Breast cancer, also known as breast cancer, is one of the most common malignant tumors in women, which originates from the uncontrolled proliferation of breast epithelial cells. The following is a detailed introduction to breast cancer: 1. Etiology The morbidity of breast cancer may be related to a variety of factors, including: 1. Family heredity: Breast cancer has a certain degree of heredity, if there is a history of breast cancer, ovarian cancer, prostate cancer and other diseases in the family, it may increase the probability of breast cancer. 2. Bad lifestyle: such as high fat, high calorie diet, lack of exercise, excessive drinking, smoking, etc. These bad lifestyles may lead to abnormal breast tissue, thereby increasing the probability of morbidity of breast cancer. 3. Abnormal hormone levels: high or unbalanced levels of estrogen and progesterone in the body may increase the risk of morbidity of breast cancer. For example, factors such as early menarche, late menopause, infertility and radiation exposure to the chest in childhood may affect hormone levels. 4. Environmental factors: Some environmental factors, such as ionizing radiation and chemical exposure, may also increase the morbidity risk of breast cancer. 5. Breast diseases: Some benign breast diseases, such as breast cystic hyperplasia and breast fibroadenoma, may become cancerous if they are not actively treated by doctors. 2. Symptoms The symptoms of breast cancer vary from person to person, but the common symptoms include: 1. Breast mass: It is the most common symptom of breast cancer. The mass is often located in the upper outer quadrant, single, painless, with unclear boundary, hard touch and poor activity. 2. Nipple discharge: Nipple discharge may occur in some patients. The discharge is often single-tube, and its characteristics can be varied, such as bloody, serous, watery or colorless. 3. Nipple changes: Nipple may appear ulceration or retraction, especially in breast Paget’s disease, often accompanied by itching, some patients may be accompanied by areola or other parts of the breast mass. 4. Skin changes * *: including skin adhesion, skin edema, superficial varicose veins, etc. When the tumor invades the Cooper ligament, it can contract and shorten, and pull the skin to form a depression, like a dimple, so it is called dimple sign. Skin edema is caused by the blockage of subcutaneous lymphatic vessels in the breast by tumor cells. 5. Lymph node enlargement: Breast cancer develops gradually, can invade lymphatic vessels and metastasize to local lymphatic drainage areas. The most common site of lymphatic metastasis is the ipsilateral axillary lymph node. 3. Treatment options for breast cancer are usually selected according to the specific conditions of patients and the characteristics of cancer, mainly including: 1. Surgery: one of the basic treatments for breast cancer, including breast-conserving surgery and mastectomy. Breast conserving surgery removes tumor tissue on the basis of preserving the breast as much as possible, while mastectomy removes the whole breast tissue directly. 2. Radiotherapy: The breast area is irradiated with high-energy rays to kill residual cancer cells and reduce the risk of recurrence. 3. Chemotherapy: mainly through chemotherapy drugs to kill cancer cells and reduce their spread and metastasis. Breast cancer chemotherapy mainly uses single drug or combination chemotherapy. 4. Targeted therapy: Precise treatment for specific molecular mechanisms of cancer cells can improve the therapeutic effect by inhibiting the growth and metastasis of cancer cells. Breast cancer can be prevented from the following aspects: 1. Establish a good lifestyle: regular life and rest, avoid staying up late, maintain a pleasant mood, reduce psychological tension factors, and insist on physical exercise. It is forbidden to drink too much alcohol for a long time and keep away from radioactive substances on a daily basis. 2. Regular breast examination: It is recommended that adult women have regular breast self-examination. If nodules or lumps are found, they need to go to the breast specialist hospital for further examination. It is generally recommended that women over 40 years of age have one molybdenum target examination and one or two ultrasound examinations every year. 3. Develop good eating habits: insisting on breastfeeding is conducive to reducing the probability of breast cancer. Eat as little fat or animal protein as possible to avoid obesity. We should try to reduce the intake of sweets, meat, fried eggs, or pickled, smoked and fried foods, and eat more vegetables, fruits, olive oil, fish and soybean products. Do not use exogenous estrogen indiscriminately. 4. Preventive treatment: For women at high risk of breast cancer, such as those with family history of breast cancer or breast cancer gene mutations, the frequency of physical examination should be increased. In addition, preventive treatment can be considered, such as the use of estrogen receptor modulators, aromatase inhibitors and other drugs, as well as surgical resection. In a word, breast cancer is a malignant tumor that needs to be highly valued. By understanding its causes, symptoms, treatment and prevention, we can better protect our health. If you have any symptoms of suspected breast cancer, you should seek immediate medical attention and receive diagnosis and treatment from a professional doctor.
How to choose the treatment of
breast cancer? Breast cancer is one of the most common malignant tumors in women worldwide, with high incidence and relatively long survival time. Because of the complexity of molecular typing, the choice of treatment for breast cancer is particularly critical. This article will discuss the treatment options of breast cancer in depth, including the treatment strategies of different molecular subtypes, the treatment progress at home and abroad, and the application of innovative drugs.
