How effective is the treatment of breast cancer?

  Breast cancer in situ is not fatal because it is not a vital organ that sustains human life activities; however, because breast cancer cells lose the characteristics of normal cells, they are loosely connected to each other and can be easily shed. Once the cancer cells are shed, the free cancer cells can spread throughout the body with blood or lymphatic fluid, forming metastasis and endangering life. Breast cancer is still a common tumor that threatens women’s physical and mental health.  The global incidence of breast cancer has been on the rise since the late 1970s. In the United States, 1 in 8 women will develop breast cancer in their lifetime. China is not a country with a high incidence of breast cancer, but we cannot be too optimistic. In recent years, the incidence rate of breast cancer in China has been increasing at a rate 1 to 2 percentage points higher than that of countries with a high incidence. According to the 2009 breast cancer incidence data released by the National Cancer Center and the Bureau of Disease Prevention and Control of the Ministry of Health in 2012, the incidence rate of breast cancer in the national tumor registration area ranked 1st among female malignant tumors, with a total incidence rate of 42.55/100,000 women nationwide, 51.91/100,000 in urban areas and 23.12/100,000 in rural areas.  Breast cancer has become a major public health problem in the current society. The global breast cancer mortality rate has shown a decreasing trend since the 1990s; the reasons for this are, firstly, the screening of breast cancer, which has increased the proportion of early cases; and secondly, the development of comprehensive breast cancer treatment, which has improved the efficacy. Breast cancer has become one of the solid tumors with the best outcome.  With the deepening understanding of the biological behavior of breast cancer and the change and update of treatment philosophy, the treatment of breast cancer has entered the era of comprehensive treatment, forming a treatment model that emphasizes both local and systemic treatment of breast cancer. Depending on the stage of the tumor and the patient’s physical condition, doctors will use various means such as surgery, radiotherapy, chemotherapy, endocrine therapy, biologically targeted therapy and adjuvant therapy with Chinese medicine as appropriate. Surgery plays an important role in the diagnosis, staging and comprehensive treatment of breast cancer. Radiotherapy is the use of radiation to destroy the growth and reproduction of cancer cells to control and destroy them. Surgery and radiotherapy are both local treatments. Chemotherapy is a treatment method that applies anti-cancer drugs to inhibit cancer cell division and destroy cancer cells, referred to as chemotherapy. Endocrine therapy is a method to regulate the endocrine function of the body and reduce the secretion of endocrine hormones by using drugs or removing endocrine glands to treat breast cancer. Molecular targeted therapy is one of the most active research fields in recent years, and is a new type of anti-tumor therapeutic agent with multi-linked mechanism of action compared with chemotherapy drugs. Chinese medicine emphasizes the principle of regulation and balance in the treatment of tumors, restoring and enhancing the body’s internal resistance to disease, so as to achieve the balance of yin and yang in the treatment of tumors. Chemotherapy, endocrine therapy, targeted therapy and TCM treatment are all systemic treatments. During the treatment process, doctors will take into account both local treatment and systemic treatment of patients, aiming to cure early and middle stage breast cancer patients and prolong life expectancy and improve quality of life for advanced stage patients.  Surgical procedures for breast cancer include both breast and axillary lymph nodes. Breast surgery includes breast preservation surgery (breast conserving surgery), mastectomy prosthesis implantation and total mastectomy. Axillary lymph node surgery includes sentinel lymph node biopsy and axillary lymph node dissection. Sentinel lymph node biopsy is the removal of only the sentinel lymph node, followed by axillary lymph node dissection after detection of metastasis in the sentinel lymph node, also known as axillary conserving surgery. There are strict indications for breast-conserving surgery, and it is not yet possible to perform breast-conserving surgery for all breast cancer patients. For those who are not suitable for breast-conserving surgery, all of the breast or breast glands need to be removed, but of course, the surgeon can use plastic surgery techniques to reconstruct the breast. Breast reconstruction can be done with autologous tissue reconstruction or with prosthesis reconstruction. Breast reconstruction can be performed at the same time as the surgery to remove the tumor or at the end of the treatment when all the results of the review are normal. Performing breast reconstruction will not interfere with the overall treatment of breast cancer.