Who is prone to breast cancer?
1. Age: In women, the incidence rate rises with age. It is rare before the first menstruation and rare before the age of 20, but the incidence rate rises rapidly after the age of 20, and is higher from 45 to 50, but is relatively flat, and the incidence rate continues to rise after menopause, reaching the highest peak around 70. The mortality rate also rises with age, with a gradual increase in mortality after the age of 25, and always maintains an upward trend until old age.
2.Hereditary factors: Women in the family with a history of breast cancer in the first degree direct relatives’ family have 2 to 3 times the risk of breast cancer than the normal population.
3.Other breast diseases.
Age of menarche: The risk of menarche is 2.2 times higher than that of women older than 17 years old.
5.Age of menopause: The risk of menopause is increased for those who are older than 55 years old than for those who are younger than 45 years old.
6. Age of first pregnancy: the risk increases gradually with the postponement of the age of first birth, and the risk is higher for those who have their first birth after 35 years old than for those who have no history of childbirth.
7. Post-menopausal estrogen supplementation: Long-term use of estrogen during menopause may increase the risk of breast cancer.
8.Oral contraceptive pills.
9.Food: Especially fatty diet can increase the risk of breast cancer.
10.Drinking alcohol.
What are the common symptoms of breast cancer?
1. Painless lumps: Painless lumps in the breast are often the main symptoms that prompt patients to visit the doctor.
2. Nipple discharge: The discharge can be colorless, milky white, yellowish, brown, bloody, etc.; it can be watery, bloody, plasma or purulent; the amount of discharge can be more or less, and the interval is not consistent.
3, nipple and areola abnormalities: nipple flattening, retraction, depression, until completely shrunken under the areola, invisible nipple. Sometimes the whole breast is elevated and both nipples are not on the same level. Nipple erosion is also a typical symptom of breast cancer. In inflammatory breast cancer, the local skin is inflammation-like; the color ranges from light red to dark red, and it is relatively limited at the beginning and soon expands to most of the breast skin, accompanied by skin edema. The skin is thickened, rough and the surface temperature is increased.
5.Proliferation and development: The multiplication time of breast cancer cells is 90 days on average. The insidious stage of the tumor is 12 years (6-20 years) on average before the lump can be detected clinically. Once a tumor occurs, its progression can occur through the following ways: local extension, lymphatic spread, and hematogenous spread.
What tests are needed to confirm the diagnosis of breast cancer?
1.How to diagnose breast cancer by ultrasound and mammography?
X-ray examination: mammography is a common method to diagnose breast cancer. Common breast diseases can be classified into lumps or nodular lesions, calcified shadows and skin thickening signs, and ductal shadow changes on x-ray. 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.
Ultrasonography: Ultrasonography is non-invasive and can be used repeatedly. Ultrasonography is more valuable for 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.
2.Is a breast lump found on examination necessarily breast cancer?
Breast lump is usually a disease in which a lump grows inside due to the different composition of breast tissue, and breast lump is the most common breast disorder. Therefore, the most important thing to distinguish between benign and malignant breast lumps is that except for breast cancer which is malignant, lumps produced by breast fibroadenoma, breast hyperplasia, breast cysts, breast fat necrosis, etc. are all benign.
3.What blood tests can detect breast cancer? Does it necessarily mean breast cancer as long as there are abnormalities?
(1) Carcinoembryonic antigen (cEA): It is a non-specific antigen that is elevated in many tumors and non-tumor diseases and has no differential diagnostic value. About 20%-30% of operable breast cancers have elevated cEA content in the preoperative examination, while 50%-70% of advanced and metastatic cancers have high CEA value.
(2) Ferritin: Serum ferritin reflects the storage status of iron in the body, which is elevated in many malignant tumors such as leukemia, pancreatic cancer, gastrointestinal tumors and breast cancer.
(3) Monoclonal antibodies: monoclonal antibody cA, 15-3 used for breast cancer diagnosis has a diagnostic compliance rate of 33.3% to 57%.
4.What kind of cases need mammography?
