[Fat Bear Science] @Women! Are women with large breasts more likely to get breast cancer? Can men get breast cancer? You must know these 7 questions

In recent years, the incidence of breast cancer has been increasing, threatening the majority of women. The 2018 Chongqing New Tumor Registration Report shows that the incidence of breast cancer ranks sixth among men and second among women, reaching 34.57/100,000. To this end, the Breast Cancer Center of the Affiliated Cancer Hospital of Chongqing University collected the 7 most frequently asked questions by outpatients and answered them.

This issue's experts

Zeng Xiaohua, doctor of medicine, postdoctoral fellow, chief physician, director of the Breast Tumor Center of the Affiliated Cancer Hospital of Chongqing University, has studied at the Louisa Church Hospital in Düsseldorf, the largest breast center in Germany.

He has been engaged in clinical work of breast surgery for more than 20 years and has accumulated rich clinical experience. He is particularly good at breast cancer surgery, such as modified radical mastectomy, breast-conserving radical mastectomy, axillary surgery (sentinel lymph node biopsy), and primary or secondary breast reconstruction after breast cancer surgery (latissimus dorsi, rectus abdominis, prosthesis reconstruction, etc.). He has profound attainments in early diagnosis of breast cancer, such as Mammotome minimally invasive excision surgery, localized biopsy of micro-lesions in breast cancer, personalized treatment of locally advanced breast cancer, multidisciplinary comprehensive treatment such as adjuvant chemotherapy, endocrine, biological targeted therapy, and rescue treatment of advanced breast cancer.

Clinic hours: Monday and Wednesday mornings, Thursday afternoons (special needs).

Won't.

The main reason for the difference in breast volume is fat, and the vast majority of breast cancers occur in the mammary duct system, and fat tissue will not become cancerous.

Therefore, there is no difference in the cancer rate between large and small breasts; however, if other high-risk factors are present, large and small breasts are likely to cause breast cancer. Women should never ignore breast examinations because they think their breasts are small, and should not avoid medical treatment. Insisting on breast examinations is the most reliable and good way.

Expert reminder:

The high-risk factors for breast cancer that really need to be paid attention to include:

① Early menstruation (before 12 years old) or late menopause (after 55 years old);

② The incidence of breast cancer is higher in women who have no children, have children late (first child after age 35), or do not breastfeed after giving birth;

③People with atypical hyperplasia of breast ducts and lobules also have an increased risk of breast cancer;

④ Women with a family history of breast cancer (first-degree relatives with breast cancer) have a 2-3 times higher risk of developing breast cancer than the general population;

⑤ Exposure to high levels of ionizing radiation, especially women whose breasts have been exposed to excessive radiation due to other diseases, increases the risk of breast cancer;

⑥In addition, a high-fat diet and long-term negative emotions will greatly increase the risk of breast cancer.

Breast cancer has a certain degree of familial inheritance, but it only accounts for 5% to 10% of the total number of breast cancer patients.

Cancer patients in the family have some common gene mutations and are prone to corresponding cancer. For example, patients with familial breast cancer may have breast cancer susceptibility genes BRCA1 or BRCA2, as well as rare familial genetic diseases such as Li-Fraumeni syndrome (P53 gene mutation), Cowden syndrome (PTEN gene mutation), etc.

Most breast cancers are not hereditary, accounting for more than 90% of the total number of breast cancers. Therefore, individuals without a family history may also suffer from breast cancer.

Experts remind: The genetic risk of breast cancer is far lower than everyone imagines. If a relative has breast cancer, your own risk may be slightly higher, but as long as you pay attention to regular check-ups and check more frequently than the general population, you do not necessarily have to develop breast cancer.

It basically will not turn into cancer, and the probability of cancer is very low.

Let's talk about lobular hyperplasia first. Doctors say that lobular hyperplasia is a benign epithelial proliferative lesion of the breast, which is common in premenopausal women. It often manifests as breast pain and nodular and lumpy thickening of local breast tissue. It is caused by imbalance of sex hormone levels and endocrine dysfunction in the body, which leads to structural changes in the breast lobules and milk ducts, and changes in breast tissue occur with the menstrual cycle.

Breast hyperplasia is a physiological process of breast epithelium, which generally does not turn into cancer. If the proliferating epithelial cells show abnormalities (atypical hyperplasia) and develop into moderate to severe atypical hyperplasia, it may turn into cancer, but the probability is very low. People with high risk factors for breast cancer should have regular checkups to detect malignant changes at an early stage.

