Breast cancer is currently the number one killer of women’s cancer. Globally, the incidence of breast cancer is increasing year by year, and in Western countries, such as the United States, about one in eight women may develop breast cancer in their lifetime, which is such a terrible statistic. Although the incidence rate of breast cancer in China is lower than that in western countries, the number of new cases of breast cancer has increased by 38.5% since 2000 to 2005, and it is increasing at a rate of 3% per year, which is one of the fastest growing countries.
There is a lack of accurate epidemiological data in Guangxi, but the number of breast cancer patients in our hospital (Guangxi Cancer Hospital) is increasing substantially year by year. In recent years, the incidence rate of breast cancer in China’s cities has ranked first among female malignant tumors, which is known as the “red-faced killer”. So far, the exact cause of breast cancer is not fully understood. Most scholars believe that it is related to the imbalance of various hormones in the body, especially sex hormones such as estrogen and progesterone.
The common risk factors of breast cancer are
1. Menstruation: early menarche or delayed menopause. Age at menarche <13 years, age at menopause >50 years, and menstruation >35 years are recognized as risk factors for the development of breast cancer. Some studies have reported that the risk is 2.2 times higher for those with menarche earlier than 13 years old than for those with menarche older than 17 years old; the risk is 1 times higher for those with menopause older than 55 years old than for those with menopause younger than 45 years old; and the risk of breast cancer is 1 times higher for those with menstrual history of more than 40 years than for those with menstrual history of less than 30 years. Menstrual cycle: Women with short menstrual cycle between 20 and 39 years old have a higher risk of breast cancer;
2. Marriage, childbirth and breastfeeding: The risk of breast cancer increases significantly in those who are infertile, have late childbirth and do not breastfeed. The incidence of breast cancer is significantly higher in women over 40 years old who are unmarried, infertile or late in childbirth (after 35 years old) than in women who are normally married; having children but not breastfeeding, or breastfeeding for a short period of time, or breastfeeding with only one breast may also have an impact on the occurrence of breast cancer, because breastfeeding rarely or never leads to breast accumulation and significantly increases the risk of breast cancer.
Family history: The risk of breast cancer in the immediate family is 2 to 3 times higher than that of the normal population.
4. Benign breast diseases: The chance of breast cancer increases 2-4 times compared to normal population after suffering from certain benign breast diseases, especially those with moderate to severe atypical hyperplasia in mastoproliferative disease.
5. Bad habits: excessive intake of fatty foods, frequent drinking, smoking, etc. lead to overweight. Overweight is the biggest risk of breast cancer in adult women, especially after menopause, because subcutaneous fat can be converted into estrogen and breast cancer is a hormone-dependent malignant tumor, the occurrence and growth of which are closely related to hormones.
6. Endocrine factors and hormones: the time of estrogen production in women’s body is earlier and the effect on breast is longer, thus the risk of breast cancer is greater.
7.Radiation, ionizing radiation, etc.
The treatment effect of breast cancer is related to the early stage of the disease when it is detected. After standardized, scientific and individualized treatment, most of the patients can get a good treatment effect. More than 90% of stage I breast cancer can be cured, while stage II and III are less effective, with the cure rate dropping to about 70% and 50%, while in situ cancer is almost 100% curable. However, the early detection and diagnosis rate of breast cancer has been extremely low for a long time.
The proportion of stage I breast cancer among breast cancer cases that seek medical attention because of breast lumps is only about 10%. In recent years, with the improvement of people’s health awareness and the application of effective examination methods such as mammography and color ultrasound, the proportion of stage I breast cancer detection and diagnosis is increasing year by year.
As most breast cancers do not form obvious lumps or lumps are small in the early stage, the traditional concept of “breast lumps” as the only primary sign for breast cancer diagnosis should be changed. Secondly, we should pay attention to medical history and predisposing factors. Thirdly, we should find out the cause of any symptom in the breast, such as nipple overflow, limited glandular thickening, nipple erosion, mild nipple retraction, mild local skin indentation, and breast pain after menstruation, etc. We should pay attention to these symptoms and go to a specialized hospital for follow-up examination.
Fourth, a variety of examination methods, including clinical palpation, mammography, color ultrasound, fine needle aspiration cytology and other joint diagnosis. The American Cancer Society recommends that women over the age of 40 should receive a mammogram once a year. In addition, regular self-examination of the breast or examination by a specialist is the key to detecting early breast cancer or precancerous lesions.
