1, the size of the chest and the risk of disease
"Flat chest" is more likely to suffer from breast cancer than "big chest". The reporter was told that more than half of Chinese women have dense breasts, and the risk of breast cancer is 4.7 times higher than that of fatty breasts, and that dense glands tend to hide early cancer symptoms. Therefore, early screening is especially important, but existing X-ray and manual ultrasound are not suitable for dense breast screening. Currently, a fully automated breast ultrasound, which has been piloted in Guangzhou's community medical institutions, is more suitable for dense breasts than other screening methods. Guangzhou will gradually promote a model that combines screening by primary medical institutions and remote diagnosis by experts from large hospitals.
Status quo: less than 20% of China's breast cancer patients are detected in the first stage
Professor Li Anhua, president of the Guangdong Ultrasound Medical Engineering Society and professor of the Affiliated Cancer Hospital of Sun Yat-sen University, said that according to data from China Cancer Statistics published by the National Cancer Center in 2015, there were more than 260,000 cases of new breast cancer in China in 2015 alone, which ranks as the highest incidence rate of all tumors among Chinese women. The incidence rate is the highest. Data released by the Guangdong Provincial Center for Disease Control and Prevention in early 2016 also showed that breast cancer is the first malignant tumor with the highest incidence rate among women in Guangdong province.
"Early screening" is the first step in breast cancer prevention and treatment. Correct and effective screening is the core of the breast cancer prevention and treatment process. However, the early detection rate of breast cancer in China is very low. Less than 20 percent of breast cancer patients are screened in the first stage, compared with 62 percent in Europe and the United States.
Li Anhua believes that elements such as mammography equipment, screening pathways, staffing levels and diagnostic tracking of microscopic lesions have become key to improving the quality of breast health screening.
Problem: Asian women are easily missed with X-ray and manual ultrasound screening
Lee explained that China's breast cancer screening standards change every year because of the inability to find a suitable method. Currently commonly used means of screening is manual ultrasound used in the first line, and the combination of palpation, found to have a problem, recall to do X-ray examination, people often say molybdenum target is one of them. "X-ray mammography is able to detect carcinoma in situ and intraductal carcinoma, and ultrasound is generally able to detect invasive carcinomas smaller than 1 centimeter, which is now **** knowledge." She said.
"However, any medical screening model needs to be supported by large sample data. Right now there is no data to support that manual ultrasound alone can accomplish breast cancer screening because manual ultrasound is prone to missing diagnoses due to incomplete smears by the examiner. What there is data to support is X-ray screening." But studies have also found that even molybdenum targets are only more effective for Western white women, Lee said. For Asian women, X-rays miss about 30 percent of breast cancers. That's because Asian women have relatively small and predominantly dense breasts.
She believes that Asian women with predominantly dense breasts may have some underdiagnosis if only manual ultrasound is used as the first line for breast cancer screening.
Analysis of cause: more than 50% of Chinese women are dense breast
Anne Li further explained that in China, more than 50% of women have dense breast. More than decades of clinical research have shown that women with dense breasts have a 4.7 times higher risk of breast cancer compared to women with fatty breasts. Moreover, dense glands tend to mask early cancer symptoms.
How do I know if I have dense breasts? Breast density is determined by a radiologist by interpreting a mammogram, she said. In the U.S., more than half the states have formal legislation guaranteeing every woman's right to know her breast density.
Anne Lee believes that a more appropriate screening tool for dense breasts should be found.
"However, in China, even mammography with X-rays can only be popularized to county-level hospitals, many of which don't have them yet, much less to the grassroots level." As for manual ultrasound, she said, the doctor's experience has a great influence on the judgment of the ultrasound image and the formation of conclusions. Moreover, manual ultrasound is also related to the density of the equipment and the quality of the images.
"Manual ultrasound requires a very high degree of professionalism on the part of the operator, and the sonographer's professionalism has 90 percent of the impact on the conclusion, and 10 percent of the image quality. And there is a shortage of qualified professional sonographers in China, a shortage no less than that of pediatricians." Almost all medical checkup centers in China are doing manual ultrasounds of the breast for screening, and the biggest potential risk here, she says, is missed diagnoses. "I've seen a lot of the more grass-roots medical checkup centers buy an extremely cheap tens of thousands of dollars manual ultrasound machine and just go around and give people breasts, and that chart, when I look at it, I can describe it as 'dismal,' and how can you do breast screening with a chart like that?"
