However, unknowingly, sinful cancer cells can secretly take root in the beautiful breasts and destroy women’s body unscrupulously. In order to prevent and detect breast cancer at an early stage, women should learn to check their own breasts. Those who have the following predisposing factors should be the key targets: (1) family history of breast cancer, especially mothers and sisters who have suffered from this disease; (2) early menarche (less than 12 years old) or late menopause (more than 50 years old); (3) late childbearing (more than 40 years old); (4) cancer in one breast and the opposite breast is also a vulnerable area, etc. Self-examination of the breast There are time and technique requirements for breast examination. Self-examination should be done within 7-10 days after menstruation (when the breasts are soft and easy to detect subtle changes) and at the same time after each menstruation (for easy comparison before and after). For postmenopausal women, the same day of the month is chosen. The first step in breast self-examination is to take off your shirt and lower your arms naturally to examine your breasts in the mirror. Observe the size, shape, contour, symmetry, and nipple height and pointing to see if there are any changes and abnormalities; in the second step, raise both arms or fork the waist with both hands to tighten the pectoralis major muscle and repeat the observation as before, and turn the body from left to right to scrutinize from different angles. If a small dimple or bulge is found on the surface of the breast, the nipple is displaced or invaginated, or there is bloody or coffee-colored overflow from the nipple, it suggests that there may be a breast lesion beneath it; the third step is to palpate the breast and armpit. Lie flat on your back with a small pillow under your left shoulder and place your left hand up next to your ear so that your left breast is fully extended. The index, middle and ring fingers of the right hand are placed together on the surface of the left breast and then gently move in small circles to detect any lumps or local glandular thickening by the sensitive touch of the fingers. While palpating, the patient moves from the nipple to the periphery of the breast or from the outside to the inside in a spiral pattern, gliding across the entire surface of the breast in order to palpate. Then, touch deep under the areola and gently squeeze the nipple to observe any overflow. Next, the left armpit is examined with the same finger technique to see if there is any enlargement of its lymph nodes; in the fourth step, the palpation of the right breast and the right armpit is completed with the left hand in the same way and with the same steps. What are the conditions of the breast that are abnormal? (1) Nipple discharge, especially bloody discharge, especially in women over 50 years of age, about half of which may be malignant; (2) Restricted thickening of the breast glands, a very common but underappreciated clinical sign. This condition is mostly physiological if it occurs in non-menopausal women, especially when there is some size variation with the menstrual cycle. If the thickened tissue persists for a long time and is not related to the menstrual cycle, or if it becomes thicker and more extensive, especially in postmenopausal women, it must be taken seriously; (3) nipple erosion that has been repeatedly and ineffectively treated locally; (4) breast pain that varies in severity with the menstrual cycle in premenopausal women, mostly physiological; if the pain is limited, has a fixed location, is not related to the menstrual cycle, or is in postmenopausal women, it is physiological. (5) Unexplained edema of the areola skin, nipple retraction and limited indentation of the breast skin should be carefully investigated; (6) The presence of masses in the breast. If unfortunately, your doctor tells you that you may have breast cancer, your consultation should include the opinions of breast surgeon, chemotherapist and radiation therapist, and you should ask about your current stage of breast cancer. A responsible team of doctors will arrange an overall treatment plan for you, instead of limiting your treatment to your own treatment or arranging your treatment in front of your own. The treatment of tumor is especially important to “initial treatment”, meaning that if the first treatment is clearly staged and the treatment plan is correct, it will lay a good foundation for the future treatment, and there is no time to take a detour and start again. Then, what are the principles of breast cancer treatment? The following terms are helpful for breast cancer patients to actively cooperate with the treatment: 1. quadrant where the lump is located: a horizontal line and a longitudinal line are drawn around the nipple to divide the breast into four areas, which are named as inner upper quadrant, inner lower quadrant, outer upper quadrant and outer lower quadrant according to their respective orientation, breast cancer is most common in the outer upper quadrant, and lumps located in the inner upper quadrant, inner lower quadrant and areola area are prone to mediastinal internal breast lymph node metastasis; 2. Breast cancer staging: this is the basis of breast cancer treatment. The clinical staging should be determined before surgery in order to determine the order of surgery, chemotherapy and radiotherapy. Currently, TNM staging is preferred, that