"Breast cancer is a malignant tumor that threatens women's health, and even if there are no genetic factors, no poor lifestyle, etc., it does not mean that there is no risk of getting a tumor." Recently, Yuan Peng, deputy director and chief physician of the Special Needs Medical Department of the Cancer Hospital of the Chinese Academy of Medical Sciences, visited the "Health Lecture Hall" column of Xinhua Net, she said that the cause of breast cancer is not clear, and it is recommended that women over 35 years old pay attention to physical examination, so as to achieve early detection, early diagnosis and early treatment.
Yuan Peng, deputy director and chief physician of the Special Needs Medical Department of the Cancer Hospital of the Chinese Academy of Medical Sciences, was a guest of Xinhua Net
The cause of breast cancer is not clear It is recommended that women over the age of 35 pay attention to physical examinations
Xinhua Net: What are the causes of breast cancer? Who is susceptible to breast cancer?
Yuan Peng: The causes of breast cancer involve sporadic tumor factors and hereditary tumor factors. Many family members worry that if the mother has breast cancer, will her daughter get it? This is a possibility, but most breast cancers are not genetically caused. What are the characteristics of hereditary breast cancer? Immediate family members, such as mothers, sisters, daughters, who have breast cancer, are at risk for their first-degree relatives. Especially if you get breast cancer at a young age, the genetic risk will be higher.
In fact, the cause of breast cancer is not very clear, such as menstrual factors, menstrual time is relatively long, the age of menstruation is relatively early, or the age of menopause is relatively old, resulting in normal cells being exposed to estrogen for a longer time, the higher the risk of breast cancer. There are also some lifestyle factors, such as obesity, staying up late, low immunity, etc. will increase the risk of breast cancer. Malignancy itself is also a disease that increases the risk of cancer as we age. There are two peaks in the incidence of breast cancer in Chinese group, in addition to 60 years old, there is also a peak in the 40 to 50 years old, so it is recommended that women over 40 years old, or even over 35 years old, should pay attention to physical examinations. It is difficult to say that if a certain factor is avoided, breast cancer must not be avoided, because the cause of breast cancer is not very clear.
Xinhua Net: Do patients who have been diagnosed with breast cancer have to undergo surgery?
Yuan Peng: In the early days, the treatment of breast cancer is mainly surgery, as far as the current point of view, the surgical treatment of breast cancer is still necessary, but in the treatment, the proportion is gradually reduced, this is due to breast cancer and many tumors, when it grows, it has spread around, the whole body, relying on a scalpel alone can not cure all patients, to consider using different ways of treatment. In the case of better and better systemic treatment, including chemotherapy and endocrine therapy, the use of drugs to control the tumor in a certain situation, whether a small operation can achieve a major surgery effect. Studies have shown that through breast-conserving surgery, the tumor of the breast is removed at the safe edge, and then through radiation therapy, the local recurrence rate is reduced, which is the same as the effect of total mastectomy, but this method needs to be selected according to different conditions.
With the improvement of living standards, everyone's requirements for beauty are getting higher and higher, and patients not only need to live, but also live better. If breast conserving can be done, it will improve the quality of life of patients later. Therefore, other treatment methods are becoming more and more powerful, and the proportion of surgical methods in the overall treatment is getting smaller and smaller, in order to achieve such an effect.
Xinhua Net: What problems need to be paid attention to after breast conserving surgery?
Yuan Peng: Most breast-conserving surgeries are done with radiotherapy after surgery, and if local radiotherapy is not done, the risk of recurrence is increased. At the same time, not only to preserve the milk but also to preserve the armpits, the cleaning of the armpits is an important part of the previous surgery, on the one hand, to observe whether the tumor is transferred to this site, on the other hand, the more lymph nodes in the armpits means the higher the risk of recurrence, and the disease period is more backward. However, after cleaning the armpits, there will be some bad conditions, such as causing some lymphatic reflux, the patient will have swelling of the upper limbs, and in severe cases, the upper limbs of one limb will be twice as thick as the other, affecting the patient's quality of life. Now with some new techniques, such as breast cancer sentinel lymph node biopsy, if there is no abnormality, it is possible to protect the armpits. This allows more patients to retain upper limb function. In fact, breast cancer surgery is not very large because it is on the body surface, but technique is important, and the long-term quality of life of the patient needs to be considered later.
There are different types of breast cancer treatment depending on the condition
Xinhua Net: Is chemotherapy necessary after breast cancer surgery? What are the side effects and treatment methods of chemotherapy?
Yuan Peng: Clinically, breast cancer is divided into different types, according to different types, different stages, and some patients' own conditions, to choose chemotherapy and other treatment methods.
It is often said that chemotherapy is carried out through infusions, injections, etc., but with the continuous changes in technology, biopharmaceutical technology has developed rapidly, and now there are drugs with higher efficacy and lower adverse reactions, allowing patients to treat in relative comfort and achieve better treatment effects.
Xinhua Net: What is targeted therapy for breast cancer?
