Breast cancer is one of the most common malignant tumors in women worldwide, accounting for a significant proportion of female malignant tumors. It originates from the epithelial cells of the breast gland, and its occurrence and development are closely related to multiple factors, including genetic factors, hormonal changes (such as early menarche, late menopause, and unmarried and childless), lifestyle factors (such as high-fat diet, lack of exercise, and long-term mental stress), and environmental factors. In recent years, the incidence of breast cancer has been increasing year by year, but with the advancement of medical technology and the popularization of early screening, the prognosis of breast cancer patients has been significantly improved. Early detection, early diagnosis, and early treatment are the key to improving the survival rate of breast cancer patients.
The treatment of breast cancer is a comprehensive treatment model based on surgery, combined with chemotherapy, radiotherapy, endocrine therapy, targeted therapy, immunotherapy and other methods. The specific treatment plan needs to be formulated according to the patient's age, tumor stage, pathological type, molecular typing, and physical condition. There is no uniform treatment standard, and individualized treatment is the core principle to ensure the curative effect and improve the quality of life of patients.
Surgical Treatment for Breast Cancer
Surgical treatment is the primary treatment method for early and mid-stage breast cancer, and its main purpose is to remove the primary tumor and regional lymph nodes to achieve the effect of radical cure. Common surgical methods include breast-conserving surgery and mastectomy.
Breast-conserving surgery is suitable for early breast cancer patients with small tumor size (usually less than 3cm), single tumor, and no extensive spread. The operation only removes the tumor tissue and a small amount of surrounding normal breast tissue, while retaining most of the breast, which can maintain the appearance of the breast and improve the quality of life of patients. After breast-conserving surgery, radiotherapy is usually required to eliminate residual tumor cells and reduce the recurrence rate. Dr. Robert Anderson, a breast cancer surgical expert, points out that breast-conserving surgery combined with radiotherapy has the same curative effect as mastectomy for early breast cancer, but it can better meet the aesthetic needs of patients.
Mastectomy is suitable for patients with large tumor size, multiple tumors, extensive infiltration of the tumor into surrounding tissues, or patients who are not suitable for breast-conserving surgery. The operation removes the entire breast, including the tumor tissue, breast gland, and skin, and may also need to dissect the axillary lymph nodes to determine whether the cancer has metastasized. For patients who need mastectomy, breast reconstruction surgery can be performed at the same time or after the operation to restore the appearance of the breast and reduce the psychological impact on the patient.
Chemotherapy for Breast Cancer
Chemotherapy is a systemic treatment method that uses cytotoxic drugs to kill cancer cells or inhibit their proliferation. It is widely used in the treatment of breast cancer, including neoadjuvant chemotherapy, adjuvant chemotherapy, and palliative chemotherapy.
Neoadjuvant chemotherapy is given before surgery, which can reduce the size of the tumor, make the inoperable tumor operable, and increase the chance of breast-conserving surgery. Adjuvant chemotherapy is given after surgery, which is used to eliminate the potential residual cancer cells in the body and reduce the risk of recurrence and metastasis. It is suitable for patients with intermediate and advanced breast cancer or patients with high-risk factors after surgery. Palliative chemotherapy is mainly used for advanced breast cancer patients with distant metastasis, whose purpose is to relieve symptoms, control the progression of the disease, and prolong the survival time of patients.
Chemotherapy drugs may cause certain side effects, such as hair loss, nausea, vomiting, fatigue, myelosuppression, etc. These side effects are usually temporary and can be relieved after the end of chemotherapy. Dr. Sarah Lewis, a medical oncologist specializing in breast cancer, reminds that patients should strictly follow the doctor's advice during chemotherapy, regularly review blood routine and other indicators, and timely report any discomfort to the doctor.
Radiotherapy for Breast Cancer
Radiotherapy is a local treatment method that uses ionizing radiation to kill cancer cells. It is often used in combination with surgery or chemotherapy to improve the curative effect. The main indications include: adjuvant radiotherapy after breast-conserving surgery, to eliminate residual tumor cells in the breast and axillary region; palliative radiotherapy for advanced breast cancer, to relieve symptoms such as bone metastasis pain and local tumor compression; radiotherapy for patients with local recurrence of breast cancer.
Radiotherapy may cause local side effects, such as skin redness, swelling, dryness, peeling, and breast edema. These side effects are usually mild and can be relieved after the end of radiotherapy. During radiotherapy, patients need to pay attention to protecting the irradiated skin, avoiding friction and irritation, and keeping the skin clean and dry.
Endocrine Therapy for Breast Cancer
Endocrine therapy is a targeted treatment method for breast cancer patients with hormone receptor-positive (estrogen receptor ER-positive and/or progesterone receptor PR-positive). It works by blocking the action of estrogen or reducing the level of estrogen in the body, thereby inhibiting the growth and proliferation of cancer cells. Endocrine therapy is mainly used for adjuvant treatment of early breast cancer and palliative treatment of advanced breast cancer.
Common endocrine therapy drugs include selective estrogen receptor modulators (such as tamoxifen), aromatase inhibitors (such as letrozole, anastrozole), and fulvestrant. The course of endocrine therapy is usually 5-10 years, and patients need to take drugs regularly and review them regularly. Endocrine therapy has relatively mild side effects, such as hot flashes, night sweats, osteoporosis, and vaginal dryness. Patients can take corresponding measures under the guidance of doctors to relieve these side effects.
Targeted Therapy and Immunotherapy for Breast Cancer
Targeted therapy is a treatment method that targets specific molecular targets of cancer cells, which has the advantages of high efficiency and low toxicity. It is mainly suitable for breast cancer patients with human epidermal growth factor receptor 2 (HER2) positive. Common targeted therapy drugs include trastuzumab, pertuzumab, and lapatinib. Targeted therapy can significantly improve the curative effect of HER2-positive breast cancer patients and reduce the risk of recurrence and metastasis.
Immunotherapy is a new type of treatment method that uses the body's own immune system to recognize and kill cancer cells. It is mainly used for advanced breast cancer patients who are ineffective to other treatments. Common immunotherapy drugs include programmed death receptor 1 (PD-1) inhibitors and programmed death ligand 1 (PD-L1) inhibitors. Although immunotherapy has shown certain curative effects in the treatment of breast cancer, it is not suitable for all patients, and the specific application needs to be evaluated by professional doctors.