Incidence of Breast Cancer
Breast cancer is one of the most common malignant tumors in women. About 1.2 million women worldwide develop breast cancer and about 500,000 women die from it every year. The incidence of breast cancer worldwide increases by 02% to 08% each year. There are regional differences in the occurrence of breast cancer: North America and Northern Europe are the regions with high incidence of breast cancer, and their incidence rates are about four times higher than those in Asia, Africa and Latin America. European and American countries are higher than Asian, African and Latin American countries. One out of every 11 women in the United States suffers from breast cancer, and its mortality rate is the first among all kinds of diseases.
Although China is a low incidence region for breast cancer, its incidence rate is increasing year by year, especially Shanghai, Beijing, Tianjin and coastal areas are the high incidence regions for breast cancer in China. In Shanghai, the incidence rate of breast cancer was 20,1/100,000 in 1972, and 28/100,000 in 1988, which was the 2nd place among female malignant tumors. In recent years, it has reached 56/100,000, which is the first place among female malignant tumors.
In Beijing, the incidence of breast cancer has surged from 11 or 97/100,000 in 1978 to 100/100,000 in the past two years, and the rapid growth rate has shocked breast disease experts at home and abroad. The high incidence age of breast cancer is 25-64 years old, with 45-64 years old being the most common. However, in recent years, the incidence rate of breast cancer among women aged 35-45 years old in China and Asian regions has been increasing rapidly.
Breast cancer is a superficial tumor and 80% of breast cancers are first detected by patients themselves. More than 90% of breast cancers can be treated if detected early. Information shows that the earlier breast cancer is detected, especially lobular and microscopic breast cancer, the higher the detection rate and the earlier the treatment, the higher the cure rate.
The main causes of breast cancer
It is related to genetic factors, hormonal factors, immune factors, lifestyle, mental depression, etc.
Breast cancer is a disease in which the epithelial cells of breast ducts lose their normal characteristics and proliferate abnormally under the effect of various internal and external carcinogenic factors, so that they exceed the limit of self-repair and become cancerous.
Natural Survival Period of Breast Cancer
Breast cancer is a malignant tumor, but its malignancy is not the highest compared to other organ tumors. The average tumor multiplication time for breast cancer is reported to be 198 days. In this calculation, it takes 16 years for a breast cancer to develop from a single starting tumor cell to a 1cm diameter cancer mass, and nearly 4 years to change from 2mm to 1cm. This shows the slow growth rate of breast cancer.
Although the growth and development rate of breast cancer varies, generally speaking, the average time from the onset of the disease to the time of consultation is 1 to 2 years. If patients do not undergo treatment, the average natural survival (survival with tumor) from onset to death is more than 3 years. About 20% of patients who develop the disease live to 5 years, and about 5% live to 10 years. Some patients may live up to 20 years.
How to detect breast cancer early
Women should learn to do their own mammogram, insist on monthly checkup and go to the hospital in time if they find any abnormality.
Second, all units should organize women comrades to go to medical units for collective examination regularly.
Third, if you find abnormalities, there is no need to panic, to go to a large hospital in a timely manner, especially to the breast specialist. In order to get reasonable and standardized treatment.
Clinical staging of breast cancer
Domestic staging.
Stage I: 5cm mass with extensive adhesion to the overlying skin, adhesion to the pectoral muscle, and enlarged lymph nodes fused into a mass in the ipsilateral axilla with little mobility;
Stage IV: the mass extensively invades the breast skin, adheres to the chest wall and is fixed, sometimes the mass is ulcerated, the ipsilateral axillary lymph nodes are fused into a mass and fixed, enlarged lymph nodes are found in the supraclavicular or contralateral axilla, often accompanied by distant metastases such as lung, liver and bone.
International TNM staging.
T (tumor).
T0 primary tumor undetected
T1 tumor length diameter ≤2,0cm
T2 tumor length diameter >2,0cm, ≤5,0cm
T3 tumor length diameter >5, 0cm
N (lymph nodes).
