The author Zhang Jinjian is a professor of surgery at National Taiwan University. Chairman of the Breast Cancer Prevention Foundation Patients after breast cancer surgery often ask doctors: "Is my breast cancer receiving the most complete treatment?" "Will my breast cancer recur?" Indeed, breast cancer recurrence is the most concerned issue for all patients and their families , is also the primary issue that doctors must fully understand, face and help patients solve.
Breast cancer recurrence includes local recurrence and distant metastasis. At present, breast cancer surgery is divided into two main streams. Some undergo breast-conserving surgery and the other undergo modified extensive mastectomy. Therefore, the manifestations of local recurrence are different. . If undergoing breast-conserving surgery, the local recurrence generally occurs in the remaining breast on the same side, with lumps or recurrence of surrounding lymph nodes; as for after total mastectomy, lumps are found on the chest wall or recurrence of peripheral lymph nodes .
Early relapse is easy to be ignored, regardless of the recurring mass on the chest wall or the same side of the breast, early patients and doctors are often negligent and unaware. They may be on the chest or on the same side of the breast, one or more at first, but the volume is very small, without any discomfort or pain; then gradually enlarge, and even cause the skin of the chest wall to deform, ulcerate, and sometimes have diffuse spots or papules; The worst case is full redness, similar to inflammation.
As for local or peripheral lymph nodes, according to their location, they can be divided into three major regions: axillary, interpectoral, and supraclavicular. Depending on the location, the clinical manifestations are slightly different. Most of them can feel a lump, and it is possible to move or fix it. A recurrent lump in the armpit, if large enough, can sometimes cause pain, limited movement of the upper arm, and even lymphedema of the arm.
Local recurrence varies according to the stage. In the early stage, because breast cancer screening was not yet common, breast cancer was discovered late, and the local recurrence rate after surgery was as high as 32%. After 1960, it dropped to about 10% to 25%, and half of the recurrence It is single, but 10% to 20% of patients with distant metastasis still have local recurrence.
The time of local recurrence varies according to the stage of breast cancer. Most of the third stage occurs within two years, most of the second stage occurs within four years, and most of the first stage recurs within six years. Recurrence within three years of treatment. If the recurrence is a single lesion and occurs after two years, the prognosis is better; if it is multiple lesions and occurs within two years, the prognosis is poor, and the five-year survival rate drops to 20%.
The principle of treatment for local recurrence is to focus on active treatment first. If it is a single lesion, local extensive resection is performed; if the first operation is reserved, complete resection of the remaining breast can also be considered. radiotherapy. Since local recurrence is often the prodromal symptom of distant metastasis, chemotherapy is still necessary. For resected recurrent lesions, such as those with positive hormone receptors, anti-hormonal drugs can of course be used in combination.
The prognosis of distant metastases is poor. As for the extensive and extremely wide local recurrence, it is a serious condition. If the patient's physical condition permits, radiation and chemotherapy can be considered at the same time. Due to the diversity of local recurrence, it is difficult to detect in the early stage, it is difficult to treat in the late stage, and it may be complicated by distant metastasis, and the prognosis is even worse, so the follow-up after breast cancer surgery is even more important.
In particular, it is important to remind that breast cancer patients must receive regular medical examinations every three months in the first five years after surgery, and must undergo breast and abdominal ultrasound, liver function and related blood tests every six months, including CEA and CA15-3. , Chest X-ray, mammography and bone scan every year; after five years, regular follow-up should be done every six months, if there are any symptoms such as unexplained fever, cough, right upper quadrant discomfort or back pain, bone pain, etc. , may be a warning sign of recurrence, you should consult a doctor at any time.
Comment
Readers, please read the whole article, it has been emphasizing the five-year survival rate, and never mentioned that breast cancer can be treated, because Western medicine cannot cure breast cancer, so women know that the more Western medicine is, the more nervous they are, and because the more nervous, the heart will be weaker. The worse it is, breast cancer occurs because of heart problems, so the more you treat it, the worse it gets, and no one survives. Please go to a Chinese medicine doctor. Any Chinese medicine doctor who knows that milk is menstruation is a good Chinese medicine doctor who can treat breast cancer. There is a Dr. Peng Zhong who practiced in Zhongli is very good. I think he can treat breast cancer. You can also go to him. (Please refer to Hantang No. 2, Hantang No. 5)
