The breast is mainly composed of the breast gland, ducts, fatty tissue and fibrous tissue. The breast gland consists of 15 to 20 lobes, each of which is divided into several lobules, each of which is composed of 10 to 100 vesicles. These vesicles are arranged closely around the small milk ducts, and the openings of the vesicles are connected to the small milk ducts. The ducts converge to form interlobular ducts, which further converge to form a duct of the entire lobe, also known as the milk duct. There are 15 to 20 milk ducts, which are arranged in a radial pattern with the nipple as the center, converging on the areola and opening at the nipple, called the milk ducts. The milk ducts are narrower at the nipple and then expand into a pot belly called the sinus of the milk duct, which has the role of storing milk. The opening of the ducts is lined with squamous epithelial cells and the narrowing is lined with migrating epithelium, while the ducts below the pot belly are lined with double columnar epithelium or single columnar epithelium. The glands secrete milk and the ducts transmit the milk to the nipple, while fatty and fibrous tissues surround the breast and the ducts to play a supporting role.
1.What is breast cancer
Under normal circumstances, the glandular epithelial cells of the breast divide and grow in an orderly manner. However, at some point, for some reason, some cells undergo genetic mutation and the cells proliferate out of control, showing disorderly and unrestricted malignant division and growth, thus evolving into adenocarcinoma cells. A large number of cancer cells proliferate and crowd into a mass in a disorderly manner, squeeze and erode and destroy the surrounding normal tissues and damage the normal structure of the breast, then gradually breast cancer is formed. Therefore, 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. Many breast cancers begin as tumors on the surface cells of the milk ducts, while others develop as tumors on the lobules of the breast. Breast cancer includes invasive carcinoma of the breast and carcinoma in situ of the breast.
4.Prevalence of breast cancer
Breast cancer has become the most prevalent malignant tumor among women worldwide, with about 1.2 million women suffering from breast cancer worldwide each year. In China, the incidence of breast cancer among women in large and medium-sized cities is the highest, and the incidence rate continues to rise. In 2005, the incidence rate in Beijing increased by 31.7% compared with that before 1996, and in Shanghai, the incidence rate increased from 17.7/100,000 in 1972 to 37/100,000 in 2000, ranking first among female malignant tumors in Shanghai. The incidence trend is younger, the peak age of the disease is 45~55 years old, 10~15 years earlier than women in western countries, and the time of consultation is quite late. Before surgery in economically underdeveloped areas of China, about 30% of patients already belong to late stage III and IV, while in the United States, the proportion is only 15%.
3.Who is prone to breast cancer?
The medical community generally agrees that the risk factors for breast cancer include genetic factors, hormonal changes in the body, mental and psychological factors brought about by an overly stressful life and previous history of breast disease. They are summarized as follows.
(1) Women with breast cancer in their family (e.g. mother, sister): If the breast cancer patient in your family is a distant relative (cousin or great-grandmother), your chances of developing the disease will be slightly higher than the average risk factor. If a close relative (mother, sister, daughter, or even father, son, or brother) has breast cancer, your chances of developing the disease are two times higher than the average person; if an immediate family member was diagnosed with breast cancer before age 50, your risk of developing the disease later in life is even greater; and if two or more close relatives have a history of breast cancer, your chances of developing the disease are If you have two or more close relatives with a history of breast cancer, you are three times more likely to develop the disease. In addition, women with a family history of ovarian, uterine and breast cancer are generally more likely to develop the disease than other women from healthy families.
(2) Menarche is earlier than 12 years old or menopause is older than 55 years old.
(3) Never had children or had children late (after age 35).
(4) Decreased duration of breastfeeding after childbirth or artificial breastfeeding. Other risk factors include breast lumps (abnormal early breast biopsy); such as heterogeneous hyperplasia (lobular or ductal), fibroadenoma with complex features, atypical hyperplasia, sclerosing adenopathy; prolonged application of estrogen: such as oral contraceptives, postmenopausal use of hormone replacement therapy; and poor lifestyle habits: such as smoking, alcohol abuse, overweight.
