Breast diseases pose a serious threat to women's health, especially breast cancer, which is the most common malignant tumor in women worldwide, with 2.26 million new cases of breast cancer in women worldwide reaching 2.26 million in 2020, accounting for 24% of all malignant tumors in women5%。China has become one of the countries with the largest increase in the incidence of breast cancer, with an annual rate of 2% to 3%, and the incidence of breast cancer among women in Beijing has reached 745 100,000. The two cancer screening work in Beijing is proceeding as scheduled, and the next topic to talk about is the importance of breast cancer screening and how to detect breast cancer early.
1. How to detect breast cancer early.
Breast cancer ranks first in the incidence of malignant tumors in women. Although the incidence of breast cancer is not clear, and there is no effective enough means to prevent the occurrence of breast cancer, practice has proved that early detection is an effective measure to improve the prognosis. In order to achieve early detection of breast tumors, the role of breast self-examination and physical examination is particularly important.
1.Breast self-examination: Although the effectiveness of breast self-examination is controversial, its advantages in the timeliness of detecting breast abnormalities are worth affirming. Here's how to do a breast self-exam:
1) Time: Between menstrual periods.
2) Extent: includes all areas of the distribution of breast tissue, in addition to the axillary and clavicle areas.
3) Key points of inspection: changes in appearance, such as "dimple sign", *edema, nipple areola desquamation and crusting or erosion, should pay attention to the contrast of bilateral breasts.
4) 3 key points of palpation: comprehensive and orderly, finger rubbing, light and heavy combination.
If there are abnormal findings such as lumps, discharge, nipple retraction erosions, ** changes (dimple signs, redness, edema, ulcers), regional lymphadenopathy, etc., you should see a doctor in time.
2.Breast screening: includes opportunistic screening (screening of individuals who come to the hospital for medical treatment) and mass screening (organized screening of asymptomatic individuals in the community or unit). The American Cancer Society recommends that women have regular breast exams by their doctors starting at age 20.
The combination of clinical examination and imaging examination is currently the most effective method to achieve early detection of breast cancer. Mammography and ultrasonography are the two most commonly used and practical tests, and they complement each other and are sometimes combined with breast MRI and breast duct endoscopy to evaluate breast lesions.
It is worth noting that any kind of examination, including self-examination, clinical physical examination of doctors and imaging examinations, has its own value and shortcomings, and the combination of multiple methods can make up for many shortcomings. Even if there are signs of breast cancer found in a certain examination, no matter how typical the presentation is, it does not mean that breast cancer has been diagnosed, and the final diagnosis of breast cancer needs to be based on the "gold standard" - pathological examination.
2. The necessity of breast cancer screening.
1.Why breast cancer screening.
Screening is a preventive measure for asymptomatic people, and the main purpose is to achieve "three earlys": early detection, early diagnosis, and early **, and ultimately reduce mortality.
The effect of breast cancer is closely related to the staging, breast carcinoma in situ can be almost clinical, the 5-year survival rate of advanced breast cancer can be as high as 99%, the 5-year survival rate of advanced breast cancer can also reach more than 85%, and the survival rate of breast cancer and above is poor. Therefore, breast cancer screening can improve the prognosis by detecting breast cancer early and promptly**.
2.People at high risk of breast cancer.
1) Moderate to severe dysplasia in the lobules of the breast ducts;
2) history of chest wall radiotherapy;
3) Breast cancer genetic predisposition:
Close relatives with BRCA1 BRCA2 gene mutation carriers;
Close relatives have male breast cancer patients;
There is one female breast cancer patient in close relatives with an age of onset of 45 years
There are 2 female breast cancer patients with a close relative, and the age of onset is 50 years
A close relative of an individual with two primary breast cancers and the age of first onset is 50 years
Close relatives with 2 or more breast and/or ovarian epithelial cancers, fallopian tube cancers, primary peritoneal cancers, and other diseases of any age of onset at the same time
Close relatives refer to first, second, and ** relatives.
First-degree relatives: parents, siblings, children.
Second-degree relatives: grandparents, maternal grandparents, uncles, aunts, nieces, nephews, nephews, grandchildren.
*Relatives: great-grandfathers, siblings, cousins, cousins, great-grandchildren.
3. What imaging tests do we need to do on the breast?
1.A breast ultrasound that is not harmful to the body.
Since 1951, ultrasound has been applied to breast examinations, and 70 years later, from the static scanning technology of black, white and gray to the current real-time color Doppler ultrasound. Color ultrasound of the breast has no radiation damage and is suitable for any population. This is especially true in young women and with dense glands. Ultrasonography can show the fine structure of the lesion, including the size, shape, location, edge, internal echo, posterior echo characteristics, elasticity coefficient, blood flow, lymph nodes and other characteristics of the lesion.
2.Mammography reveals breast cancer that cannot be touched.
Mammography is a diagnostic method that uses the physical properties of X-rays and the different isodensities of human breast tissue to project a two-dimensional image of the breast on an X-ray scan. The imaging manifestations under mammography were comprehensively analyzed from breast lumps, asymmetry, structural distortion, calcifications, and ** changes. The study found that mammograms could reduce breast cancer mortality by 40 to 19 percent in 74-year-old women. It is recommended that 35 should have a basic x-ray at the age of 40 and an annual x-ray after the age of 40. Mammography can also detect subclinical microscopic lesions, which can advance the diagnosis of breast cancer by 2 to 4 years.
3.Since the launch of the "Two Cancer Screening" project in 2009, the specialist team of the Breast Center has participated in breast cancer screening for more than ten consecutive years and has accumulated rich experience. We have a specialized imaging team and advanced examination equipment, and complete more than 30,000 breast ultrasound examinations, 10,000 X-ray examinations, and more than 200 cases of breast cancer diagnosis every year. Breast ultrasound is suitable for all ages, but is more suitable for young dense breasts. The sensitivity of mammography can be as high as 98% for fatty breasts, while the sensitivity of dense breasts is reduced. Therefore, for women over 40 years of age, a combination of the two tests is recommended to improve the diagnostic effect. Based on the single-center data analysis of the department, the sensitivity of breast ultrasound combined with X-ray examination in the diagnosis of breast cancer is more than 95%, which provides a solid foundation for the early diagnosis of breast cancer.
Text|Breast Center Fan Xiaobo.