I. Understanding of the etiology and pathogenesis of breast cancer The discussion of breast tumors in Chinese medicine is as early as the “Treatise on the Origin of Diseases” by Chao Yuanfang in the Sui Dynasty, where it is written that “a hidden nucleus in the breast, which does not hurt but grows gradually and is hard, is called a stone carbuncle”. If the nucleus is small, or like a turtle chess piece, not red and not painful, but gradually grows bigger and bigger, f rock crumbles and breaks like a ripe pomegranate, or collapses into a deep hole, this is a case of depression and anger in the liver and spleen, and loss of qi and blood, which is called breast rock”, the first time the name “breast rock” was used, and pointed out that its pathogenesis lies in “depression and anger in the liver and spleen, and loss of qi and blood”. In the Yuan dynasty, Zhu Danxi said in his “Ge Zhi Yu Lun” that “a woman’s anger and depression, accumulated overnight, can cause her spleen temper to subside and her liver qi to rebel, resulting in a hidden nucleus such as a chess piece, which is not painful and does not itch, but develops over several years, and is called breast rock, because the sore is shaped like a rock cavity and is incurable”, pointing out that In the Ming dynasty, Chen Shigong’s “Surgical Authenticity” recorded that “at first it is as big as a bean, gradually like a chess piece, half a year, two years, three years, no pain, no itch, gradually grows and grows larger, begins to have pain, pain is no relief, later swelling like a pile of corn, or like a double bowl, purple The gas is filthy, gradually ulcerated, deep as a cavern, convex as a lotus, pain even the heart, bleeding is smelly, when the five organs are decaying, and then become four major unsaved, named breast rock. All those who commit this, one hundred people will die”, a detailed description of the gradual development process of “breast rock”, and pointed out the difficulty of its treatment, the prognosis is not good; the Qing Dynasty Gao Jinting “ulcerology insights collection” in the basis of “Surgery Zhengzong” on its prognosis added that “if you can clear your mind If you can clear your mind, no hang-ups, no hindrances, do not have to reluctantly cure, still can be prolonged, when to add the flavor of prolapse, spleen soup or benefit qi nourishing rong soup main; this disease ulcerated body weakness, there are also sores bleeding like a note, instant death, and loss of camp evidence the same”. From the above medical treatises, most of them tend to relate the disease mechanism to “depression and anger in the liver and spleen and loss of qi and blood”, especially the role of emotional depression in the development of the disease should be emphasized. Modern medical science believes that breast cancer is related to ovarian function, marriage and breastfeeding, and genetic factors: for example, abnormal increase of estrone and estradiol and lack of estriol are related to the development of breast cancer; the incidence of breast cancer is higher in celibate women or married women with no children, and the incidence of breast cancer is also different between those who breastfeed after childbirth and those who do not breastfeed, and the incidence of breast cancer is higher in those who do not breastfeed; the probability of breast cancer in women with first-degree relatives who have breast cancer is 2-3 times higher than those without family history. If a first-degree relative has bilateral breast cancer before menopause, the relative risk is up to 9 times higher. In addition, the incidence is higher in women with a history of previous benign breast tumors. Other factors include radiation, viruses, chemical stimuli, and certain diseases such as diabetes mellitus may also increase the incidence of breast cancer. Based on the experience of previous authors and the results of modern medical research, it is pointed out that, in terms of Chinese medicine meridians, the nipples are part of the foot sympathetic liver meridian, the breasts are part of the foot Yangming stomach meridian, and the outer breast front and armpits are part of the foot Shaoyang bile meridian, so the formation of breast rocks is mostly related to the seven internal emotions, blood and qi exhaustion, depression and liver injury, thought and spleen injury, meridian exhaustion, phlegm and fear, which have been discussed by many medical doctors for many generations. But what has not been noted is that women’s physiology has its own peculiarities. The woman’s blood is used, the menstrual blood, marriage and childbirth, breastfeeding, are related to the two channels, such as