BREAST CANCER AND NUTRITION
Breast cancer is the most common malignancy in women. It is the second most common cancer-related death after lung cancer.
Malnutrition and weight loss are considered to be one of the most important causes of death in cancer patients. Cachexia; It is defined as a complex syndrome that occurs with 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 to make a suitable comprehensive nutrition program for them. Nutritional support should start at the time of diagnosis and should be included in the treatment plan in all disease stages. Nutrition should primarily be oral. Oral nutritional support is recommended for patients who cannot receive adequate nutrients orally. In patients who cannot meet their daily nutritional needs orally, enteral tube feeding should be started as early as possible. Parenteral nutrition should be used only in cases where the gastrointestinal tract is not suitable, such as severe malabsorption, high-output fistula, dysmotility and abdominal pain. Nutrition should be supported with electrolytes, trace elements and vitamins. Because oxidative stress markers increased and antioxidant levels decreased in cancer patients.
Keyword:Breast cancer, Cachexia, Nutritional support, Nutrition in cancer patients
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 masses are not cancerous. Breast cancer is the most common malignancy in women and is the second most common malignancy in cancer-related deaths, after lung cancer. Breast cancer is also rarely seen in men. 1 breast cancer occurs in every 100,000 men. %one’ Breast cancer is rare before the age of 30 and shows a rapid increase in the reproductive years following this age. This increase continues to increase with a slow slope after menopause. Breast cancer is mostly seen in women over the age of 40. In addition to advancing age, the most important risk factor for the development of breast cancer is the family history of breast cancer. 10%It is remarkable that the incidence of cancer in both breasts is higher in this group of patients at younger ages.
women’s cancers in the United States 30%of women’s cancers in Turkey 25-28%A woman’s lifetime risk of developing breast cancer 10-12.8%or 1:8-1:10. While the incidence of breast cancer in our country was 37.3/100.000 in 2006, it is estimated that this rate has reached 50/100.000 according to studies conducted by the Ministry of Health in recent years.
SYMPTOM AND SCREENING OF BREAST CANCER
The symptoms of breast cancer vary according to the extent of the disease in the body and from person to person. It is also stated that although breast cancer appears in most women as painless at first, the following symptoms will be seen.
- Presence of a mass in the breast
- The appearance of the breast in the form of an orange peel,
- Nipple recession, regardless of congenital causes,
- Bloody or bloodless discharge from the nipple,
- The occurrence of ulcers, redness and edema on the breast skin,
- It is seen that swelling and edema formation in the lymph nodes and arm, etc. is important.
Although most of the palpable masses in the breast are not cancer, precautions should be taken when a different mass is noticed by women. The aim of early diagnosis is to reduce deaths from cancer, increase the chance of treatment, and prolong survival.
Breast cancer primarily spreads to the regional lymph nodes and often involves the axillary lymph nodes. Cancer cells that exceed the regional lymph nodes may join the blood circulation and spread to the lungs, pleura, bone, liver, peritoneum, adrenal glands, brain and ovaries, respectively.
Breast Self Examination (BSE), Clinical Breast Examination i( KMM) Mammography is a common screening method used in the diagnosis of breast cancer. mammography ‘a gold standard’while being accepted as BSEand KMMThe effect of reducing mortality is low. Early diagnosis in breast cancer deaths 30%rate reduction.
BREAST CANCER STAGES
cancer disease international TNM graded according to the system. spread of the tumor (T)disease of the lymph nodes (N)and the degree of spread of the disease to other organs (M) is evaluated, and the disease is classified as follows.
T0 No Tumor
T1 Tumor can reach up to 2 cm in diameter
T2 Tumor can reach up to 5 cm in diameter
T3 Tumor over 5 cm in diameter
T4 Tumor has spread to the skin or tissues surrounding the breast
TX Undecided on tumor spread
N0 Lymph nodes not infected
N1 Tumor has reached axillary lymph nodes
N2-3 Tumor has reached axillary lymph nodes and/or major vessels in the thorax; lymph nodes are no longer displaced between themselves or against surrounding tissues
Unable to decide on disease of NX Lymph node
M0 No spread (metastasis) to other organs
M1 There is a spread to other organs. Ex: like bones and lungs
MX It is not possible to decide whether to spread to other organs. (12)
BREAST CANCER TYPES
When looking at breast cancer cancer cells under a microscope, there are different types. In some cases, a single breast tumor may be a combination of these, or it may be a mixture of invasive and in situ cancer. And in some rare types of breast cancer, the cancer cells may not appear to form a tumor at all.
Ductal carcinoma in situ
Ductal carcinoma in situ (DCIS)It is considered non-invasive or pre-invasive breast cancer. DCIS The difference between and invasive cancer is that it does not spread to the surrounding breast tissue through the duct walls. because DCISCannot metastasize outside the breast .DCIS It is considered a pre-cancer, in some cases it can progress to invasive cancer. Almost all women diagnosed at this early stage can be cured.
Invasive (infiltrative) ductal carcinoma
This is the most common type of breast cancer. (or infiltrative)ductal carcinoma (IDC), begins in the breast milk duct, crosses the wall of the duct and grows into breast adipose tissue. At this point, it travels to other parts of the body via the lymphatic system and blood. (metastasis)can spread.
Invasive (or infiltrative) lobular carcinoma
Invasive lobular carcinoma (LAC)in milk-producing glands (in lobules)starts. IDCsuch as other parts of the body. (metastasis)Invasive lobular carcinoma is more difficult to detect by a manogram than invasive ductal carcinoma.
inflammatory breast cancer
Inflammatory breast cancer (IMC) is the most aggressive form of breast cancer that manifests itself with involvement of the breast skin. IMT all breast cancers 1-6%forms the .
Usually there is swelling or tumor in one breast. In inflammatory breast cancer (IMC), the breast skin appears red and the breast feels warm. Also, the breast skin has a thick, pitted appearance similar to an orange peel.
Breast Paget’s disease
Paget’s disease is a rare disease that occurs together with breast cancer. Paget’s disease on the nipple or the area of darker skin surrounding it (areola) starts. It usually appears primarily as a red, scaly rash. It may be itchy.
This rare type of tumor is found in the breast stroma rather than in ducts or lobules. (in connective tissue) is developing. 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 large margin of normal tissue or by mastectomy.
Primary angiosarcoma of the breast is a rare tumor. Angiosarcomas; primary
It is clinically classified into three groups: breast angiosarcoma, chronic lymphedema, radiotherapy-mastectomy. Despite early diagnosis and treatment, the prognosis is poor.