is, to evaluate the primary focus, lymph nodes and distant metastasis in three aspects, including the size of breast mass, the relationship with the skin of chest wall, the metastasis of axillary and mediastinal lymph nodes and the presence of common metastatic sites such as liver, lung and bone, to divide breast cancer into four stages. Patients with stage I and II breast cancer (lump size <5.0cm, no lymph nodes under the ipsilateral tuck or isolated movable lymph nodes, and lump size >5.0cm but no lymph nodes under the ipsilateral tuck) can be treated surgically first, mostly by modified radical surgery; stage IV patients with distant metastases should be treated with other treatments first, and palliative local excision should be performed only when needed; stage III patients (any lump size with the following three types of metastases) should be treated first. Stage III patients (any size lump with one of the following three conditions: confined to the breast but accompanied by ipsilateral axillary fused inactive lymph nodes; or direct invasion of the chest wall or skin; CT confirmed ipsilateral internal breast lymph node metastasis) are best treated with preoperative chemotherapy before surgery. After surgery, the pathological stage should be determined based on pathological examination to determine the next step of chemotherapy, radiotherapy and endocrine therapy; 3. Receptor status: Larger hospitals will issue immunohistochemical staining report at the same time of pathological examination, including the expression of estrogen receptor (ER), progesterone receptor (PR) and C-erb2. Positive expression of ER and/or PR indicates that female hormones play a greater role in the occurrence of breast cancer, and anti-estrogen drugs (i.e. endocrine therapy) can play a therapeutic role, the more positive expression, the better the effect; positive expression of C-erb2 is a poor prognostic factor, suggesting rapid tumor progression and easy resistance to chemoradiotherapy, which can be combined with biological targeted therapy. Targeted therapy drugs are still expensive and should be used selectively according to the results of target testing. Breast cancer is treated by the following means: 1. Surgery: This is an important means and key to cure breast cancer. A comprehensive examination should be done before surgery to clarify the stage. For breast masses without clear preoperative pathology, they should be prepared for radical breast cancer surgery, and the first step should be to remove the masses and send them for rapid freezing examination. Of course, some patients who meet the indications for breast-conserving surgery can be treated according to the procedure of breast-conserving surgery; 2. chemotherapy: adjuvant chemotherapy should be started within 2-4 weeks after surgery for patients with stage II and III; for patients with lumps ≤2 cm in maximum diameter and no lymph node metastasis, i.e. stage I patients, not everything is fine after surgery, adjuvant chemotherapy should be considered if the following high-risk factors are present: (1) high histological malignancy, poor cell differentiation, and (2) intravascular cancer thrombus. (2) intravascular thrombus; (3) intra-lymphatic thrombus; (4) estrogen and progesterone receptor negativity; (5) second surgery; (6) pregnancy and lactation; (7) young women; (8) inflammatory breast cancer; (9) C-erb(+). Adjuvant chemotherapy is sufficient for 6-8 cycles. The use of chemotherapy regimens for stage IV patients should vary according to the stage and the individual, and the first-line regimen should be as efficient as possible, to ensure adequate and timely chemotherapy. Radiotherapy should be administered after 2-4 cycles of chemotherapy, and no later than 6 months after surgery. 4.Endocrine therapy: Breast cancer is a kind of tumor closely related to endocrine, so it is more meaningful to add endocrine therapy, especially for postmenopausal and hormone receptor positive patients. It can be divided into non-steroidal anti-estrogenic drugs such as tamoxifen (TAM), aromatase inhibitors such as amiloride, exemestane, letrozole, etc., and progestins such as megestrol, etc. The use of endocrine drugs should be determined according to the receptor status. TAM can be used both before and after menopause, after chemotherapy, one tablet each time, twice a day, for 5 years or more, and after 5 years, change to aromatase inhibitors can improve the efficacy, and aromatase inhibitors are preferred for postmenopausal patients. For estrogen receptor-positive patients of advanced age, endocrine therapy is preferred over other means of initial treatment; 5. It is generally used in combination with chemotherapy for high-risk patients who meet the indications for the use of biologically targeted therapy. The treatment effect of breast cancer has improved significantly in recent years, mainly due to the development of comprehensive treatment and the development of new effective anti-cancer drugs. Effective adjuvant therapy before and after surgery for early stage patients can improve the cure rate and long-term disease-free survival, while active treatment for advanced stage patients can improve the quality of life and prolong the survival period. It is believed that with the improvement of women’s awareness of self-care and the strengthening of comprehensive treatment measures for breast cancer, the treatment of breast cancer will be further improved.