Dispersion studies
Once a breast cancer has been diagnosed, a search is always made for possible metastases. If metastases are discovered, this has an influence on further therapy planning and the prognosis as a whole, so finding them is of great importance. Metastases indicate advanced cancer.
Therefore, general symptoms are often already present such as reduced performance, pain, loss of appetite, nausea, weakness, possibly fever and shortness of breath. The larger a tumour is, the more likely it is that metastases have already formed in other organs of the body. However, breast cancer can also form metastases at a very early stage, when the tumour is still small.
This depends on the biological nature of the tumour cells and the type of tumour (see also breast cancer types). Compared to other types of cancer, metastasis in breast cancer occurs relatively early. In breast cancer, metastases can spread lymphogenically and haematogenously.
Lymphogenic means that the tumour cells enter lymph nodes via the lymphatic system and form new nodes. Hematogenous means that the tumor cells reach various organs via the bloodstream and form nodes there. Breast cancer metastasizes lymphogenically first into the lymph nodes of the armpit and/or the sternum.
Not all organs in the body are equally likely to be affected by daughter tumours. This is different for each type of cancer. In the case of intestinal cancer, for example, metastases are most frequently found in the liver. Breast cancer cells are most often found in the: The skin and brain can also be affected. – Lymph nodes
- Bones (spine, ribs, pelvis, skull),
- In the lung, on the pleura and
- In the liver.
Lymph node metastases
Lymph node metastases play a special role. They are the most important factor in the prognosis of breast cancer and actually always occur before haematogenic metastases. Lymph node metastases can become noticeable through swelling or nodes in the armpit or on the breastbone.
In order to determine whether the tumour has already metastasised to the lymph nodes, the sentinel lymph node technique is frequently used today, in addition to other methods. This technique is described in detail under the topic of breast cancer surgery. .
Bone metastases
In a quarter of all cases in which daughter tumours have formed, the first metastases are discovered in the bone, where they make themselves felt through pain. In order to detect metastases in the bone, the so-called bone scintigraphy is used. In a bone scintigraphy, the patient is injected with a radioactive liquid before the examination.
The substances contained in the fluid have the property of being deposited in those areas of the bone where remodelling processes take place and of emitting a weak radioactive signal from there. Normally, remodelling processes are constantly taking place to a certain extent throughout the bone. However, in the case of bone metastasis, but also in inflammatory diseases such as rheumatism, these processes are increased at circumscribed sites: a particularly large amount of the radioactively marked fluid can then collect at these sites and thus be made visible with a special X-ray machine. An X-ray image is then taken of the areas suspected in the bone scintigraphy, which provides more precise information as to whether there is a metastasis or, for example, “only” an inflammatory process. Bone metastases can also be detected with computer tomography (CT) or magnetic resonance imaging (MRI).
