Women between the ages of 20 and 40 should have a mammogram at least once every three years, while women over 40 and those with a family history of breast cancer should have an annual checkup
Breast cancer is the most common malignant tumor in women. According to the data released by the World Health Organization in 2012, breast cancer ranks first in the incidence and mortality rate of malignant tumors among women worldwide. The situation in China is not optimistic either. According to the data published by the National Cancer Center in 2012, breast cancer is the malignant tumor with the highest incidence rate among Chinese women, accounting for 16.81% of all malignant tumors in women.
Incidence rate of breast cancer in China is increasing year by year
”In terms of incidence rate alone, the incidence rate of breast cancer among Chinese women is not high, but it is particularly important to note that the incidence rate of breast cancer in China is surging at a rate of 3 to 4 percent per year.” Xu Binghe, chairman of the Breast Cancer Committee of the Chinese Anti-Cancer Association and director of the Department of Internal Medicine at the Cancer Hospital of the Chinese Academy of Medical Sciences, told tWatch East that although the causes of breast cancer are not yet fully understood, the results of numerous clinical epidemiological surveys show that the sustained increase in the level of estrogen in humans leads to a significant increase in the incidence of breast cancer.
Xu Binghe explained that estrogen is a physiological hormone that is generally released at a relatively constant rate or in a certain rhythm, and once the regular movement is disturbed by external interference, the normal fluctuation of hormone levels will be disrupted. If the hormone level continues to rise, the stimulation of estrogen on the breast epithelium will be prolonged, which will then affect the endocrine environment in the body and may induce cellular malignancy, leading to the development of breast cancer.
”Chinese women’s estrogen secretion has increased significantly compared to 20 years ago, and the age of menarche for women has advanced from 14 or 15 years old to 11 or 12 years old, while the age of menopause has been postponed from the 40s to the 50s, which is tantamount to inadvertently lengthening the secretion time of hormones; at the same time, the phenomenon of estrogen secretion disorder is becoming more and more common. ” Xu Binghe said.
He also pointed out that aborting pregnancy and supplementing estrogen during menopause can affect the disorder of estrogen secretion, “We must follow the laws of nature, if we always apply emergency brakes to a car that should be running at a uniform speed, it will definitely cause damage to the internal structure of the car.”
Only 20% of breast cancers in China are in early stage
Although people always talk about cancer, Xu Binghe believes that breast cancer is totally a malignant tumor that can be detected and treated at an early stage and is expected to be cured.
”The five-year survival rate for early-stage breast cancer can reach more than 90 percent, and the chances of undergoing breast-preserving surgery are relatively high.” Xu Binghe said that in Europe, America, Japan and Korea, more than 50 percent of women with breast cancer are found to be in the early stage, while only 20 percent of breast cancers in China are in the early stage.
”At present, screening for two cancers (breast and cervical cancer) for women is more common in first-tier cities, but it is far from popular in third- and fourth-tier cities, especially in rural areas.” Xu Binghe told the journalist that the Chinese Population Association had made a survey and the results showed that only 5% of Chinese women would have annual breast screening.
He suggested that women between the ages of 20 and 40 should go to the hospital for a mammogram at least once every three years, while women over 40 and those with a family history of breast cancer should go to the hospital once a year.
”Usually doctors will perform a manual examination after knowing the medical history, and then combine it with imaging examinations such as color ultrasound and mammography (i.e. mammogram).” Xu Binghe said that color ultrasound is not damaging to the body and is suitable for young women. Mammography is the main method recommended internationally for breast cancer screening in recent years, which can detect breast cancer that cannot be detected by clinical examination, and is usually suitable for women over 40 years old, whose breast is not sensitive to radiation and has limited radiation damage, and whose breast density is relatively low, so it is easy to detect abnormalities through mammography.
Our reporter learned that ultrasound and mammography can detect 80% to 85% of early breast cancers, while the combination of ultrasound and mammography can detect more than 95% of early breast cancers.
Targeted treatment is the first step to overcome breast cancer
Li Huiping, Director of Department of Breast Oncology, Peking University Cancer Hospital, told “tWatch East” that in addition to early prevention, early detection and early treatment, standardized and comprehensive treatment is the best way to improve the treatment effect of breast cancer. With the wide application of molecular biology technology in breast cancer research, the treatment of breast cancer has also entered the era of individualized multidisciplinary comprehensive treatment.
According to our reporter, breast cancer can be divided into at least four subtypes according to the causative genes, namely Luminal A, Luminal B, triple negative, and HER2-positive. According to Li Huiping, to distinguish the types and carry out targeted treatment is the first step to overcome breast cancer.
Generally speaking, patients with Luminal A type need endocrine therapy; patients with Luminal B type choose chemotherapy or endocrine therapy according to the actual situation; triple negative breast cancer is mainly treated with chemotherapy.
Among all breast cancers, HER2-positive breast cancer, which accounts for 20-30%, is the more aggressive subtype, with more malignant tumor cells, faster progression and more likely to recur and metastasize to distant sites. Li Huiping said, “For HER2-positive breast cancer, we have found an effective targeted therapy.”
”The combination of surgical treatment and drug therapy is the predominant treatment for breast cancer today. Drug therapy is both targeted drug therapy, as well as endocrine therapy and chemotherapy.” Xu Binghe said, “As long as people can achieve early screening and early diagnosis, and go to professional hospitals for standardized treatment as soon as they are detected, breast cancer is a malignant tumor that can be overcome.” Xu Binghe said.
People at high risk of breast cancer are
(1) Have a family history of breast cancer.
(2) First menstruation before the age of 12 and menopause after the age of 55.
(3) Single, late childbearing, not breastfeeding.
(4) Obese people.
(5) Long-term stress and depression.
(6) Long-term estrogen therapy.
(7) Mammary hyperplasia: benign mammary hyperplasia is generally not malignant, but those with older age, longer history, larger lumps, and lumps not obviously related to menstruation in mammary hyperplasia are at risk of malignancy.