The latest statistics show that breast cancer has become one of the most common malignant tumors among Chinese women, with the number of patients increasing at an annual rate of 2% to 3%. Although the incidence rate of breast cancer remains high, the mortality rate has decreased significantly. Therefore, the key to change breast cancer from “incurable disease” to “chronic disease” is to actively consult and choose reasonable and orderly treatment. Yan Min, Department of Breast Medicine, Henan Cancer Hospital
There are two kinds of equipment commonly used for breast cancer screening, namely molybdenum-palladium X-ray and high-frequency ultrasound, and some patients are suitable for breast nuclear magnetic examination. Different screening techniques are used for different people, different ages and different body shapes, among which mammography screening is the more common method internationally and domestically. In general, mammography is not suitable for young women younger than 35 years old because of the risk of radiation, and also because of the relatively dense breast gland in young women, which affects the detection rate of lesions.
How should breast cancer be treated after detection? Specialized treatment is the key to achieve the best outcome.
For patients with initial breast cancer, the treatment options are: surgery is the first choice for patients with small primary lesions and no axillary lymph node metastasis, and postoperative chemotherapy, endocrine therapy or radiotherapy should be reasonably arranged according to the pathological indexes; for patients with large breast lumps or axillary lymph node metastasis, the preoperative chemotherapy-surgery-postoperative standard treatment model should be chosen. For patients of advanced age or advanced stage, local tumor reduction surgery is considered or conservative treatment is given after pathological results are obtained. The goal of early breast cancer treatment is to strive for a cure.
The unsatisfactory part is that although most patients are completely cured after strict standard treatment, some patients still develop recurrence and metastasis. Therefore, regular postoperative review is very important. It is generally required to review once every four to six months within five years after surgery and once a year after five years. The purpose of review is to detect recurrence and metastasis as early as possible so as to get a head start on the subsequent treatment.
The treatment of breast cancer has made remarkable progress in the past half century. Even if recurrent metastasis occurs after surgery, it can significantly prolong the survival and improve the quality of life by receiving reasonable and orderly treatment. The treatment for patients with recurrent metastases includes a comprehensive treatment strategy based on chemotherapy, endocrine therapy, anti-HER-2 gene targeting therapy, anti-angiogenic factor therapy, bisphosphonate therapy and other systemic treatments, supplemented by radiotherapy and local surgery when appropriate.
The diagnosis and treatment of breast cancer require close cooperation among multidisciplinary specialists. In order to better serve many breast cancer patients, Henan Provincial Department of Health established Henan Provincial Breast Disease Medical Center based on the former Henan Cancer Hospital Breast Department. After the establishment of the center, under the leadership of the center director Prof. Cui Shude, experts in breast surgery and breast medicine work closely together and join hands with multidisciplinary experts in radiotherapy, pathology and imaging to develop precise and individualized treatment plans for patients with different stages of disease in order to achieve better outcomes. The joint consultation system will be established to further promote the standardized and individualized diagnosis and treatment level of breast cancer in our province, so that the diagnosis and treatment level of breast cancer in our province will be in line with the international and domestic first-class level.
Issues that should be noted by patients at different stages of consultation.
Routine screening stage: including monthly self-examination, annual expert physical examination and instrumental screening (mammography or ultrasound).
Detection of breast lumps or other suspicious indications: do not rashly undergo lump removal surgery, but always visit a specialist hospital to start treatment after a clear diagnosis and a comprehensive treatment plan is made.
After surgical treatment of breast cancer: whether it is lumpectomy or modified radical mastectomy, the resected primary mass must be tested for pathology and immunohistochemistry (estrogen receptor, progesterone receptor and epidermal growth factor receptor, and other treatment and healing indicators), which are crucial indicators to guide subsequent treatment.
In case of recurrence and metastasis: do not rush to the doctor or give up treatment easily. You should choose a specialist in mammary gland medicine for consultation, review and re-test the necessary indicators, clarify the extent of the lesion, and choose the appropriate individual treatment according to the indicators, condition and economic status to achieve long-term survival and ensure good quality of life as much as possible.
Of particular importance: at any stage of treatment, patients should back up their treatment history so that it is available at the next visit. Complete information should include: preoperative staging, postoperative pathology report, immunohistochemistry report, postoperative chemotherapy drugs and dose, postoperative radiotherapy site and dose, whether endocrine therapy and targeted therapy drugs were used, diagnostic report and imaging data after recurrent metastasis, and drugs, dose and efficacy evaluation of each treatment after recurrent metastasis.