Breast cancer is the most prevalent tumor in women worldwide. In recent years, it has quietly gone from being a small, unknown tumor to a “famous tumor” that almost no one knows about now. Indeed, we find that there are always people around us who have this disease, and many famous people have had their mammary glands removed or died because of breast cancer. According to statistics, the incidence of breast cancer in China is on the rise in recent years, but the mortality rate is gradually decreasing, thanks to the effective and painstaking work of scientists, clinicians and popular scientists in the prevention and treatment of breast cancer.
In 2014, WHO reported that breast cancer is the most prevalent cancer among women worldwide, with more than 1 million new cases each year. The incidence of breast cancer is highest in developed and affluent regions, with an incidence rate of approximately 80 per 100,000 women. The incidence of breast cancer in Chinese women is relatively low, but the incidence has increased significantly in recent years. Currently, there are about 470,000 breast cancer patients in China. Some statistics show that in 2008, breast cancer became the most prevalent tumor among Chinese women, with an incidence rate of 21.6 per 100,000 women. In addition, one characteristic of breast cancer incidence in China is that the incidence rate in urban areas is 1.3 times higher than that in rural areas, i.e. 2.3 times higher than that in rural areas. Another characteristic is the younger age compared to western countries, the average age at diagnosis of breast cancer in China is 45 to 55 years old.
Breast cancer is very close to us and the incidence rate is relatively high, but breast cancer is not scary. Although the incidence rate has increased in recent years, the mortality rate has decreased significantly. The five-year survival rate of breast cancer in China is 73%, which is the highest among all tumors. This is attributed to early prevention, early treatment and reasonable therapy.
What kind of people are prone to breast cancer?
First of all, it is important to know which are the high-risk factors that cause breast cancer.
First, age and gender are the highest risk factors. 99% of breast cancer cases are women and only 1% are men. Age is gradually increasing after the age of 30 and the incidence of breast cancer increases with age. The median age at diagnosis of breast cancer in China is 48 to 50 years old, and the average age is 45 to 55 years old, which is much lower than the age of onset in the West. Epidemiological surveys show that there are two peak incidences in two major cities, Beijing and Shanghai, at the ages of 45 to 55 and 70 to 74.
Second, there is a family history and genetic history, and patients with these two histories have a significantly higher incidence than the general population. Family history and genetic history are not exactly the same thing. Patients with family history do not necessarily have genetic history, and those with genetic history usually have family history. According to statistics, about 15% of all breast cancer patients have a family history, while only 5% have a genetic history.
Third, reproductive factors. Early menarche (<12 years old), late menopause (>55 years old), longer age of menstruation, and furthermore, not getting married, not having children, having children at a later age (>35 years old), not breastfeeding after having children, etc., in general, is a longer time of estrogen stimulation, which is also a high risk factor for the development of breast cancer.
In addition, hormone replacement therapy has a strong relationship with the development of breast cancer. Hormone replacement therapy is a popular method of treating menopausal syndrome with estrogen in the past. However, modern research has confirmed that hormone replacement therapy has a strong relationship with the development of breast cancer, and the closer to menopause a woman receives hormone replacement therapy, the greater her risk of developing breast cancer.
Furthermore, there are environmental and lifestyle factors. Obesity, less exercise, alcohol consumption, etc., may increase the chance of breast cancer. There are also some other factors such as previous history of breast radiotherapy, history of breast cancer (breast cancer on one side increases the development factor on the opposite side), and history of benign breast disease, all of which are related to the development of breast cancer.
If our readers have these high-risk factors mentioned above, they should eliminate the factors that can be controlled and have early prevention, physical examination and self-examination, so that once detected, they can be treated and cured early, and the cure rate of early breast cancer is very high.
How should the screening be done?
Screening for breast cancer helps in early detection. Screening can be done either by self-examination or at the hospital.
