Dr. Lian Zhenqiang, Deputy Chief Physician of Breast Department of Guangdong Maternal and Child Health Hospital, pointed out that although women’s health care awareness has increased with social development, in reality, there are still many women who do not understand breast cancer and have misconceptions about breast cancer, so many of them often miss the best time for breast cancer diagnosis and treatment. Have you fallen into the following misconceptions?
Truth 1: Breast cancer is not an incurable disease
Breast cancer is the most common malignant tumor in women and its incidence is increasing year by year. There are more than 1.2 million new cases of breast cancer and more than 400,000 women die from breast cancer each year worldwide, making it the most common malignant tumor among women. In the past decade, the incidence of breast cancer in China has been increasing at a rate of 3% per year, and in recent years, the incidence has been rising rapidly and the age of patients is trending younger.
”Due to the influence of many film and television works or hearsay around, many people in real life still regard malignant tumors as ‘incurable diseases’ and are even afraid of talking about cancer.” Lian Zhenqiang said, in fact, with the development of medical science, the emergence of new drugs and new treatment methods, many malignant tumors have been given a chance to be cured. In recent years, the incidence of breast cancer is increasing, but the mortality rate of breast cancer has decreased, which proves that breast cancer is not an incurable disease. Of course, different stages of malignant tumors have different chances to be cured, but the clinical cure rate of early stage breast cancer can reach over 90%, and the key lies in early detection and early treatment.
According to Lian Zhenqiang, the natural course of breast cancer is the longest in the asymptomatic pre-clinical stage, which accounts for about 2/3 of the whole course of the disease, making the early detection of breast cancer an objective condition. Current information shows that early diagnosis and screening of breast cancer can reduce the mortality rate of breast cancer by 15%-25%. The rate of distant metastasis is low and the 10-year tumor-free survival rate is more than 90% for breast cancer that cannot be detected clinically by imaging. In addition, even in advanced breast cancer, with reasonable drug or biological treatment, patients can prolong their survival and improve their quality of life. Therefore, when you have breast cancer, you should not hesitate to seek medical treatment and should treat it early to get the best treatment result.
Truth 2: Cancer can occur even without family history
Hollywood actress Jolie cut her breast to prevent cancer, so many people know that breast cancer is related to heredity, so “my grandmother and mother have not suffered from breast cancer, so I am sure I will not suffer from breast cancer?” Lian Zhenqiang’s answer is of course no. Many people believe that malignant tumors are caused by the fact that they are not genetic.
Many people believe that malignant tumor is a genetic disease because of the abnormal growth of tissue cells due to genetic mutation. The occurrence of malignant tumor is determined by various external environmental factors and the genetic susceptibility of human body. Individuals with certain genetic defects or immunodeficiency disorders show a predisposition to certain tumors, i.e. genetic susceptibility to tumors.
Epidemiological studies have shown that the causes of breast cancer are complex, and the mechanism and development process cannot be fully explained by known single-factor or multi-factor models so far. Therefore, genetic factors are only one of the factors that influence the occurrence of breast cancer, and other risk factors may also have an important impact on the development of breast cancer, according to Zhenqiang Lian. Current research on mutations in the breast cancer susceptibility genes BRCA1 and BRCA2 can resolve most hereditary breast cancers, but there are still many genes associated with hereditary breast cancers, and more than 50% of hereditary breast cancers are still unexplained. In fact, hereditary breast cancer accounts for approximately 5-10% of all breast cancers, and most breast cancers are associated with a multifactorial effect. Other factors that influence the occurrence of breast cancer include estrogen stimulation, ionizing radiation, dietary habits and other diseases of the breast.
Truth 3: Men can also get breast cancer
Lian Zhenqiang pointed out that breast is not a unique organ for women, men also have breast tissue, but it is not obvious in appearance. Breast cancer is the most common malignant tumor in women, and its incidence rate ranks first among female malignant tumors, compared to the lower incidence rate of male breast cancer, which is only about 1% of female breast cancer. The median age of onset of male breast cancer is 55-65 years old, accounting for 0.7%-1.2% of all breast cancers in the literature.
