Is breast cancer a disease exclusive to women? Will it not recur five years after surgery? Here comes the truth!

Author: Hu Zhongdong, deputy chief physician, registered dietitian, health manager, and speaker of the Healthy China Action

Reviewer: Zheng Xiaodong, Chief Physician of Breast Center, Affiliated Cancer Hospital of Chongqing University

gossip

Breast cancer is one of the common malignant tumors in women. Many people believe that "breast cancer has early typical symptoms" and "women with breast nodules will definitely get breast cancer". There are also rumors that "only women will get breast cancer" and "breast cancer surgery will not recur five years later". So, is this the truth?

analyze

What is breast cancer?

Breast cancer refers to a malignant tumor that occurs in the epithelial tissue of the mammary gland. Breast cancer cells can spread throughout the body through lymph or blood, most commonly metastasizing to important organs such as bones, lungs, liver, and brain. It is the most common malignant tumor that endangers women's life and health. The diagnosis and differential diagnosis of breast cancer should be based on the patient's clinical manifestations, physical examination, imaging examination, histopathology, etc.

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5 Breast Cancer Myths

01

Myth: Breast cancer only affects women

Analysis: Incorrect, men can also get breast cancer.

Male breast cancer accounts for less than 1% of all breast cancers, but its incidence has been increasing year by year in recent years. Research data shows that the incidence of male breast cancer is about 1.2/100,000, and the average age of diagnosis is 67. At the same time, the mortality rate of male breast cancer patients is 19% higher than that of female patients.

02

Rumor: Breast cancer has early typical symptoms

Analysis: Inaccurate, breast cancer has no typical early symptoms.

Breast cancer is not easy to be discovered by patients in the early stage, and is often discovered through physical examinations or breast cancer screening. The following are typical signs of breast cancer, which often appear in the middle and late stages of cancer.

1. Breast lumps: 80% of breast cancer patients first present with breast lumps. Most breast cancers are painless lumps, with only a few being accompanied by varying degrees of dull pain or tingling.

2. Nipple discharge: blood, serous fluid, milk, or pus flows out of the nipple during the non-pregnancy period, or milk continues to flow out after breastfeeding has stopped for more than half a year.

3. Skin changes: The most common is that the tumor invades the suspensory ligament of the breast (also known as Cooper's ligament) and adheres to the skin, resulting in dimples. If the cancer cells block the dermal lymphatic vessels, orange peel-like changes will occur.

4. Nipple retraction, nipple skin itching, erosion, ulceration, scab, desquamation, accompanied by burning pain.

5. Swollen axillary lymph nodes.

03

Rumor: Having breast nodules will definitely lead to breast cancer

Analysis: Not necessarily. The presence of nodules does not mean that you have breast cancer.

Breast nodules refer to a mass in the breast that is different from normal tissues. Before the specific disease is known, it is generally called a nodule. Many breast diseases such as breast cysts, breast fibroids, and breast cancer may manifest as nodules.

Breast cysts are mainly divided into simple cysts and milk cysts. Breast ultrasound is generally used to determine the solidity of the cyst.

Breast fibroids are painless lumps whose size is unrelated to the menstrual cycle. They generally grow slowly and are more common in young women.

Breast cancer is usually a painless lump in the early stages, usually without any pain for several months or even years. It is generally hard, mostly single, with poor mobility, and some can adhere to the skin. It can develop rapidly over a period of time. The lump has nothing to do with menstruation or emotions.

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04

Myth: If you don’t have a family history of breast cancer, you won’t get breast cancer

Analysis: This is not true. It is possible to get breast cancer even if there is no family history of breast cancer.

Breast cancer and heredity do have a certain relationship. But for breast cancer patients, those with a family history are only a small part. Women with a family history of breast cancer have a higher risk of cancer than normal people and need regular checkups and preventive measures. However, many breast cancer patients without a family history get sick because of an unhealthy living environment and lifestyle.

05

Myth: Breast cancer surgery will not recur five years later

Analysis: Not necessarily. After five years, the risk of recurrence and metastasis of breast cancer patients decreases year by year, but there is still a possibility of recurrence and metastasis.

The five-year survival rate of early breast cancer patients is as high as 90%. After the first five years of danger, most patients can achieve long-term survival. After the five-year hurdle, some breast cancer patients completely let down their guard and do not have regular checkups, which gives cancer cells an opportunity to take advantage.

The causes of long-term recurrence and metastasis of breast cancer patients are closely related to the age of the disease, whether they are menopausal, whether they have received neoadjuvant chemotherapy, whether they have received postoperative adjuvant therapy, the number of lymph node metastases, etc. Standardized treatment is the first step to prevent long-term recurrence and metastasis! It is recommended that breast cancer patients undergo follow-up examinations every 3 to 6 months for the first 2 years after surgery, every 6 months for the next 3 years, and once a year after 5 years.

Who is at high risk of breast cancer?

The "Guidelines for Breast Cancer Screening for Chinese Women (2022 Edition)" defines people at high risk of breast cancer as those who carry breast cancer susceptibility genes or have one of the following conditions:

(1) There is a family history of breast cancer in direct relatives (parents, children, brothers, and sisters);

(2) Women with a history of breast cancer;

(3) history of chest radiotherapy (cumulative radiotherapy dose ≥10 Gy before the age of 30);

(4) Women with a history of lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH) before the age of 40.

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In addition to those with a family history of breast cancer or ovarian cancer, who are at high risk, people who smoke and drink for a long time; have irregular work and rest schedules and lack of sleep; are obese and eat a high-fat diet; have never given birth or gave birth to their first child at age 30 and did not breastfeed; are emotionally unstable and anxious; women with early menarche (before age 12) and late menopause (after age 55); and women who take hormone supplements for a long time after menopause (>5 years or more) also have the risk of cancer.

Recommended starting age for screening

The starting age for breast cancer imaging screening in the general risk population is 40 years old; breast cancer-related knowledge education and breast examinations should be carried out starting at the age of 18.

For high-risk women, imaging screening is required in advance, depending on the risk of cancer: for healthy women carrying high-penetrance harmful mutation genes, the screening start age is recommended to be advanced to 25 years old;

For women with a history of lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH), screening should start at the age when LCIS, ADH, or ALH was diagnosed; for high-risk women with a family history of breast cancer, screening should start at an age 10 years younger than the youngest person in the family diagnosed with breast cancer, but should be ≥ 25 years old.

Preventing Breast Cancer

The following measures should be taken

1. Go to bed early and get up early, don’t stay up late;

2. Keep exercising and do more exercise;

3. Be optimistic and less angry;

4. Control your weight, control your diet, limit the intake of high-fat, high-salt, high-sugar, and high-energy foods, quit smoking and control alcohol.

In addition, it is recommended to avoid long-term use of contraceptives; give birth early, breastfeed more, and avoid multiple artificial abortions; pay attention to some benign breast diseases, follow up regularly, and actively treat them.

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in conclusion

Breast cancer has no typical early symptoms; you can get breast cancer even if you don't have a family history of breast cancer; men can also get breast cancer; not all nodules are breast cancer; and regular checkups are still required five years after breast cancer surgery to prevent recurrence and metastasis.

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