Today we mainly give you a science popularization, breast cancer treatment model under the concept of modern medicine. The treatment of breast cancer is a comprehensive treatment including surgery, chemotherapy, radiotherapy, endocrine therapy and targeted therapy.
- Surgical treatment
Surgical treatment of breast cancer is a local treatment, its significance lies in the removal of primary breast lesions and regional lymph nodes. The original medicine believed that breast cancer was a localized lesion of the breast, which could be cured by surgery. At the end of the 19th century, Halsted invented radical breast cancer surgery, which improved the prognosis of breast cancer patients; subsequent radical breast cancer surgery further expanded the scope of surgical resection, but did not further improve the prognosis of patients, but brought more postoperative complications disease! With Fisher’s suggestion that breast cancer is essentially a systemic disease, there may be distant metastases in its early stages! Breast cancer surgery has undergone two conceptual changes: 1. The scope of surgery has gradually narrowed, and there has been modified radical mastectomy for breast cancer, breast conserving surgery, and sentinel lymph node biopsy (preserving axilla); 2. Focusing only on tumor treatment Developed to pay equal attention to tumor treatment and beauty, breast conserving surgery, breast tumor plastic surgery and breast reconstruction surgery. The narrowed operation range still obtains an excellent local control rate; while ensuring tumor treatment, it achieves a better cosmetic effect and improves the patient’s quality of life. In recent years, some people have begun to explore the possibility of exempting surgery after chemotherapy, but whether it can be waived or not is still unknown. At present, breast cancer surgery is still an important part of comprehensive breast cancer treatment.
Simply speaking, it is a systemic treatment method that uses chemical drugs to be treated by intravenous infusion and oral administration. Its significance is to kill potential metastases in the body and improve the cure rate. Chemotherapy drugs mainly include side effects of the gastrointestinal system (nausea, vomiting, diarrhea, etc.), blood system (leukopenia, thrombocytopenia, erythrocyte reduction); the main side effects of different types of chemotherapy drugs are different, such as anthracene Cyclic drugs have cardiotoxicity, the hair loss of yew drugs is very obvious, and the vomiting reaction of platinum drugs is obvious. Current chemotherapeutic drugs are not very targeted, and have a killing effect on tumor cells and normal cells, which is also the reason for the side effects of chemotherapy. With the development of medicine, the targeting of chemotherapeutic drugs continues to increase, and side effects are gradually reduced! For example, the ADC drug (T-DM1), which combines targeted drugs and chemotherapeutic drugs, has created a new era of breast cancer treatment, also known as “biological missiles.”
- radiation therapy
Radiation therapy is the use of radiation to irradiate the primary breast tumor and regional lymph nodes. It is a local treatment method. Its significance is to increase the local control rate and reduce the local recurrence rate. For patients with breast-conserving breast cancer treatment and total mastectomy with high-risk recurrence factors, square radiation therapy must be performed. The side effects of radiation therapy are mainly radiation dermatitis (skin damage), radiation pneumonia, and radiation myocarditis. With the continuous development of radiotherapy technology, the accuracy of radiotherapy continues to increase, and the side effects of radiotherapy continue to decrease.
- Endocrine therapy
Some breast cancers are hormone-dependent breast cancers, which are simply positive for estrogen receptor (ER) and progesterone receptor (PR), so estrogen can play a therapeutic role in patients. Endocrine therapy is a systemic treatment with little side effects, slow onset, and high efficiency. Endocrine therapy has evolved from the initial ovariectomy to a variety of mechanisms of treatment today, such as anti-estrogen therapy (tamoxifen, toremifene), aromatase inhibitors (letrozole, anastrozole, estrogen Ximeitan), castration needle (goserelin, leuprolide). Different endocrine therapy drugs have different side effects. For example, tamoxifen may cause endometrial cancer, thrombosis and other side effects. Aromatase inhibitors can cause side effects such as osteoporosis, which should be dealt with in time.
- Targeted therapy
According to different genes expressed by breast cancer cells, it is a systemic treatment method to use targeted therapeutic drugs to target tumor cells carrying the therapeutic target. The most commonly used targeted therapy drugs are anti-HER2 targeted therapy drugs, including trastuzumab, pertuzumab, T-DM1, lapatinib, and pirotinib. The main side effects of trastuzumab, pertuzumab, and T-DM1 are cardiotoxicity. Attention should be paid to monitoring the change of left ventricular ejection fraction of the heart; The main side effect is diarrhea. There is also a cross-generation targeted drug-(CDK4 / 6 inhibitor), mainly used in combination with endocrine therapy, for the treatment of HR + advanced breast cancer, significantly prolonging the PFS (progressive survival) of HR + advanced breast cancer and OS (total survival time). The main side effect is the reduction of white blood cells and platelets, but the mechanism of white blood cell and platelet reduction caused by chemotherapy is completely different. Most people can recover after stopping the drug. In severe cases, the treatment dose must be reduced.
The treatment of breast cancer also includes other treatment modes such as immunotherapy, biological therapy and traditional Chinese medicine treatment. In general, the treatment model for breast cancer has entered an era of precise and comprehensive treatment with multidisciplinary close cooperation. Through the joint consultation system of breast cancer multi-disciplinary experts, comprehensive professional opinions of breast tumor surgery, breast tumor internal medicine, pathology, radiology, radiotherapy, and imaging doctors, based on the actual situation of patients, formulate individualized treatment plans and rational arrangements The treatment sequence makes the patient benefit the most! Comprehensive treatment of breast cancer is indispensable. Modern medicine and traditional medicine are closely combined to give patients the best treatment plan!