Our national doctors recommend women older than 18 years old to have a monthly self-examination; women between 18 and 40 years old to be examined by a doctor every 3 years; and women older than 40 years old to have a formal breast examination at a hospital once a year. Those who are at high risk, such as those with a family history of breast cancer, should have a formal examination every year from the age of 30.
The time of examination, pre-menopausal women usually start the examination one week after the start of menstruation, which is the time when the breast is the softest.
There are two methods of self-examination: one is to feel the breast from inside to outside in a clockwise direction while showering to check for abnormal lumps, including underarms; the second is to lie down and put a pillow under the shoulder, also in a clockwise direction, to feel the breast and check for lumps.
The most common and widespread method of breast cancer screening is to do mammogram and ultrasound, which is the golden partner of breast cancer screening. MRI can also screen for breast cancer and is very sensitive, but because MRI is more expensive, it is generally only used as a screening test for high-risk women or as a supplemental test to mammograms, ultrasounds and physical exams for suspected cases. The current international recommendation and the one we commonly use is mammography plus ultrasound, which is a mammogram. The screening age is generally recommended to be once a year for women over 40 years old, and for dense breast cancer it is recommended to combine with ultrasound.
We have just mentioned high-risk women, which group of people does this refer to?
Firstly, those who have obvious genetic predisposition to breast cancer; secondly, those who have previous moderate to severe atypical hyperplasia of breast ducts or lobules or lobular carcinoma in situ; and thirdly, those who have had radiation treatment to the chest.
How exactly should the screening be done?
Screening for breast cancer can help in early detection. The method of examination can be self-examination or hospital examination.
Besides regular check-ups, how should we prevent breast cancer in our daily life?
The development of breast cancer is a relatively long process. From a normal breast duct, to hyperplasia, to atypical hyperplasia, to ductal carcinoma in situ, and finally to invasive breast cancer, it is actually a very long time, so there is still a lot of room for prevention.
There are several common prevention methods: surgical and drug prevention, Chinese medicine prevention, and lifestyle prevention.
Surgery and drugs are the more drastic prevention methods.
Surgical prevention is preventive mastectomy or even oophorectomy for women at high risk, such as those with a genetic history, who can have preventive mastectomy and oophorectomy. For example, the American actress Angelina Jolie opted for preventive mastectomy because she had the family gene BRCA1, which means that the risk of breast cancer increases with age. In addition, there are drugs to prevent breast cancer, such as tamoxifen and anastrozole, which are drugs to treat breast cancer and are also used as preventive drugs for women at high risk. However, these two means are more drastic and generally very few Chinese people adopt them. In foreign countries, even the percentage of high-risk people adopt them is not high, and only 15% of high-risk women in the United States are taking drugs for prevention.
Therefore, in China, Chinese medicine prevention is more acceptable and more commonly used. The correlation between obesity and overweight and the risk of postmenopausal breast cancer is well known, especially the correlation between abdominal fat. The reasons for the risk of tumor initiation by overweight and obesity are complex and these mechanisms include immune function, insulin and estradiol hormone levels and metabolism, regulation of cell proliferation and growth factors such as insulin-like growth factor (IGF-1).
A healthy diet for breast cancer means eating more vegetables and fruits, diversifying foods, and eating less large fish and meat. Alcohol consumption can increase the risk of breast cancer. The risk of developing the disease is the same whether you drink wine, beer. Drinking light to moderate alcoholic beverages daily or sparingly is unlikely to significantly affect the risk of developing breast cancer. So it is emphasized that if you drink alcohol, please keep it moderate and moderation is the key. Alcohol may affect estrogen inactivation in the liver.
How does TCM specifically prevent breast cancer?
Chinese medicine is actually a “regimen of health and prudence” under the guidance of Chinese medicine theory. The emphasis is on regularity of living and diet, which means that we should do what we should do when we should do it – get married when we should get married, have children when we should have children, get up when we should get up, and sleep when we should sleep, which is a benign stimulus for the body.
