Cancro mammario

Ultimo aggiornamento  17/07/2023

Il  cancro mammario è una neoplasia maligna che origina nei tessuti della mammella. Si distinguono due forme principali:

1. Carcinoma lobulare: origina nei lobuli mammari
2. Carcinoma duttale: origina nei dotti e rappresenta la forma più frequente.

Le neoplasie maligne della mammella da un punto di vista istologico sono nella gran parte dei casi di origine epiteliale. Esse originano dall’epitelio dell’unità ghiandolare duttulo-lobulare. Prendono il nome dal luogo in cui si sono sviluppati e in cui eventualmente si diffondono: nel 70% dei casi si tratta di carcinomi duttali; nel 15% dei casi di carcinomi lobulari; di più raro riscontro sono alcune altre varianti istologiche, come il ca. tubulare. il ca. papillare (caratterizzato dalla presenza di formazioni papillifere), ca. midollare (caratterizzato da abbondante infiltrato linfocitario) e ca. mucinoso o colloide (isolotti ghiandolari circondati da abbondante mucina); questi ultimi tutti a prognosi abbastanza favorevole. Di eccezionale riscontro, sia nel sesso femminile che in quello maschile, sono i tumori mammari di origine mesenchimale (sarcomi) che non superano l’1% dei tumori maligni della mammella (1-4).

FATTORI DI RISCHIO:

● Età  >40 anni (in particolare età superiore ai 65 anni)
● Anamnesi personale positiva per neoplasia mammaria
● Anamnesi familiare positiva per neoplasia mammaria

● Mutazione di alcuni geni come quello HER2 (Human Epidermal Receptor2), 

●perdita dell’apoptosi,

●perdita della capacità di inibire la crescita cellulare,

●instabilità del genoma

● Densità mammaria in post-menopausa
● Popolazione occidentale
● età

● Nulliparità
● Prima gravidanza tardiva (> 30 anni)
● Scarso esercizio fisico
● Dieta ricca di grassi e povera di frutta e verdura
● Terapia ormonale sostitutiva (HRT) protratta
● Radiazioni

● menarca precoce e menopausa tardiva,

●alcool,

●fumo,

●obesità

CARCINOMA DUTTALE IN SITU (DCIS) – Il DCIS è una forma iniziale di  cancro mammario, stadio 0, detto anche precancerosi, pre-invasivo, intraduttale. Le cellule neoplastiche si sviluppano all’interno dei dotti rimanendo “in situ” cioè non si estendono al di fuori della membrana basale del sistema duttulo-lobulare.

CARCINOMA LOBULARE IN SITU (LCIS)

CARCINOMA DUTTALE INVASIVO

CARCINOMA LOBULARE INVASIVO

CARCINOMA TUBULARE

CARCINOMA MIDOLLARE

CARCINOMA INFIAMMATORIO

CARCINOMA MUCINOSO

CARCINOMA METAPLASTICO

TUMORE FILLOIDE MALIGNO

CARCINOMA CRIBRIFORME

CARCINOMA PAPILLARE

CARCINOMA METASTATICO
Il carcinoma mammario metastatico è il cancro che si è diffuso oltre la mammella provocando delle metastasi principalmente a:

1. Polmonari
2. Ossee
3. Cerebrali

CARCINOMA MAMMARIO IN GRAVIDANZA

Il carcinoma alla mammella durante la gravidanza è piuttosto raro e rappresenta l’1-3% di tutte le diagnosi di cancro al seno.
Le donne alle quali è stato diagnosticato un tumore al seno durante la gravidanza hanno anche la preoccupazione per la sicurezza del nascituro.

Oggi, generalmente non è più necessario interrompere la gravidanza perché le nuove cure sono:

• Efficaci,
• Con minori rischi il bambino.

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