Let's talk about breast fibroadenomas. Breast fibroadenomas are the most common benign breast tumors. They are often found accidentally or during physical examinations. They appear as painless masses, single or multiple, unilateral or bilateral, with clear boundaries. They generally grow slowly. A very small number of adolescent fibroadenomas can rapidly increase in size in a short period of time, with a diameter exceeding 8 to 10 cm, which is called a giant fibroadenoma. Fibroadenomas can only be removed surgically, and it is currently believed that fibroadenomas rarely become malignant.

Experts remind: Breast hyperplasia is common in most women, accounting for about 60% to 80%, while the incidence of breast cancer is much lower than this ratio, and the two are not an inevitable development process; most breast fibroadenomas do not need immediate surgical treatment, but can be followed up and observed regularly, and surgery can be considered when necessary. It is a benign tumor and generally will not recur after surgery.

Breast cancer patients do not have to stay away from beans.

Although the pathogenesis of breast cancer has been clearly shown to be related to estrogen, and estrogen in the human body acts on estrogen receptors to promote the proliferation of breast cells, thereby promoting the occurrence of breast cancer and endometrial cancer, such effects of phytoestrogens contained in beans are less than one thousandth of human estrogen.

Secondly, phytoestrogens will exhibit promoting or antagonistic effects depending on the level of estrogen in the body. When the estrogen level in the body is high, phytoestrogens can compete for the receptors that originally belong to human estrogen, thereby effectively weakening the target cells' response to estrogen and playing an anti-estrogen role; and when the estrogen level in the body is low, it will come on as a substitute and play a role in protecting the cardiovascular system and preventing osteoporosis.

Experts remind: moderate intake of soy products is beneficial to health and will not cause cancer. According to the "Dietary Guidelines for Chinese Residents", it is very safe for each person to consume 30-50 grams of soybeans or an equivalent amount of soy products per day. Eating beans will not only not increase the risk of breast cancer, but will protect the breast and help breast cancer patients recover. However, it is usually recommended not to eat animal estrogens, such as placenta, honey, snow clam, etc., because they are similar to animal estrogens in the human body, so you should control your diet.

It is certain that men can get breast cancer.

Because breast cancer is related to high estrogen levels in the body, men also have breast tissue, so they can also get breast cancer. However, the incidence rate in men is low and rare, accounting for 1% of all breast cancers, and only 0.5-1% in the western region, which means that 1 in 100 breast cancer patients has male breast cancer.

Male breast cancer has the following characteristics: older age of onset, higher malignancy, easy invasion of surrounding tissues and distant metastasis, and higher mortality rate. However, as long as it is discovered and treated early, the treatment effect is basically the same as that of women.

Experts remind: It is not surprising that men can also get breast cancer. If you find any abnormalities in the breast, you should seek medical attention in time. Don't be afraid or shy. Men have smaller breasts, so male breast cancer is easier to detect early.

In fact, cancer is not contagious, and breast cancer is not contagious at all.

Many family members of cancer patients often worry about being infected, and worry about contracting breast cancer after contact with breast cancer patients. Some family cancers have a strong clustering tendency, with multiple members suffering from cancer at the same time or one after another, as if suggesting that cancer is contagious. This is mainly related to family genetic factors and the fact that family members have more common carcinogenic factors, and is not caused by infection.

In addition, the occurrence and development of some cancers are indeed related to certain infectious diseases. It can be said that "some cancers are caused by infectious diseases", but this does not mean that cancer is contagious.

Experts remind: Breast cancer is not an infectious disease and you will not be infected by contact with breast cancer patients.

The answer is no.

First, early breast cancer often has no clinical symptoms or signs. 20% to 30% of latent breast cancer lesions are discovered through imaging tests such as mammography, ultrasound, and MRI, and cannot be found through clinical examinations.

If you find a breast lump, don't panic. You should go to the hospital for examination immediately to determine the type of lump, such as hyperplastic lump, inflammatory lump, tumor lump, etc. If it is a tumor, you should further determine whether it is benign or malignant.

Experts remind: Breast lumps are not necessarily breast cancer. If a breast lump is found, further examination is needed to clarify the nature of the lump. However, if there is no lump, women are also advised to do daily self-examination and regular check-ups. If any abnormality is found, please seek medical attention in time.

Text/Fat Bear Photos/Internet (Please contact us for deletion) Review/Zeng Xiaohua

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Science Popularization China Co-construction Base

Chongqing Science Popularization Base/Chongqing Health Promotion Hospital

Chongqing Municipal Science and Technology Commission Science and Technology Communication and Popularization Project

National Health Commission National Basic Public Health Service Health Literacy Project