Breast Cancer Awareness
In our daily work, we often face the question “How does breast cancer occur?”. In fact, scientists have never stopped exploring the tumor. In fact, scientists have never stopped exploring the tumor. We now know the process of breast cancer development. Most of the normal cells in the body are dividing and proliferating steadily and evenly every day to replace the old or damaged cells and to maintain the body’s functions in all aspects.
However, when some external factors change and cause the cells to divide or multiply faster, a local mass will form, which can be benign or malignant. If the mass is malignant and occurs in the breast, it is called breast cancer. Most breast cancers are located in the lactiferous ducts of the breast and are called ductal cancers.
A small percentage is also located in the lobules at the end of the ducts and is called lobular carcinoma. If the tumor is confined to the ducts or lobules, it is called non-invasive cancer or carcinoma in situ, but when the tumor has grown into the surrounding tissues or metastasized to other parts of the body, it is already an invasive cancer and the prognosis is very dangerous. This is the process of breast cancer production.
Standard treatment of early breast cancer
The process of tumor growth and proliferation requires the formation of new blood vessels in which vascular endothelial growth factor plays an important role. The VEGF family includes VEGF-A, VEGF-B, VEGF-C, VEGF-D and other related molecules. Among them, the most important in tumor neovascularization is VEGF-A. This factor promotes the growth and proliferation of vascular endothelial cells and binds to growth factor receptors produced by vascular endothelial cells to activate downstream signal transduction pathways, which ultimately promotes neovascularization.
When a patient with early-stage breast cancer is diagnosed, he or she often eagerly asks, “Doctor, can I be cured? What is the best treatment?” . This may seem to be a very important and urgent question, but the answer is very simple. Because the modern medical model has changed from empirical medicine to evidence-based medicine, the choice of treatment plan is no longer the accumulation of treatment experience of individual doctors for a few patients, but the meta-analysis of scientific treatment results from thousands, tens of thousands or even larger samples of similar patients around the world. These treatment guidelines are disseminated to specialists through medical books, journals, and the Internet, and are constantly revised based on the latest research findings to ensure that patients receive the latest and best treatment options.
A breast cancer patient was diagnosed with breast cancer and brought her complete case history to multiple oncology centers on both the east and west coasts of the United States, and the results were amazingly consistent. This reaffirms the concept of “the earth is flat”, where medical experts of the same specialty sit around the same table in the same office, referring to common diagnostic and treatment criteria, to choose the treatment plan. In other words, once a breast cancer patient’s case data is collected, the correct treatment plan for that patient is determined, and there should be no big difference even in different countries, different hospitals and different doctors.
This is because as long as a specialist is qualified to practice his or her specialty, he or she should be familiar with the standard consultation and treatment guidelines of the specialty. However, in our country, due to the large gap between urban and rural areas, specialist hospitals and general hospitals, the specialist admission system is not sound, the promotion and education of professional guidelines is still in the initial stage, coupled with the uneven quality of national culture, some heartbreaking medical errors occur from time to time.
Patients who could have preserved their breast were mistakenly chosen to have mastectomy, bringing them eternal regret; those who should have chosen post-operative radiotherapy were not given radiotherapy, directly leading to local recurrence of tumor; and some patients were not suitable to receive targeted therapy for hundreds of thousands of dollars, but sold their houses to enjoy the fashionable treatment without any benefit.
In order to avoid early breast cancer patients to take a detour, I think the following steps are important to remember.
1.Perfect comprehensive systemic examination before surgery to clarify the clinical stage, pathological type, differentiation degree and molecular index status of breast cancer;
2. Carefully discuss whether there is a chance of breast conservation before surgery;
3.After surgery, scientific adjuvant chemotherapy, radiotherapy, endocrine therapy and molecular targeted therapy are formulated strictly according to the tumor risk classification.
In order to avoid the limitation of treatment plan selection, it is advisable to consult with several authoritative breast cancer specialists after breast cancer diagnosis to ensure the correct treatment choice.
Scientific treatment of recurrent metastatic breast cancer
Despite the application of the best treatment resources, only 60% of breast cancer patients are cured, and many of them have recurrence and metastasis. How to choose treatment for this group of patients is a very difficult problem for both doctors and patients, but it is by no means the end of the world. Because breast cancer cells have their own characteristics, they usually proliferate relatively slowly and progress slowly, and the prognosis of the disease is relatively better than liver cancer and lung cancer.
In addition, even if the tumor recurs and metastasizes, the prognosis of patients will vary greatly depending on the location and degree of recurrence. For example, if the recurrence is only localized, there is still a good chance to get a cure. Even if bone, skin, soft tissue or lymph node metastases are present, good tumor control can usually be achieved. Sometimes metastases in the lung, liver and brain can be detected early enough to achieve long-term tumor stability.
In other words, when doctors face a patient with advanced breast cancer with recurrent metastasis, in the choice of treatment strategy, they should first pre-determine whether the patient has curable recurrent metastasis or incurable recurrent metastasis, and the former should generally choose a more aggressive strategy choice, while the latter should choose a strategy of palliative treatment and prolonged survival.
For breast cancer patients with recurrent metastasis, the eight-word policy of “no change in formula, no change if ineffective” advocated by Professor Song Santai, an expert in breast cancer internal medicine, should be the principle for both doctors and patients to follow when formulating specific treatment plans. Specifically, based on a comprehensive understanding of the tumor status of breast cancer patients, we should collect information about the patient’s previous treatment process and distinguish those treatments that are ineffective, those that are not accepted and those that are not evaluated.
The treatment plan is formulated according to the principle of excluding ineffective treatment, preferring unaccepted treatment, and secondly selecting treatment with undetermined efficacy. Once the applied treatment regimen is effective, it should never be abandoned at will, and should only be terminated when the three conditions of deteriorating efficacy, intolerable, and financially unsupportable, in order to strive for the longest tumor control time. Since breast cancer also has an endocrine treatment option that other tumors lack, sometimes chemotherapy and endocrine therapy can be applied alternately, just like our left and right hands, the left hand is tired for the right hand, and the right hand is tired for the left hand.
Since advanced breast cancer patients with recurrent metastasis have shown systemic dissemination of tumor, local treatment means such as surgery and radiotherapy are usually not the main treatment options, but radiotherapy can often play a good role in the management of brain metastasis, control of local pain of tumor, relief of spinal cord compression and other tumor emergencies, but it must be remembered that radiotherapy is only a local treatment means.
IV. Social return of breast cancer patients
The psychological rehabilitation and social return of breast cancer patients have always been neglected by the society and medical community. Once women suffer from breast cancer, they fall into a whirlpool of pain and depression, “I am a cancer patient”, “I will have recurrence and metastasis”, “my colleagues and friends will discriminate against me”. They are constantly troubled by these problems, and their quality of life is obviously reduced, so they are afraid of not being able to finish the day.
Breast cancer is a tumor with a high cure rate, and most patients can be cured if they receive standardized and scientific comprehensive treatment. In other words, after surgery, chemotherapy, radiotherapy and endocrine therapy, there is a high possibility that there are no more tumor cells in your body, which means that your danger is lifted.
The subsequent regular follow-up or adjuvant endocrine therapy is only a post-insurance measure because we cannot be sure of the presence of tumor in our body by some means yet. Enjoying every day of life has become an important meaning of life. The attentive care from your family and the careful treatment from your medical care is the hope that you can enjoy the joy of life again.