At the beginning of 2021, WHO released the latest global cancer burden evidence in 2020. In 2020, 19.29 million new cancers were added worldwide, of which breast cancer increased by 2.26 million new , replacing the lung cancer that has always been ranked first in the past, and became the world's largest cancer and the most common cancer in the world.
Similarly, among all cancers in my country, the incidence rate of breast cancer is also ranked first and the mortality rate is fourth! According to statistics, one person is diagnosed with breast cancer every 76 seconds in in my country.
October of each year is "Breast Cancer Prevention and Treatment Month" , the purpose is to call on the public to pay attention to breast health. Today we will take a closer look at "breast cancer" -
The precursor of breast cancer
What everyone cares most about is whether they have breast cancer. People often start to worry when they feel a little pain in their breasts, or pinch a piece of hard skin, and feel anxious. So what are the symptoms of breast cancer? Let’s take a look from the beginning:
1. Nipple:
First look, the appearance of the nipple changes, such as invasiveness, redness of the skin around the nipple, eczema , and even desquamation and scabs;
pinch it again, and the nipple may have a discharge, spontaneous flow or can squeeze out liquid, which is mostly clear liquid, and is also bloody.
2. Skin:
Local skin depression, similar to dimples, called " dimples ";
Some people show that the skin changes the same as orange peel, called " orange peel sign ";
Some people have skin ulcers, forming ulcers .
3. Mass:
This is the most common and typical manifestation of breast cancer , and is often the first symptoms to be discovered. It should be noted that the lump we talk about is not felt when pinched or grabbed. Many people will feel that the breasts are hard when grabbed. It is not a lump, it is the breast gland... The real lump must be touched, it is just a normal touch!
Most of the tumors in cancer are single in , hard, irregular in shape, unclear edges, and difficult to push . Most of them are not accompanied by pain. A small number of people touch the tumors in the armpits and collarbone.
If you touch a lump, it is quite smooth, can move back and forth, and it is accompanied by pain, it is likely not cancer (of course there is also a problem, but the problem will not be too big).
4. Pain:
Some people may experience breast pain, such as pulling.
The most common manifestation of breast cancer is painless lumps or thickening. Once you find a different lump, regardless of whether you have any discomfort, you must seek medical treatment as soon as possible and do not delay. Breast mass surrounding the skin, forming multiple scattered nodules, which are often manifested in advanced breast cancer.
Who is prone to breast cancer?
The following is the latest expert consensus that mentions high-risk factors with clear evidence -
- Some benign breast diseases patients have a high risk of breast cancer;
- endometriosis increases the risk of breast cancer;
- high endogenous estrogen levels will increase the risk of breast cancer;
- specific menstrual fertility factors (late childbirth, unfertility, early menarche) is related to the incidence of breast cancer;
- family history of breast cancer is a risk factor for breast cancer;
- breast cancer susceptibility gene BRCA1/2 mutation is associated with breast cancer;
- Obesity is a risk factor for breast cancer: compared with normal weight women, obese women have a 20-40% increased risk of breast cancer. Studies have shown that for women who do not use hormone replacement therapy (HRT), the risk of breast cancer after menopause will increase by 11% for every 5 kg/m2 increase in BMI value of ;
- large amount of drinking is a risk factor for breast cancer;
- smoking is a risk factor for breast cancer;
- women exposed to therapeutic ionizing radiation have an increased risk of breast cancer.
In addition, as breast , both men and women, men also have a risk of breast cancer, but male breast cancer accounts for only 0.5-1%. However, due to factors such as men themselves do not pay much attention to it and different breast structure, most men find that breast cancer is advanced and may have a higher risk, so they should also pay attention.
How to reduce the risk of disease?
There are risk factors, and correspondingly there are protective factors. There are two protective factors that currently have clear evidence for breast cancer:
- Breastfeeding
- Appropriate physical exercise
In addition, for risk factors, try to avoid smoking and alcoholism, stay away from radiation, lose weight, avoid unnecessary intake of exogenous estrogen, maintain a good mood, etc. are all methods to reduce the incidence of breast cancer.
Focus on one key point:
Don’t smoke or drink heavily!
