There are 3.5 billion women in the world, but only 6.48 billion breasts. According to this calculation, 1.2 million breast cancer patients will be “born” in the world every year, and about 800,000 of them will lose one or both breasts as a result. The increasing incidence of breast cancer and its rhythm of killing people has given breast cancer another nickname, the “Red Death”. In the face of this “disaster” lurking around women, how can we win this “breast defense” battle? Estrogen is the “culprit” of breast tissue malignancy Estrogen is like a “balancer” in a woman’s body. It can make women become attractive and charming. Likewise, high estrogen levels can become a “flare” that attracts the attention of breast cancer and is quietly targeted. For many years, the direct cause of breast cancer has remained elusive and is thought to be a combination of multiple factors. However, it is certain that estrogen is the primary culprit that induces malignant changes in breast tissue. Therefore, the first step in winning the “breast defense” is to place the “equalizer” in a horizontal position to “keep out” factors that may trigger increased estrogen levels. As the saying goes, “If a woman’s waist increases by one size in ten years, her risk of developing breast cancer increases by 30%”. Perhaps this is an exaggeration, but obese women have relatively high estrogen levels and are inextricably linked to breast cancer. A national study found that Chinese women (both premenopausal and postmenopausal) with a BMI greater than or equal to 24 kg/m2 had a four-fold increased risk of breast cancer compared to those with a BMI less than 24 kg/m2. According to the current trend, overweight and obesity will lead to a steep increase in the prevalence of postmenopausal breast cancer in young Chinese women in the future. In addition, women who have not had children or have not breastfed and have a family history of breast cancer are also at high risk for breast cancer. Despite multiple births in Western women, the incidence remains high. Other exogenous estrogens are also responsible for this. For example, a Westernized diet that is high in calories and protein. Many postmenopausal women in the West use hormone replacement to retain their beauty and youth, unaware that in the process of slowing down the aging process, they are also at risk of sustained high levels of estrogen-induced breast cancer. Early screening is better than self-examination The golden rule of cancer prevention is “tertiary prevention”, and this is also true for breast cancer. Pre-screening self-examination is already well established as primary prevention. However, a recent study reveals that the percentage of missed diagnoses is more than 30% when self-screening is done without professional education. In clinical practice, we found that many patients who came to the clinic only after self-examination found overflowing nipples, orange peel-like changes in the breast skin, and bilateral breast asymmetry had already missed the early stage of the disease, and some were even in the middle or late stage, missing the opportunity for surgical treatment. Early screening and early detection are two similar concepts, but different. Early screening is dedicated to detecting “micro-cancer” and pre-cancerous lesions that can only be caught by sensitive medical instruments. Only by screening these patients or “prospective patients” from the normal population at an earlier stage can we effectively improve the efficacy and survival rate of breast cancer. In the Cancer Hospital of Fudan University, I breast cancer can be completely cured after surgery, with a 5-year survival rate of more than 95%, and breast-conserving surgery can be achieved for patients who have the conditions. There are four “screening tools” in breast cancer, namely mammography, ultrasound, MRI and hollow needle aspiration. The purpose of these four screening tools is different, but there is only one goal: “to improve the detection rate of early breast cancer by using a comprehensive diagnostic approach.” At present, breast cancer is very finely staged and has an independent “biological ID”, some lesions can be detected by multiple examinations, while sometimes only one examination can catch some “traces” of breast cancer, such as some patients with very early stage breast cancer. For example, in some early stage breast cancer patients, conventional ultrasound and mammogram fail to detect the “traces”, but only MRI can detect the microscopic cancer. Finally, for patients who are highly suspected of having cancer, we now use the most advanced “minimally invasive diagnosis”, i.e., hollow needle aspiration under the guidance of ultrasound or molybdenum and palladium, to make an accurate qualitative diagnosis for each suspected patient, so as to gain time for the next timely treatment. This allows time for timely treatment. Recognize the three “unequal signs” in the report There are many women who undergo early screening for breast cancer. The words “calcification, mastopexy, lobular hyperplasia, fibroid” in the screening report often make people shudder. In fact, these diagnoses are not as bad or generalized as one might think. First of all, calcification is not the same as having a “bad disease”. Mammography can reveal calcifications in the breast tissue, both benign and malignant lesions. Once the calcification is graded as grade 4, women should pay close attention to it, suggesting that your calcification is likely to be closely related to breast cancer. Similarly, during ultrasound, the physician will also grade the lump, and once it is at grade 4 or above, the risk of breast cancer increases dramatically. Currently, the diagnosis and treatment of breast cancer is closely related to its stage. Once there is a “grade” in the diagnostic report, you should be alert, especially if it is grade 4 or above, and go to the hospital for further investigation. Second, lobular hyperplasia should not be equated with breast cancer. Lobular hyperplasia of the breast is not a disease but a physiological change of the breast cycle. In case a woman with lobular hyperplasia finds a suspicious lesion, a puncture or biopsy proves that it is an atypical hyperplasia, which may be associated with the development of breast cancer. Other than that, there is no need for excessive panic. Finally, there is fibroids. When people see “tumor”, they will panic and worry that it is like a time bomb that will turn into a “cancer” in 3-5 years if they are not careful. In fact, breast fibroids, which occur more often in young women, are usually not cancerous. Such women should follow up every six months. If the size of the tumor becomes larger, we can get a radical solution through outpatient surgery.