the “Women’s Section Summary” pointed out that “the menstrual water, Yin blood, is also born of the pulse of the Chong Ren, up for the milk, down for the moon water”, “Sheng Ji General Record” also said “to Chong Ren two channels, up for the milk, down for the moon water “This means that the two channels are the link between milk and menstrual water. Since menstruation is related to ovarian function and breast and milk are related to marriage and breastfeeding, it is easy to understand the close relationship between breast cancer and ovarian function and marriage and breastfeeding. The General Record of Shengji also points out that “a woman is based on the rushing of the body, if she loses her mind, the rushing of the body is not in harmony with the …… body, the gas will not disperse and will accumulate between the breasts, either hard or swollen, with painful nucleus”, which indicates that the disharmony of the rushing of the body is one of the pathological bases for the development of this disease. In addition, modern studies have shown that breast cancer is very rare in women younger than 20 years of age and uncommon in women younger than 30 years of age, and that the incidence of breast cancer increases year by year from the age of 35 years, and that this increase in incidence continues almost throughout a woman’s life, leveling off slightly between the ages of 45 and 50 years, and rising steeply again later [2]. This actually indicates that the elucidation of the etiology solely by the TCM doctrine of meridians and liver-depression and spleen-deficiency cannot yet be called complete. The book Huangdi neijing? Suwen? It is pointed out in “Shanggu Tianzhen Lun” that before the age of 35 years, as a woman grows older, her “kidney qi is strong, Tianjue arrives, the Ren vein is open, and the Taichong vein is strong”, and her body is strong, so her ability to resist diseases is enhanced; as she grows older, “the Yangming vein declines, the Sanyang vein declines, the Ren vein is weak, the Taichong vein declines, and the Tianjue is exhausted “This is undoubtedly an important reason for the occurrence and development of breast cancer. Since “the Ren pulse is open and the Taichong pulse is strong” originates from “the Kidney Qi is strong and the Heavenly Capsules arrive”, “the Ren pulse is weak, the Taichong pulse is weak and the Heavenly Capsules are exhausted” starts from “the Yangming pulse is weak This indicates that the fullness or otherwise of the Punch and Ren Chakra is closely related to the state of the successive heavenly bases of the Spleen and Kidney. Therefore, the onset of breast cancer is mostly related to liver and spleen depression and anger, qi and blood deficiency, and spleen and kidney deficiency leading to disharmony of the two channels, which is a disease of positive deficiency and evil reality. The main formula is formulated according to the cause of the disease, and the formula is added and subtracted according to the changes of the disease mechanism, with special emphasis on the characteristics of “women with blood”, easy to worry and depression, and liver qi not being relaxed. Patients with the so-called “liver and spleen depression and anger” often have liver depression and heat, impatient and irritable, unable to sleep at night or sleep restlessly, and the spleen and stomach are not in harmony, the heart is troubled and happy to vomit, so we often use Dan Gardenia Free and Easy San with Sha Shen, Scutellaria, Qing Han Xia to clear heat and eliminate annoyance, harmonize the stomach and stop vomiting; such as “qi and blood deficiency” For “deficiency of qi and blood”, the main herbs are Astragalus, Yuan Zhi, Radix et Rhizoma Atractylodes Macrocephalae, Poria, Lotus Pulp, Longan Pulp with peony and Angelica; for deficiency of qi and yin, the main herbs are Radix et Rhizoma Macrocephalae, Wu Wei Zi with Sha Shen, Tian Men Dong, Sheng Di, Angelica, He Shou Wu, and Radix et Rhizoma Polygonati; for deficiency of spleen and kidney, the main herbs are Radix Rehmanniae, Cornu Cervi Pantotrichum, Yam, Poria, Radix et Rhizoma Polygonati, Poria, Radix et Rhizoma Astragalae, Radix et Rhizoma Polygonati, and Radix et Rhizoma Polygonati. The main herbs are raw Radix Rehmanniae, Cornu Cervi Pantotrichum, Rhizoma Polygonatum, Poria, Radix Astragali, Radix Angelicae Sinensis, Radix Paeoniae Alba, and Radix et Rhizoma Polygonatum. On the basis of the above main formula, supplemented with helianthus bark and nightshade vine to tranquilize the mind or cypress seeds and fried jujube seeds to nourish blood and calm the mind, supplemented with mountain cichlid mushroom, zhebei mother, raw dragon