Who are prone to breast cancer? Patients who have previously suffered from breast cancer or have a history of benign breast tumors; 2. Family history of breast cancer, if more than one of the first-degree relatives (mother, sister) has suffered from breast cancer, then they are more likely to suffer from breast cancer; 3. Women whose first pregnancy is older than 30 years old have a slightly higher risk of breast cancer than women who have never given birth; 4. Women who eat too much animal fat and are overweight after menopause Women with certain chronic breast diseases (e.g. ductal epithelial atypia, papillomatosis, etc.); 6. Women with menarche before the age of 12 or menopause after the age of 55; 7. Women who apply estrogen to control menopausal symptoms have a moderately increased risk of breast cancer after many years; 8. People with cancer on one side of the breast have a 5 to 7 times higher chance of having cancer in the opposite breast than normal. Breast cancer age trend It is very rare for breast cancer to occur in women younger than 20 years old, and the disease is not common in women younger than 30 years old. From the age of 35, the incidence of breast cancer gradually increases. In the United States, this increase in incidence occurs almost throughout a woman’s life. However, epidemiological studies have found a slight plateau between the ages of 45 and 50, followed by a steep rise. This result strongly suggests that hormone levels in women may play an important role in the etiology of breast cancer, as the age-incidence curve for non-hormone-dependent tumors does not change in such a way near menopause in women. In countries with low or intermediate incidence of breast cancer, the shape of this age distribution curve is approximately the same as in countries with high incidence, only the absolute incidence is significantly lower. The diagnosis of breast cancer is mainly based on clinical manifestations, physical examination, mammography, mammography, and endoscopy. The above-mentioned examination methods for breast diseases, including physical examination, mammography, ultrasound, and endoscopy, all have certain false-positive and false-negative results, so the final diagnosis still depends on pathology to clarify the benign and malignant nature of the lesion. Pre-operative puncture and intra-operative freezing for pathological examination are feasible. Pre-operative puncture is generally recommended to characterize the lesion, determine the surgical approach and reduce the operation time, and post-operative pathological diagnosis will confirm the diagnosis again and provide immunohistochemistry as the basis for subsequent treatment. The importance of pathological diagnosis Breast cancer surgery, especially radical surgery, is a heavy blow to the patient’s physiology and psychology, so preoperative definite diagnosis is an important principle of breast cancer surgery. The above mentioned examination methods for breast diseases, including physical examination, mammography, B-ultrasound, breast duct endoscopy, etc. all have certain false positive and false negative results, so ultimately we still have to rely on pathological diagnosis to clarify the benign and malignant nature of the lesion. Another role of pathological diagnosis is to clarify the pathological type and characteristics of the lesion, thus providing a basis for further selection of appropriate treatment plan. For example, the treatment options for invasive ductal carcinoma and intraductal carcinoma in situ are very different. The most common methods to obtain preoperative pathological diagnosis include cytological diagnosis and biopsy: cytological diagnosis includes exfoliative cytology and fine needle aspiration cytology; biopsy includes excisional biopsy, hollow needle aspiration biopsy, and axillary lymph node biopsy. Treatment of breast cancer At present, the treatment of breast cancer is mainly based on surgery, including chemotherapy, radiotherapy, endocrine therapy, Chinese medicine, etc. Surgery includes radical mastectomy, modified radical mastectomy, simple mastectomy, breast-conserving surgery + axillary lymph node dissection, and some patients can have breast reconstruction. Now there is breast lumpectomy + axillary lipolysis aspiration, which is a minimally invasive surgery with faster postoperative recovery than traditional surgery. What are the clinical manifestations of breast cancer? A typical breast cancer is a lump that appears in the breast and gradually grows to an infiltrative size with a firm texture, then the skin adheres to a dimple and may be accompanied by nipple indentation, skin edema, orange peel-like changes, tumor ulcers, satellite nodes and enlarged lymph nodes under the armpit. Can screening detect early breast cancer? Applying some kind of test to asymptomatic people to detect early stage cancer patients among them is called screening. Breast cancer screening usually uses physical examination, mammography and ultrasound. The purpose of screening is to detect breast cancer at an early stage. Because the tumor is small, it has the highest cure rate and can preserve the breast. Data show that the average diameter of breast cancer detected during screening is significantly smaller than that of symptomatic patients, and the rate of no axillary lymph node metastasis is significantly higher. Currently, there is no way to prevent breast cancer. In terms of treatment, after decades of continuous improvement, there has not been a major impact on the survival rate of breast cancer, so early detection and treatment of breast cancer is the only way to reduce the death rate of breast cancer, which is the hope of controlling breast cancer. China is