What Are the Stages of Breast Cancer Progression?

Early breast cancer is called early breast cancer or early-stage breast cancer in English. There is no clear definition so far. It is generally accepted that early breast cancer is expected to be permanently cured. Early breast cancer often appears in books and literature but is not specifically identified. Most scholars believe that if the early breast cancer is seen before surgery, the tumor should be less than 2 cm, the axillary metastasis does not touch the metastatic lymph nodes, and no distant metastasis; In recent years, with the development and popularization of breast-conserving surgery, some people have expanded the early breast cancer to less than 3 cm in diameter based on histopathological findings. There is no or minimal metastasis of axillary lymph nodes on the ipsilateral side and no distant metastases patient. Early breast cancer undergoes a relatively high rate of breast-conserving surgery and has a good treatment effect. Long-term cure can be achieved for more than 90%.

Basic Information

nickname

earlybreastcancer, early-stagebreastcancer

Visiting department

Oncology

Multiple groups

50 to 54 year old women

Common causes

Breast cancer

Common symptoms

Breast lump

Early breast cancer etiology

Early breast cancer is the early stage of breast cancer, and its etiology is the same as that of breast cancer.

The cause of breast cancer is not completely clear. Studies have found that women with high risk factors for breast cancer are susceptible to breast cancer. The so-called high-risk factors refer to various risk factors related to the incidence of breast cancer, and the risk factors that most breast cancer patients have are called high-risk factors for breast cancer. According to the Chinese Cancer Registry Annual Report, the age-specific incidence of breast cancer in women is low at the age range of 0-24 years, gradually increasing after 25 years of age, reaching a peak at 50-54 years of age, and gradually decreasing after 55 years of age. Family history of breast cancer is a risk factor for breast cancer. The so-called family history refers to patients with breast cancer in first-degree relatives (mother, daughter, sister). In recent years, it has been found that dense breast glands have become a risk factor for breast cancer. Risk factors for breast cancer include early menarche (<12 years) and late menopause (> 55 years); unmarried, unfertile, late fertility, and no breastfeeding; no timely diagnosis and treatment of benign breast disease; hospital biopsy (biopsy) Atypical breast hyperplasia has been confirmed; the chest has been exposed to high doses of radiation for some reason; long-term use of exogenous estrogen; postmenopausal obesity; long-term excessive drinking; and mutations associated with breast cancer. What needs to be explained is the susceptibility genes of breast cancer. European and American countries have done a lot of research. BRCA-1, BRCA-2, p53, and PTEN are known. Breast cancers associated with these gene mutations are called genetics. Sexual breast cancer accounts for 5% to 10% of all breast cancers. Women with these high risk factors do not necessarily have breast cancer. It can only be said that their risk of breast cancer is higher than normal people. The incidence of breast cancer in Chinese women is still low.

Early breast cancer clinical manifestations

Early breast cancer can feel a lump on the breast, most of which are not accompanied by pain. Some patients have breast tenderness at the same time, and even bilateral breast tenderness, which has nothing to do with the menstrual cycle, is caused by endocrine disorders, and has nothing to do with the masses felt. There are also some early breast cancers where no mass can be found on physical examination, and they are found by imaging studies (breast ultrasound, radiography, magnetic resonance). The first symptom of early breast cancer is nipple discharge, which is often associated with single-hole bloody discharge. "Dimple sign" can appear in early breast cancer. The so-called "dimple sign" is a small depression in the breast skin, like a small dimple. The reason is that the Cooper ligament, which connects the breast skin and the deep pectoralis fascia, is shortened by the invasion of breast cancer and loses its elasticity, pulling the skin of the corresponding part to form a dimple-like skin depression. Breast cancer can cause nipple retraction if it is located at or near the nipple. The tumor is far away from the nipple, and the large duct in the breast is invaded and shortened, which can also cause the nipple to retract or raise. Breast eczema-like cancer, which is Paget's disease of the breast, and some are also early breast cancers, manifested by itching, erosion, ulceration, scabbing, scaling, and burning pain of the nipple skin to the nipple retraction. Early breast cancer usually cannot detect metastatic lymph nodes in the axilla. If the axilla touches the hard lymph nodes and sticks to the skin; or multiple lymph nodes are fused and fixed to each other; it is no longer early breast cancer.

Early breast cancer screening

In the breast clinic, after the doctor understands the medical history, the doctor will first carry out a physical examination to check the bilateral breasts. It will also combine imaging examinations, including mammography (mammography of mammography), color ultrasound, and breast magnetic resonance examinations if necessary. (MRI). Mammography is the main method of breast cancer screening recommended internationally in recent years. It can be found that breast cancer can not be detected by clinical examination. It is usually used for women over 40 years of age. Sensitive, less radioactive damage, and relatively low breast density, mammograms are easy to find abnormal signs. Color Doppler ultrasound is not harmful to the human body, and it is ideal for young women and dense breasts. MRI can find multifocal and multicenter small lesions, and it is also an imaging method for early diagnosis. Finally, the diagnosis will be based on cytology or pathological diagnosis, and biopsy will be performed on the basis of abnormalities found in clinical examination. Puncture or surgical methods can be used. Once cancer cells are found, treatment should be taken immediately. If the patient has nipple discharge, some methods for nipple discharge can be developed, such as bronchoscopy, mammography, and cytology smears to find cancer cells.