peony, gunner’s nail and turtle nail to clear heat and detoxify, soften hardness and disperse knots, and citron, Buddha’s hand, green calyx plum, rose hips, curcuma and trigon to move qi and activate blood. For those with bone metastases, the formula is given to tonify liver and kidney, strengthen tendons and bones, adding papaya, mulberry, cow’s knee, chicken blood vine, etc. For those with local pain, the formula is given to activate blood stasis, promote blood circulation and relieve pain, adding loofah, lutong, Wang Bu Liu Xing, curcuma, trigon, turtle worms, ground dragon, etc. For those with spontaneous sweating, the formula is given with Gan Mai Da Zao Tang; for those with pleural fluid, the formula is given with Han Fang Ji, pig ling, etc. Case 1 Patient Fang Moumou, female, 80 years old, from Beijing, was first diagnosed in August 2003. The patient underwent modified radical surgery for left breast cancer in June 2002. Postoperative pathology diagnosed invasive ductal carcinoma, axillary lymph 6/16, estrogen receptor (-) and progesterone receptor (-). In July 2003, the patient did not undergo chemotherapy because of the metastasis in the left supraclavicular and left cervical lymph nodes, the largest metastasis was 2.5×3.0 cm. At the initial consultation, he was depressed, with a yellowish complexion, pale eyelids, irritability, dry mouth, sleepless nights, poor appetite and vomiting, dry stools, dark tongue with yellow coating and thin pulse. Auxiliary examination: blood count: WBC 3.8×109/ L, N 58%, Hb 82g/L. Stool occult blood test (-). The evidence belongs to liver depression and spleen deficiency, depression and heat, deficiency of Qi and blood, and stagnation of evil toxins, the treatment is to dredge the liver and strengthen the spleen, to support the righteousness and dispel the evil, and to use the following medicine: Dampi 10g, fried gardenia 10g, fried Chai Hu 10g, red and white peony 10g each, raw dragon peony 15g each, San Qi 5g, raw Pu Huang 10g, Scutellaria 10g, Huang Lian 10g, Zhe Bei Mu 10g, Gunnison 10g, Turtle A 15g, and 10g of Cyperus rotundus, 12g of Xia Gu Cao Cao, 10g of Zhi Mu, 30g of Hop Huan Pi, 10g of Sang Guan Octopodia, 5g of Beehive, 30g of Chicken Nei Jin, 10g of Raw Hawthorn, 10g of Fried Grass Cassia, 10g of Lotus Leaf, 15g of Cao He Che, 10g of Roasted Grass. 1 dose every 2 days, divided into 2 doses daily. After the treatment for more than 5 years, the symptoms were significantly relieved, the spirit improved, the appetite and night sleep improved, the bowel movement was smooth, the mood was stable, the routine blood tests were in the normal range several times, and the ultrasound of superficial lymph nodes in June 2008 showed that the largest metastatic lesion in the left supraclavicular and left cervical lymph nodes was reduced to 0.8×1.2 cm, which is still under treatment. Case 2 Zhang, female, 43 years old, from Beijing, was first diagnosed in August 2001. The patient underwent left mastectomy in February 2001 and was pathologically diagnosed with invasive ductal carcinoma, axillary lymph 2/11, estrogen receptor (+) and progesterone receptor (+). Gano plus pirenzosin chemotherapy was given for 6 times and radiotherapy was given in parallel. At the initial consultation, she was seen to be fatigued, with a weak complexion, poor sleepiness, dry mouth and bowel movements, a pale tongue with thin coating and a weak pulse. Auxiliary examination: blood routine: WBC 3.2×109/ L, N 65%, Hb 80g/L. Stool occult blood test (-). The evidence belongs to deficiency of Qi and blood, deficiency of blood and stagnation of evil, the treatment is to strengthen the spleen and benefit the Qi, nourish the blood and stomach, support the righteousness and eliminate evil, the medicine is used: 30g of raw Astragalus, 15g of Radix Astragali, 15g of fried Atractylodes, 10g of Poria, 10g of Yuan Zhi, 10g of longan, 30g of fried jujube, 5 jujubes, 10g of Angelica, 10g of wide mullein, 10g of green calyx plum, 5g of nux vomica, 10g of Curcuma, 15g of double flower, 10g of mountain mushroom, 10g of Zha Bei Mu 10g, Gunnels 10g, Turtle A 15g, Turtle Board 15g, White Flower and Snake Tongue 15g, Cao He Che 15g, Xia Ku Cao 12g. 1 dose every 2 days, divided into 2 doses daily. Later on, he added and subtracted with the evidence. After treatment for more than 6 years, his symptoms have been significantly relieved, his spirit has improved, his appetite and night sleep have improved, his mood is stable, his blood routine has been repeatedly rechecked within the normal range, and no recurrence or metastasis has been seen in superficial lymph node ultrasound, lung CT and tumor marker examination.