Breast cancer is a common malignant tumor that endangers women’s physical and mental health. One in eight to nine women in Europe and the United States will develop breast cancer in their lifetime. Since the 1970s, a large number of randomized controlled studies have increasingly clearly demonstrated that breast cancer is another malignancy after cervical cancer that can reduce mortality through screening, and such tumors often have Such tumors often have a long clinical stage, early treatment can change the prognosis, and their screening methods are easy, reliable, sensitive, safe and more economical.
Breast cancer shows the following characteristics.
1. Since the late 1970s, the incidence of breast cancer has been ranked first among female tumors worldwide and is increasing at a rate of 2% per year. It is expected that the annual number of new cases of breast cancer worldwide will reach about 1.4 million in 2010. Although China is not a country with high incidence of breast cancer, the average annual growth rate is 1 to 2 percentage points higher than that of countries with high incidence.
The global mortality rate of breast cancer has started to decrease, mainly due to the screening of breast cancer in many high incidence countries, the proportion of early stage breast cancer is increasing, followed by the improvement of treatment methods, which can not only detect breast cancer with palpable lumps, but also diagnose breast cancer without palpable lumps.
The treatment of breast cancer tends to be both radical and functional. For early stage breast cancer that meets the condition of breast preservation, comprehensive breast cancer treatment with breast preservation can be performed. The 10-year survival rate of early breast cancer is around 80%, and now breast cancer has become one of the solid tumors with the best curative effect.
Analysis of the reasons affecting the early diagnosis of breast cancer.
The breast is located on the surface of the human body, so the diagnosis should be relatively easy according to reason, but as far as the statistics of our hospitals are concerned, early cases still account for a minority, what are the reasons that delay the diagnosis?
1. Insufficient popularization of scientific knowledge about breast cancer, lack of awareness of the clinical characteristics of breast cancer and lack of vigilance to this disease in daily life.
2.Early breast cancer is a painless swelling and the body can be free of any discomfort, which neither affects life nor work.
3. A few women are bound by stereotypes, old-fashioned thinking, shy to check their body, unwilling to expose their breast, and even more unwilling to go to hospital for examination.
4.For the sake of saving time and convenience, they listen to the nonsense of a certain person or are too superstitious about the diagnosis of a certain doctor or a certain instrument, so they relax their vigilance and stop further examination.
5.Some people have read some books on tumor or are influenced by people around them, and they are so afraid of having breast cancer that they dare not go to the hospital for examination, and they do not know that they have entered a misunderstanding. Going to see a doctor can rule out breast cancer and relieve psychological pressure.
6. The fast pace of life and busy work make them unable to care about their own body, and even if they have discomfort, they do not have time to go to the hospital and deal with it casually.
Breast Screening
The target of the screening is mainly women over 35 years old, and the interval is usually 1 to 2 years. Many people mistakenly think that the screening should be mainly for the high-risk group, but in fact, only about 30% of breast cancer patients have clear risk factors. Therefore, although the high-risk group is the priority group for breast cancer screening and may be the target of preventive intervention, the current screening and education efforts should target all women.
Currently, the main methods of breast cancer screening are clinical examination and mammography and ultrasound examination. Mammography is the most important tool in breast cancer screening. The abnormal images are nodal shadows, microcalcifications and local structural disorders of the breast. Mammography not only diagnoses benign and malignant, but also helps doctors to detect breast cancer that cannot be detected by clinical examination at an early stage.
Breast ultrasound is an economical, easy, non-invasive and painless examination method, which is more suitable for young women, especially pregnant and lactating women, but is not as sensitive as mammography in detecting microcalcifications. The two methods can complement each other and improve the detection rate of breast cancer.
Breast self-examination
Regular breast self-examination can improve the detection rate of early breast cancer. How to perform breast self-examination: Stand or sit in front of a mirror and carefully observe both breasts, including the size, shape, contour, skin and color of the breasts, whether there are any changes, and whether the nipples are elevated, retracted or overflowing. When palpating the breasts, fingers should be stretched out and together, and the breast should be touched with the fingertips, with the left hand on the right side and the right hand on the left side, either in a clockwise or counterclockwise direction, without missing the nipple, areola and armpit. Breast self-examination should be done once a month, and the best time should be chosen within 7 to 10 days after menstruation, when the breast is relatively soft and painless, so it is easy to find abnormalities. Women who have stopped menstruating can choose a fixed time of the month for the examination. Each self-examination should be compared with previous self-examinations, and any abnormalities found should be seen by a doctor in time to achieve early detection and early diagnosis.
Cytopathological examination of suspicious lesions
Research data shows that the sensitivity of mammography is only 54%. Some benign lesions can be accompanied by malignant signs in mammography, and some malignant tumors can also show benign features, and similar problems exist in breast ultrasound. The diagnosis should also be based on cytological or histological diagnosis.
The so-called cytological diagnosis is to use a 5-10 ml common syringe with a 6-8 gauge needle to puncture the clinically suspicious lesion, then extract the cells from the lump with negative pressure, apply the cells on a slide and ask the cytopathologist to make a diagnosis. This method is easy to perform, less invasive, less expensive, and promptly reported, and correct fine needle aspiration will not cause tumor dissemination. However, because the number of cells obtained by fine needle aspiration is small, it requires a high level of diagnostic skills. Histological diagnosis is performed by taking biopsies from breast lesions for pathomorphological examination, i.e. observing the cell morphology and the relationship between cells under the microscope. The purpose is to determine the benignity or malignancy of the lesion, to predict the patient’s prognosis and to guide treatment.
In summary, it is recommended that women should have a monthly breast self-examination from the age of 20 and a clinical breast examination every 3 years. 35 to 40 years of age should have a basic mammogram; over 40 years of age, a mammogram should be taken annually. A clinical physical examination should also be performed at the time of film taking.