1. Molecular typing and treatment strategies of breast cancer Molecular typing of breast cancer is an important basis for the formulation of treatment plans. According to the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2) and proliferation cell nuclear antigen Ki-67 detected by immunohistochemistry, breast cancer is mainly divided into the following molecular types:
1.1 HER-2 negative, HR (hormone receptor) positive This type of breast cancer relies heavily on the hormone receptor (HR) signaling pathway for growth and proliferation, and treatment options typically include endocrine therapy and chemotherapy. Endocrine therapy includes anti-estrogen drugs (such as tamoxifen) and aromatase inhibitors (such as letrozole), which inhibit the growth of tumor cells by blocking the binding of estrogen to the receptor or inhibiting the synthesis of estrogen.
1.2 HER-2 positive HER-2 positive breast cancer cells have a large number of HER-2 receptors on their surface, and this overexpression leads to rapid proliferation and invasiveness of tumor cells. For this type of breast cancer, treatment options often include HER-2 targeted drugs (e.g., trastuzumab, pertuzumab) in combination with chemotherapy. These targeted drugs inhibit the growth and division of tumor cells by binding to HER-2 receptors, thus prolonging the survival of patients.
1.3 Triple-negative breast cancer Triple-negative breast cancer refers to breast cancer that is negative for ER, PR, and HER-2 and lacks the three therapeutic targets mentioned above, so treatment options are relatively limited. At present, chemotherapy is the main treatment for triple-negative breast cancer, including neoadjuvant chemotherapy, adjuvant chemotherapy and palliative chemotherapy. In addition, with the progress of immunotherapy, some PD-1/PD-L1 inhibitors are undergoing clinical trials in triple-negative breast cancer, which is expected to lead to new treatment options for such patients.
II. Progress
of Breast Cancer Treatment at Home and Abroad 2.1 Progress
of HER-2 targeted drugs Since Herceptin (trastuzumab) was developed and marketed by Genentech in 1998, HER-2 targeted drugs have achieved remarkable results in the treatment of breast cancer. The invention of trastuzumab has brought good news to HER-2 positive patients, and is currently recommended by NCCN (National Comprehensive Cancer Network) as neoadjuvant therapy, adjuvant therapy and advanced first-and second-line drugs. However, domestic breast cancer HER2 targeted drugs are 3-5 years behind the United States, which to some extent limits the treatment options of domestic patients. In recent years, domestic enterprises have made remarkable progress in the research and development of HER-2 targeted drugs. Pirotinib, independently developed by Hengrui Pharmaceutical, is the light of China for HER2 targeted drugs, which shows good efficacy and safety in the treatment of HER-2 positive breast cancer. In the future, pyrrotinib is expected to become an important choice for the treatment of HER-2 positive breast cancer in China, and promote the level of breast cancer treatment in China.
2.2 Progress in the treatment of
HR + breast cancer The treatment of HR + breast cancer mainly depends on endocrine therapy and chemotherapy. However, with the in-depth study of tumor biological mechanisms, more and more innovative drugs have been developed to improve the prognosis of HR + breast cancer patients. PI3K/AKT/mTOR is one of the important signaling pathways in HR + breast cancer, and inhibitors targeting this pathway are showing good efficacy in clinical studies. For example, Everolimus, as an mTOR inhibitor, has achieved some success in the adjuvant treatment of HR + breast cancer.
2.3 Progress
of immunotherapy The study of immunotherapy in breast cancer has attracted increasing attention. At present, only Roche’s Tecentriq has been approved for breast cancer indications, and it has been approved for the first-line treatment of PD-L1-positive patients with triple-negative breast cancer in combination with albumin-bound paclitaxel. Although the efficacy of immunotherapy in breast cancer still needs to be further verified, it provides a new treatment option for breast cancer patients, especially in the refractory disease of triple-negative breast cancer.
3. The selection of breast cancer treatment should follow the principles of individualization, integration and precision. The principle of individualization emphasizes the individualized treatment plan according to the patient’s age, physical condition, tumor stage and molecular typing, while the principle of integration emphasizes multidisciplinary collaboration, combining surgery, radiotherapy, chemotherapy, endocrine therapy and immunotherapy to improve the therapeutic effect and the quality of life of patients; The principle of precision emphasizes the precise classification of patients and the selection of treatment options based on advanced technologies such as gene detection and biomarker detection.
3.1 Treatment options for
early breast cancer For patients with early breast cancer, surgery is the treatment of choice. Depending on the size, location, and stage of the tumor, breast-conserving surgery or total mastectomy may be chosen. After operation, according to the molecular classification and pathological results of patients, appropriate adjuvant therapies were selected, such as chemotherapy, radiotherapy, endocrine therapy and targeted therapy. For HER-2 positive patients, targeted drugs such as trastuzumab can be used as adjuvant therapy to reduce the risk of recurrence and metastasis.
