The breast is not only the breast-feeding organ of women, but also the second sex organ of women. The latest global cancer data for 2020 released by the International Agency for Research on Cancer of the World Health Organization shows that female breast cancer has surpassed lung cancer for the first time to become the most common cancer in the world. Among newly diagnosed cancer patients, about 1 in 8 is breast cancer Breast cancer poses a serious threat to women’s health. This issue invites experts to answer questions about breast cancer for you.
In China, breast cancer is a common malignant tumor in women. In 2020, there will be about 420,000 new cases of breast cancer and about 120,000 deaths. It is the number one killer that seriously threatens women’s health.
1. What factors can cause breast cancer?
The exact cause of breast cancer is not fully understood and may be related to factors such as genetics, nutrition, hormones, smoking, obesity and the environment.
2. What are the early symptoms of breast cancer?
Dimple sign Dimple sign is an important manifestation of breast cancer. The reason for the dimple sign is that the skin surface of the breast lesion is sunken due to tumor invasion of the mammary ligament.
Nipple discharge is sometimes the only symptom of early breast cancer, especially a bloody, coffee-colored discharge.
Breast lumps Lumps in the breast are a very common sign among women, but this is also the most common manifestation of early breast cancer. Don’t think that breast lumps can be ignored if they are not painful or itchy. You must go to the hospital as soon as possible.
When the size and shape of breasts change, you should pay more attention to the changes in your breasts and go to the hospital for regular checkups.
Abnormal nipples and areolas Itching and redness of the nipples and areolas should not be ignored. This may be an early sign of breast cancer.
Breast orange peel-like changes Breasts are delicate organs. When the skin tissue changes due to lymphedema and the skin shows orange peel-like changes, you must pay attention to it and see a doctor in time, so as not to miss the best treatment time.
Enlarged lymph nodes around the breast or under the armpit The underarm is a place with very dense lymph nodes. If you find a small bump in the breast, under the armpit or collarbone area, it is usually due to enlarged lymph nodes. You must pay attention to it. This may be the early manifestation of breast cancer .
Inverted nipples Inverted nipples are not only a genetic factor, but if a tumor develops beneath the nipple, pulling on the nipple can also cause the nipple to deviate or sink. Symptoms of breast eczema-like carcinoma are nipple crusting, desquamation, and erosion, which recur and are difficult to heal.
Breast pain Some patients with early breast cancer often feel local discomfort even though there is no obvious lump in the breast, especially postmenopausal women, sometimes feel mild pain and discomfort on one side of the breast, or pain on one side of the shoulder and back. Heaviness, soreness and discomfort, even the upper arm on that side is uncomfortable. The vast majority of patients have no obvious pain, and a small number of patients seek medical treatment with pain. The pain is mostly paroxysmal tingling and dull pain.
3. What inspections are required?
Biopsy is very important for pathological examination and is also an important standard for diagnosis.
Imaging methods clinically used to screen for breast cancer mainly include mammography (mammography is generally not recommended for women under the age of 40 unless they have a family history of breast cancer) and breast ultrasound.
In recent years, with the development and application of magnetic resonance technology, enhanced breast magnetic resonance imaging technology has shown unique advantages. Magnetic resonance has shown higher sensitivity, specificity, and accuracy than mammography and ultrasound combined in the diagnosis of breast nodules and masses.
4. How is breast cancer treated?
Surgical treatment Surgical resection is currently the mainstay of treatment for all solid tumors, and breast cancer is no exception.
Chemotherapy, referred to as “chemotherapy”, is a treatment method that uses chemical drugs to kill tumor cells, inhibit the growth and reproduction of tumor cells, and promote the differentiation of tumor cells.
Radiation therapy Radiation therapy is the use of high-energy rays to kill cancer cells. The procedure is completely painless and each treatment takes a short time.
Endocrine therapy Because the breast is the target organ of sex hormones, it is very sensitive to endocrine therapy, but endocrine therapy is not suitable for all breast cancer patients. Tamoxifen (tamoxifen) is the commonly used estrogen antagonist in premenopausal patients, while aromatase inhibitors are often used in postmenopausal patients.
