I. Etiology.
Breast cancer is the second leading killer after cervical cancer in women and is a serious threat to women’s life and health. Every year, about 500,000 women perish because of breast cancer. For the treatment of breast cancer, the first step is to understand the factors and symptoms of breast cancer. So, what are the factors leading to the development of breast cancer?
1. Long-term stimulation of endogenous or exogenous estrogen: The activity of estrogen plays an important role in the occurrence of breast cancer. The incidence of breast cancer is higher in premature menstruation (less than 12 years old) or late menopause (later than 55 years old), not having children, late childbirth (first child after 35 years old) or not breastfeeding after childbirth.
2.Virus: Oncogenic RNA virus may be associated with breast cancer.
3.Atypical hyperplasia of breast: Those with atypical hyperplasia of breast ducts and lobules have an increased risk of breast cancer. (Note: here we are talking about atypical hyperplasia, not mammary hyperplasia as it is usually spoken)
4. Genetic and family history: The multiplicity of breast cancer in families has also been confirmed in statistics. Women with a family history of breast cancer (first degree immediate family member with breast cancer) have 2-3 times the risk of breast cancer than the general population.
5.Nutritional factors: there is a correlation between excessive intake of high-fat substances and the occurrence of breast cancer.
6. Excessive pressure in the heart and inability to release emotions.
7.Radiation: Women who receive high level of ionizing radiation, especially those who have received too much radiation to the chest due to other diseases, have an increased risk of breast cancer.
Clinical manifestations
In the early stage of breast cancer, except for lumps, most patients do not have breast pain and cosmetic changes. The following symptoms of breast cancer will appear only when it has developed to a certain level.
Breast lumps and localized thickening of the breast Breast lumps are the main symptoms of breast tumors, and localized thickening of the breast with increasing thickness and scope associated with changes in menstrual cycle, especially when it occurs after menopause, about eight percent of such lesions are cancerous and must be taken seriously.
2, breast pain sudden, continuous, relatively intense pain and tenderness in the breast, often acute infectious diseases, such as local throbbing pain, may have been septic; and with the menstrual cycle related to the periodic swelling or needle-like pain, for breast hyperplasia; breast mild vague or dull pain, and the onset of no obvious pattern, because the pain is not obvious often ignored, but this is likely to be the early malignant breast disease signal, should pay sufficient attention. This may be a signal of early malignant breast disease and should be taken seriously. If there is severe persistent burning pain in the breast, transient or progressive aggravation should immediately seek medical attention.
3. Bleeding nipples or discharge from non-lactating women with nipple overflow are mostly pathological, with intraductal papilloma accounting for about half of the cases, followed by cystic hyperplasia and ductal dilation of the breast, and about 15% of patients with breast cancer. It is generally believed that hematochezia has 60% cancer potential, while those with plasma, milk-like or water-like are more likely to have benign lesions; those aged 50 years or older or with lumps are more likely to have cancer, while non-hematochezia under 40 years or without lumps are often benign.
Most breast diseases do not have any skin changes. Acute mastitis often has skin redness and swelling, breast tuberculosis or plasma cell mastitis may have skin ulcers or fistulas, and breast cancer skin may appear wrinkled or sunken to form “dimples”. If the skin around the nipple has repeated eczema and itchy skin that does not heal, it may be Paget’s disease, which is a special type of breast cancer.
5. Changes in the contour of breast. The normal breast has a complete curved contour, but the curved defect or abnormality is often the early manifestation of breast cancer.
6. Change of nipple Unilateral nipple invagination or axial change of nipple is mostly seen in breast cancer.
7. Axillary lymph node enlargement and upper arm edema can occur in both breast inflammation and breast cancer, while upper arm edema is caused by axillary lymph node metastasis.
III. Diagnosis
What can be done to properly detect breast cancer patients? In the current form, more and more women are likely to suffer from breast cancer, which can be very harmful to the health of patients. Experts have said that the diagnosis of breast cancer is something that we should grasp. Only when we know how to diagnose breast cancer, we can arrive at an accurate diagnosis accordingly and carry out active treatment. So what can be done to check out breast cancer patients correctly?
1. Physical examination: First of all, you should do monthly self-examination. Every woman should do self-examination on the fifth day after the end of each month’s period. The method is to apply soap to your hand and search this breast, as well as the armpit and clavicle fossa, clockwise by tapping with the belly of your middle and index fingers. Expert tip: Since the early symptoms of breast cancer are not obvious, it may not be obvious in self-examination, so it is more important to go to the hospital for regular checkups!
Also, you can doctor palpation. Specialists are very experienced and it is more accurate to determine the presence or absence of lumps by touch. This simple touch can screen out a significant number of patients.
