fibrosarcoma of the breast
Introduction
Introduction to breast fibrosarcoma Fibrosarcomaofbreast is more common in breast sarcoma, second only to phyllodes cystosarcoma. The tissue type of this disease is complex and diverse, and it is usually derived from fibrous tissue in the subcutaneous or fascia. It is characterized by no epithelial components in the tumor and is composed of mesenchymal components. basic knowledge The proportion of illness: 0.012% Susceptible people: women Mode of infection: non-infectious Complications: acute renal failure, stress ulcer
Cause
Causes of breast fibrosarcoma
Cause:
There is currently no clear cause
Pathogenesis
When fibrosarcoma is detected, it usually reaches a certain volume, and its pathology has the following characteristics.
1. Gross shape: The tumor is large, most of them are more than 5cm in diameter, and have limited growth. They are round or oval-shaped nodules, and there are incomplete false capsules. The texture is mostly hard and tough, but sometimes it can appear locally. Softer or cystic area, uniform, moist, shiny, gray-red or gray-white fish-like, with hemorrhagic necrosis and hyaline degeneration, mucoid degeneration, but no lobulated structure.
2. Histological morphology: According to its cell morphology and nuclear division, fibrosarcoma can be divided into two types: well-differentiated fibrosarcoma and poorly differentiated fibrosarcoma.
(1) well-differentiated fibrosarcoma: microscopically, the tumor cells are abundant, the cell morphology is similar to that of fibroblasts, and it is fusiform, the shape is neat, uniform, and the heteromorphism is not obvious. The nuclear division is not common, and the nucleus is long fusiform, deep. Dyeing, uniform distribution, cytoplasm is not pink, tumor cells and collagen fibers are arranged in a braided shape, this type of fibrosarcoma has invasive growth, recurrence after local resection, but no metastatic tendency.
(2) poorly differentiated fibrosarcoma: microscopically seen tumor cells are abundant, arranged in a bundle, with moderate to high degree of heteromorphism, irregular cells, round or oval, fusiform, etc., mitotic figures are more common The cytoplasm is rich, the nucleus is large and deeply stained, the tumor cells are poorly differentiated, and no collagen fibers are produced. It is a malignant undifferentiated fibrosarcoma, which is easily metastasized and relapses.
Prevention
Breast fibrosarcoma prevention
1. Maintain a good mentality and a healthy life rhythm, overcome bad eating habits and hobbies, and work regularly. Life is an effective way to prevent the occurrence of breast diseases.
2. Wear less bras or tights and use bras reasonably. A properly modeled bra is important for breast health. It is best to use a soft, breathable, absorbent cotton bra. Usually do not bring a bra without a belt, do not bring a bra to sleep.
3. Use estrogen-containing drugs and health care products with caution, and use breast enhancement products with caution.
4, avoid bathing with hot water for a long time to stimulate the breast, not to soak in hot water for a long time, the water temperature at the bath is about 27 °C. Regular sexual life can promote the blood circulation of the breast and increase the secretion of sex hormones, which is conducive to the health of women's breasts.
5. Maintain an appropriate amount of exercise. Exercise not only helps breast bodybuilding, but also reduces the incidence of breast disease.
6, monthly breast self-test, annual professional inspection. Generally choose one week to two weeks after menstruation is the best time to check. If you find a breast with a lump, local skin or nipple depression, axillary lymph nodes, you must see a doctor in time.
Complication
Breast fibrosarcoma complications Complications acute renal failure stress ulcer
Most of the complications of breast fibroma are a benign lesion of hyperplasia, and most of the clinically found benign tumors, the chance of canceration is small, and some are accompanied by hyperplasia of mammary glands or lobular hyperplasia.
Common complications after surgery include: postoperative massive hemorrhage and diffuse intravascular hemorrhage, respiratory diseases, circulatory diseases, acute liver failure, acute renal failure, stress ulcers, incision complications, and urinary tract infections.
Symptom
Breast fibrosarcoma symptoms Common symptoms Lactation disorders Breast lumps Nodular skin adhesions
The disease grows very fast, it is huge in a short period of time, mostly single hair, painless mass, occasionally multiple, the mass is round or oval, nodular, located in the center of the breast or occupy the entire breast, the boundary is clear, push It can move, the nipple is not trapped, a small number of lumps are huge, the skin of the breast is often very thin, often with obvious vein dilatation, occasionally the appearance of adhesion to the skin is orange peel-like, the tumor mass quickly invades the chest muscle and is fixed, and most The blood is transferred to the lungs, liver, brain and other organs, and the lymph node metastasis is less, so the axillary lymph nodes are often not swollen.
Painless breast lumps, long course of disease, slow growth is characteristic, individual patients can have a disease course of more than 30 years, often found tumor volume is large, but the length of the disease is not proportional to benign and malignant, the body surface of the tumor can be seen Bright, but no nipple retraction, skin without orange peel, rare axillary lymph node metastasis, palpation can be seen that the mass of the mass is hard, the boundary is clear, early push can be moved, when invading the chest muscle is fixed, surgical resection can be seen on the surface of the mass Incomplete envelope, the cut surface is solid light red fish.
X-ray films showed circular, burr-free, coarse-density mass images, and immunohistochemical Vimentin type I collagen reaction was positive.
Examine
Examination of breast fibrosarcoma
1. Histopathological examination: the outline of the mass is clear, there is a false envelope, the cut surface is grayish white, shiny or fish-like. Under the microscope, the tumor cells are fusiform, the chromatin of the nucleus is more and evenly distributed; the cytoplasm is less, pink Collagen fibers are often arranged with adult tumors or feathers in a crisscross pattern, with more silver-stained fibers surrounding each cell.
2. Immunohistochemical examination: Fibrosarcoma is positive for Vimentin type I collagen, and is negative for smooth muscle tissue cell markers or basement membrane components.
3, mammography X-ray film: visible mass is a clear round or slightly lobulated mass, no burrs, local can have a rough density image.
Diagnosis
Diagnosis and diagnosis of breast fibrosarcoma
diagnosis
Diagnosis is based on clinical features and examinations.
Differential diagnosis
The tumor needs to be differentiated from breast phyllodes cystosarcoma, breast cancer and liposarcoma.
1. Breast phyllodes cystosarcoma: The clinical manifestations and gross findings of phyllodes cystosarcoma of the breast are similar, but in histology, the lobular sarcoma has a large fissure that makes the tumor lobulated, showing epithelial lining On the inner wall of the fissure, this is the most important distinguishing point from fibrosarcoma.
2. Breast cancer: breast cancer can appear nipple discharge, nipple retraction, the general shape sees the mass without capsule, the boundary with the surrounding tissue is unclear, the cut surface is grayish white, hard, crab-like infiltration growth, multi-menopausal Metastasis, histology, the tumor cells of breast cancer are nested, and silver staining can be seen around the cell cluster.
3. Liposarcoma: Fat cells can be found in the tumor, and tiny fat droplets appear in the cytoplasm by staining with Sudan III.
