1. What is the current incidence of breast hyperplasia in China? What are the main causes? First of all, I would like to say that breast hyperplasia is a broader concept, including the clinical commonly known as fibrocystic breast disease, cystic hyperplasia, breast lobular or tissue hyperplasia and other conditions. The pathological mechanism is due to the excessive growth of breast epithelial cells resulting in a benign accumulation of cells, which results in the formation of a breast lump or localized thickening of the tissue, accompanied by pain or cyst formation. Mammal hyperplasia is most common in women between the ages of 20 and 50, and is mostly relieved to some extent after menopause due to the decline in estrogen. In the outpatient clinic, the diagnosis of breast hyperplasia accounts for 60-80% of the patients in the breast specialty clinic, and also accounts for 20-40% of the women in the census population. With the development of society and the accelerated pace of people’s lives, the incidence of breast hyperplasia has gradually increased. The causes are mainly related to hormonal endocrine imbalance and neuropsychiatric factors. Generally speaking, too much estrogen and low progesterone will induce the proliferation of breast epithelial cells. The diet of modern people favors high fat and animal protein, which can promote the synthesis of estrogen, and excessive mental stress can also induce hormonal imbalance. In addition, some women take some beauty products for the pursuit of beauty also contain exogenous estrogen, which can induce the proliferation of breast epithelial cells. 2. Many women are worried that breast hyperplasia will further develop into breast cancer, so in your opinion will breast hyperplasia become cancerous? If it is only periodic breast pain and lumps, and disappears after menstruation, it is usually not a problem and will not lead to cancer. However, if the pain and lumps are persistent, it is necessary to consult a breast specialist for further examination to understand the degree and pathological type of breast hyperplasia in order to determine whether there is any possibility of cancer. 3.What are the main types of breast hyperplasia, how high is the risk of cancer for each type of breast hyperplasia, and which type of breast hyperplasia is most likely to become cancerous? If there is only periodic tissue thickening or lumps, which disappear after menstruation, the cancer risk of this type of breast enlargement is not increased and it is the same as that of a normal person. If there is a persistent breast lump, it is necessary to identify whether it is cystic or solid. If it is just a cyst, there is no increased risk of cancer. However, if the lump is solid and imaging suggests malignant potential, biopsy is recommended to determine the nature of the pathology. If the pathology report is of cellular hyperplasia but the morphology is the same as that of normal cells (no atypia), the risk of this type of carcinoma is slightly higher than that of a normal person by 30-90%. The most dangerous is atypical cell hyperplasia with abnormal cell morphology, and the risk of cancer is 4-12 times higher than normal. 4. What are the risk factors for breast hyperplasia to develop into breast cancer? What should be done to prevent breast hyperplasia from developing into breast cancer? The risk factors for breast cancer progression from hyperplasia are high hyperplasia or atypical hyperplasia on pathologic biopsy. It is recommended that these patients should have a low-fat diet and stop the intake of exogenous estrogen, and should be followed up closely for early detection of breast cancer. Tamoxifen may also be considered if the hyperplasia is severe. Surgical removal of the lesion or even prophylactic mastectomy may also be considered if there is a combination of other risk factors for breast cancer, such as intraductal papilloma, family history of breast cancer or contralateral breast cancer, and mutations in the breast cancer susceptibility gene (BRCA1/2). For patients without atypical hyperplasia, prevention and treatment of breast hyperplasia can be carried out to alleviate or reduce the occurrence of breast hyperplasia, so as to prevent it from progressing to atypical hyperplasia and thus prevent breast cancer. 5.Some studies have claimed that improper treatment of breast hyperplasia will lead to breast cancer, do you think this claim is justified? Have you encountered such patients in your clinic? What are some of the treatments that may lead to breast cancer if not used properly? I have seen this statement, but I think it refers to the fact that improper treatment of breast enlargement can lead to delayed disease, rather than directly to breast cancer, such as localized symptomatic relief that leads to neglect of regular follow-up. Patients with atypical hyperplasia on pathologic biopsy need to be followed up every 3 months, and if they do not see a doctor for a year because of symptomatic relief, there is a real possibility that malignant changes may not be detected in time. I personally have not come across any cases of breast cancer due to improper treatment of breast enlargement, but I have come across many patients who did not have early detection of cancer because they did not have timely follow-up. If estrogenic products or drugs are used on patients with breast enlargement, it is possible to accelerate malignant changes, but I think such doctors should be very few. 6. What kind of examination should be done to detect breast cancer early in patients with breast hyperplasia? What are the commonly used screening methods in the clinic? Regular checkups (6-12 months) and follow-up anytime there is a change in symptoms should be done. Clinical examination mainly involves palpation, and commonly used auxiliary examinations include ultrasound and molybdenum target. Asian women develop breast cancer 10 years earlier than European and American women on average, and their breasts are generally denser, so ultrasound is the first choice, and it is a non-invasive examination, which can be carried out several times. Mammography is generally used for women over 40 years of age and can be performed once a year to detect tiny calcifications that cannot be seen on ultrasound. Magnetic resonance has high soft tissue resolution and high sensitivity, but also has a high false-positive rate, and is not recommended as a routine examination because of its high price. 7.What living habits and dietary behaviors can prevent breast cancer? (1) Change dietary habits, prevent obesity, eat less high-fat food and supplements, and eat more vegetables and fruits. (2) Exercise more, modern people are sitting in the office too much and exercising less, so the incidence of breast hyperplasia and breast cancer are increasing. A study found that 2 hours of fast walking or more per week can significantly reduce the risk of breast cancer. (3) Adjust work and life stress appropriately and sleep regularly. Excessive stress and depression can lead to endocrine disorders and breast enlargement. (4) Don’t wear tight underwear, so as not to compress the blood and lymph circulation of the breasts. (5) Avoid excessive use of contraceptive pills and estrogen-containing beauty products and drugs, and do not consume estrogen-fed chicken and beef. (6) Stay away from tobacco and alcohol. (7) Breastfeeding as much as possible. (8) Monthly self-breast examination and regular breast specialist outpatient review.