The pathogenesis of male breast cancer is still unclear and may be related to genetic factors (BRCAl and BRCA2 gene mutations), endocrine factors, electromagnetic radiation and environmental carcinogenic chemicals. Lien Zhenqiang said that, like female breast cancer, the incidence of male breast cancer is increasing year by year. Due to the lack of publicity about male breast cancer prevention and treatment and the fact that male patients and some health care professionals often take it lightly, many male breast cancers are not detected and treated early, thus affecting the clinical treatment effect. Therefore, the clinical concern about male breast cancer should be raised.
Truth 4: Self-examination is not a substitute for regular physical examination
Breast self-examination is a regular breast palpation performed by women themselves in order to improve the early detection of breast cancer, but the sensitivity of BSE is only 20-30%. Lian Zhenqiang said, admittedly, the breast is a body surface organ and many signs of breast cancer can be detected by self-examination, such as breast lumps, bloody nipple overflow and breast skin changes. However, many breast cancers, especially those with small lesions, have no obvious clinical symptoms and need to be detected by clinical imaging methods. The results of current clinical research trials show that breast self-examination only improves the detection and biopsy rates of benign tumors, but does not improve the early diagnosis rate of breast cancer, nor does it effectively reduce the mortality rate of breast cancer. As a result, the American Cancer Society’s “Guidelines for Early Detection of Cancer” no longer recommend breast self-examination as a routine measure for early diagnosis of breast cancer, but still recommend that women be informed of the potential benefits (increased self-awareness) and limitations (primarily false-positive rates) of breast self-examination.
Therefore, “it is still recommended that women undergo regular breast checkups at specialized hospitals, and especially for women over 40 years of age and those at high risk of breast cancer, regular relevant imaging examinations are recommended in order to achieve improved early diagnosis of breast cancer”. This is what Lian Zhenqiang said.
Truth 5: Breast cancer can occur even if no lump is touched
The main clinical manifestation of breast cancer is breast lump, but it is not the only clinical manifestation. In the past, many people mistakenly believed that as long as there is no lump in the breast, it is not possible to have breast cancer. With the increasing awareness of self-care and the screening and early diagnosis of breast cancer, more and more non-palpable breast lesions are detected, and 25%-35% of these non-palpable lesions are clinical. Most of the clinical non-palpable breast cancers are detected by mammography and ultrasonography. In addition to breast lumps, sometimes tiny foci of calcification are even the only manifestation of breast cancer diagnosed on mammography. Some of the non-palpable breast cancers are detected by ultrasound in 22-30% of cases, especially in young patients with dense glands. Some early breast cancers are clinically manifested only by nipple discharge, especially bloody nipple discharge, which is negative by mammography and ultrasound and can only be detected by ductoscopy. With the development of medical imaging, the application of breast-specific MRI (magnetic resonance imaging) has further improved the clinical detection of non-palpable breast cancer.
In addition, compared to breast cancers with palpable lumps, most of the non-palpable breast cancers are early stage breast cancers (stage 0, I and II breast cancers) with good clinical outcome. At present, it is clinically recommended for women to have annual clinical breast examination and breast ultrasound examination; for women over 40 years old, it is recommended to increase the number of mammograms every 1-2 years, and for people with high risk of breast cancer, it is recommended to have selective MRI examination in order to improve the diagnosis of early breast cancer and achieve early detection and treatment.
Truth 6: Not all breast lumps are breast cancer
Lian Zhenqiang said that although more than 80% of breast cancer is clinically manifested as breast lumps, not all breast lumps are breast cancer. In fact, many breast lumps are benign lumps. Breast cancer lumps are usually painless, hard, poorly defined and less mobile, while most lumps that are smooth and mobile may be benign. Of course, how to identify the benign and malignant nature of breast lumps can be initially determined by ultrasonography and mammography, but eventually histological pathological examination is needed to determine the benign and malignant nature of breast lumps.
Of course, it is difficult for people who have not received professional training to initially determine whether a breast lump is benign or malignant. Therefore, if a breast lump is found, the first step is to go to a breast specialist for further diagnosis to avoid delaying the diagnosis and treatment.