case replay
33-year-old Ms. Zhang just gave birth to a third baby not long ago and has been insisting on breastfeeding. However, she has always breastfeeded on her left breast, and her right breast has never breastfeeded. Therefore, when feeding, her right breast often swells very much, and she can vaguely touch a small lump. Because it doesn’t hurt or itchy, she thought it was just a small matter like “bacterial milk block”.
After the breastfeeding period, Ms. Zhang participated in the unit physical examination and found a lump in her right breast. She suspected that it was breast hyperplasia , and she was advised to undergo breast conditioning. With the recommendation of relatives and friends, she spent a lot of money to massage and "maintenance" at the so-called breast maintenance agency, and took the folk remedy for breast circulation. As a result, after three months of tossing, the lump on her right breast became bigger and bigger, and then she came to the breast center of Shunyi Women and Children's Hospital of Beijing Children's Hospital for treatment. After receiving a careful inquiry from the doctor, she suggested that she have an breast ultrasound examination for . It was found that not only is the breast lump huge, but also the lymph node also had suspicious metastasis. After puncture pathology, it was further confirmed that breast cancer was associated with axillary lymph node metastasis.
Experts remind that breast cancer during breastfeeding is pregnancy-related breast cancer, that is, breast cancer diagnosed during pregnancy and postpartum breast cancer diagnosed within one year after delivery. is one of the most common malignant tumors in women during pregnancy and breastfeeding . The disease occurs around 25,000 new cases worldwide every year, and almost one case occurs every 3,000 to 10,000 pregnant women, accounting for about 0.2% to 3.8% of all breast cancer patients and 2.6% to 7.0% of female breast cancer patients under 45 years old.
Dr. Fu Hui, a Breast Center of Shunyi Women and Children's Hospital in Beijing Children's Hospital, said that there are many causes of pregnancy breast cancer . Breast cancer is a hormone-dependent tumor. When women are in pregnancy and lactation, estrogen and progesterone in the body are at a higher level. Therefore, may cause the tumor to grow rapidly. In addition, more and more women are late marriage, late childbirth or having multiple births. Life and work pressure, negative emotions that cannot be released for a long time are all risk factors for breast cancer. Therefore, breast cancer during pregnancy and breastfeeding is not uncommon in clinical practice.
lactation breast cancer has three major characteristics:
First, due to changes in hormone levels in the body, the increase in the levels of prolactin and growth hormone during the lactation period, and the decrease in the number of T cells in the blood, the body's immune function is reduced, which can lead to the accelerated growth rate oftumor and the increase in malignancy of .
Second, during pregnancy and lactation, the tumor is prone to spreading and congestion due to the increase of capillaries in the breast and dilated.
Third, at this time, due to the substantial increase in breast of and the hyperplasia of glands, the breast physiologically enlarges and swells, making the tumor difficult to be discovered early in .
The clinical manifestations of breast cancer during breastfeeding are similar to those of general breast cancer. They are mainly painless lumps with progressive enlargement, often accompanied by swelling of the axillary lymph nodes, and may also show nipple discharge. Bloody and serous discharges are more common, and there will also be symptoms such as nipple invasion, local inflammation, and skin rupture.
It should be emphasized that should pay attention to the difference between breast cancer during lactation and mastitis . The main clinical manifestations of breast mastitis include redness, swelling, heat, and pain in the breast, and the formation of local lumps and abscesses, which may be accompanied by enlarged axils, increased body temperature, and increased white blood cell count. The treatment effect of anti-inflammatory is obvious. Sometimes, these two diseases occur at the same time, manifested as long-term anti-inflammatory treatment ineffective, the lump gradually increases and the texture is hard. At this time, in order to prevent the spread of tumor cells, remember not to use physical therapy, microwave and other physical treatment methods at will, and do not apply Chinese medicine externally or use folk remedies. You should go to the hospital's breast specialist for treatment in time to avoid delaying the best treatment opportunity.
Fu Hui particularly emphasized that breastfeeding is not the "gold medal for avoiding death" for breast cancer, and Early diagnosis and treatment of breast cancer during breastfeeding is extremely important. Like Ms. Zhang, she felt a lump in her breasts as early as during breastfeeding, but ignored this "precursor signal".
Fu Hui said that women should never ignore the health of their breasts at any time, and should raise awareness of prevention. , even during pregnancy and breastfeeding, should not neglect to check , and do not blindly believe that breastfeeding will not suffer from breast cancer.
She suggested that women should conduct a comprehensive breast examination as soon as possible before planning to get pregnant. Especially pregnant women over 35 years old, women with a family history of breast cancer or with underlying breast lesions, breast cancer screening should be performed before pregnancy, during pregnancy and breastfeeding.
Many women are worried that imaging examinations will have a bad impact on infants' milk feeding. In fact, this kind of worry is unnecessary.
Experts point out that is safe for breast ultrasound or mammary X-ray examination, is safe for breastfeeding mothers. Generally speaking, for breastfeeding mothers, doctors prefer breast ultrasound examinations, because breast ultrasound examinations are radiation-free and have strong repeatability, and are targeted at the dense breasts of young mothers, which show that the lesions are more sensitive. The radiation dose of mammary X-ray examination is about 0.004Gy, which is far lower than the 0.1Gy teratogenic radiation exposure threshold even for pregnant mothers. Therefore, pregnant women can undergo mammary X-ray examination if necessary.
Experts point out that if breast cancer is diagnosed, there is no need to panic too much, and its treatment principles are the same as those of breast cancer during non-pregnant breast cancer. The medical team will formulate personalized treatment strategies for patients, use new auxiliary treatment plans, and prevent and treat possible adverse reactions in patients. Coupled with careful care and close follow-up, the patient's adverse reactions can be minimized. As long as you receive standardized treatment on time, there will be no significant difference in the prognosis of breast cancer during breastfeeding and common breast cancer.
Source: China Population News
