4 frequently asked questions about breast cancer. The answers may be different from what you think | Breast Cancer Prevention Month

In the golden month of October, you may see pink ribbon-shaped publicity or activities in many countries around the world. The "pink ribbon" is a recognized symbol of global breast cancer prevention activities, used to promote the message of "early prevention, early detection, and early treatment." Governments of various countries have designated October of each year as "Breast Cancer Prevention Month."

Breast cancer is often called the "pink killer" and its incidence rate ranks first among female malignant tumors. Men can also get breast cancer, but it is less common. The following questions are 4 frequently asked questions about breast cancer on the Internet.

I have a close relative who has breast cancer.

How dangerous am I?

This question is actually asking whether breast cancer is a hereditary disease. Speaking of this, we have to mention Angelina Jolie, a famous Hollywood actress. Her mother suffered from breast cancer for many years and was in great pain. After genetic testing, she found that she also carried the same carcinogenic gene, and her risk of breast cancer was much higher than that of ordinary people. In May 2013, she announced that she had preventively removed both breasts to reduce the risk of breast cancer.

Breast cancer is indeed a very typical type of tumor in which genetic factors play an important role. The two genes related to hereditary breast cancer are mainly BRCA1 and BRCA2. Compared with the general population, carriers of BRCA1/BRCA2 mutations have a 10-20 times higher risk of developing breast cancer and ovarian cancer. Not only that, carrying this gene will also increase the risk of ovarian cancer, pancreatic cancer, male breast cancer, prostate cancer, etc.

The proportion of breast cancer patients in the Chinese population carrying BRCA1/BRCA2 mutations is 3.9%, while the mutation rate in people with a family history can reach 16.9%. For people with a family history and under 50 years old, this proportion is as high as 20%.

If you test positive, it means that the probability of having breast cancer is about 80%. But don't be too nervous. If your test result is positive, you should be glad that you at least have enough time to prevent, screen in advance, and treat early, so that you have a chance of cure.

Oh my god, cancer!

Can't I die of old age?

This requires an answer to the question of the cure rate of breast cancer. With the development of medical technology, breast cancer has become one of the most effective solid tumors. Especially for early breast cancer, the 5-year survival rate can reach more than 90%.

The medical community in my country has used comprehensive treatment methods for breast cancer (including surgery, chemotherapy, radiotherapy, endocrine therapy and targeted therapy), and has brought the five-year cure rate for breast cancer to a level close to that of Western countries.

Breast cancer is a systemic disease. The treatment effect is closely related to factors such as pathological stage and whether the treatment is standardized. Therefore, patients should pay attention to the full treatment and management model consisting of surgery, chemotherapy, radiotherapy, endocrine therapy, targeted therapy, etc. In addition, only early detection, early diagnosis, and early treatment can reduce the mortality rate of breast cancer. You should know that the cure rate of advanced breast cancer is significantly reduced.

Can surgery definitely preserve breasts?

Whether or not you can preserve your breasts depends on the conditions.

With the change of treatment concepts, especially the change of patients' concepts, coupled with the continuous progress of systemic treatment, including endocrine and targeted therapy, the treatment concept of breast cancer has also changed from the maximum tolerable treatment to the effective treatment with the least damage, which is reflected in the continuous improvement of breast conservation rate in breast cancer surgery. Whether breast conservation is possible should consider the following conditions:

First of all, it is a single lesion, not multiple lesions.

Secondly, the tumor should not be located in the central area of ​​the nipple or areola, and its size should be less than 3 cm.

Furthermore, the ratio between the tumor and the breast should be considered. The smaller the proportion of the tumor to the breast, the higher the probability of successful breast conservation.

Another question is whether the patient is suitable for radiotherapy after breast-conserving surgery, because radiotherapy after breast-conserving surgery is particularly important for reducing local recurrence. Radiotherapy after surgery can greatly reduce the risk of local recurrence. For patients who are not suitable for local radiotherapy, doctors do not recommend breast-conserving surgery.

Of course, the patient's wishes are the most important. The patient's understanding of breast-conserving surgery and the requirements for his or her own body appearance will affect the patient's decision.

If the condition is not suitable for breast conservation, it is recommended to consider breast reconstruction surgery (also called reconstructive surgery) to change the appearance of the breast. The surgery is divided into primary reconstruction and secondary reconstruction. Primary reconstruction is also called immediate reconstruction, which refers to reconstruction immediately after mastectomy. Secondary reconstruction is performed when the condition is relatively stable, 1 to 2 years after surgery. The main methods of reconstruction are autologous latissimus dorsi reconstruction and prosthetic reconstruction. Currently, prosthetic reconstruction is more commonly used. The attending physician and the patient need to communicate and choose which reconstruction method is suitable.

Is the recurrence rate of breast cancer high?

There are several factors that contribute to breast cancer recurrence.

First of all, the recurrence of breast cancer depends on the degree of malignancy of breast cancer. The prognosis of hormone receptor-positive, HER-2-negative Luminal A breast cancer is relatively good, but some breast cancers are highly malignant, with high rates of local recurrence and distant metastasis, such as triple-negative breast cancer.

Secondly, if the patient's breast cancer is already in the locally advanced stage when it is discovered, it is also prone to recurrence.

Another situation is that the treatment is not standardized. This is an important reason for breast cancer recurrence. Many patients blindly choose treatment plans when they are diagnosed in the early stage, and do not receive standardized comprehensive treatment. They lack postoperative auxiliary treatment, such as radiotherapy, chemotherapy, endocrine therapy, targeted therapy, etc. This will leave a great possibility for tumor recurrence.

The patient's own reasons can also affect the condition. If the patient's mental state is good, he can face the disease positively, maintain a good mental state and lifestyle, the recurrence rate will be greatly reduced.

Finally, being too young is also an unfavorable factor affecting the prognosis of breast cancer. Generally speaking, if the disease occurs before the age of 40, the risk of recurrence is higher than that after the age of 40.