X-ray examination: It is the most advantageous for detecting calcified foci of breast cancer, and digital X-ray photography can help CAD. Mammograms can finely record the X-ray images left by soft tissues with different penetrating abilities, especially capturing the tiny calcified foci that are diagnostic for breast cancer. Clinical applications confirm that it can detect cancers smaller than five millimeters and can detect breast cancer at least one year earlier than clinical. Its diagnostic value is even greater when combined with localized puncture examination. Because of this, the American Anti-Cancer Society proposes.
(1) Women between the ages of twenty and thirty-nine should have a monthly breast self-examination, a physical breast examination every three years, and a basic mammogram for women over the age of thirty-five.
(2) Women aged forty to forty-nine should have monthly breast self-examinations, annual breast examinations, and mammograms every one to two years.
(3) For women over the age of fifty, monthly breast examinations and mammograms.
Will breast puncture aggravate breast cancer or cause metastasis?
There are different opinions on whether breast puncture examination will cause the spread of cancer. This issue has been studied and observed by many experts as well as clinicians in China and abroad. Statistics on the 5-year survival rate of breast cancer patients who underwent external aspiration and puncture showed that there was no significant difference between the 5-year survival rate of patients who underwent puncture examination before surgery and those who did not. The 5-year survival rate of the former was 82.7% and that of the latter was 88.8%, which were basically similar. From the analysis of tens of thousands of punctures of various tumor cases, no cases of cancer spread and metastasis due to punctures were found, because puncture surgery is less irritating and less damaging, and its possibility of contributing to the spread of cancer cells is smaller and less than that of biopsy surgery.
It can be seen that instead of worrying about the spread of puncture and delaying the diagnosis, patients should get early diagnosis and timely treatment after timely puncture. It is better to get early diagnosis and timely treatment after puncture, rather than waiting for the disease to develop to a more serious or advanced stage before going for major surgery, or losing the chance to save the disease, resulting in serious consequences and lifelong regrets.
What should I do if I am diagnosed with breast cancer?
Surgical treatment
Surgery is still one of the main treatment methods for breast cancer. The general trend is to minimize surgical damage and to preserve the shape of the breast as much as possible for patients with early stage breast cancer, if the equipment allows. Regardless of the type of surgery, the principle of radical treatment and preservation of function and appearance must be strictly followed.
Chemotherapy
Most of the breast cancers are systemic diseases, which have been confirmed by many experimental studies and clinical observations. When breast cancer develops to a size larger than 1 cm and a lump can be palpated clinically, it is often a systemic disease and there may be distant micro-metastases, but they cannot be detected by current examination methods. The purpose of surgical treatment is to maximize local control of the primary tumor and regional lymph nodes, reduce local recurrence and improve survival rate. However, after tumor removal, residual tumor cells are still present in the body. Based on the concept that breast cancer is a systemic disease at the time of diagnosis, the purpose of systemic chemotherapy is to eradicate the residual tumor cells in the body to improve the cure rate of surgical procedures.
Radiation Therapy
Radiation therapy is a major component of breast cancer treatment and is one of the local treatment options. Compared with surgery, it is less limited by anatomy and patient’s physical condition, but the effect of radiation therapy is influenced by the biological effect of radiation. However, the effect of radiation therapy is influenced by the biological effect of radiation. It is difficult to achieve “complete tumor destruction” with the current radiotherapy facilities, and the effect is inferior to that of surgery. Therefore, most scholars currently do not advocate radiation therapy alone for curable breast cancer. Radiation therapy is mostly used for comprehensive treatment, including adjuvant treatment before or after radical surgery, and palliative treatment for advanced breast cancer. In the last decade or so, there has been an increase in the number of comprehensive treatments based on local excision for earlier breast cancers, and the efficacy is not significantly different from that of radical surgery, and radiation therapy plays an important role in reducing the scope of surgery.
Endocrine therapy
Endocrine therapy for breast cancer is non-curative, but it can receive different degrees of palliative effect for hormone-dependent breast cancer. The more estrogen receptors (ER) are present in the cytoplasm and nucleus of the cancer cells, the more hormone-dependent they are. And it should be kept in mind that breast cancer occurring before menopause is treated differently than breast cancer occurring after menopause.