Avoid or reduce exposure to relevant factors
as much as possible. Some factors cannot be avoided or reduced, such as family history and age. A woman’s risk of breast cancer doubles if her first-degree relatives, including mom, sister, and daughter, have breast cancer. This happens in up to 15% of breast cancer patients. Another breast cancer risk factor is age. Half of breast cancer patients are women over the age of 62. Although these two factors are terrible, many other risk factors for breast cancer have been well controlled or even eliminated. It can also prompt you to pay more attention and do a good job of early screening. Other factors can avoid or reduce exposure to a certain extent, such as reasonable diet, reducing fat intake, increasing the intake of crude fiber, carotene and vitamin C, proper exercise, weight control to avoid overweight and obesity, smoking cessation and alcohol restriction, full-term pregnancy and childbirth at the appropriate reproductive age, breastfeeding as far as possible, and reducing the frequency of unnecessary radiation exposure, etc. What you can do to reduce your risk of breast cancer: Even if you have a high risk of breast cancer, you can take steps to reduce your risk of breast cancer, including: limiting your alcohol consumption to one drink a day; not smoking; controlling your weight, because being overweight or obese increases your risk of breast cancer; being physically active; breastfeeding your child, and the longer you breastfeed, the more protective it is; Control the dose and duration of corticosteroid therapy, because hormone combination therapy for more than 5 years increases the risk of breast cancer; avoid radiation and environmental exposure, and perform medical imaging only when necessary. 2. Chemical prevention. Recent studies have shown that taking tamoxifen or exemestane can reduce the morbidity of high-risk groups of breast cancer, but only under the guidance of specialists, depending on the situation, can not buy drugs on their own. 3. Preventive mastectomy. Some women at high risk of breast cancer in areas with a high incidence of breast cancer choose to undergo prophylactic double mastectomy to avoid or reduce the risk of breast cancer. At present, women with obvious familial genetic tendency and BRCA1 and BRCA2 gene mutations found by genetic testing are mostly selected, but whether these high-risk groups of familial breast cancer must undergo mastectomy to prevent breast cancer? In my opinion, it depends on the specific situation, because this issue is still controversial, and most of the relevant research data and evidence come from European and American countries, while the research on Chinese population is still lacking. Personally, I don’t oppose or recommend it. Studies have found that about 1% of breast cancer has a family history and may have BRCA1/2 gene mutations. These women with BRCA1/2 gene mutations have a lifetime risk of breast cancer of about 80%. Preventive mastectomy can significantly reduce the incidence of breast cancer in these women, but it is only a probability, not an absolute possibility. Therefore, preventive mastectomy can be considered for these high-risk groups of familial breast cancer, but it is not necessary to do so. Preventive mastectomies can be total mastectomy, which removes the entire breast and nipple, or subcutaneous mastectomy, which preserves the nipple and areola and removes the breast. Personally, I suggest that mastectomy with nipple preservation and breast reconstruction with prosthesis implantation should be used to minimize physical and psychological trauma. However, it must be noted that the prevention of breast cancer can not be “everything”, whether to perform preventive mastectomy, depending on their wishes, psychological anxiety, etc., under the guidance of specialists, integrate the specific circumstances of all aspects, weigh the pros and cons, and make a prudent choice. To prevent breast cancer, it is more important to do a good job of regular examination. For people at high risk of breast cancer, it is recommended to screen according to the requirements of the breast cancer screening guidelines formulated by the Breast Cancer Professional Committee of the Chinese Anti-Cancer Association: (Definition of people at high risk of breast cancer: those with obvious genetic tendency to breast cancer; those with moderate to severe atypical hyperplasia of breast ducts or lobules or lobular carcinoma in situ; Lymphoma patients who have received chest radiotherapy in the past) are recommended to be screened in advance (before 40 years old), and the screening interval is recommended to be once every six months. In addition to clinical physical examination, B-mode ultrasound and mammography commonly used by the general population, MRI and other imaging methods can be used. The specific operation can be consulted in detail by an oncology specialist or a breast specialist. In addition, it must be known that preventive mastectomy can only remove most of the breast tissue, but there will still be a few residual tissues, which may still cause breast cancer, so before deciding to do preventive mastectomy, we must fully consider the pros and cons. The American Cancer Society recommends that “only very strong clinical and/or pathological indications should be used for this preventive surgery.” After careful consideration and thorough evaluation, preventive mastectomy in some cases is more beneficial than harmful for some women, or at least an option.
