What is breast cancer?

Breast cancer is a phenomenon in which mammary epithelial cells proliferate uncontrollably under the action of multiple carcinogenic factors. In the early stages of the disease, symptoms such as breast lumps, nipple discharge, and enlarged axillary lymph nodes often occur. In the late stages, cancer cells may metastasize to distant sites, leading to multi-organ lesions and directly threatening the patient's life.

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What is the cause of breast cancer What is the cause of breast cancer

What is the cause of breast cancer

The breast is the target organ of many endocrine hormones, among which estrone and estradiol are directly related to the incidence of breast cancer. Early menarche ( <12 years old), late menopause (>55 years old), infertility and late first childbirth (>30 years old), short breastfeeding time, estrogen replacement therapy after menopause, etc. can increase or prolong the exposure of estrogen in the body and are closely related to the incidence of breast cancer.

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Typical symptoms of breast cancer

Early symptoms

The symptoms of early breast cancer are mostly not obvious and are often dominated by local symptoms such as breast lumps, breast skin abnormalities, nipple discharge, nipple or areola abnormalities, etc., which are very easy to ignore because of the inconspicuous manifestations.

Breast lumps

Breast lumps are the most common symptom of early breast cancer. The breast is divided into cross sections, and the lumps are often located at the outer upper limit. They are mostly unilateral and single, hard, with irregular edges, and the surface is not smooth, and it is not easy to be pushed. Most breast cancers are painless lumps, and a few cases are accompanied by varying degrees of dull pain or tingling.

Breast skin abnormalities

Breast lumps are often easy to invade the surrounding local tissues, which makes a variety of signs appear. When the lump invades the ligament between the gland and the skin, it can pull the skin to form a depression, like a dimple, so it is called the "dimple sign".

Nipple or areola abnormalities

When a lump invades the nipple or the area below the areola, the nipple may be pulled, causing it to sink, deflect, or even completely retract behind the areola. Special types of breast cancer, such as eczematoid nipple cancer, may cause itching of the nipple, areola, and surrounding skin on one side, with a red patchy eczema-like appearance, and the surface may have exudative scabs or keratinized desquamation. In severe cases, ulcers may form.

Disease Distinction

Breast cancer needs to be differentiated from benign diseases such as breast fibroadenoma, breast cystic hyperplasia, and plasma cell mastitis.

Breast fibroadenoma

It refers to a benign tumor composed of two components, glandular epithelium and fibrous tissue, which is common in young women. Except for breast lumps, there are often no other symptoms. The lumps are hard, elastic, like rubber balls, with smooth surfaces and easy to push. Histopathological examination helps to identify it.

Breast cystic hyperplasia

It’s also known as breast lobular hyperplasia, fibrocystic disease, etc., it refers to a benign disease with hyperplasia of milk ducts and alveolar epithelium accompanied by cyst formation, which is common in middle-aged women. Its typical symptoms are unilateral or bilateral periodic breast pain and breast lumps, which are obvious before menstruation and relieved after menstruation. Breast mammography and ultrasound examination help to identify it.

Plasma cell mastitis

It’s also known as mammary duct ectasia, it is a chronic non-bacterial inflammation of the breast. It is more common in non-lactating women aged 30 to 40. The lumps are often located around the areola, are tough or hard, have unclear boundaries, and are not attached to the chest wall. The breast skin has varying degrees of redness, swelling, heat, and pain, and the systemic inflammatory reaction is mild. It is often differentiated from breast cancer through breast puncture cytology.

Disease differentiation Disease differentiation

Related Examinations

The first visit is usually to the Department of Breast Surgery. If there is distant metastasis, it is usually to the Internal Medicine Department of Oncology or the Internal Medicine Department of Breast.

It is used for the initial screening of breast cancer to determine whether the patient has abnormal breast signs (such as breast lumps, breast skin changes, nipple discharge, etc.), as well as the condition of lymph nodes. Later, it needs to be diagnosed in combination with other auxiliary examination results.

Physical examination

It is widely used in the screening of breast cancer. Its advantage is to see calcification foci, especially some small calcification foci (which may be the manifestation of very early breast cancer).

Breast molybdenum target

It is used for the diagnosis and differential diagnosis of breast cancer and can judge the nature of the lump. It can be used as the preferred imaging examination for young, pregnant, and lactating women.

Breast ultrasound

Breast MRI is used for the staging assessment of breast cancer. It has advantages in finding small lesions, multicenters, and multifocal lesions, and evaluating the range of lesions.

Breast MRI

Breast cancer related treatment

Chemotherapy

Chemotherapy is a systemic treatment method that kills cancer cells by using cytotoxic drugs. It can be divided into adjuvant chemotherapy and neoadjuvant chemotherapy.

Medication

Due to the large individual differences, there is no absolute best, fastest, and most effective medication. In addition to commonly used OTC drugs, the most appropriate drug should be selected under the guidance of a doctor in combination with personal conditions.
Breast cancer related treatment

Adjuvant chemotherapy

It refers to systemic chemotherapy performed after surgery, the purpose of which is to kill small lesions that can’t be removed by surgery, reduce cancer metastasis and recurrence, and improve the patient’s survival rate.

Neoadjuvant chemotherapy

It refers to systemic chemotherapy performed before the implementation of local treatment methods (such as surgery or radiotherapy), in order to shrink the tumor through chemotherapy first, and then cure the tumor through treatment methods such as surgery or radiotherapy.

Endocrine therapy

It prevents the growth of cancer cells by removing or blocking the action of hormones. Compared with chemotherapy, endocrine therapy has the advantages of definite efficacy, low toxicity, ease of use, no need for hospitalization, and easy acceptance by patients. Although it takes a long time to take effect, it has a long remission period and is particularly suitable for breast cancer patients with positive hormone receptors (ER/PR) at all stages.

Prognosis of breast cancer

Prognosis of breast cancer

Disease Prognosis

The prognosis of breast cancer is closely related to the stage of disease development. The earlier the disease is discovered, the greater the chance of survival within 5 years.
According to statistics from the International Cancer Organization, the 5-year relative survival rate of breast cancer patients is 89.9%, of which the 5-year survival rate of carcinoma in situ is 98.8%, the 5-year survival rate of early invasive cancer is 85.5%, while the 5-year survival rate of invasive cancer with distant metastasis is only 27.4%.

Complications

- The most common complications after surgery include: Hemorrhage under the skin flap, skin edge necrosis, subcutaneous effusion, upper limb lymphedema, etc.

- Common complications of chemotherapy include: Gastrointestinal reactions (such as nausea, and vomiting), bone marrow suppression, cardiac toxicity, severe hair loss, oral mucosal bleeding, low immunity, etc.

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