2.X-ray examination: mammography is a common method to diagnose breast cancer. Common breast diseases can be divided into lumps or nodular lesions, calcified shadows and skin thickening signs, and ductal shadow changes on the x-ray film. The higher density of the mass and the presence of burr signs at the edges are very helpful in the diagnosis. When the burr is longer than the diameter of the lesion, it is called a stellate lesion. x-ray films often show a smaller mass than clinical palpation, which is also a sign of malignancy. The shape, size, and density of the calcified dots on the film should be noted, and the number and distribution of calcified dots should be considered. When the calcified spots are clustered, especially within 1 cm, there is a high possibility of breast cancer. If there are more than 10 calcified spots, the possibility of malignancy is high.
3.Ultrasound imaging: Ultrasound imaging is non-invasive and can be used repeatedly. Ultrasonography is more valuable for those with dense breast tissue, but the main purpose is to identify whether the mass is cystic or solid. The correct rate of ultrasonography for breast cancer diagnosis is 80% to 85%. The strong echogenic band formed by the infiltration of cancer into the surrounding tissues, the destruction of normal breast structure and the local skin thickening or depression above the lump are all important reference indicators for the diagnosis of breast cancer.
4.Thermal image examination: The application of image shows the temperature distribution of the body surface. Since the proliferating mass of cancer cells is rich in blood flow, the corresponding body surface temperature is higher than the surrounding tissues, and this difference can be used to make the diagnosis. However, this diagnostic method lacks exact image standard, and the site of thermal abnormality does not correspond to the tumor, so the diagnostic rate is poor, so it has been used less and less in recent years.
5.Near infrared scan: The wavelength of near infrared ray is 600~900μm, which can easily penetrate soft tissues. The use of infrared light shows various shades of gray through different densities of breast tissue, thus showing breast lumps. In addition, infrared light is sensitive to hemoglobin, and breast vascular shadow is clearly displayed. Breast cancer often has increased local blood flow and thickened blood vessels nearby, and infrared light has a better image display for this, which helps to diagnose.
Treatment
There are many treatment methods and measures for breast cancer, including surgery, chemotherapy, radiotherapy and endocrine therapy. At present, most of the treatments are based on surgery. If breast cancer can be diagnosed early and treated appropriately, its prognosis is relatively good
1.Surgical treatment: The main treatment for breast cancer is surgical resection. Early, middle and late stage breast patients should prefer surgical treatment as long as their physical condition can tolerate surgery. The purpose of surgical treatment is to maximize local control of the primary tumor and regional lymph nodes, reduce local recurrence, and improve the survival rate of patients.
2.Chemotherapy: including chemotherapy before, during and after surgery, especially adjuvant chemotherapy after surgery is the most commonly used, which aims to eliminate microscopic lesions remaining after surgery, never prolong the recurrence-free survival period, reduce mortality and improve survival.
3.Radiotherapy: It is one of the main treatment methods for breast cancer and belongs to local treatment. It is mainly used in: preoperative and postoperative adjuvant treatment; radical emission therapy; dividend radiation therapy
4.Endocrine therapy: estrogen receptor (ER) and progesterone receptor (PR) positive patients are particularly effective. It is used for postmenopausal intermediate and advanced breast cancer.
V. Prevention
Although breast cancer treatment technology and drug level have greatly reduced the death rate of breast cancer, the number of patients is increasing, and the early prevention of breast cancer has become the focus of women’s attention
1. Pay attention to your diet: If women consume four kinds of vegetables and fruits every day, their probability of developing breast cancer will be reduced. Avoid foods containing polyunsaturated fats, such as corn oil and sunflower oil, and replace them with nut oils or olive oil. Sugar in soft drinks and junk food are also foods that should be avoided. From the perspective of breast cancer prevention, it is still necessary for lesbians to maintain their traditional low-fat, high-fiber dietary habits. In addition, products containing estrogen have been proven to contribute to the occurrence of breast cancer. Foods with high estrogen content, such as royal jelly, should be consumed sparingly.
2.Strengthen physical exercise:To strengthen healthy physical exercise, you can strengthen the functional exercise of upper limbs. These are more common for breast cancer prevention. And physical exercise can also prevent other diseases, so women are recommended to do some physical exercise.
3. Pay attention to self: breast cancer prevention also requires avoiding unnecessary chest x-ray, avoiding marriage and childbirth at an advanced age, trying to breastfeed and avoid using estrogen during menopause. If you find any lump in your chest, breast, armpit or above or below the collarbone, you should go to the hospital for examination in time.
4. Regular check-ups: Women over 40 years old should receive a mammogram once a year, and women under 40 years old should be checked at least once every three years. Women with a family history of breast cancer should start getting checked as early as possible. In addition, women who gain more than 20 kg during adulthood are twice as likely to develop breast cancer after menopause. Women who do not regain their pre-baby weight after childbirth should also be extra cautious.