Yuan Peng: The original targeted therapy refers specifically to drugs that attack a certain type of target. For breast cancer, a type of breast cancer was discovered 30 years ago that expresses a receptor called human epidermal growth factor receptor 2, which was thought to be a poor indicator of healing, and tumors with this marker on cells tend to recur and metastasize easily. Later, experts made some relative drugs for this target, and the effect achieved was that when the drug entered the body, it only bound to the cells with this receptor, that is, tumor cells. Therefore, such drugs will directly attack the tumor for targeted therapy. The target is the feature of the tumor cell above, which is the target. This class of drugs is called targeted therapy. However, targeted therapy does not specifically refer to a certain mode of administration, it can be intravenous infusion, or oral, etc., and will not be limited to the mode of administration. Such targeted therapy is also the mainstream treatment method in various tumors, because different tumors have different targets, and there may be other targeted drugs in the future. In the past, we called targeted therapy for one target, but now there are more drugs for other targets. This field will also become wider and wider, and there will be more and more "weapons" to truly cure diseases.
Xinhua Net: What are the common postoperative complications of breast cancer? How to restore?
Yuan Peng: Common complications after breast cancer surgery are infection, flap necrosis, subcutaneous effusion, etc. There are also some patients who will always feel numb after surgery, which is due to the fact that some nerves will inevitably be hurt during the operation, etc., and it is very difficult for these nerves to grow again, so to give patients psychological construction, they must accept this feeling from the heart.
If the armpit is cleaned, there is a risk of upper extremity edema, at this time the patient should pay attention to the exercise, so that the muscles and ligaments stretched. In addition, after the armpit sweep, it is recommended that this side try not to lift heavy objects, which may cause swelling of the upper limbs due to poor lymphatic reflux. It is also necessary to avoid mosquito bites, if you are bitten in the case of poor reflux, there is a possibility of infection due to low immunity. In addition, it is recommended not to roast the fire, this side of the limb as far as possible no injections, no infusions, no blood pressure, these actions will increase the risk of edema. Therefore, it is necessary to keep the armpits as much as possible and not to do the operation of cleaning the armpits, which will be of great help to the patient's future life.
Xinhua Net: What is the new adjuvant treatment for breast cancer?
Yuan Peng: Breast cancer after surgery, through chemotherapy, endocrine therapy, etc., to help achieve good expectations after surgery, as an adjuvant treatment. Later, as systemic treatment becomes more and more extensive, it is necessary to shrink the tumor through systemic treatment before surgery, so that breast conserving therapy can be carried out, so that the treatment before surgery is neoadjuvant therapy. In general, postoperative treatment is adjuvant therapy, and preoperative treatment is neoadjuvant therapy. The purpose of neoadjuvant therapy is to improve the patient's chances of surgical radical cure and breast conservation.
Breast cancer during pregnancy is treated according to fetal development
Xinhua Net: What should I do if breast cancer is found during pregnancy? Can it be treated?
Yuan Peng: During pregnancy, it will be divided into different time points, within 3 months, the embryo is not fully formed, it is relatively fragile, and it is not recommended to do systemic treatment and drug treatment at this stage. After 4 months, most of the fetal organs have been formed, and systemic therapy is available.
For surgical treatment, it is generally not necessary to do major surgery during pregnancy, because the breasts of expectant mothers are enlarging during pregnancy, the cells are rapidly increasing, and there will be more bleeding during surgery, and the risk will be greater. Surgery is not recommended at this stage, but medication is the mainstay. For example, in the fetus is more than 7 months old, close to the process of maturity, the child can also be delivered by caesarean section and then treated, this timing should be judged according to the maturity of the fetus. Therefore, the treatment of breast cancer has now formed a multidisciplinary common consultation system.
For lactating mothers, breast cancer surgery can be performed if breast cancer surgery has been done for many years, such as three to five years. However, for mothers who have just completed surgery, breastfeeding is not recommended on one side, but it is okay to breastfeed on the opposite side.
Breast cancer treatment after the possibility of recurrence prevention needs to do "three early"
Xinhua Net: Will breast cancer return? How to prevent the recurrence of breast cancer?
Yuan Peng: Malignant tumors are characterized by recurrence and metastasis, and can be fatal in severe cases. For breast cancer, the overall treatment effect is still good. A small percentage of people experience local recurrences that can be treated again by surgery. There are also some patients will have distant metastasis, such as transfer to the lungs, liver, bones, and even transfer to the nervous system and other positions, for distant metastasis, theoretically, the current means can let it be controlled for a relatively long time, which is drug control, mainly systemic treatment.
Xinhua Net: For ordinary people, how to prevent breast cancer?
Yuan Peng: If there is no family history, the first is to maintain a good attitude, and the second is not to be disturbed by the external environment. Third, we must have good living habits. Such as a reasonable diet, maintain a reasonable weight, because obesity is a cause of breast cancer, but also have enough sleep. If immunity drops, the tumor grows. Fourth, exercise regularly and maintain a relatively good mental state.
If the above is done well, it does not mean that there is no risk of getting a tumor, so it is necessary to check the body regularly. We often say that there is no guarantee that there will be no tumors, but we can detect the tumors early through physical examinations so that they do not endanger our lives. Different stages of tumors found, the effect of treatment is completely different. We must achieve "three early", early detection, early diagnosis, and early treatment. First of all, you must be conscious and check yourself regularly. Second, regular physical examinations are conducted to allow professionals to screen for early tumors in a professional manner.