Treatment and prevention of breast cancer

  There are several different treatment options for breast cancer, the most common of which are: surgery, radiation therapy, chemotherapy, and endocrine therapy. The main factors that influence the choice of breast cancer treatment options include: the stage of the tumor, the type of tumor, the woman’s age, menstrual status (whether she has stopped menstruating or not), and general health status.  1.Surgical treatment: Most breast cancer patients need to undergo surgical operation to remove breast tumor and perform axillary lymph node dissection, and then observe the tumor cell type and whether there is cancer invasion in axillary lymph nodes under microscope.  1) Breast-conserving surgery: It is a kind of surgery to remove the tumor in the breast but preserve the breast, which is a more advanced surgical method at present. Breast-conserving surgery can not only remove the cancerous tumor, but also reduce the impact of the surgery on the patient’s body shape and aesthetic appearance. However, not every patient can undergo this treatment. Patients who undergo breast-conserving surgery usually require axillary lymph node dissection (to check for metastases in the axillary lymph nodes) and post-operative radiation therapy. Axillary lymph node dissection can be performed at the same time as breast-conserving surgery or later, and the surgical incisions are often separate.  2) Modified radical breast cancer surgery: Surgery to remove the whole affected breast and part of the chest wall muscles, and to perform axillary lymph node dissection at the same time or later.  3) Radical breast cancer surgery (also called Halsted radical breast cancer surgery): Surgery to remove the entire breast, pectoralis major and minor muscles with the tumor, and to perform axillary lymph node dissection.  2.Radiation therapy: usually used after surgery to prevent local recurrence. If lymph node metastasis is confirmed after surgery, radiation therapy will be performed in supraclavicular, parasternal or axillary areas. For advanced breast cancer, radiation therapy can shrink the tumor, and in some cases, it can even make breast cancer that is not suitable for surgery metastasize to be surgically resectable. For isolated local recurrent lesions and skeletal metastases of breast cancer, it has certain palliative effect. However, for patients with early breast cancer without lymphatic metastasis, it is not necessary to routinely perform radiation therapy. Radiotherapy has evolved from conventional external irradiation to three-dimensional conformal radiotherapy and intracavitary radiotherapy in recent years, which has reduced the complications of radiotherapy and improved the therapeutic effect.  3.Endocrine therapy: The adverse effects of endocrine therapy are less than chemotherapy, and the efficacy is longer lasting. Those with positive estrogen receptor measurement can be treated alone or combined with endocrine therapy, and the drugs and means used vary according to menstrual status. The drugs used for endocrine therapy have been developed from classical triamcinolone to aromatase inhibitors.  Chemotherapy: Breast cancer is one of the most effective tumors among solid tumors, and chemotherapy plays an important role in the whole treatment. Chemotherapy has developed from the previous combination regimen based on traditional chemotherapeutic drugs traditional alkylating agents to the current combination chemotherapy based on anthracyclines and paclitaxel, and is developing towards better selective targeted drugs. Most of the combination drugs are used, which can generally reduce the postoperative recurrence rate by about 40%, but require 4-8 consecutive courses of application, aiming to kill the cancer cells in their different proliferation cycles. Liver function and white blood cell count should be checked frequently during chemotherapy.  5.Bio-targeted therapy: Bio-targeted therapy is a new type of treatment by blocking the overexpression of certain malignant genes or receptors unique to tumor cells, which is carried out by antibodies or small molecule drugs, and has achieved very good clinical efficacy, such as Herceptin and other drugs.  Breast cancer patients should have regular post-operative review at the hospital, once every quarter in the first year after surgery, once every six months in the second to fifth years, and once a year thereafter.