Targeted therapy In theory, normal human cells and tumor cells differ in many genetic expressions, and these differences may serve as targets.
Immunotherapy is a treatment method that uses appropriate methods to adjust and enhance the body’s immune response to breast cancer to control the growth of cancer cells.
5. Can breast nodules become cancerous?
When you discover an unknown new creature and cannot determine its nature, how do you describe it? The larger ones we call “lumps” and the smaller ones we call “nodules”. Doctors can roughly determine whether these “nodules” are harmful to health or whether they will become malignant through the growth time, speed, size, texture, shape, and degree of adhesion of the “nodules” to the surrounding tissues.
For “nodules” that will not become cancerous,
such as mild hyperplasia of the breast and mastitis, the doctor will tell you that your “nodules” will not become cancerous. Because mammary gland hyperplasia is only a diagnosis of exclusion, not a disease, it is the result of the periodic action of hormones on the breast, and it is an occasional disorder in the process of hyperplasia and repair, so it cannot be called a disease. Mastitis is an inflammatory response caused by bacterial infection of the mammary glands during breastfeeding. It has nothing to do with malignant transformation. However, there is a special type of breast cancer called “inflammatory breast cancer”, which appears to be the same as mastitis, but actually It is a very dangerous malignant tumor that cannot be surgically removed casually. Doctors generally do not deal with such “nodules” or “lumps”, unless the pain is particularly severe, the doctor will prescribe some traditional Chinese medicine or Chinese patent medicine for promoting blood circulation and removing blood stasis to relieve symptoms. Mastitis is usually treated with antibiotics.
”Nodules” that have the potential to become cancerous
Benign tumors and lesions of the breast, including breast fibroadenoma, breast lipoma, breast phyllodesarcoma, breast hamartoma, breast cyst, breast intraductal papilloma, etc., these “nodules” have the possibility of malignant transformation, But the probability is very small. For example, the malignant transformation rate of intraductal papilloma of the breast is 6% to 8%, which means that if the nodule is diagnosed as a benign disease, it has a certain malignant transformation rate. It is recommended to review it every 3 to 6 months.
The “nodule” is already a cancerous “nodule” of the
breast. When a doctor describes it, he cannot give a positive diagnosis casually. Once the “lump” or “nodule” is diagnosed as a malignant tumor, it needs to be diagnosed according to the cancer treatment. Therefore, when the doctor talks about breast cancer surgery with you, the “nodules” of breast cancer must be malignant and bad “nodules”.
When such “nodules” appear, the doctor will suggest surgery as soon as possible. You must learn more about the relevant knowledge, be mentally prepared, and actively cooperate with the treatment.
6. Can breast hyperplasia become cancerous?
When it comes to breast hyperplasia, most female friends are familiar with it, but many people have misunderstandings. Some women are often worried about breast cancer when breast hyperplasia is detected during physical examination. In fact, under the action of endocrine hormones (especially estrogen and progesterone), as the menstrual cycle changes, breast hyperplasia and involution will occur once a month. If the endocrine disorder, the hormone secretion is too strong, the hyperplasia is too obvious, and the involution is incomplete, mammary gland hyperplasia will appear after a period of time, and it is not necessarily related to breast cancer. Breast hyperplasia is a phenomenon that occurs every month, and it cannot be said to be a disease in the strict sense. 70% to 80% of women will have breast hyperplasia, don’t be nervous, it has no necessary relationship with breast cancer; doctors order women with breast hyperplasia to have annual physical examinations, not because they have a high risk of cancer, but because of the clinical symptoms of breast cancer. The manifestations are easily covered by breast hyperplasia and are not easy to be found, so it is recommended that they go to the hospital for examination, and use imaging methods and doctor’s experience to help them identify breast cancer early.
