Author: Zhou Jieying Date: 2018-07-24
"Most of the breast cancer patients still really want to keep breast milk, but once breast milk and life-saving can only choose one, most people will not hesitate to sacrifice their lives under strong fear. But in fact, everyone is misunderstood. It can be said that breast-protection is the 'life-saving'." At the 5th China Breast Surgery Conference and the 2018 China Southern Breast Cancer Summit held recently, Professor Su Fengxi, director of the Breast Cancer Center of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, lamented that in breast cancer. In terms of breast-conserving treatment, not only patients, but also the concept of many doctors need to be updated. "Preserving milk is a culture." Su Fengxi said.
At this forum, breast experts across the country launched a brainstorm on the most cutting-edge technologies for breast disease treatment. Experts say that with the development of various new medical technologies, breast surgery has become "smaller and smaller", and surgeons will change from "knife" to "needle" in the future, plus chemotherapy, radiotherapy, and immunotherapy. The advancement and popularization of technologies such as gene sequencing, the future treatment of breast cancer will truly achieve the smallest effective treatment to replace the largest tolerable treatment, patients do not need to do the "preservation or life-saving" this multiple choice question.
Breast-conserving surgery is no longer just a simple surgery
Su Fengxi has long been committed to the advocacy of breast cancer treatment concept for early breast cancer. He said, "Preservation surgery is a standardized surgical treatment for early breast cancer." In Europe and the United States, the breast-conserving rate can reach 50%, while in China, even in coastal developed cities, it is less than 20%. The rate is only 10% to 30%. "The patient is afraid of recurrence in the heart, many breast surgeons lack confidence, and the lack of collaborative support in the imaging and pathology departments, which restricts the development of breast-conserving treatment." Su Fengxi believes that medical development to today, there is increasingly accurate radiotherapy technology To protect the local control of the tumor, there is a strong systemic treatment for the three-dimensional control of systemic diseases. It should be recognized that breast-conserving surgery is not just a simple surgery, but includes breast health, physical function protection, life preservation and life. A multi-dimensional treatment program, including quality protection, “hopes to maximize the beauty and dignity of women.â€
Resection of the breast may also transfer recurrence
Su Fengxi said that many patients and even grassroots doctors are too deeply misunderstood about "preserving breast milk". They always think that "cutting" is a hundred, and they will not relapse, and "guarantee" means "after suffering." In fact, the tumor is a systemic systemic disease. The removal of the breast does not completely reduce the risk of cancer to zero. The lymph nodes are not a barrier to tumor metastasis. The tumor cells can also be transferred through the bloodstream; whether international or Zhongshan. The trial of the breast center of Sun Yat-sen Memorial Hospital of the University has been confirmed by a large number of long-term randomized clinical trials. Breast-conserving surgery and cutting surgery in breast cancer patients with suitable conditions have no difference in efficacy and life extension. Some types of breast tumors are protected. The efficacy of milk is even better than resection.
With the development of precision radiotherapy technology and the improvement of multidisciplinary comprehensive treatment, the quality of life of patients receiving breast-conserving treatment is even higher than that of resection. The most worrying risk of local recurrence can be controlled to be equivalent to resection. It should be emphasized that it is impossible to completely remove tumor cells, whether it is cut or protected. However, patients undergo long-term systemic treatment, long-term follow-up, and strict compliance with medical advice. Most of the conditions can be controlled and the maximum effect can be obtained.
The future: implanting a small silicone tube can prevent tumors
The chairman of the forum and Professor Wang Xianming of the First Affiliated Hospital of Shenzhen University mentioned in the keynote speech that breast surgeons face the challenge of technological evolution and must upgrade to the “3.0 version†of surgeons in the future. He cited the introduction, the current direction of the industry is that breast surgery is getting smaller and smaller, axillary lymph node dissection can be replaced by systemic therapy and radiotherapy, sentinel lymph node biopsy staging can be replaced by genomics, if it is cancerous in the mammary duct, the future can also Surgery is replaced by active monitoring and local attention treatment, not to mention the use of non-invasive treatment of tumor ablation and the use of vaccines and immunotherapy. In the future, the "knife" in the hands of breast surgeons may become smaller and smaller, as small as "needle," Wang Xianming said.
Wang Xianming introduced the practice of the international advanced medical team, from endocrine therapy to genetic analysis, genetic testing and screening, plastic surgery, image screening, etc.; especially some emerging topical therapies, such as implantable drug delivery devices, The silicone tube can be placed in the location of the tumor lesion in the mammary gland for 5 to 10 years to accurately infuse the therapeutic drug, and these tests are currently being carried out internationally. Although these speeches are aimed at the “upgrade transformation†of surgeons, for ordinary patients, breast surgery is moving in the direction of becoming a “small†thing, and the emergence of various emerging technologies will guarantee Milk treatment offers more and more powerful protection.
Genetic testing: "predicting the future" to develop treatment options
The most well-known example of screening and predicting the onset of breast cancer by genetic testing is that in 2013, American actress Angelina Jolie passed the test to determine that she had a high risk of breast cancer, and that she was not ill. Prophylactic mastectomy and breast reconstruction.
In this regard, Professor Gong Chang, director of the Breast Diagnostics Specialist of Sun Yat-sen Memorial Hospital of Sun Yat-Sen University, pointed out that in view of the various factors such as the cost of testing, medical insurance and even the level of breast reconstruction and reshaping, the practical significance of domestic genetic testing in the prevention of healthy people is still relatively good. Limited, "It is not recommended for high-risk groups to imitate Julie's practice for routine mastectomy." Gong Chang said that the greater significance of genetic testing lies in the application of the disease population, such as patients with confirmed breast cancer can pass genetic testing To accurately predict the patient's sensitivity to the drug, the probability of recurrence after treatment, the probability of metastasis and even the survival rate, thus assisting in the development of accurate and effective personalized treatment.
According to reports, the application of genetic testing in the field of breast cancer diagnosis and treatment and prognosis is based on the collection and calculation of a large number of clinical data. At present, the international algorithm standards are still based on European and American populations, which may not fully meet the needs of Asian populations. At present, Sun Yat-sen Memorial Hospital of Sun Yat-sen University is conducting a large number of clinical data collection and research verification at a number of oncology centers in the United Nations. It is expected that a guideline for the use of Chinese and even Asian populations will be developed in the near future. It can be said that the use of genetic testing will also be a powerful guarantee for breast-protection. (All-Media Reporter Zhou Jieying)
Source: Guangzhou Daily
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