Breast cancer treatment also needs "addition and subtraction" trend "tailored" precision treatment

At the recent "12th Tianjin International Breast Cancer Conference", experts pointed out that the diagnosis of breast cancer diagnosis and surgery, radiotherapy, chemotherapy, endocrine therapy, targeted treatment and other systematic treatment methods to "add and subtract" design, the development of tailor-made precision treatment strategy, has been the new direction of breast cancer diagnosis and treatmentRegular imaging tests are essential to early detection of breast cancerThe average woman can do 1 breast ultrasound screening every year after the age of 25, every 2 years to do mammograms, for 45 years of age and older, with a family history of early breast cancer, early menstruation or late menopause of breast cancer at high risk, it is recommended to do 1 breast X-ray joint breast ultrasound screening every year, if necessary, can supplement the mammogramsin recent years, the incidence and mortality rate of breast cancer in China has been increasing year by year, with the growth rate ranking among the highest in the worldAccording to the data of the National Cancer Center, there were about 278.9 million new cases of breast cancer in women nationwide in 2014, accounting for 16.51% of all malignant tumors in women, with a incidence rate of 41.82 per 100,000, ranking first among women's malignancies and one of the most important malignant tumors threatening women's health in ChinaHowever, with the widespread dissemination of the concept of "early diagnosis and treatment" and the continuous progress of medical technology, breast cancer has become one of the most clinically treatable and effective physical tumors, new detection techniques, treatment methods and programs are emerging, breast cancer patients have greatly extended their survival, and further improve the quality of life has become the new needs of breast cancer patientsHow to "add and subtract" the diagnosis and treatment of breast cancer, and formulate tailor-made precision treatment strategy, has been the new direction of breast cancer diagnosis and treatmentAugust 23-24, "The 12th Tianjin International Breast Cancer Conference and 2019 American Clinical Oncology Society Overseas Conference" was held in TianjinWith the theme of "Precision Diagnosis and Treatment of Breast Cancer", the conference brought together more than 800 experts and scholars from China, the United States, Germany, the United Kingdom, Japan and other domestic and foreign breast cancer fields, and conducted academic exchanges on breast cancer precision medical strategies, translational medicine, imaging diagnosis, comprehensive treatment, multidisciplinary collaboration, etc., to convey the latest research results and developments in the progress of the international breast cancer discipline, and to discuss the characteristics of breast cancer in Asia, disease status, diagnosis and treatment direction, and further promote the development of breast cancer along the waybreast cancer incidence increased with age 55 years to peak, but patients under 50 years old still accounted for 40% of thethe President of the General Assembly, the Chinese Cancer Association Breast Cancer Professional Committee, Tianjin Medical University Cancer Hospital, the director of the department of breast cancer, Professor Zhang Wei introduced, unlike Western countries, China's breast cancer patients are relatively large, the average age of diagnosis is 45 to 55 years old, 10 to 20 years younger than Western womenIn terms of age distribution, the incidence of breast cancer increased rapidly with age after the age of 20, and reached a peak in the 55-year-old age group, with about 10% to 15% of patients under the age of 35 and about 40% of female patients under 50 years of age" China's women menstrual early, late menopause, compared with western women menstruation is longer, estrogen in the human body for a longer period of time, more likely to induce breast cancerIn addition, the change in lifestyle and diet structure to Westernization, increased intake of high-fat, high-calorie foods, decreased exercise, mental stress, obesity, etcare likely to be related factors to the growth of breast cancer and the trend of youngerbreast cancer in the Chinese and Western populations also has different biological characteristics due to different susceptibility factors and lifestyles, which suggests that screening and treatment of breast cancer in Asia should explore different strategies rather than blindly adopt a one-size-fits-all approach to breast cancer patientsto achieve regular screening and self-examination, early diagnosis and treatment of breast cancer patients survival rate of up to 95% early prevention of cancer and high-risk screening, is the key link to improve the effectiveness of treatment If the early stage of breast cancer can be found and standardized treatment, the patient's five-year survival rate can reach 95%, phase II patients can also reach more than 80% breast cancer is one of the most common lystoses associated with genetic