If you suffer from breast hyperplasia, you should self-regulate your emotions and mentality, and try not to get angry; maintain a regular life; you can apply hot compresses to the breast; if necessary, take some drugs such as soothing the liver and regulating qi, regulating menstruation and blood circulation, and estrogen can be added for more obvious lumps Competitive inhibitory drugs such as tamoxifen; the most important thing is regular review. Regular review is the key magic weapon for early detection of breast cancer and one of the important prerequisites for the cure of breast cancer.
7. Is breast pain a sign of breast cancer?
Some female friends feel breast pain and worry about whether they have breast cancer. If you feel breast pain, 90% of them are not breast cancer, especially if there is no palpable lump and no swelling of the breast skin, the probability of breast cancer is very small, and early breast cancer is generally painless. Breast pain is often caused by breast hyperplasia.
8. Is a mastectomy the removal of the breast?
Surgical treatment is the main treatment method for early breast cancer. Timely surgical resection of the mass can prevent cancer metastasis, but it is necessary to decide whether to perform surgical resection according to the stage of the tumor and the patient’s constitution.
For many women, losing their breasts may mean losing their beauty and self-confidence, which is a huge test for their quality of life, family harmony and self-confidence. Therefore, some breast cancer patients refuse treatment in order to keep their breasts; some patients mistakenly believe that breast cancer must be removed if they have breast cancer, otherwise treatment will be delayed.
There are many treatment options for breast cancer patients, and not all patients require the entire breast to be removed. The traditional treatment for breast cancer is mastectomy. Although the health is kept in this way, the women lose their breasts, beauty and self-confidence, which is a kind of harm to the body and mind of female patients.
Until 30 years ago, there was a new treatment for breast cancer, which was breast-conserving surgery, that is, like cutting a cake or a watermelon, only cut off “a piece of mammary gland” in the lesion, allowing female patients to keep their breasts, and essentially Like traditional treatments, this is undoubtedly good news for breast cancer patients.
According to authoritative data, the curative effect of breast conserving surgery combined with radiotherapy and chemotherapy for breast cancer is no less than that of radical surgical mastectomy. The 5-year survival rate is over 90%, and the breast preservation rate is 90%. The survival rate and recurrence rate are high, and the body shape of breast cancer patients is maintained, which improves the quality of life.
Patients with early breast cancer can be treated with breast-conserving surgery, but not every patient is suitable for breast-conserving surgery. Generally, this surgery can only be used when the lesion is in the early stage and the tumor is small. Doctors will weigh various factors to choose the appropriate surgical method for the patient.
Breast-conserving surgery is to remove part of the glandular tissue containing the lesion according to the lesion, retain the rest of the normal glandular tissue, and perform appropriate treatment on the axillary lymph nodes, so that the patient does not have to experience the pain of breast loss.
Breast-conserving surgery not only preserves the integrity of the breast shape, but also takes into account the recovery of postoperative function. Combined with postoperative comprehensive treatment, the treatment effect is consistent with that of radical mastectomy. For women, breasts are a very important part of the body. In order to avoid complete mastectomy or deformation after surgery, early detection and breast-conserving treatment should be the current advocated concept.
For patients who cannot undergo breast-conserving surgery, breast reconstruction can also be performed at the same time as breast cancer surgery, which reduces trauma and does not affect subsequent treatment. “Breast reconstruction” is to recreate a new breast for patients who have lost their breasts through surgery, and to meet their needs for body restoration on the premise of ensuring complete removal of lesions.
9. How to check yourself?
The time for self-examination is generally 7 to 10 days after the menstrual period.
◎Looking in the mirror, with your hands hanging down, carefully observe whether the breasts are symmetrical in size, whether there are abnormal protrusions, whether the skin and nipples are sunken or eczema.
Skin: The color is normal, without edema, rash, damage, superficial venous distension, skin folds, and orange peel-like changes.
Nipple and areola: no local redness and swelling, no nipple depression.
Nipple discharge: Whether there is discharge from the nipple, and carefully check whether it is spontaneous discharge or overflow after squeezing, unilateral or bilateral, and the nature of the discharge, etc.