Currently, the following are available: color multispectral ultrasound (color ultrasound): indicates a mass as a substantial occupying lesion with blood supply; mammogram: typical breast cancer images show a shadow with unclear borders and/or more than 10/cm3 sandy calcified spots locally; MRI (magnetic resonance imaging); PET/CT (positron emission tomography); biopsy pathology of the mass, which is the most accurate diagnosis, but partial excision of the mass cannot be done and additional surgery is performed as soon as possible after surgery.
The main reasons affecting the early diagnosis of breast cancer are
①Lack of awareness of breast cancer and lack of vigilance;
②Early breast cancer is a painless lump, which can be without any physical discomfort and does not affect either life or work;
③A few women are bound by stereotypes, old-fashioned thinking and shy to have medical check-ups;
④For the sake of saving time and convenience, they listen to someone’s nonsense or are too superstitious to believe in the diagnosis of a certain doctor or a certain instrument, and relax their vigilance without further examination;
⑤ Some people are afraid of breast cancer for various reasons and are afraid to go to the hospital for examination, not knowing that going to the doctor can eliminate breast cancer and relieve psychological pressure;
⑥Life is fast-paced and work is busy, so you can’t take care of it.
If you are unfortunately suffering from breast cancer, if there is no metastasis and the tumor can be removed surgically, i.e. clinical stage I, II and IIIA, you should first choose surgery (surgery can completely remove the tumor and possible metastatic lymph nodes, which cannot be replaced by other treatment methods, radiotherapy and chemotherapy are all adjuvant treatment after surgery or palliative treatment if you cannot operate, currently all solid tumors that can be removed surgically are preferred At present, all solid tumors that can be surgically resected are preferred to be treated with surgery. After surgery, the need for chemotherapy, radiotherapy, endocrine therapy and biologically targeted therapy is determined by the size of the tumor, whether the lymph nodes are metastatic, hormone receptors and some related genetic tests.
With the further development of biological science, information science, material science, computer science and network technology, the treatment mode of “eradicating tumor while preserving function” has become the goal of oncologists in the 21st century. In recent years, the concept of breast cancer treatment has undergone a fundamental change from the pursuit of “maximum tolerable treatment” to “minimum effective treatment”.
Extensive radical breast cancer surgery not only affects the aesthetic appearance and quality of life of patients, but also makes it difficult to eliminate microscopic metastases that lead to systemic metastases. At present, it is believed that breast cancer is a malignant tumor that may metastasize at an early stage, so surgery is only a local treatment, and it is impossible to completely remove the ectopic microscopic lesions that have metastasized. Therefore, it is often counterproductive to extend the survival period only by expanding the scope of surgery.
For this reason, modern breast surgeons have changed from the previous policy of “cutting as much as possible” to the strategy of “cutting only what needs to be cut”. In recent years, the scope of breast cancer surgery has been gradually narrowed, starting with the preservation of the pectoralis major and minor muscles to the implementation of breast-conserving surgery, providing more breast cancer patients with the right to survive and to love beauty.
For breast cancer patients, there are two problems to be solved: one is survival and the other is quality of life, which in layman’s terms means both living long and living well. The goal pursued by medical practitioners is to make each patient have both a survival period as long as possible and to maintain a better body and mind, to maintain a good quality of life, and to reproduce a perfect family and social life.
Early stage breast cancer, such as clinical stage I or IIA breast-preserving mastectomy, can achieve the same therapeutic effect as total mastectomy with standardized scientific comprehensive treatment after surgery, and breast-preserving surgery must be taken with standardized scientific chemotherapy and radiotherapy to reduce and avoid local recurrence.
It is also possible to adopt mastectomy with breast skin preservation and stage I or II breast reconstruction for patients who have had their breasts removed, applying autologous tissue or breast prosthesis for breast repair and reconstruction, which can not only completely remove the tumor and guarantee the overall treatment effect of breast cancer, but also restore the patient’s confidence and beauty to the maximum extent according to the patient’s actual situation.
After recurrence and metastasis of breast cancer does not mean that there is no hope. After standardized scientific and effective treatment, recurrence and metastasis, i.e. stage IV breast cancer, still has a five-year survival rate of 25%-30%, and through treatment, the patient’s pain will be reduced, symptoms will be relieved, and the quality of life will be significantly improved. Therefore, even for advanced breast cancer, do not give up lightly.
Finally, for the sake of breast health, please go to a qualified breast specialist hospital.