currently conducting a million women breast screening. The screening method uses physical examination, B-ultrasound and mammography, and the target population is mainly women over 40 years old, with a general interval of one to two years. For those who have a family history of breast cancer and have high risk factors for breast cancer, the interval between screening can be shortened appropriately. Can I detect breast cancer by myself? The breast gland is located on the surface of the body, so it is easy to detect breast cancer. In fact, most breast cancers are detected by themselves, and this has been proved by clinical practice both at home and abroad. However, the question is under what circumstances the patient finds it, i.e. whether the lesion is early or intermediate or late. A considerable number of patients are discovered unintentionally, some of them are earlier breast cancers, but a significant number of them are discovered when the lump grows to a large size. The former is clinically easy to treat and has a good prognosis, while the latter is the opposite and has a relatively poor prognosis. Such unintentional detection is a passive act. However, if women can understand some relevant medical knowledge and can check their breast and underarm frequently, regularly, systematically and consciously, it is possible to detect early breast cancer in time. Early diagnosis and early treatment can achieve good therapeutic effect and radical cure, and it is possible to preserve the breast. We hope that women can learn the method of breast self-examination so that they can adopt proactive behavior and turn passive into active. Clinical experience shows that the earliest way to detect changes in the condition is the breast self-examination method. As long as the required monthly self-examinations are performed, it is more important and reliable to seek medical attention in a timely manner if abnormalities are detected than regular hospital outpatient examinations. Clinical large-scale randomized controlled trials have demonstrated the benefits of early detection of breast cancer, and early detection, early diagnosis, and early treatment are the keys to improving treatment outcomes. During the interval between regular physician physical examinations and mammograms, a significant number of patients obtain early diagnosis, treatment and good prognosis through the self-examination method. Women are encouraged to understand the importance of self-examination method and enhance their awareness of self-care so as to protect their health. Can breast cancer be prevented? The answer is yes, the chance of breast cancer in women with bilateral mastectomy is almost zero. However, such preventive measures are obviously too harsh and unnecessary for women with a low to moderate risk of developing breast cancer. It has been shown that taking 10 mg of triamcinolone twice daily for 5 years can reduce the incidence of breast cancer by nearly half. A number of other chemopreventive drugs are also being studied. The cause of breast cancer is not yet fully understood, but epidemiological studies have found that it is not unrelated to dietary and environmental factors. Therefore, the risk of breast cancer can be reduced by properly controlling the caloric intake in the diet, strengthening exercise, and improving poor lifestyle habits. How to detect breast cancer early? There is no preventive measure other than prophylactic mastectomy to prevent the occurrence of breast cancer, therefore, it is important for women at high risk of breast cancer to take measures to detect breast cancer at an early stage so as to obtain the best treatment. Early detection of breast cancer is currently advocated by breast radiographs, ultrasound, clinical examination and self-examination. Ultrasound is the only clinically proven tool for breast screening, especially for post-menopausal patients, which can detect subclinical breast cancer one to two years before the onset of clinical symptoms and reduce the mortality rate of breast cancer in the population by 30%. Clinical examination is an effective complement to mammography screening, suitable for women of all ages, and can solve some practical problems. Self-examination of the breast is easy to perform and suitable for women of all ages, but its effectiveness varies depending on the patient’s education level and the teaching of the transmitter. Prevention strategies for women at high risk for breast cancer First, you should consult with your doctor or a relevant specialist about whether you are at high risk for breast cancer and what your chances are of developing breast cancer in the next few years. You should then choose preventive measures according to your risk level, and of course you must refer to your physician’s advice and recommendations. If you choose preventive mastectomy, it is important to seek a second specialist’s opinion, especially to understand the physical and psychological changes you will face after bilateral mastectomy; you can also seek the help of a plastic surgeon for your breast reconstruction. For most women, close monitoring for early detection of breast cancer is a good recommendation, and all you have to do is a monthly breast self-examination, a clinical examination every four to six months, and a mammogram every one to two years from the age of 35 and an ultrasound twice a year. Of course you can take more aggressive, but non-disfiguring, preventive measures such as taking triamcinolone and participating in other ongoing chemoprevention trials. The final piece of advice is that if you do unfortunately develop breast cancer, you should face the reality and treat it aggressively, as it is still curable in 2/3 of cases.