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Breast Cancer

Traditional Chinese Medicine (TCM)Clinical OncologyGeneral Surgery

Breast cause occurs when some breast cells begin to grow abnormally which develops into a tumor, if malignant it becomes what we call breast cancer. In 2020 Hong Kong registered 5000 new cases of breast cancer, compared to 2010 this number has increased 6 times. Breast cancer is currently the most commonly seen cancer in Hong Kong women with rates of breast cancer having increased 3 fold.

Symptoms

Patients with early stages of breast cancer may not have clear symptoms until the tumor has formed a mass or hyperplasia or even metastasized.

The following are more commonly seen breast cancer-related symptoms:

On the breast: formations of a lump with varying and changes in size. The skin can also appear with dotted depressions and an orange peel pattern.
Nipples or Areolas may present with discharge or blood and changes in shape and dimpling
Armpit: Swollen in the general area or swollen lymph nodes

Women often feel lumps before menstruation. It may be due to hormonal changes during menstruation. It is a normal physiological reaction and there is no need to worry too much.

Causes and Risk factors

Currently, the medical community is not entirely sure of the cause of breast cancer. Currently over half of the breast cancer patients in Hong Kong are above the age of 50.

Besides the family history, the following risk factors also increase the chances of developing breast cancer.

Early or late on-set menopause
Long term consumption of high animal fat food
Smoking, high consumption of alcohol, lack of exercise
Long-term use of birth control or consist use of HRT (Hormone Replacement Therapy) for more than 5 years.
Increase in weight after menopause (which may affect Estrogen production)

Diagnosis

If you are suspecting that you might have breast cancer ,you should have a doctor check as soon as possible. After understanding the patient’s history they will first assess the patient’s condition. Early assessments of breast cancer include an X-ray scan and an ultrasound of the breast tissue. If needed the doctor may perform a biopsy to see whether the tumor is malignant or benign.

Treatment

The treatment of breast cancer is mainly split into 5 categories：

Surgical options: The surgeon will remove part of the breast that has cancer cells. The areas removed will depend on the size and location of the tumor, if most or all of the breast tissue needs to be removed, it will be necessary to decide before the operation whether plastic surgery is required after operation.
- Breast reconstruction by implantation of prosthetic breasts or skin flap transplantation allowing patients to restore their image and confidence
Radiation therapy to pinpoint cancer cells with high-energy rays and destroy them without affecting the normal cells
Chemotherapy: Through the use of medications to destroy cancer cells, however, healthy cells also have a low tolerance for these medications. Therefore destroying both cancer and healthy cells which may cause side effects.
Hormone therapy: Estrogen and progesterone can dangerously stimulate the proliferation of breast cancer cells. As such suppressing these hormones by medications or surgical options can prevent the growth of cancer cells.
Targeted Therapies use medications specific to the genetic mutations responsible for the cancerous growth targeting their ability to grow further and limit their tumor’s ability to function leading to cell death.

Prevention and Screening

Lifestyle habits are heavily related to breast cancer. For those who are concerned about breast cancer, consider not smoking, drinking less, doing more exercise, maintaining a healthy body weight, reducing stress, and reducing consumption of animal fat products.
Make sure that you are vigilant and pay attention to the health and condition of your breasts, consistently checking if there are any changes.
Seek medical attention as soon as possible if you notice any abnormalities in your breasts.

Women above the age of 40 are generally recommended to have regular mammograms every one to two years. For those who are at higher risk of breast cancer may want to start regular mammography screening and monitoring earlier. For recommendations regarding detailed breast cancer assessment and screening please consult medical professionals.

TCM in Cancer Therapy

In recent years, the Hong Kong medical community has advocated for the combined treatment of cancer with both Western and traditional medicine. Chinese medicine can help patients relieve pain, improve fatigue and insomnia allowing for the body to heal and reduce the risk of recurrence.

Advantages of combining Western and traditional medicine:

Increase overall quality of life, lowered amounts of fatigue, insomnia and emotional problems
Reducing the side effects of chemotherapy
Increase treatment completion rate
Consistent use of Chinese medication can help lower the chances of remission.

Frequently Asked Questions

Although over half of breast cancer patients are over the age of 50 at the time of admission people below that age can also develop breast cancer. Increasing your understanding of breast cancer and consistently going for regular checkups can potentially help discover breast cancer early, something that is especially important for younger women.

As medicine advances the rate of recovery for breast cancer has increased as well, early detection and treatment of breast cancer will also improve recovery rates. Maintaining a positive mindset and good quality of life habits such as a balanced diet, good sleep quality, and lowering stress are all instrumental to dealing with breast cancer. There are also various organizations dedicated to providing support services for breast cancer patients such as familial and psychological support.

Treatment for breast cancer is specific for each patient, sometimes doctors will need to perform cytopathological examinations to help determine the most suitable treatment plan, as such it’s suggested your friend ask their doctor about their treatment options.

Women above the age of 20 should perform breast exams on themselves monthly, it should be performed on the seventh to tenth day after the onset of menstruation. For those who have stopped menstruation, the examination should be tested on the same day each month. Using the “Observe, Touch, Compare” method. Look out for any changes in the breast skin, nipples or if there is any discharge. Touch feel your breasts for any hard lumps, thickening or pain, unusual touch on only one side of the breasts may not be associated with menstruation Compare the current and previous breast size and look for any changes in both sides of your breast. If you find anything has changed, seek medical advice. For more information see: https://heal-oncology.com/cancer/breast-cancer/

^1.Overview of HK Cancer Stat 2020_tc.pdf (from Hospital Authority)

²Breast Cancer Oct 22C (from Cancer Fund)