4. What are the symptoms of breast cancer?
Need to be alert to the following symptoms: painless lumps: hard lumps the size of a fava bean, movable, which is a common early clinical manifestation; breast skin changes: “dimple sign” and “orange peel sign”; nipple overflow: non-pregnant nipples secrete yellowish, brown or bloody fluid. Nipple changes: nipple depression or elevation, or deviation to one side. Lymph node enlargement: ipsilateral axillary lymph node enlargement is the most common.
In short, the three major signs that reveal the original form of breast cancer are
(1) Dimple sign: As the name implies, it is like the dimple that appears on the cheek when a person smiles. It is caused by the invasion of Cooper’s ligament in the breast by cancerous tissue. This sign can occur even at a very early stage of the disease. Generally speaking, if the “dimple sign” is present in the absence of inflammation, breast trauma, or surgical history, the possibility of cancer is quite high. How to examine: The patient lies flat on his back, put the four fingers together on one side of the lump, then push the lump to the other side and observe the lump and the surrounding epidermis. The presence or absence of “dimples” can be detected.
(2) Orange peel phenomenon: If the epidermis of the breast appears to change like an orange peel, you should be highly alert to breast cancer. This is because the cancerous tissues will invade the subcutaneous lymphatic network and cause the skin lymphatic flow obstruction, thus forming many enlarged dotted holes in the skin follicles, which looks like an “orange peel”. It is often a sign of advanced breast cancer. However, during the acute inflammation of the breast, the orange peel phenomenon may also appear and must be differentiated.
(3) Nipple retraction: The nipple is supported by smooth muscle and breast ducts, which makes it look straight. However, if the supporting tissues are poorly developed, the nipple will retract. If cancerous tissues invade the supporting tissues underneath, contracture of the supporting tissues will occur and pull back the nipple. Therefore, if you find that the nipple is slowly retracting and cannot be put back in place, especially if there is a lump under it, you should be highly alert to breast cancer.
5. Actively screen for breast cancer
Regular screening is the most effective way to reduce the risk of breast cancer, and it is recommended that people with family history of breast cancer and other high-risk factors should be screened earlier (the starting age of screening should be advanced to 20 years old). Early detection and treatment is currently the most effective strategy to reduce breast cancer mortality.
Encourage monthly breast self-examination: Self-examination can be done on the fifth day after menstruation. Method: Touch the entire breast with the fingertips of the middle and index fingers in a tapping motion, gently touching any lumps or changes under the skin. Look in the mirror and check both breasts for any changes in shape or contour, including nipple discharge, folds, indentations, or changes in the texture of the breast skin. Note: Not finger grasping.
Hospital physical examination: breast physical examination every 1-3 years for general women under 40 years old; breast physical examination and mammogram and breast ultrasound once a year for general women between 40 and 59 years old; breast physical examination and mammogram and breast ultrasound every 1-2 years for general women between 60 and 69 years old; breast physical examination and mammogram and breast ultrasound once every 2 years for women over 70 years old.
6. Treatment of breast cancer
(1) Surgery: the most basic treatment for breast cancer, which can directly remove the tumor, divided into: radical surgery, breast-conserving surgery and palliative surgery.
Radiation therapy: mainly used after breast-conserving surgery, it is a local treatment, in which a certain dose of X-ray is used to irradiate the area where the tumor is located to kill the tumor cells.
(2) Endocrine therapy: Applicable to breast cancer patients with positive hormone receptor test, the treatment plan will be different before and after menopause.
(3) Chemotherapy: an important systemic treatment modality to kill the hidden microscopic lesions and avoid tumor cells from spreading through the blood, and also to shrink the primary lesions to create conditions for surgery.
(4) Molecular targeted therapy: Currently, it mainly targets HER-2 positive breast cancer patients.
7. Can breast cancer be cured?
There are many factors that determine the outcome of breast cancer treatment, the most important one is the early or late stage. Early detection, early diagnosis and early and correct treatment are the keys to improve the cure rate. With continuous progress in treatment, many advanced breast cancers can still survive for a long time.
8. Warm Tips.
(1) Have children at an appropriate age and prolong breastfeeding time.
(2) Consume more vegetables and fruits.
(3) Control weight, avoid excessive fat and exercise more.
(4) Limit alcohol consumption.
(5) Maintain a good state of mind and focus on physical and mental relaxation in general.
(6) Adhere to regular self-examinations and physical examinations, and seek medical attention early if problems are found