New technology - fully automated whole breast ultrasound is more suitable for dense breast
Then what exactly is a more accurate means of screening? Li Anhua introduced, at present, a fully automated whole breast ultrasound scan is relatively more suitable for Asian women. This technology uses the principle of ultrasound to establish a three-dimensional image of the breast tissue, is a fully automated, can get rid of the doctor's experience and tactics to rely on the means of breast ultrasound screening, moreover, can be captured to each breast of the six sections of the data, to be able to find 2 mm of the tumor, basically can solve the problem of missed diagnosis. "Of course, as far as being able to detect earlier cancers, that needs to be confirmed by the data."
Li Anhua analyzed that there are two characteristics of breast cancer in Chinese women, one is that they are generally dense breasts, which are not very sensitive to X-rays, and the other is that the peak incidence is at the age of 49 years, while in Europe and the United States it is at the age of 65 years. "Since the incidence of breast cancer in Chinese women is trending younger, especially for women before the age of 40, ultrasound screening is safer and can be performed first using fully automated whole breast ultrasound scanning." She said X-rays can be added in case of non-dense breasts, or in high-risk groups with a family history of childlessness.
New model - community doctors screen for diagnosis by specialists at larger hospitals
Screening, of course, is only the first step, Lee Anwar said. After that, diagnosis needs to be done by a qualified hospital.
Since the fully automatic whole breast scanning examination can be standardized operation, standardized imaging, so as to form a standardized report, get rid of the traditional ultrasound equipment use depends on the operator sweeping method of limitation, can automatically generate standardized, full volume ultrasound image, therefore, the operator's technical requirements are not high, the general nurses, technicians, and even family doctors after one week's training will be able to get started. The screening can be done in the primary care setting. Screening can be done in primary care by simply transmitting the generated ultrasound images in real time via a remote system to a tertiary care hospital ultrasound specialist, who will perform a remote reading and provide an authoritative diagnostic report.
Li Anhua introduced, in Guangzhou, will be in the Haizhu District Shayuan health service institutions for the pilot, by the grass-roots doctors scanning, collected all the images will be sent to the remote end, by the Affiliated Cancer Hospital of Sun Yat-sen University and other major hospitals, experts "read the film" and make a diagnosis. "Shayuan Health Service Organization, Haizhu District, Guangzhou City, is the first public community medical institution in the country that can do ABUS full breast scan." It is reported that in Guangdong, public hospitals that can do this test also include Guangdong Provincial Hospital of Traditional Chinese Medicine and Affiliated Cancer Hospital of Sun Yat-sen University. (Reporter Huang Rongfang)
2, how to protect the health of the breast
1. Strengthen the bodybuilding physical exercise
Best to learn aerobics, rhythmic gymnastics or disco aerobics, while strengthening the upper limbs and pectoral muscles, and to prevent hunchback.
2. Strengthen the nutrition
Appropriately increase the intake of animal protein and animal fat. Some young women, in order to prevent obesity, only eat some vegetarian dishes, vegetarian, and develop a habit of partiality, which is extremely unfavorable to the development of breasts. Some countries in Europe and the United States women's mammary gland development plump. In addition to genetic and racial relationships, high protein and animal fat dietary habits are also very important factors.
3. Adhere to the breast massage
For the breast shape is not full enough in the years of women in addition to usually pay attention to the whole body fitness exercise, adhere to the morning and evening every day to do self-breast massage can also make the breasts fit. This is because massage can promote blood circulation in the breast, promote the smooth muscle development of the nipple, can also prevent nipple inversion. As the breast tissue is arranged in a radial pattern, the massage needs to be carried out in the direction of the breast tissue.
How do women protect their breasts?
4. Correcting bad habits
(1) Do not squeeze: After the breasts are squeezed by external forces, the soft tissues inside the breasts are easy to be bruised, or make the internal cause of hyperplasia. Moreover, after being squeezed by external forces, it is easy to change the external shape, so that the uplifted nipples appear to be sagging and collapsing phenomenon.
(2) Maintain the correct sleeping position: women sleep on their backs as the best try not to lie on their sides in one direction for a long time, which not only squeezes the breasts, but also easily causes bilateral breast development imbalance.
(3) Choose the right bra: Choose a bra that is elastic and of the right size for sagging breasts as well as during breastfeeding, and let it play the best lifting effect. For patients with skin allergies, it is not advisable to use bras made of chemical fiber fabrics.
5. Adhere to normal marriage and childbearing
Adhere to normal marriage and childbearing, and insist on breastfeeding after giving birth to reduce the incidence of lobular hyperplasia of the mammary glands, breast cancer and so on is of great significance.
6. Emphasize the importance of adjusting the mood
Pay attention to maintaining a calm, quiet, cheerful and optimistic state of mind, and timely treatment of menstrual disorders, etc., is very important to the breast health.