The world's number one cancer beyond lung cancer: is the "prelude" of breast cancer a breast nodule?

According to the latest data released by WHO's International Agency for Research on Cancer in 2022, the number of new cases of breast cancer worldwide reached 2.26 million in 2020, surpassing 2.2 million cases of lung cancer to become the world's largest cancer. In China, there are about 420,000 new breast cancer patients every year, and the incidence rate increases by 3%-4% every year. As the most common malignant tumor in women, what are the causes and treatment options for breast cancer? How far are breast hyperplasia and breast nodules common in women's physical examination reports from breast cancer?

Image source: Visual China

70% of women have breast hyperplasia

 What is breast hyperplasia?

Because women's breast tissue will accompany the physiological cycle with a series of changes, the growth and development of the breast is also regulated by estrogen, progesterone and many other sex hormones, breast hyperplasia is a structural disorder caused by breast tissue hyperplasia, is a benign disease common in women of childbearing age. Studies have shown that 70%~80% of women of childbearing age have breast hyperplasia of varying degrees.

Common breast hyperplasia is not directly related to breast cancer and does not increase the risk of cancer. Female breast B ultrasound suggests breast hyperplasia, if no abnormalities are found in breast tissue, regular review can be done.

What are the symptoms of breast hyperplasia and how to relieve it?

Breast hyperplasia often causes breast pain and is usually cycle-related. Many women will have more severe breast pain before menstruation, which will gradually relieve after menstruation; A small number of women will have severe pain for a long time, which may also be related to many life factors such as emotional stress, stress, and staying up late.

This kind of pain generally does not have to worry too much, rest well, keep a comfortable mood, avoid alcohol, coffee and other irritating drinks, do not wear tight underwear when pain occurs, do not do strenuous exercise, pain will generally be gradually relieved. If the symptoms are really severe, they can be relieved by taking medication after seeking medical attention.

Image source: Visual China

How far is a breast nodule from cancer?

Can breast nodules become cancerous?

Breast nodules are not clearly defined, and can also be called breast lumps and breast masses. Breast nodules can be divided into cystic nodules and solid nodules.

Cystic nodules: not something growing on the mammary glands, but a thin layer of cyst skin wrapped in fluid, which is basically benign and rarely malignant. However, if the cyst wall is thick or there is a thick internal septum, the risk of malignant transformation cannot be completely ruled out.

Solid nodules: Most of the nodules found in women are solid nodules, which do have a risk of cancer, but the probability is not high, most of the solid nodules are benign, usually keep observed. If the diameter is more than 2~3 cm, or if you feel an obvious lump, you can also consider surgical removal. However, if malignant changes are suspected, they should be removed regardless of the size of the nodules.

Color ultrasound, mammography, NMR... How to choose the inspection method?

Common breast examination methods include color ultrasound, mammogram, MRI, etc.

Among them, color ultrasound has no radiation, strong repeatability, almost all ages (including pregnant women) can be used, and has advantages in the differentiation of breast nodule cystic solidity, which can accurately measure tumor size, whether the internal echo is uniform, internal blood flow and blood flow impedance.

Mammogram is a special X-ray examination, the radiation is very low, very sensitive to radiopaque lesions such as microcalcifications, etc., can indicate early breast lesions, suitable for women over 40 years old or glands with more fat than tissue.

In general, women under 40 years old can choose ultrasound for routine screening, and women over 40 years old can choose ultrasound plus mammogram, which can show most breast lesions. If the results of the two examinations are not consistent, or there are multiple nodules, you can choose MRI to make a third-party judgment. Breast catheteroscopy is indicated for patients with nipple discharge.

Small nodules are difficult to pay attention to by palpation in the early stage, so in addition to monthly self-examination, be sure to go to the hospital at least once a year for a professional health examination to find early nodules.

Is the mammary node energy efficient?

Cystic nodules may be absorbed, solid nodules are unlikely to heal spontaneously, and the most effective treatment is surgical removal of the lesion, but most benign small nodules can be observed. In addition, massage has a limited effect on eliminating breast nodules, especially when the nature of the nodules is not clear, which may increase the risk of metastasis of malignant nodules.

Image source: Visual China

How to prevent and treat the world's largest cancer?

What are the risk factors for breast cancer and the age of high incidence?

There are two main risk factors for the development of breast cancer:

The first category is uncontrollable: for example, the incidence of breast cancer in women is higher than in men; The incidence of breast cancer in one breast and breast cancer on the opposite side is higher than that of ordinary people; The overall incidence of Asians is lower than that of developed countries in Europe and the United States; Family history of breast cancer increases incidence, etc.

The other category is controllable: such as abnormal menstrual status, long-term oral contraceptives, smoking, alcoholism, unbalanced diet, etc.

From the incidence curve of breast cancer, the incidence of normal women has gradually increased since the age of 25, and the early development level is slow, and Asian women over 45 years old have entered a relative peak, and there is a small peak at the age of 70~75. Although the incidence of breast cancer in young women has indeed increased in recent years, it is generally no higher than 1 in 1,000.

In addition, a small number of men can also get breast cancer. About 1 in 100 breast cancers occur in men, but the age of onset is slightly later.

How do I choose a treatment plan?

Modified radical mastectomy: The most classic way to treat breast cancer is modified radical mastectomy, which removes the entire breast and clears the lymph nodes. Follow-up treatment with this treatment regimen is simple, but may result in functional deficits such as breast loss and upper extremity lymphedema.

Breast-conserving surgery with radiotherapy: for early-stage breast cancer, local control and survival can be obtained with this method, but it is not suitable for tumors with extensive or excessive disease. Patients with breast cancer or a history of radiation therapy and connective tissue disease of the chest wall should also be cautious in pregnancy.

Local radiofrequency or cryoablation: If it can completely cover the tumor and the surrounding 1~2 cm safety range, it can also destroy the tumor, and it is more inclined to early and pathologically classified small tumors to replace traditional breast-conserving surgery. Within 3 cm in diameter, no lymph node metastasis or few metastases, it belongs to early-stage breast cancer, and the treatment effect is very good. In addition, endocrine therapy, targeted therapy, immunotherapy, etc. are also commonly used.

Chemotherapy: Chemotherapy is one of the treatments for breast cancer, but the side effects vary depending on the drug and regimen, and although most regimens cause hair loss but hair will grow back, it is not necessary to give up the necessary treatment because of resistance.

How well is breast cancer cured?

Most of the recurrence and metastasis of early breast cancer occur within five years, and if it does not occur after five years, there is a high probability of long-term survival or cure. Most breast cancers are better healed, detected early, and treated well, and the five-year survival rate of domestic early breast cancer is about 83%, and the larger specialized hospitals can approach 90%, which is basically in line with international standards; The five-year survival rate for stage I breast cancer is also close to 95 percent.

Can breast cancer be prevented early?

It can actively monitor breast health (palpation 3~7 days after menstruation every month, regular physical examination), try to avoid hormonal drugs and high-fat food intake, avoid staying up late and alcoholism and ionizing radiation, etc., which can be meaningful to reduce the occurrence of breast cancer.

Optimism can also balance endocrine by controlling pituitary hormones, improve its effect on the mammary glands, and reduce the risk of breast cancer.

Births to term before the age of 30 and WHO-recommended breastfeeding of more than two years can also protect the mammary glands. At present, there is no clear research that shows that underwear is directly related to breast cancer, but wearing too tight underwear for a long time may compress the mammary glands, resulting in local discomfort and even lesions of the breast, so underwear should be mainly comfortable.

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