ulcer, redness and edema on the breast skin,
- Swollen lymph nodes and arm It is seen that k and edema formation etc. are important
Although most palpable masses in the breast are not cancer, precautions should be taken when women notice a different mass in the breast. Early diagnosis of cancer before the disease symptoms appear. allows detection in the period. The aim of early diagnosis is to reduce deaths from cancer, increase the chance of treatment, and extend survival time.
Breast cancer first spreads to regional lymph nodes and often involves the armpit lymph nodes. Cancer cells that exceed the regional lymph nodes can enter the bloodstream and spread to the lungs, pleura, bone, liver, peritoneum, adrenal glands, brain and ovaries, respectively.
Breast Self-Examination(KKMM), Clinical Breast Examination (CMM) and Mammography are common screening methods used in the diagnosis of breast cancer. While mammographyis accepted as a 'gold standard', BSE and KMM have a low mortality reduction effect. Early diagnosis causes 30% of breast cancer deaths. It reduces the rate.
STAGES OF BREAST CANCER
Cancer disease is graded according to the international TNM system. Accordingly, the disease is classified as follows by evaluating the extent of tumor spread(T), disease of the lymph nodes(N) and spread of the disease to other organs (M).
T0. No Tumor
T1 Tumor has a diameter of up to 2cm
T2 Tumor has a diameter of up to 5cm
T3 Tumor has a diameter of over 5cm
T4 The tumor has spread to the skin or tissues surrounding the breast
TX It cannot be determined whether the tumor has spread
N0 The lymph nodes are not infected
N1 The tumor has reached the axillary lymph nodes
N2-3 The tumor has reached the axillary lymph nodes and/or large vessels in the rib cage; The lymph nodes no longer move among themselves or against the surrounding tissues
NX It cannot be decided whether the lymph node will become diseased
M0 There is no spread (metastasis) to other organs
M1 Other There is spread to organs. For example: to bones and lungs
MX It cannot be decided about spread to other organs. (12)
TYPES OF BREAST CANCER
When breast cancer cells are examined under a microscope, it is observed that there are different types. In some cases, one single A breast tumor may be a combination of these, or a mix of invasive and in situ cancer. And in some rare types of breast cancer, the cancer cells may not form a tumor at all.
Ductal carcinoma in situ
Ductal carcinoma in situ (DCIS)is considered non-invasive or pre-invasive breast cancer. The difference betweenDCISand invasive cancer is through the duct walls. It does not spread to the surrounding breast tissue. Because DCIS cannot metastasize outside the breast.DCISis considered a pre-cancer, in some cases it can progress to invasive cancer. Almost all women diagnosed at this early stage can be treated.
Invasive (infiltrative) ductal carcinoma
This is the most common type of breast cancer.Invasive (or infiltrative) Ductal carcinoma (IDC) begins in the breast milk duct, breaks through the wall of the duct and grows into the breast fatty tissue. At this point, it spreads through the lymphatic system and blood to other parts of the body. (met astasis) may spread.
Invasive (or infiltrative) lobular carcinoma
Invasive lobular carcinoma (LAC)milk It begins in the producing glands (lobules). Like IDC, it can spread (metastasize) to other parts of the body. Detection of invasive lobular carcinoma by a manogram, invasive ductal carcinoma
Inflammatory breast cancer
Inflammatory breast cancer (IBC) is the most aggressive form of breast cancer that manifests itself with involvement of the breast skin. IBC constitutes 1-6% of all breast cancers.
There is usually a swelling or tumor in one breast. In inflammatory breast cancer (IMK), the breast skin appears red and warmth is felt in the breast. Additionally, the breast skin has a thick, dimpled appearance similar to orange peel.
Breast Paget's disease
Paget's disease is a rare disease that occurs together with breast cancer. Paget's disease begins in the nipple or the area of darker skin surrounding it (areola). It usually appears primarily as a red, scaly rash. It may be itchy.
Phyllodes tumor
This rare type of tumor develops in the breast stroma (connective tissue) rather than in the ducts or lobules. Benign phyllodes tumors are treated by removing the tumor along with a margin of normal breast tissue. A malignant phyllodes tumor is treated with a wide margin of normal tissue or mastectomy.
Angiosarcoma
Primary angiosarcoma of the breast is a rare tumor. Angiosarcomas; It is clinically classified into three groups: primary
breast angiosarcoma, chronic lymphedema, and radiotherapy-mastectomy-related. Despite early diagnosis and treatment, the prognosis is poor. product.
Read: 0
