cancer epidemic
Breast cancer (BC) is the most common type of cancer among women. It is one of the five deadliest diseases both in the world and in Russia.
According to the World Health Organization, approximately one in 12 women will experience breast cancer in their lifetime.
Therefore, it is important to detect pathology in the early stages. To do this, you need to regularly undergo self-examination, as well as undergo instrumental diagnostics: ultrasound of the mammary glands and mammography. It is the diagnostic results that will form the basis of the treatment tactics that will be determined by the oncologist-mammologist at the appointment.
“There is a classification of neoplasms in the mammary gland to determine the potential danger.
In accordance with his educational suspicion, the doctor gives him a rating from one to five. One – there is education, but it is almost 100% benign, and five – experts are almost sure that it is cancer. If the education is given a grade of 3, it is already difficult to say whether it is a malignant tumor.
Then the doctor offers the patient two tactics: observation and control of features or biopsy (the procedure for selecting cells from the body for further laboratory analysis), ”says Marina Sekacheva, professor at Sechenov University, director of the Institute of Personalized Oncology.
suck the cancer
Vacuum aspiration biopsy (VAB) is the most accurate method for early detection of breast cancer, as well as a modern high-tech method for removing benign breast tumors.
According to the expert, doctor of medical sciences, oncologist-mammologist of scientific and clinical center No. Academician BV Petrovsky Anatoly Levanov, VAB allows you to determine cancer with 100% accuracy, including whether the neoplasm is less than one centimeter, when other methods can give a false-negative result.
“With the help of the robot needle, even the smallest piece of tissue can be removed, which cannot be reliably obtained completely and most importantly under the control of the eye with other available methods.
With the VAB method, several neoplasms up to 2-3 cm can be removed at once through small holes of only 2-5 mm. The procedure is performed on an outpatient basis. It takes between 15 minutes and half an hour, it is done under local anesthesia.
A special anesthetic is used instead of traditional lidocaine. This is a minimally invasive method – we make a puncture with a special robotic needle under ultrasound control and completely “suction” the neoplasm with a vacuum. All the material removed is then sent to the laboratory for a full histological examination.
VAB value and contraindications
The VAB method is of particular value with grouped calcifications (formation from deposits of calcium salts) in the treatment of such a diagnostically complex pathology as intraductal papilloma, so-called “complex” cysts, foci of mastopathy (diseases with benign changes in the mammary glands).
In open interventions, the surgeon will not be able to see them, removal is blind and requires resection of part of the mammary gland, which can lead to deformation and also sometimes does not guarantee complete removal of the neoplasm.
The method has almost no contraindications. According to Sekacheva, VAB is not recommended if the patient does not see a neoplasm on ultrasound, if there are disorders of blood coagulation (including due to drug therapy), and in case of inflammation.
Levanov states that more than 80,000 such interventions are made annually in the United States and close to 3,000 in Russia, and that there are about 50 devices that allow PSA to be made across the country. It has no domestic analogues yet, and the price of consumables is constantly increasing. At the same time, the method was completed and developed in Russia.
How was the method developed?
In some cases, complications in the form of hematoma and bruising may occur in patients after VAB. Usually this happens after the simultaneous removal of several neoplasms in one breast. The standard method of prevention is the use of hemostatic drugs (hemostatics) and the use of elastic compression bandages, which are wrapped around the chest for 2-3 days.
“Previously, when performing ultrasound-guided VAB and removing a single mass in a breast, satisfactory hemostasis was possible in most cases, but problems arose when removing multiple formations. This significantly reduced the declared low invasiveness of the method, aggravated and prolonged the rehabilitation period, ”explained Levanov.
However, the problem has been solved. To prevent bleeding in the VAD under ultrasound guidance, the doctor began using a two-wavelength LED surgical laser.
This was the basis for the development and application of the interstitial laser coagulation method in VAD.
“After vacuum resection, laser coagulation occurs immediately – a thin laser light guide is inserted into the needle channel, which “burns” the manipulation site. After the new method is put into practice, the probability of bleeding and accordingly hematoma and bruising decreases to zero.
Thanks to this, it became possible to simultaneously remove several formations in one or even both mammary glands. And you can remove the elastic bandage not on the third day, but on the morning of the second day after the procedure, ”said Levanov.
He added that the main task is not only to completely eliminate neoplasms and confirm their non-cancerous nature, but also to ensure that the patient can lead a normal lifestyle two hours after surgery without any consequences for the beauty and health of the breast.
Does not replace cancer treatment
Despite all the advantages of VAB, the procedure cannot replace anticancer treatment.
“In terms of benign lesions, VAB is an ideal way to remove them completely. However, after the procedure, the patient should still remain under the supervision of a mammologist.
Levanov emphasized that VAB is not an alternative to the radical treatment of breast cancer.
“For all patients, benign neoplasms are removed with VAB, but in some cases, we get cancer after a full histological examination, a result confirming possible errors in the biopsies.
Most of these patients have cancer in situ, which is the earliest stage of cancer. This literally saved lives.
after all, women come to VAB with a histological result in hand that they have a benign tumor. And according to the results of PSA, we got a very unpleasant, but very important result, which made it possible to carry out the necessary treatment in a timely manner and practically guarantee a cure, ”the specialist concluded.