Early breast cancer diagnosis

Early breast cancer often does not have the typical symptoms and signs of breast cancer, and is usually not easy to detect. Diagnosis and differential diagnosis of breast cancer need to be combined with breast imaging examination or histopathology and cytopathology (conditional hospital) examination.

Imaging and pathological examination of the breast can only be performed in conditional hospitals, so women with high risk factors for breast cancer should go to the hospital regularly. Women who master and insist on breast self-examination find abnormalities in breast self-examination; or women who have not performed breast self-examination usually find breast abnormalities, including breast masses, nipple discharge, etc., in a timely manner. It is recommended that middle-aged women and older to actively participate in breast cancer screening, which can help early detection of breast disease. Self-examination of the breast needs to stand or sit in front of the mirror, and carefully observe the breasts on both sides of the mirror, including changes in breast size, shape, contour, skin and color, whether the nipples are elevated, retracted, and fluid. When palpation, spread your fingers together and touch the ventral side of your breast with your fingers. Check the right side with your left hand and the left side with your right hand. Touch clockwise or counterclockwise. Don't miss the nipples, areola and armpit area. Breast self-examination should be performed once a month, and the best time should be selected within a few days between menstruation. At this time, the breast is relatively soft, no swelling and pain, and it is easy to find abnormalities. For women who have stopped menstruating, they can choose a fixed monthly time. Perform a self-examination. Each breast self-examination should be compared with previous self-examinations. If abnormalities are found, they should go to the hospital in time to achieve early detection and early diagnosis.

Early breast cancer treatment

Treatment options for early breast cancer depend on the pathological type of breast cancer.

Early breast cancer includes breast carcinoma in situ, which is further divided into lobular carcinoma in situ and ductal carcinoma in situ based on histological origin. In 2003, WHO introduced a new histological classification of breast tumors, and proposed new names for lobular carcinoma in situ and ductal carcinoma in situ, respectively, as "lobular tumor formation" and "ductal intraepithelial tumor", and classified as precancerous lesions. . "Lobular tumor formation" can only constitute a risk factor for a small number of women and may develop into invasive cancer in the future. "Catheter intraepithelial tumor" has a potential, but not necessarily a tendency, to progress to invasive cancer.

At present, most hospitals in China still use the concepts of breast lobular carcinoma in situ and ductal carcinoma in situ. The biological behavior and prognosis of these two carcinomas in situ are different, so the treatment methods are different. Endocrine therapy can be used in patients with lobular carcinoma in situ confirmed by surgical resection and without other cancers. Breast ductal carcinoma in situ can be treated with local enlarged tumor resection plus postoperative radiotherapy, or a total mastectomy, with axillary sentinel lymph node biopsy and breast reconstruction as appropriate. If an invasive cancer is found during surgery, it should be treated as an invasive cancer. If it is early invasive cancer, the doctor can choose breast-conserving surgery plus radiotherapy or modified radical mastectomy or total mastectomy plus sentinel lymph node biopsy according to the specific conditions. Immediate breast reconstruction surgery is feasible for patients undergoing mastectomy. Sentinel lymph node biopsy only removes sentinel lymph nodes. After detection of sentinel lymph node metastasis, axillary lymph node dissection is performed. If there is no metastasis of sentinel lymph nodes, the axillary can no longer be operated. Some people call it axillary preservation surgery. Postoperatively, it is necessary to decide whether to perform chemotherapy, radiotherapy, endocrine therapy, and targeted therapy based on the pathological test report and the status of lymph node metastasis, hormone receptors, and HER-2. Patients undergoing breast-conserving surgery must undergo radiotherapy after surgery.

Early breast cancer prevention

Early breast cancer is the early stages of breast cancer. The cause of breast cancer is not fully understood, so there is no exact way to prevent it. From the epidemiological analysis, the following aspects can be considered in the prevention of breast cancer:

1. Establish a good lifestyle, adjust the pace of life, and maintain a comfortable mood.

2. Insist on physical exercise, actively participate in social activities, avoid and reduce mental and psychological tension factors, and maintain a peaceful mindset.

3. Develop good eating habits, pay attention to nutritional balance, and promote breastfeeding during infants and young children; reduce the intake of excessive high-protein and low-fiber diets during child development; do not consume large amounts of fat and animal protein during adolescence, and strengthen physical exercise ; Control your total caloric intake during menopause to avoid obesity. Usually develop a habit of not taking too much meat, fried eggs, butter, cheese, sweets, etc., eat less salted, smoked, fried, grilled foods, and increase consumption of fresh vegetables, fruits, vitamins, carotene, olive oil, fish, beans Products.

4. Actively treat breast diseases.

5. Do not mess with exogenous estrogen.

6. No long-term excessive drinking.

7. The United States has carried out clinical research on drug prevention in high-risk groups of breast cancer, which has not yet been carried out in China.

Female friends with breast cancer risk factors should visit the hospital regularly for medical examinations. It is recommended that female friends know some popular knowledge about breast diseases; master the method of breast self-examination, develop the habit of regular breast self-examination; and actively participate in breast cancer screening.