In addition to attention to living and diet, we must also pay attention to spiritual adjustment, to be calm and void, the spirit within the guard, because this breast disease, is the most related to the emotions of the disease. Breast diseases are often caused by emotional disorders and blockage of qi and blood, which become breast cancer over time. In fact, these theories in TCM are now confirmed in modern research: excessive tension, stress, anxiety, emotional overstimulation, etc. are all closely related to breast cancer.
In addition, Chinese medicine has many methods to strengthen the body, for example, Five Animal Exercises and Eight Duan Jin are very good methods to strengthen the body, including modern yoga, which can help blood flow and de-stress the emotions.
Chinese herbal medicines, such as Chai Hu Dao Xie Hep Wan, Zhuan Yao Wan, Xiao Jin Wan, etc., are used to regulate the emotions and disperse the nodes, which can be taken when there are benign lumps in the breast to help regulate the emotions and play a role in the prevention of breast cancer.
If unfortunately breast cancer is detected, how to treat it? How does Chinese medicine treat it?
Breast cancer is a systemic disease and the treatment includes surgery, chemotherapy, radiotherapy, endocrine therapy, biological therapy, Chinese medicine and psychotherapy, which are multidisciplinary and comprehensive.
Surgery, chemotherapy, radiotherapy and endocrine therapy are all conventional Western medical treatments, which are widely used in the international and domestic arenas, and the treatment methods and means are constantly improved and updated, and the treatment effects are widely recognized.
The role of TCM in breast cancer treatment depends on the different stages of western medical treatment and the stage of the disease. For example, during the period of surgery, chemotherapy and radiotherapy, TCM mainly plays an auxiliary role to reduce some side effects of these treatments, such as radiotherapy and chemotherapy, there will be side effects such as gastrointestinal reactions, blood toxicity, kidney toxicity, liver damage and radioactive pneumonia, etc. The purpose of TCM treatment at this time is to reduce toxicity and increase effectiveness; then For example, after surgery, there will be postoperative problems such as lymphedema, non-healing wounds and limited function of upper limbs, etc. Taking Chinese medicine can ensure the smooth progress of treatment and play the role of reducing toxicity and increasing effectiveness and escorting. As for the maintenance treatment stage after the end of intensive western medical treatment (this stage also often has patients with side effects brought about by endocrine therapy, such as baking fever, sweating, joint pain, etc., which seriously affects patients’ quality of life or even interrupts endocrine therapy), or the late stage of recurrence and metastasis, the purpose of Chinese medicine treatment at this time is to prevent recurrence and metastasis in the former, and to control disease progress in the latter, so that patients can live a wonderful and The former is to prevent recurrence and metastasis, and the latter is to control disease progression so that patients can live a wonderful and longer life.
Regardless of the stage and the stage of treatment, in principle, we not only pay attention to the four diagnoses and eight syllabuses of Chinese medicine, but also insist on the combination with the molecular typing of breast cancer, because the understanding of breast cancer in modern medicine can help us broaden our thinking, for example, there is a concept of treatment in Chinese medicine called “first to protect the place where the evil has not been received”, which is actually part of “treating the untreated”. According to the metastatic characteristics and rules of different molecular subtypes, we will increase the resistance of metastasis-prone areas according to the “preferences” of each part when using drugs, so that “the righteousness can be kept inside, and the evil cannot be interfered with”. The metastasis will be blocked by increasing the resistance of the metastasis-prone area according to the “preference” of each part of the body.
In addition, breast cancer patients who have finished a period of treatment must pay attention to review, and regular review is very important. Generally, it is recommended to review every four to six months within five years after surgery, and every six months for those who have had surgery for more than five years. The items to be reviewed are the areas prone to recurrence and metastasis and the side effects of drugs, such as B-ultrasound, chest X-ray, blood count, biochemistry, tumor markers and so on.
Finally, I would like to give a word of advice to our friends: breast cancer can be prevented and treated; the ancient is used in the present, the foreign is used in the Chinese, and the Chinese and Western complement each other to create a medical miracle.