Breast morphology: Whether the appearance, size, and position of the breast are normal.
◎Press (touch) Standing position, raise the left hand to the back of the head, check the left breast with the right hand, press the breast gently with the pulp of the fingers, feel whether there is any hard lump, start from the nipple to check in a circular clockwise direction, gradually by Outside (3 to 4 circles), until the left breast is checked. Examine the right breast in the same way.
Lie down on your back, put a pillow under your left shoulder, bend your right hand under your head, repeat the “touch” method, and check both breasts.
◎Examination In addition to examining the breasts, check whether there are enlarged lymph nodes in the armpits. Then squeeze the nipple with the thumb and index finger, and pay attention to whether there is any abnormal discharge.
Breast lumps: Check the location, shape, size, number, texture, smoothness of the breast lumps, whether they are mobile, and whether they are tender.
10. Who needs breast cancer screening?
The non-high-risk group is 20-39 years old. Breast screening is not recommended for the non-high-risk group. 40 to 49 years old, suitable for opportunistic screening, mammogram once a year, recommended combined with clinical physical examination, recommended combined with B-ultrasound examination for dense breasts. Ages 50 to 69 are suitable for opportunistic screening and population census. Mammography is recommended every 1 to 2 years. It is recommended to combine it with clinical physical examination. For dense breasts, it is recommended to combine it with B-ultrasound. Opportunistic screening is suitable for those aged 70 and over. Mammography is recommended once every two years. It is recommended to be combined with clinical physical examination. For dense breasts, it is recommended to be combined with B-ultrasound examination.
High-risk groups It is recommended that breast cancer high-risk groups (early menarche, late menopause, late marriage and childbearing, non-breastfeeding, family history of breast cancer, etc.) be screened in advance (20-40 years old), and annual screening is recommended during the screening period. In addition to the clinical physical examination, color Doppler ultrasound and mammogram commonly used by the general population, screening methods can also use imaging methods such as MRI.
11. How to prevent breast cancer?
◎Regular examination The most important measure to prevent breast cancer is regular physical examination, because the symptoms of many diseases are not obvious in the early stage of the disease. When some symptoms appear in the body, the disease may have developed to the middle and late stages, and the difficulty of curing will increase at this time. Therefore, it is necessary to know the health of the body through regular physical examination.
◎Weight control Pay attention to reasonable weight control in normal times, especially for postmenopausal women to maintain normal weight. Postmenopausal women’s body ages faster, and fluctuations in hormone levels in the body can easily lead to diseases. If you can control your weight and keep your endocrine levels stable, it will help prevent diseases.
◎Emotional stability To effectively prevent breast cancer, you need to master the correct method. Generally, you need to control your personal emotions in the process of preventing the disease. Some people are always prone to losing control of their emotions. Under the influence of mood swings, in addition to stimulating the brain nerves, it is also easy to cause blood pressure to rise. Long-term emotional loss, anxiety, depression, etc. may lead to endocrine dysfunction and further affect the health of women’s breasts. In order to prevent breast cancer, you should maintain emotional stability and face life with a good attitude, so that the incidence of the disease can be reduced.
◎Stay away from alcohol and tobacco to effectively prevent breast cancer. You should stay away from alcohol and tobacco. If you can avoid alcohol and tobacco, the prevalence of many diseases will decrease. Many people usually smoke and drink excessively, and always smoke and drink a lot. The body is easily damaged by harmful substances in tobacco and alcohol, which invisibly increases the burden on the body and increases the probability of suffering from diseases. If you stay away from smoking and alcohol in peacetime, the probability of suffering from diseases will be much lower.
◎Appropriate exercise can effectively prevent breast cancer, and you should keep exercising at ordinary times. Exercise is an effective measure to improve the immune function of the human body, and exercise can regulate endocrine function, maintain the normal operation of the body, and reduce the incidence of breast cancer.
In addition, stay up late less. Eat less grilled and fried foods. If menopausal women use estrogen, they must follow the doctor’s guidance.