Shenzhen Business Daily • Reading Client Reporter Zhao Hongfei Correspondent He Yue Xiang Yuhang
April 15-21, 2024 is the 30th National Cancer Prevention and Treatment Awareness Week, and this year's theme is "Comprehensive Measures, Scientific Cancer Prevention".
For women, breasts are one of the most problematic areas of the body. Not long ago, 39-year-old Shenzhen migrant worker Sister Xin (pseudonym) accidentally felt a hard lump on her right chest while taking a bath, and was diagnosed with mid-stage breast cancer after going to the hospital for examination.
Fortunately, the Department of Nail and Breast Surgery of Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital) (hereinafter referred to as "Nanshan Hospital") performed a pedicled transverse rectus abdominis muscle flap (TRAM) breast reconstruction for her, which "turned waste into treasure" on her belly, and recreated a breast for her while removing the tumor. Through chemotherapy, targeting, radiotherapy, surgery and other comprehensive treatments, Sister Xin "saved" her breasts, and she is fighting cancer with confidence.
At the age of 39, she never had a physical examination, and she was diagnosed with breast cancer with a lump on her chest
Sister Xin has worked hard in Shenzhen for more than ten years, and in 2023, because of her child's college entrance examination, she will return to her hometown to accompany the exam for half a year. Not long after the child's college entrance examination ended, she felt a big lump on her chest when she was taking a shower.
"I had never had a physical examination, but I felt that something was wrong with this lump all of a sudden, so I went to the county hospital for a color ultrasound, and the doctor told me that the condition was not good, and it was probably breast cancer. Sister Xin said.
Breast cancer is a malignant tumor with a high incidence in mainland women, and the incidence is increasing year by year, which seriously threatens women's health. According to the data, in 2023, there will be 45,000 new cases of malignant tumors in Shenzhen, including 25,518 women, of which 4,252 will be breast cancer, ranking third, accounting for 1/6.
Sister Xin returned to Shenzhen without telling her children, and came to Nanshan Hospital with her husband for treatment in the Department of Nail and Breast Surgery. After completing the relevant examinations, the doctor in charge, Wang Huanyu, diagnosed that Sister Xin's right breast was found to have multiple lumps, the largest of which was 5 cm, the size of a fried bun, and multiple lymph nodes in the right armpit were abnormally swollen, but fortunately there was no metastasis to other parts. Sister Xin was diagnosed with intermediate-stage invasive ductal carcinoma of the breast.
Considering that Sister Xin is still very young, the cancer stage is relatively early, and the type of cancer is sensitive to targeted therapy. The optimal plan for the benefits finally given by the team of the Department of Nail and Breast Medicine of Nanshan Hospital is to carry out chemotherapy and targeted therapy first, and then operate after "beating" the tumor, the effect will be better.
Cut off the mammary glands and "make up" them back with the meat on the belly
At first, Sister Xin's chemotherapy effect was very good, and the first chemotherapy combined with targeted therapy directly "hit" the tumor away, and Sister Xin also felt that the hard lump was deflated and she couldn't feel it.
Next is the surgical plan, breast cancer patients face not only the fear of cancer, but also the fear that the breast may be removed, and the same is true for Sister Xin. Chen Tianwen, director of the Department of Nail and Breast Surgery at Nanshan Hospital, proposed a surgical plan that surprised and delighted her, "It can ensure that people can't see that you have had surgery." ”
Knowing that Sister Xin already had two children and had no plans to have another child, after assessing the breast volume and the thickness and tightness of the subcutaneous fat in the abdomen, Chen Tianwen suggested that "total resection of the subcutaneous gland of the nipple areola of the right breast + axillary lymph node dissection + pedicled TRAM flap first-stage breast reconstruction". In layman's terms, it means that after removing the mammary glands, she recreates a breast from the fat on her own belly.
Chen Tianwen said that TRAM flap breast reconstruction specifically refers to the transfer of lower abdominal skin, fat and rectus abdominis muscle pedicle to the chest wound to shape the reconstructed breast according to the size and shape of the contralateral breast. This surgery is a combination of abdominoplasty in plastic surgery and breast tumor removal surgery, and is a jewel in breast tumor surgery.
"This procedure will benefit the patient even more. Breast reconstruction using one's own tissue can achieve a more natural result, with no foreign body sensation and no rejection like implants. The belly will also be flatter and firmer, achieving a tighter abdominal wall and a weight loss-like effect. Chen Tianwen said.
After 4 months, the conditions for surgery are reached. The operation was extremely difficult and took more than 5 hours in total. After the successful completion of the operation, Sister Xin will undergo regular postoperative adjuvant treatment.
"At first, my expectation was to save my life, then to protect my breasts, but now I have less fat on my waist and abdomen, and my body is better than before. Luckily, I haven't lost my breast to cancer. Sister Xin said with emotion. At present, her body is gradually recovering, and she also sees the dawn of defeating cancer.
Chen Tianwen said that most patients do not understand breast cancer treatment, and once diagnosed, they are afraid of losing their breasts. In fact, "everything" is a thing of the past. Today, breast cancer patients can not only maximize the benefits of chemotherapy, targeted, radiotherapy, and surgery, but also achieve radical tumor curation and reshape the appearance of the breast.
Breast conservation is as important as life preservation, and the breast reconstruction rate is less than 15%
Sister Xin's worries about losing her breasts are not unique. According to a survey by the Shenzhen Cancer Society, the divorce rate of women after total mastectomy is 40%, and the depression rate has also increased significantly. At present, the breast conservation rate of breast cancer surgery patients in China is about 25%, and most patients face total breast resection, and the breast reconstruction rate is less than 15%.
Chen Tianwen said that the breast reconstruction rate in breast cancer surgery in Nanshan Hospital is more than 30%. About half of breast cancer patients do not choose breast reconstruction surgery because they do not understand breast reconstruction technology, the disease itself, family support and many other factors. In fact, in addition to pedicled TRAM flaps, free TRAM flaps, inferior abdominal wall perforator flaps (DIEP), latissimus dorsi flaps, and adjacent flaps can also be used to reconstruct the breast. Breast reconstruction at the same time as radical tumor surgery can also prevent patients from suffering the loss and pain of losing their breasts at intervals. "Saving the breast" is one more step than treating cancer, so that the patient's life can be better.
Doctors recommend that breast cancer prevention is a top priority. At high risk of breast cancer, annual screening should begin at the age of 35, including patients with a family history of breast cancer, breast ductal or lobular dysplasia or lobular carcinoma in situ (LCIS), and patients with a history of thoracic radiotherapy. It is necessary for non-high-risk groups to do X-ray examination, 40~45 years old women should do it once a year (plus breast ultrasound), 45~69 years old every 1~2 years, 70 years old or above every 2 years.