N0 No regional lymph node metastasis
N1 ipsilateral axillary lymph node metastasis, movable
N2 ipsilateral axillary lymph node metastasis and fusion, or fixed with other tissues
N3 ipsilateral parasternal lymph node metastasis
M (distant metastasis).
M0 without distant metastasis
M1 with distant metastasis
Staging criteria.
Stage 0: T0N0M0
Stage Ⅰ: T1N0M0
Stage II: T0-1N1M0, T2N0-1M0, T3N0M0
Stage IIIA: T0-3N2M0, T3N1M0
Phase IIIB: T4 any NM0, any TN3M0
Stage IV: any T any NM1
Types of symptoms of breast cancer
There are various types of breast cancer symptoms, the main clinical manifestation is breast lumps, special attention should be paid to those lumps that are not painful, and they are often pre-symptomatic, accounting for about 95% of breast cancer cases. The lumps are often solitary, with no unusual sensation, hard texture, uneven edges and unsmooth surface. In a few cases, the lump may also be painful.
In about 10% of cases, the lumps are soft and even have a cystic feeling or fluctuating sensation.
The mobility of the lump depends on the degree of tumor infiltration. Early and middle stage breast cancer can have certain mobility and can be pushed; in advanced stage, if the tumor invades the pectoralis major muscle, the mobility of the lump will be limited, and if the tumor invades the chest wall, the mobility of the lump will disappear.
Clinical manifestations of different stages of breast cancer
Early stage: small painless breast lumps with or without nipple discharge.
Middle stage: large breast lumps, nipple overflow, skin changes, nipple changes, and enlarged lymph nodes in the ipsilateral axilla.
Late stage: breast lump, skin changes, enlarged axillary lymph nodes, distant metastases (lung, liver, bone, etc.).
Tissue types of breast cancer
I. Non-invasive carcinoma (carcinoma in situ).
Pre-invasive carcinoma with cancer cells confined to the ducts, terminal ducts within the lobules or within the basement membrane of the alveoli. Common types.
1.Intraductal carcinoma ;
2. lobular carcinoma in situ.
2.Early infiltrating carcinoma.
Carcinoma in situ breaks through the basement membrane of ducts, terminal ducts or alveoli and starts to infiltrate into the interstitium, with more limited lesions. There are.
1.Early infiltration of ductal carcinoma;
2. early infiltration of lobular carcinoma.
3. Infiltrating carcinoma.
It refers to the invasion of cancer cells into the interstitium by penetrating the basement membrane of terminal ducts or alveoli. The tissue types are classified as
(a) Infiltrative special type carcinoma.
1.Papillary carcinoma.
2.Medullary carcinoma with massive lymphocytic infiltration
3. tubular carcinoma (highly differentiated adenocarcinoma) 4. adenoid cystic carcinoma
5.Mucinous adenocarcinoma
6. Sweat gland-like carcinoma
7.Squamous cell carcinoma
8.Papillary Paget’s disease
(II) Invasive non-specific carcinoma.
1.Infiltrating lobular carcinoma
2.Infiltrating ductal carcinoma
3.Sclerocarcinoma
4.Medullary carcinoma
5.Simple carcinoma
6.Adenocarcinoma
(C) Other rare carcinomas.
1.Secretory type carcinoma
2.Lipid-rich carcinoma (lipid-secreting carcinoma)
3.Adenofibrosarcoma carcinoma
4.Papillary neoplasm carcinoma
5. Carcinoma with chemosis
Treatment methods of breast cancer
I. Surgical treatment
1.Modified radical mastectomy for breast cancer.
3.Breast-conserving surgery for breast cancer.
4.Modified radical surgery with stage I mastectomy.
5.Surgery for breast cancer after neoadjuvant chemotherapy.
II. Chemotherapy.
Radiotherapy.
Endocrine therapy.
Biological immunotherapy.
Chinese herbal medicine treatment.