mutations, the most common genetic genes are BRCA1 and BRCA2, which increase women's risk of breast cancer up to 80 percent if they mutate Therefore, people with a family history of breast cancer, especially those with more than 2 first-degree relatives who have had breast cancer or carry breast cancer pathogenic genetic mutations, need to pay close attention to their breast health, adhere to regular examination in addition, Asian women are mostly less fat, glandmass dense breasts, such as the appearance of lumps is also relatively easy to be found through imaging examination As long as the attention to their own high-risk factors, to achieve regular screening and self-examination, it is possible to achieve early diagnosis and treatment of breast cancer breast tumor early may not necessarily appear obvious symptoms, relying solely on self-examination is difficult to detect in a timely manner, in order to achieve early detection, regular imaging examination is indispensable For ordinary women without high-risk factors, after 25 years of age, mammograms can be screened once a year, once every 2 years, for 45 years of age, with a family history of early breast cancer, early menstruation or late menopause of breast cancer high-risk groups, it is recommended to do 1 breast X-ray joint breast ultrasound screening every year, if necessary, can supplement the mammograms breast cancer treatment trend "addition and subtraction" design, the implementation of tailor-made precision treatment breast cancer diagnosis and surgery, radiotherapy, chemotherapy, endocrine therapy, targeted treatment and other systematic treatment methods for the "addition and subtraction" design, the development of tailor-made precision treatment strategy, has been the new direction of breast cancer diagnosis and treatment , for example, in the surgical treatment of breast cancer, from the initial root ingendors, improved root surgery to today's breast-care surgery, breast reconstruction, the scope of surgery is constantly "reduced", in ensuring the effectiveness of treatment at the same time to achieve the appearance and function of the preservation, to improve the quality of life of patients, improve mental health after surgery has played an important role The precise changes in the surgical "addition and subtraction" method of are also reflected in the treatment of the lymph nodes of the armpits Past treatments for breast cancer have emphasized that all surgical patients need lymph node sweeps, which inevitably lead to complications such as edema, pain, nerve damage, sensory and dysfunction in the upper limbs Now can be "increased" outpost lymph node biopsy, pre-judge the outpost lymph nodes of the affected situation, if the outpost lymph node biopsy did not see significant tumor violations, can "minus" the armpit lymph node cleaning chemotherapy for breast cancer is also being "subtractioned." Chemotherapy is also required before and after some breast cancer surgery, and nausea, vomiting and other toxic side effects from treatment have plagued breast cancer patients Now with the in-depth study of breast cancer development mechanism and the progress of gene testing technology, it is possible to selectively screen the appropriate breast cancer treatment population the advent of targeted drugs, so that chemotherapy is no longer the only means of breast cancer can prolong survival, chemotherapy from the past three or two drugs combined chemotherapy, gradually into a single-drug chemotherapy combined targeted treatment By combining precision diagnosis with individualized treatments, the side effects of chemotherapy are further reduced, resulting in longer disease-free survival and better quality of life different from breast preservation treatment, outpost lymph node biopsy, armpits and other "subtraction", for patients with receptor-positive breast cancer endocrine treatment more emphasis on doing "addition", through further extension of treatment duration, increase the auxiliary drugs, can improve the survival time of premenopausal receptor-positive patients, effectively reduce the long-term risk of tumor recurrence " we should also see that although the level of technology and medical conditions are advancing rapidly, but China's breast cancer in the diagnosis and treatment concept and prevention and control strategy still has a long way to go Professor Zhang Wei introduced, due to the past "cut more and more clean" and other ideas, the current breast cancer rate of breast cancer, recycling rate is only 20% and 10%, with the Western developed countries 60% of the level is still not small gap At the same time, the characteristics of breast cancer group in China are also different from western countries, the difference of molecular segmentation leads to differences in chemotherapy and targeted treatment drug selection, and the characteristics of higher proportion of premenopausal breast cancer patients suggest that clinical trials should be designed around endocrine therapy to obtain clinical data belonging to Asian women, so as to improve the overall survival of breast cancer as a whole.