Weight loss, weight loss, weight loss!
Sports, exercises, exercises!
How to prevent breast cancer
Regular screening, is the best way to prevent it.
According to the tumor registration data of the National Cancer Center in my country, in 2015, the incidence of breast cancer in women at the age of 45 in my country showed an upward trend and remained at a relatively high level, earlier than the age of high incidence of breast cancer in Western women. Therefore, according to the latest breast cancer guidelines in my country, the recommendations are:
1. Screening age and frequency for people with high risk of breast cancer
- , it is recommended to start breast cancer screening at the age of 40, and screening once a year;
- general risk groups, screening from the age of 45, and once every 1-2 years.
2. Screening method:
- High-risk population: breast ultrasound combined with breast X-ray examination;
- General risk population: breast ultrasound can be used alone. If it is dense breast, it is recommended to breast X-ray combined with breast ultrasound .
Image source: Tencent Medical Dictionary
PS: Breast magnetic examination is not a routine screening method, but for BRCA1/2 gene mutation carriers, breast magnetic screening can be considered, but it is not recommended as the preferred method for screening.
or above recommended age is comprehensively considered by comprehensively considering the incidence of patients in my country and health economics and other reasons. If conditions permit, screening can actually be carried out earlier. The following figure shows the incidence of breast cancer in 2015. You may also suffer from breast cancer at the age of 20.
tips:
Dense breast: Breast X-ray can be found, a normal type of breast.
What is a high-risk group?
meets any of the following A, B, and C conditions, which are high-risk groups:
A has a family history of genetics, that is, any of the following:
(1) First-degree relatives have a history of breast cancer or ovarian cancer;
(2) Second-degree relatives have 2 or more breast cancer before the age of 50;
(3) Second-degree relatives have 2 or more ovarian cancer before the age of 50;
(4) At least one first-degree relative carries a known pathogenic genetic mutation of BRCA1/2 gene; or carries a pathogenic genetic mutation of BRCA1/2 gene.
B has any of the following:
(1) Menopause age ≤12 years;
(2) Menopause age ≥55 years;
(3) A history of breast biopsy or surgery for benign breast diseases, or a history of atypical hyperplasia of breast (lobular or catheter) with pathological confirmation;
(4) Hormone replacement treatment with "estroprogesterone combined" is not only half a year;
(5) After the age of 45, the breast parenchymal type (or breast density) is uneven or dense.
C has any two of the following:
(1) No lactation history or lactation time is <4>
(2) No live birth history (including never giving birth, miscarriage, stillbirth) or the first live birth age is ≥30 years;
(3) Only use hormone replacement treatment with "estrogen" for no less than half a year;
(4) Abortion (including spontaneous abortion and artificial abortion) ≥2 times.
Note: First-degree relatives refer to mothers, daughters and sisters; second-degree relatives refer to aunts, aunts, grandmothers and grandmothers.
Finally, I would like to emphasize that if you find breast nodules in the screening, don’t worry too much. Most breast nodules are benign. If ultrasound grades of breast nodules:
1 and 2 levels, there is no need to worry, and it does not need to be processed;
3 levels, regular review is enough;
4 levels or above needs further examination;
5 levels or above needs further treatment biopsy , and you must actively cooperate with the treatment.
Although this is a malignant tumor, the cure rate will not be mentioned, the survival rate of early breast cancer is generally high. However, you must pay attention to regular re-examinations afterwards, because the recurrence rate of breast cancer is also relatively high. Fortunately, after , early breast cancer , after regular treatment, the survival rate of 20 years is more than 55%.
Breast cancer -year survival rate is above 90% , and the cure rate of early breast cancer in is as high as more than 95% , so must be detected and treated early!
references
[1] He Jie et al. Expert group for formulating guidelines for breast cancer screening and early diagnosis and treatment for women in China. Guidelines for breast cancer screening and early diagnosis and treatment for women in China (2021, Beijing) [J]. Chinese Tumor, 2021, 30(3):161-191
[2] Shao Zhimin, Shen Zhenzhou, Xu Binghe. Breast Oncology. Fudan University Press, 2013.
