Breast cancer has a relatively good prognosis. How can patients be treated to live longer and better?
According to the latest data from the National Cancer Center, there are about 304,000 new breast cancer patients every year, and its incidence ranks first in female malignant tumors, but its mortality ranks fifth in female malignant tumors, about 70,000 per year. Therefore, Breast cancer is not very bad, the treatment effect is better. The 5-year survival rate of breast cancer in our country is generally around 70%, and in some big cities it is close to 90%, which is not worse than that of developed countries in Europe and America, and many of them have been cured.
There are two points in order to obtain better treatment effect of breast cancer. One is early diagnosis and early treatment, which is the same for all cancers, and the other is standardized treatment, including surgical resection, radiotherapy and chemotherapy, endocrine therapy, and targeted therapy.
- Surgical excision
Surgery for breast cancer has a long history. It is said that records of "breast cancer" surgery were found in the Egyptian pyramids, but at that time, surgery should be as simple and rude as cutting "bad fruit"!
With the recognition of the existence of breast cancer invasion and lymph node metastasis, about 130 years ago, the operation no longer only removed the breast, but also removed the axillary lymph nodes, pectoralis major and pectoralis minor muscles together, which is called radical mastectomy. . This surgical method has been used in our country until the 1970s and 1980s.
The drawbacks of radical surgery are very obvious, which brings great inconvenience to the patient's life after recovery, especially the upper limb on the affected side, and even amputation. Later, people improved the surgical method to preserve muscle and limb function, and mastectomy + axillary lymph node dissection became the standard surgical method. Later, there were breast-conserving surgery, sentinel lymph node biopsy and axillary-preserving surgery.
- Radiotherapy and chemotherapy
When it comes to radiotherapy and chemotherapy, some people may "grit their teeth". Their toxic and side effects are indeed worrying and frightening, but if used properly, radiotherapy and chemotherapy will avoid or reduce the recurrence and metastasis of patients after surgery. This is the result of a large number of clinical studies. conclusions, not the opinions of someone or someone.
Radiation therapy is also a local treatment, mainly used for breast-conserving surgery and patients with positive axillary lymph nodes. Some genotypes of Luminal A and early breast cancer may be exempt from chemotherapy after surgery. In other cases, adjuvant chemotherapy should be considered, and sequential therapy with adjuvant chemotherapy and radiotherapy is recommended after surgery.
For triple-negative breast cancer, chemotherapy is still the main systemic treatment method, and endocrine therapy and Her-2 targeted therapy are not available.
- Endocrine therapy
Estrogen receptors, or/and progesterone receptors can be detected in breast tumor specimens, which means that estrogen and progesterone have a stimulating effect in the pathogenesis of breast cancer, and reducing the hormone content in the body will also reduce the risk of recurrence.
The main source of estrogen and progesterone is the ovary. Some people choose drugs to destroy ovarian function. This treatment method can also reverse the ovarian function. Some people are willing to remove both ovaries. The effect is of course better than drugs, but psychological preparation and courage are required.
There are many drugs for anti-estrogen therapy. The most commonly used "Xifene" is tens of yuan per month, and there are also several thousand or tens of thousands of drugs per month. The recommended use time is the same, 5-10 years.
- Targeted therapy
Breast cancer is genotyped by factors such as ER, PR, Her-2, and Ki-67. Her-2 positivity is an indicator of poor prognosis and an indicator of targeted therapy.
"Monoantibody" drugs combined with chemotherapy, the standard treatment for 1 year, the drug was also included in the medical insurance last year, if the economy allows, there is also a recommendation for "double-drug combination" targeted therapy.
In recent years, breast cancer immunotherapy has "suddenly emerged", and the effect is also good, but it is not widely used for the time being. There is also traditional Chinese medicine treatment, which needs to be used correctly, not including "home prescriptions and proven prescriptions to treat serious illnesses", not to mention "ancestral secret recipes".
To fight cancer scientifically, it is necessary to clarify the nature, genotype, and staging of breast cancer when discovering breast cancer, and select an appropriate treatment plan after a comprehensive evaluation, so as to obtain the maximum survival time and the best quality of life! I'm Dr. Liu Yongyi, thank you for reading!