Author: Baidu know netizens don't be surprised (Doctor of Medicine, University of Tokyo)

20 13 In May, Hollywood movie star Angelina Jolie published an article in The New York Times, telling the public that she had BRCA 1 gene (a gene that increased the incidence of breast cancer) and that her mother died of breast cancer, so she decided to take preventive measures and simply had bilateral mastectomy. For an actress who is famous for her sexy image, it is commendable to choose to remove it in advance and face the public frankly. But behind this courage is my familiarity with breast cancer prevention and treatment knowledge. In the United States, due to the maturity of plastic surgery, it is not uncommon for women with BRCA/KLOC-0 mutation to choose preventive mastectomy as high as 36.3%.

Many years ago, I was in the outpatient department of Peking University Hospital, and an aunt in her 60 s came to see a doctor. She is coy. When I asked, it was the right breast festering and running water. The physical examination surprised me. Her breast cancer is almost the size of a fist, and her surface ulcer is serious. I asked her why she didn't see the doctor earlier. My aunt comes from rural Shandong. Not only did she know nothing about breast cancer, but she was also ashamed to see a doctor when she found the lump, so she was delayed so late. My aunt died six months later.

Both examples point to a word that scares the public: cancer. I don't know how many women will start introspection because of Julie's bravery, but I'm sure countless women will start looking down at their breasts because of her story.

The word "cancer" first appeared in Bao Shu, Wei Ji in the Song Dynasty. "Cancer started at first, but it didn't have a clue. After 17 and 27 years old, it suddenly turned purple and slightly swollen, and gradually felt no pain", indicating carbuncle, which is not a "cancer" in the modern sense. The ancients called anal cancer carbuncle. It is the Japanese who regard cancer as a malignant tumor in the modern sense. It was first seen in the New Book of Choosing Doctors by Hirozawa, Daejeon, Japan. The rock under the diseased head refers to hard breast cancer.

Breast cancer is the number one enemy of women. It is estimated that 500,000 women worldwide die of breast cancer every year. 69% of them are from developing countries. With the extension of life expectancy, urbanization and the immersion of western lifestyles, the incidence of breast cancer in developing countries has increased year by year. Statistics show that female breast cancer in China increases by 165438+ 10,000 every year, with an annual increase of 2-3%.

This number looks terrible, but is breast cancer really that terrible?

According to the statistics of 20 13 years in the United States, the 5-year survival rate of 1 stage (early stage) breast cancer reached 100%, the second stage reached 93%, the third stage reached 72%, and even the very late stage 4 reached 22%. The 20-year survival rate after diagnosis was 64.5%. The overall 5-year survival rate reached 89.0%. From 1990 to 2007, the mortality rate of breast cancer in the United States decreased at an annual rate of 2.2%, with an overall decrease of 2 1%. At the same time, the mortality rate of breast cancer in China has increased by 155%.

Looking at another figure, 80% of breast cancer in the United States is diagnosed at an early stage. In China, the early diagnosis of breast cancer only accounts for about 20%.

Do you see why there is such a big gap in breast cancer mortality between China and the United States?

Yes, the key word is "early".

Julie's example is early, but Aunt's example is too late.

Early breast cancer (less than 5 cm, no metastasis) is a curable disease. For local tumors, if the estrogen receptor is positive, the cure rate can be as high as over 90%.

So, how can we find it early and how can we prevent or reduce the incidence of breast cancer?

Let's talk about the risk factors of breast cancer first.

There are two risk factors for breast cancer.

One is that you can't change, such as sex, age and heredity (5- 10% of breast cancer comes from heredity, and carrying BRCA 1 and BRCA2 greatly increases the risk of cancer. Julie is a typical example), family history (having immediate family members, such as mother and sister, suffering from breast cancer, the risk doubles; If two lineal blood relatives have breast cancer, the risk is doubled), breast tissue is dense (the prevalence rate of women with firm breasts is higher than that of other women), specific breast hyperplasia (atypical hyperplasia), early menstrual period (menarche is earlier than 12 years old), late menopause (later than 55 years old), and chest irradiation (such as receiving high-dose radiation due to other diseases);

The other category can be changed, such as reproductive age (the incidence of breast cancer in women who are childless and whose first child is later than 30 years old is slightly increased), oral contraceptives (slightly increased, but the risk returns to normal after stopping 10 years), postmenopausal estrogen therapy (such as for menopausal symptoms or osteoporosis), breastfeeding (the risk of lactating women is lower than that of those who have never breastfed, especially for more than one and a half years), and further reduction.

As for whether the environment circulating on the Internet, smoking and staying up late are related to breast cancer, there is no evidence to support it.

Knowing these risk factors, we can understand how to prevent breast cancer. Simply put, 1, exercise regularly, 20-30 minutes a day is enough. The important thing is persistence; 2. Keep your weight within the normal range, not too fat or too thin; 3. Avoid or try to drink as little as possible; 4. Breastfeed your child as much as possible. If the first three items are achieved, not only will the risk of breast cancer be reduced, but other cancers and adult diseases, such as diabetes and cardiovascular and cerebrovascular diseases, will also be reduced together.

Let's talk about how to find breast cancer early.

Early detection of breast cancer is related to personal medical environment, national medical policy and medical resources, but at least what individuals can do is: self-examination. When taking a bath every day, check your breasts by hand. If you find an abnormal lump, see a doctor in time. This is very simple and practical. Before the age of 40, if conditions permit, you should be examined by a specialist at least once every three years. After the age of 40, it is suggested that it is best to have a physical examination once a year and do a mammography examination, that is, take a mammogram. High-risk women, such as BRCA 1 or BRCA2 gene mutation, first-degree blood relatives of breast cancer, and those who have received chest radiotherapy between 10 and 30 years old, should receive mammography and magnetic resonance imaging once a year if conditions permit. This estimate is difficult for most people, only for those with excellent medical conditions.

Now, you should know that although breast cancer sounds terrible, the cure rate is actually very high, and even if it is unfortunate, the quality of life is also very high. The key word is "early". So this "tiger" doesn't have to keep a straight face.