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How to deal with breast cancer recurrence and metastasis?

How to deal with breast cancer recurrence and metastasis? What factors are related to the recurrence and metastasis of breast cancer?

According to the latest global cancer burden data released by the International Agency for Research on Cancer (IARC) of the World Health Organization in 2020, 2.26 million new cases of breast cancer worldwide in 2020, surpassing lung cancer (2.21 million) for the first time, become the world’s largest cancer This is 11.7% of new cancer cases.

Although the clinical cure rate of early breast cancer can reach 80%~90%, 30%~40% of patients still have recurrence and metastasis after radical treatment. Once the patient relapses and metastasizes, not only the difficulty of treatment will increase, but the survival prognosis will also be significantly affected.

So, what factors are related to the recurrence and metastasis of breast cancer?

First of all, it is the age factor. The younger the patient (<35 years old), the higher the risk of recurrence and metastasis. Secondly, the larger the tumor and the greater the number of lymph node metastases, the more difficult it is for cancer cells to be completely eliminated, laying down hidden dangers for recurrence and metastasis. Finally, different molecular types also have a certain impact on recurrence and metastasis.

Related studies have shown that among all molecular subtypes of breast cancer, basal cell-like type (mostly triple-negative breast cancer) and HER-2 overexpression type have a worse prognosis than Luminal A and Luminal B types. The total risk of postoperative recurrence and metastasis of breast cancer presents a bimodal distribution, occurring in the second and fifth years after surgery, but the basal cell-like type will have a small peak in the third year after surgery.

▌Four factors are essential to prevent recurrence and metastasis

01, standard treatment, regular review

How to deal with breast cancer recurrence and metastasis?

The incomplete treatment gave cancer cells a chance to make a comeback. It is recommended that patients standardize treatment, pay attention to the first rational treatment, improve treatment compliance, and avoid unauthorized interruption of treatment. In addition, since the time of recurrence and metastasis shows a certain regularity, patients should be reviewed regularly after treatment for early detection and early treatment.

Re-check frequency:

2 years after surgery, usually follow-up once every 3 months;
3~5 years after operation, follow-up every 6 months;
More than 5 years after operation: Follow-up every 1 year until life.

If there is any abnormality, you should see a doctor promptly instead of sticking to a fixed time.

02. Keep exercising and improve physical fitness

Related research results show that physical activity after diagnosis of breast cancer patients can reduce the risk of breast cancer death by 34% and the risk of breast cancer recurrence by 41%. After the anti-tumor treatment is over, proper exercise will help improve the physical fitness of breast cancer patients. But when to start, what intensity, and what kind of exercise should be consulted with a specialist.

Adult breast cancer patients under the age of 64, insist on at least 150 minutes of moderate-intensity exercise or 75 minutes of high-intensity aerobic exercise every week. 5 times a week, 15~30 minutes each time.

If elderly breast cancer patients over 65 have chronic diseases with restricted mobility, they should adjust the exercise time and intensity according to the doctor’s guidance to avoid being inactive for a long time.

Slow walking, walking, swimming, Tai Chi and other exercises are more suitable for breast cancer patients. What I want to remind everyone is that exercise should be moderate, gradual, and the most important thing is persistence.

03. Scientific diet to ensure nutrition

Breast cancer patients should eat nutritionally balanced and diversified foods to ensure the normal functioning of the body. At present, there is no evidence that a certain food is directly related to breast cancer recurrence and metastasis. Therefore, we should not blindly “taboo” and fall into the misunderstanding of “this can’t be eaten, then can’t eat”.

But it should be reminded that excessive intake of high-fat and high-sugar foods can lead to obesity, and postmenopausal obese women may produce more estrogen in their bodies, which affects the prognosis of breast cancer patients. In your daily diet, pay attention to eating less high-sugar and high-fat foods. In addition, foods like royal jelly, placenta, and alcohol should be avoided.

04, maintain a good attitude

A good mentality is a free weapon against the recurrence and metastasis of breast cancer. Studies have found that more than 80% of cancer patients have experienced adverse events before they become cancerous. People who have been suffering from negative emotions such as mental depression, anxiety, and fear for a long time are more likely to get sick and harder to recover than those who are cheerful and sunny.

Having breast cancer, we should face it positively and avoid negative attitudes. It should be known that breast cancer is the one with a better prognosis among all cancer types. Even after recurrence and metastasis, many people survive for decades.

▌Treatment of recurrence and metastasis, cutting-edge treatment is very important

Even if unfortunately he is recruited again, there is no need to be too anxious when the disease progresses. There are also many new treatments for different types of breast cancer.

Take triple-negative breast cancer, which is the most headache for breast cancer patients, as an example. Because its ER, PR, and HER-2 expression are all negative, it is not sensitive to endocrine therapy and targeted therapy. The treatment after metastasis is usually chemotherapy. However, the survival benefit of patients is limited, and other more effective treatments are urgently needed.

Because triple-negative breast cancer has more tumor-infiltrating lymphocytes and has a better response to immune checkpoint inhibitors, and triple-negative breast cancer has higher levels of programmed death receptors (PD- 1) With its ligand PD-L1 expression, immunotherapy has taken the lead in making breakthroughs in triple-negative breast cancer.

Atelizumab is the first PD-1/PD-L1 inhibitor. In March 2019, atilizumab was approved by the FDA to be used in combination with albumin-bound paclitaxel to treat patients with advanced metastatic triple-negative breast cancer. It is also the world’s first drug for triple-negative breast cancer immunotherapy. In addition, pembrolizumab has also been approved to treat triple-negative breast cancer.

In addition, recently, the FDA officially approved the TROP-2 inhibitor Sacituzumab Govitecan (Trodelvy), becoming the first targeted therapy for triple-negative breast cancer. This targeted drug, which the majority of patients have been waiting for, has finally “turned right”. In addition, there are some antibody-coupling drugs (ADCs) under development that have also shown positive effects in clinical trials, which are worth looking forward to.

In the face of recurrence and metastasis of triple-negative breast cancer, our anti-cancer “weapons” are increasing day by day. I hope breast cancer patients are not afraid of recurrence and metastasis, and active treatment can still live long and good lives!

(source:internet, reference only)

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