The spread of metastasis of breast cancer, breast cancer is a common malignancy of women, men rarely, about 120 million women worldwide every year suffering from breast cancer , about 50 million women die of breast cancer in Northern Europe, North America and other areas of high incidence of breast cancer, The incidence rate is about 80/10 million, although the breast cancer of low-prone areas, but its incidence is increasing year by year, which Beijing, Shanghai, Tianjin and coastal areas prone areas, especially in Shanghai the highest, there are statistics in 1988 The incidence rate of 28/10 million. Incidence of breast cancer tumor in the country accounted for about 10% of the body, second only to cervical cancer in women, the tendency in recent years, more than cervical cancer, according to statistics national incidence rate of 20%.
1. Hematogenous metastasis of breast cancer cells can invade the blood along the blood vessels to distant metastasis. Deep breast tissue, breast and chest wall of the vein import axillary vein, into the subclavian vein and innominate vein into the pulmonary circulation, causing pulmonary metastases. Intercostal offshoot shed by thoracic vein after ipsilateral innominate vein into the pulmonary circulation. Intercostal vein into the azygos vein, semi-azygos vein, superior vena cava into the lungs to import. Azygos vein system can intervertebral veins, vertebral venous plexus is connected with the vertebral vein. Intra-abdominal pressure changes in the vertebral venous system and the Department of vena cava blood flow to each flow. Therefore a small number of breast cancer patients in the vena cava does not appear before the transfer, there collarbone, spine, pelvis, ribs, femur, etc. of the transfer.
The proliferation of breast cancer metastasis, hematogenous distant metastasis rates and tumor size, lymph node metastasis and pathological grade of the number of a great relationship. Distant metastasis rate of blood were also receptor situation, tumor cells, DNA content, the length of the tumor cell doubling time, cell cycle S phase fraction and other factors.
The most common sites of hematogenous metastasis of lung, bone, liver and other tissues, followed by the pleura, brain, adrenal, some statistics about breast cancer 10% of the clinical diagnosis have distant metastasis. The patients with axillary lymph node metastases found that about 20% of the preoperative bone abnormality, but in general patients with no clinical symptoms. lung metastases: breast cancer cells through the blood into the lungs, blood vessels within the hair cells in the lungs to stay, grow and form metastases, and lung tissue when the tumor invasion of lymphatic and pulmonary veins, can cause lung lymphoid tissue transfer. Performance in clinical lung metastases as cough, shortness of breath, purple threads. bone metastases: breast cancer bone metastases to the chest, spine and pelvis most common, followed by ribs, femur, etc., most of osteolytic bone metastases of change, change into a rare bone. Spinal metastases, the tumor can cause spinal cord compression paraplegia; transfer of long bones, pathological fractures can occur, clinical manifestations of lesions in patients with persistent pain. Pain in joints, easily misdiagnosed as traumatic arthritis. liver metastases: early symptoms of breast cancer was not obvious, a small number of patients have fatigue, loss of appetite, etc., easily misdiagnosed. Advanced liver pain can occur. CT examination and ultrasound can help the early detection of liver metastases. Chemotherapy and hormone therapy are not effective with poor prognosis. pleural metastasis: lung metastasis of breast cancer can occur in pleural metastasis, pleural metastasis alone are rare, clinical manifestations, chest pain, pleural effusion, pleural puncture and to bloody pleural effusion. Can sometimes find cancer cells. Chemotherapy treatment can also be injected with chemotherapy plus the chest. brain metastases: breast cancer brain metastases, patients have headaches, CT examination is a routine examination, help to identify lesions. Radiation therapy can relieve symptoms skull, poor efficacy.
2. Regional lymph nodes during breast cancer growth, may invade the lymphatic vessels in the breast tissue, cancer cells in lymphatic tied together into a transfer to lymph nodes through lymphatic vessels. Stop growth in the lymph nodes, and the formation of metastatic breast cancer lesions. Metastasis of breast cancer axillary lymph nodes is the most common, the transfer rate depends on the primary cancer of the pathological type, tumor size and disease duration and other factors, often surgery, 20% _40% of breast cancer metastasis. Therefore, cure of breast cancer axillary lymph node dissection must be careful to pathological examination.
The proliferation of breast cancer metastasis, the internal mammary area (parasternal) second only to axillary lymph node metastasis, the general transfer of most of the intercostal lymph nodes in 1,2,3 and surrounding adipose tissue. It was observed that according to pathological type and transfer rate according to the original site of cancer without axillary lymph node metastases and vary: axillary lymph node negative, primary breast cancer in this area outside the shower when the Pat-transfer rate of about 5%; If the inside of the primary cancer in the breast, then the regional lymph node metastasis rate was 15%; axillary lymph nodes, the primary cancer in the lateral, the regional lymph node metastasis rate is about 25%, such as the inside of the primary cancer in this regional lymph node metastasis rate of about 50%. Supraclavicular lymph node metastasis of breast cancer is relatively rare in clinical practice is generally believed that breast cancer metastasis to go through the axillary or internal mammary lymph node metastases to supraclavicular lymph nodes only after. Therefore, supraclavicular lymph node metastasis occurs when the advanced stage. Some areas in the surgical routine lymph node biopsy in this area found that about 20% positive.