May 30, 2024

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What are the treatments for breast cancer?

What are the treatments for breast cancer?


What are the treatments for breast cancer?  Breast cancer has surpassed lung cancer to become the most common cancer in the world, and the symptoms of breast cancer in the early stage are often not particularly obvious, and it is easy to be confused with diseases such as breast nodules.

What are the treatments for breast cancer?

What are the symptoms of breast cancer? How to distinguish breast cancer from some diseases? These are all issues that everyone is very concerned about. We are honored to invite Professor Wang Ouchen from the First Affiliated Hospital of Wenzhou Medical University, a well-known domestic breast cancer expert, to answer common questions about breast cancer.



What is breast cancer?

As shown in the figure above, the internal structure of the breast is like a horizontal fruit tree, and the mammary ducts at all levels are like the branches of the tree, and finally merge into a trunk. The fruit on the branches is the breast lobules. Breast cancer is a disease in which the cells of the ductal epithelium or glandular lobules of the breast are out of control and multiply, and then develop into malignant tumors.

Expert profile: Wang Ouchen, Chief Affiliated Hospital of Wenzhou Medical University, Chief Physician, Professor, Doctor of Oncology, Master’s Tutor, Director of Department of Thoracic and Breast Surgery. Member of the Breast Expert Committee of the Chinese Society of Clinical Oncology (CSCO); Vice Chairman of the Breast Cancer Specialty Committee of the Zhejiang Medical Doctor Association; Deputy Chairman of the Breast Cancer Specialty Committee of the Zhejiang Integrated Traditional Chinese and Western Medicine Association; Chairman; Member of the Standing Committee of Thyroid Cancer Specialty Committee of Zhejiang Anticancer Association; Member of the Breast Disease Specialty Committee of China Medical Education Association and Standing Member of Zhejiang Branch; Chairman of the Breast Cancer Specialty Committee of Wenzhou Anticancer Association.



What are the symptoms of breast cancer?

Early breast cancer has no obvious symptoms. Breast lumps are the most common first symptom of breast cancer. Painless, single small lumps appear on the breast. The lumps are hard, not smooth on the surface, and have unclear edges and are not easily pushed. In addition, it is also accompanied by symptoms such as nipple discharge and orange peel-like lesions of the breast skin.

Who are the high-risk groups who need to be screened?

Like most cancers, the occurrence of breast cancer is the result of many risk factors. Common risk factors for breast cancer are:

(1) Menstruation comes prematurely, especially before the age of 13;

(2) Menopause is relatively late, especially at the age of 55 years without menopause;

(3) Unmarried, childless, or late in giving birth, especially after 35 years of age;

(4) No breastfeeding after giving birth;

(5) The weight of women after amenorrhea increased significantly;

(6) Have a family history of breast cancer;

(7) Long-term use of estrogen or long-term use of estrogen cosmetics or health products after menopause may induce breast cancer;

(8) Postmenopausal hyperplastic breast diseases, especially accompanied by atypical lobular hyperplasia, may induce breast cancer;

(9) When he was young, he received repeated X-ray irradiation on his chest. Excessive X-ray exposure is also a high-risk factor for breast cancer;

(10) Heavy smoking and drinking.



How to screen for breast cancer?

Commonly used examination methods for breast cancer are:

(1) Molybdenum target: It is the preferred imaging method for breast cancer, which can clearly show microcalcification.

(2) Breast ultrasound: It can better show the characteristics of breast masses, it is simple and practical, and has wide clinical applicability.

(3) Breast magnetic resonance imaging: It has excellent soft tissue resolution and non-radiation characteristics, and has unique advantages for breast examination.


How to prevent breast cancer?

(1) Develop good living habits: control weight, quit smoking and alcohol, eat a reasonable diet, take more physical exercises, stay up late, etc.;

(2) Regular screening: It is recommended that women with a family history of breast cancer start screening at the age of 30, and those without a family history should be screened every year from the age of 40. This is determined by the characteristics of Chinese patients.

(3) Do more self-examinations. After you are familiar with your breasts, it is easier to identify abnormal breast tissue.

Is it necessary to remove breasts to prevent breast cancer?

I think everyone has heard more or less the news of actress Julie’s breast removal to prevent breast cancer. Because she was a carrier of the related mutation gene, her mother also died of breast cancer because of the same gene. This decision was made after various trade-offs and considerations. It is doubtful whether it is necessary for the general high-risk population to adopt this more extreme method. For Chinese women with family history, it is generally recommended to have early screening and follow the professional guidance of doctors.


Is breast cancer a lump in the breast?

Not necessarily. Prevention of lumps may also be breast hyperplasia, breast cysts, fibroadenoma, etc., and these are all benign. Generally speaking, 80% of breast nodules are benign. Malignant lumps are generally painless, single-shot small lumps, the lumps are hard, the surface is not smooth, the edges are not clear, and it is not easy to be pushed.


Will breast nodules develop into breast cancer?

In fact, there is no strict definition of breast nodules. Clinically, small lumps are called nodules, so breast nodules are small lumps that occur in the breast. Since it is a lump, it must be benign and malignant.

We need to do some inspections, such as the B-ultrasound and mammography X-ray inspections we often do to identify them. The doctor will give a BI-RADS classification based on the results of the examination. If the nodule is BI-RADS type Ⅰ, Ⅱ or Ⅲ, these are all benign nodules and should be reviewed regularly without special treatment.

If after the examination, the nodule is said to be classified as four types, it is suspiciously malignant at this time, and further examination is needed. We generally recommend that the patient take a needle biopsy and make a clear pathological diagnosis to confirm whether it is breast cancer. If the nodule is already in category five or six, it is considered a malignant tumor.


What are the treatments for breast cancer?

The main treatment methods for breast cancer include surgery, radiotherapy, chemotherapy, endocrine therapy, targeted therapy, immunotherapy and so on.

Surgical treatments such as breast-sparing surgery, mastectomy, sentinel lymph node biopsy or axillary lymph node dissection, modified radical mastectomy, breast reconstruction, etc., patients of different stages have different surgical options;

Radiotherapy for breast cancer is mainly used to reduce the risk of recurrence after breast-conserving surgery, after mastectomy, and after the lesion has spread to other parts. Radiotherapy mainly includes external beam radiation and brachytherapy.

Chemotherapy is still one of the important treatments for breast cancer patients. Chemotherapy includes neoadjuvant chemotherapy before surgery, adjuvant chemotherapy after surgery, and chemotherapy for metastatic breast cancer. Commonly used chemotherapy drugs include anthracyclines and capecitabine. , Platinum, yew, etc.;

Endocrine therapy is to reduce the effects of estrogen on cancer. Common drugs include tamoxifen, toremifene, fulvestrant, aromatase inhibitors, etc. With more and more therapeutic drugs, endocrine therapy has entered the era of targeted therapy, from single-drug to dual-drug to multi-drug, multi-target, and multi-combination.

Targeted drugs include trastuzumab, pertuzumab, lapatinib, lenatinib, etc. for HER2 mutations, PARP inhibitors such as olaparib for BRCA mutations, and so on.

At present, immune checkpoint inhibitors are mainly used in the treatment of breast cancer, mainly for patients after chemotherapy has failed, and PD-L1 monoclonal antibody is mainly used for the treatment of triple-negative breast cancer.





(source:internet, reference only)

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