3.2 Treatment options for
advanced breast cancer For patients with advanced breast cancer, the main goals of treatment are to relieve symptoms, prolong survival and improve quality of life. The choice of treatment should be based on the patient’s molecular classification, tumor burden, previous treatment history and physical condition. Endocrine therapy is one of the main treatments for patients with HR + advanced breast cancer. For patients with HER-2 positive advanced breast cancer, targeted drugs such as trastuzumab and pertuzumab can be used as first-line or second-line treatment to significantly improve the prognosis of patients. For patients with triple-negative breast cancer, immunotherapy combined with chemotherapy may become the future treatment trend.
3.3 Selection
of neoadjuvant therapy Neoadjuvant therapy refers to the adjuvant therapy given to patients before surgery to reduce the size of the tumor and reduce the stage, thereby improving the success rate of surgery and the prognosis of patients. Targeted drugs such as trastuzumab can be used as neoadjuvant therapy for patients with HER-2 positive breast cancer. Endocrine therapy can also be used as a neoadjuvant therapy option for patients with HR + breast cancer. The choice of neoadjuvant therapy should be based on the patient’s specific situation and the doctor’s advice.
IV. Specific implementation
of breast cancer treatment plan 4.1
Surgical treatment Surgical treatment is one of the main treatments for breast cancer. According to the specific situation of patients, breast-conserving surgery or total mastectomy can be chosen. Breast-conserving surgery is suitable for patients with small and shallow tumors and patients who want to preserve their breasts. Total mastectomy is indicated for patients with large tumors, deep tumors, or patients who do not wish to preserve the breast. After surgery, appropriate adjuvant therapy should be selected according to the pathological results and molecular typing of patients.
4.2 Chemotherapy Chemotherapy is one of the commonly used adjuvant therapies for breast cancer. For patients with early breast cancer, chemotherapy can reduce the risk of recurrence and metastasis; for patients with advanced breast cancer, chemotherapy can relieve symptoms and prolong survival. The selection of chemotherapy drugs should be based on the molecular classification, tumor stage and physical condition of patients. Commonly used chemotherapy drugs include paclitaxel, doxorubicin, cyclophosphamide and so on.
4.3 Radiotherapy Radiotherapy is one of the commonly used local treatments for breast cancer. For patients after breast-conserving surgery, radiotherapy can reduce the risk of local recurrence; for patients with advanced breast cancer, radiotherapy can relieve pain and shrink the tumor. The dose and frequency of radiotherapy should be based on the patient’s specific condition and the doctor’s advice.
4.4 Endocrine therapy Endocrine therapy is one of the main treatments for HR + breast cancer. The growth and proliferation of tumor cells can be inhibited by inhibiting the synthesis of estrogen or blocking the binding of estrogen to receptors. Commonly used endocrine therapy drugs include tamoxifen, letrozole, exemestane and so on. The choice of endocrine therapy should be based on the patient’s specific situation and the doctor’s advice.
4.5 Targeted therapy Targeted therapy is a method of treating specific molecular markers of tumor cells. Targeted drugs such as trastuzumab and pertuzumab can be used as first-line or second-line therapies for patients with HER-2 positive breast cancer. These targeted drugs inhibit the growth and proliferation of tumor cells by binding to HER-2 receptors, thus significantly improving the prognosis of patients.
4.6 Immunotherapy Immunotherapy is a new treatment method that has attracted much attention in the treatment of breast cancer in recent years. By activating the patient’s own immune system, it can recognize and attack tumor cells, so as to achieve the purpose of treatment. At present, immunotherapy drugs approved for breast cancer indications are limited, but immunotherapy combined with chemotherapy or targeted therapy may become the future trend of treatment.
5. Evaluation and adjustment of the efficacy of breast cancer treatment programs The evaluation of the efficacy of breast cancer treatment programs is an important basis for judging the therapeutic effect and adjusting the treatment programs. Curative effect can be evaluated by imaging examination, pathological examination and biochemical detection. Commonly used imaging examination methods include ultrasound, CT, MRI, etc.; pathological examination methods include tissue biopsy, cytological examination, etc.; biochemical indicators include tumor markers. According to the results of efficacy evaluation, the treatment plan can be adjusted. For patients with good treatment effect, the original treatment plan can be maintained; for patients with poor treatment effect, the treatment plan should be adjusted according to the specific situation, such as changing chemotherapy drugs, increasing radiotherapy dose or switching to other treatment methods.
6. Conclusions and prospects Breast cancer is a highly heterogeneous disease, and the choice of treatment should be individualized, comprehensive and precise according to the specific conditions of patients. With the continuous progress of medical technology and the emergence of innovative drugs, the treatment effect of breast cancer will be better and better, and the survival time and quality of life of patients will be significantly improved. In the future, the development direction of breast cancer treatment will be more precise and personalized treatment. Through advanced technologies such as gene detection and biomarker detection, patients can be more accurately classified and treated. At the same time, with the continuous development and improvement of new treatment methods such as immunotherapy, cell therapy and gene therapy, more treatment options and better therapeutic effect will be provided for breast cancer patients. In conclusion, the treatment of breast cancer is a complex and long-term process, which requires multidisciplinary collaboration and individualized treatment. Through continuous research and innovation, we believe that we can provide more accurate, effective and humane treatment services for breast cancer patients in the future.
Breast cancer
