Recurrence is the biggest cause of death Breast cancer is a malignant tumor that occurs in the glandular epithelial tissue of the breast, and is one of the most common malignant tumors in women. The onset is often related to genetics and other factors, and the incidence rate is higher in women between 40 and 60 years old, before and after menopause. In western countries, breast cancer is the first malignant tumor among women. In China, the incidence of breast cancer is increasing year by year, and in big cities such as Beijing and Shanghai, breast cancer has risen to the first place of female malignant tumors, and the incidence is getting higher and higher. Prof. Shao Zhimin, director of Breast Surgery Department of Cancer Hospital of Shanghai Fudan University and director of Breast Cancer Committee of China Anti-Cancer Association, said in an interview that even early breast cancer patients still have the risk of recurrence after surgery, especially in the 1 to 3 years after surgery. However, at present, many patients think that the treatment of breast cancer is simply surgery, as long as the cut is clean, there will be no recurrence, which is actually a misconception. There are many forms of breast cancer recurrence, mainly local recurrence, contralateral new recurrence and distant metastasis. Distant metastasis refers to the transfer of breast cancer to distant parts of the body through blood, and lung, bone, liver and other organs are the most common sites of metastasis; nearly two-thirds of breast cancer recurrence will lead to distant metastasis of breast cancer, and distant metastasis of breast cancer is the biggest cause of death of breast cancer patients. Numerous medical practices have proven that breast cancer is one of the best treated cancers available and that breast cancer patients can have a long survival period as long as the risk of recurrence is successfully controlled. However, once breast cancer recurrence or metastasis occurs, treatment will be much more difficult and directly threaten the patient’s life. After breast cancer metastasis occurs, the survival rate of patients will be significantly reduced, such as the 5-year survival rate of 16% for bone metastasis, 12% for lung metastasis, and zero for liver metastasis. Shao emphasized, “Although breast cancer is a little better treated compared to other malignant tumors, breast cancer is not all right after surgery; there is also a tendency of risk of recurrence and metastasis after surgical treatment, and this rate is about 30-40%.” The results of a large international survey showed that 41.8% of clinical breast cancer specialists believe that the worst job is to inform his patient that her breast cancer has recurred and is difficult to cure. 72% of physicians believe that informing a patient of a recurrence is much more difficult than informing a patient that she has been diagnosed with breast cancer. Almost all physicians agree that a breast cancer recurrence can be devastating for both the patient and her family. Follow-up is important “Recurrence of metastasis after breast cancer surgery occurs mostly 2 to 3 years after surgery, and 5 years, so there is no doubt that follow-up of patients after breast cancer treatment is important.” Shao Zhimin said, “Although the incidence of breast cancer in Europe and the United States is increasing year by year, the mortality rate of breast cancer in the United States and other countries is decreasing, why? One is that breast cancer can be diagnosed at an early stage through some very advanced methods, and the second is that follow-up and adjuvant treatment after surgery has improved the overall level of breast cancer treatment.” Shao said repeatedly that follow-up is a very, very important task. Its significance is that on the one hand, it can help doctors to detect early breast cancer recurrence or metastasis so that patients can get better treatment in time; at the same time, any drug has adverse effects, so it needs a large number of patient follow-ups to get this information and summarize the lessons learned. On the other hand, for breast cancer patients, they are able to use the medication reasonably under the guidance of doctors according to their own situation. Breast cancer is a tumor that is closely related to estrogen and other hormones in the patient’s body, and its development is related to abnormal estrogen levels in the body and its metabolism. Adjuvant endocrine therapy has become a very important part of the comprehensive breast cancer treatment plan. By blocking or stopping the production of estrogen, endocrine therapy eliminates the stimuli that contribute to tumor growth. The two main classes of drugs currently used in endocrine therapy for breast cancer are triamcinolone acetonide and the new generation aromatase inhibitor Renintex. The results of an 11-year medical study called ATAC were recently presented at the 30th San Antonio Breast Cancer Conference (SABCS) in the United States. The results of the world’s largest adjuvant breast cancer clinical trial with the longest follow-up period and the most mature data to date showed that adjuvant treatment with Rynindal after surgery was better able to avoid the peak of recurrence 1 to 3 years after surgery compared to the traditional drug triamcinolone; compared to triamcinolone, Rynindal was able to further reduce the risk of recurrence by 24%, the risk of contralateral new breast cancer by 40% and a 16% reduction in the risk of distant metastases. While the benefits of postoperative follow-up for breast cancer are clear, the situation in China is not encouraging. Only in one specialized hospital, Fudan University Cancer Hospital, where Shao Zhimin works, a significant proportion of breast cancer patients are not followed up; for those who are followed up, although the one-year follow-up rate can reach 93%, by the fifth year the follow-up rate is only 60%.