0 1, the results of pathological examination after standardized treatment of breast cancer will tell us that TNM staging and genotyping of the disease are the most important for postoperative treatment.
According to ER (estrogen receptor), PR (progesterone receptor), Her-2 (oncogene, human epidermal growth factor receptor -2) and Ki-67 (proliferation size), breast cancer can be divided into hormone sensitive type, Her-2 positive type and triple negative type. Except for a few early hormone-sensitive breast cancers, most of them need adjuvant chemotherapy!
If Her-2 is positive, targeted therapy is recommended 1 year, and if hormone receptor is positive, it should be endocrine therapy for 5 5- 10/year.
Some women have breast-conserving surgery, or axillary lymph nodes are positive, and need postoperative adjuvant radiotherapy to remove local residual cancer cells.
02, monitoring and review of breast cancer treatment can not be sloppy, some people do not pay attention to the review, it is impossible, after all, it is a malignant tumor, with the "nature" of recurrence and metastasis! Some patients are too nervous, which is not good. The recurrence and enlargement of tumors come slowly, and most of them will not change significantly in a short time!
Patients should pay attention to the contralateral breast, armpit and chest wall, and often check themselves carefully. Then go to the hospital for examination. What are the mandatory options? Contralateral breast ultrasound, molybdenum target, liver ultrasound, lung CT, blood routine and biochemical examination.
Some people miss the contralateral breast examination, just like "black under the lamp". The probability of cancer in the contralateral breast is many times that of healthy people! Some people have poor lung examination and chest plain film, and CT examination should be better. These two situations are relatively common and should be paid attention to.
Some tests should be checked every time, such as bone scan and brain examination. The positive rate of tumor markers in early breast cancer is very low, but the examination is simple and you can choose to do it. Many patients feel sore limbs and worry about bone metastasis after endocrine therapy. Bone radionuclide scanning can also be considered. Generally, bone metastasis of breast cancer first reaches the spine and ribs, with fewer limbs. Whole-body radionuclide scanning can also be reassuring.
Patients with long-term endocrine therapy should also pay attention to whether the endometrium is thickened, and check the bone mineral density if necessary.
03, healthy diet, exercise, breast cancer and diet have a certain relationship, non-special circumstances, reasonable food mix, healthy diet, that is, normal diet. Avoid eating too much fat, such as fat and red meat. High fat can lead to the increase of estrogen in the body, which is also the cause of obesity, which is not conducive to the recovery of postmenopausal breast cancer. Foods containing estrogen, such as royal jelly, wood frog, placenta products, etc. And beauty care products should be cautious, or contain estrogen. No drinking, not a drop of wine.
Many times we comfort patients to have more rest. In essence, staying in bed without exercise is not conducive to recovery. There are many benefits of exercise, such as increasing appetite, increasing gastrointestinal peristalsis, improving immunity, improving mood and so on.
04, a good attitude, return to society, cancer patients are inevitably afraid, understandable. A patient found lymph nodes in the neck 3 months after operation. The examination was small, smooth and active. Combined with early and axillary lymph node metastasis history, it should be normal lymph nodes. Suggest observation, the patient is very nervous. Heart disease is the most difficult to treat, what should I do?
The support of relatives and friends should be ok, and then find ways to relieve stress by yourself, such as practicing yoga and keeping a diary, which suits you and makes life meaningful.
The patient is just sick, not worse than others, right? If your health permits, I suggest you resume your previous job. You can choose something less intense to do. There is no need to care about other people's pointing fingers!
There are many factors for the recurrence and metastasis of the disease, although there are many objective factors, such as staging, genotyping and histological grading of breast cancer. But there are also many subjective reasons that can be changed, such as treatment and review. Fate is not entirely resigned, and some can be mastered by yourself! I'm Dr. @ Liu Yongyi, thank you for reading!
After a series of treatments such as surgery, chemotherapy, radiotherapy and targeted therapy, breast cancer patients still need regular review. Why do they need regular review?
First, the significance of postoperative review
As the saying goes, cancer can't be cured, but this is the previous statement. With the new technology and drugs entering the clinic, the prognosis of breast cancer is getting better and better. Although the prognosis is better than before, regular review is necessary. The significance of the review includes three aspects:
1. Find recurrence or metastasis as soon as possible, so as to deal with it in time; 2. Understand whether patients insist on adjuvant therapy and can tolerate adverse reactions caused by adjuvant therapy;
3. Adjust and improve the follow-up treatment plan.
Second, the time of postoperative review
The follow-up review of invasive cancer generally begins with the last hospitalization (the time of surgery or last chemotherapy), and it is generally recommended to start regular review 6 months after operation. For patients with high recurrence risk, it can be suggested that they should be reexamined once every three months within 1-2 years after operation, once every six months from the third year to the fifth year, and once every six years from the sixth year.
Third, review the project.
1, ultrasound (breast, thyroid, supraclavicular lymph nodes, abdominal ultrasound) (once every 3 to 6 months)
2. Blood biochemistry (liver and kidney function), blood routine, tumor markers (including AFP, CEA, CA 15-3, etc. ), and can add ferritin, ceruloplasmin and other items in conditional hospitals (once every 6 months).
3. Mammography (0 years 1 time) and chest CT(6 months or 1 year 1 time); Head MRI (once every 65,438+0 years), bone scan (once every 65,438+0-2,65,438+0 times), breast MRI or PECT should be performed when necessary according to the reexamination results, and not routinely used for postoperative reexamination.
Four, postoperative endocrine therapists need special examination items:
If the hormone receptor is positive, the patient needs endocrine therapy 5- 10 years after operation. Different endocrine therapy drugs have different side effects. Long-term treatment needs regular review and escort, so as to find side effects as soon as possible, change endocrine treatment plan in time and reduce the harm of side effects.
5. What should I do if I find something abnormal?
If there are abnormal test results, first of all, don't be blindly anxious and see a professional doctor. Some abnormal results may need further examination to make clear the results, listen to the doctor's judgment and treatment, and don't be overly alarmed.
Breast cancer is the number one killer of female friends. Although unfortunately diagnosed with breast cancer, it was still early and the operation was successful. You have bravely taken the first step against tumor jun. What should you pay attention to after the operation in order to completely defeat tumor jun?
Precautions after operation 1. Postoperative standardized treatment
Surgery is one of the most important treatments for breast cancer. After surgical resection of the tumor, in order to improve the cure probability of the tumor, there is another important thing to do, that is, to evaluate whether it is necessary to continue adjuvant therapy after operation. Generally, it needs to be reexamined about one month after operation, and then according to the pathological results after operation, according to the pathological type of breast cancer, the size of tumor, and whether there is metastasis of axillary lymph nodes, the need for postoperative adjuvant chemotherapy, radiotherapy, targeted therapy and endocrine therapy is comprehensively evaluated.
2. Functional exercise after operation
Breast cancer surgery is usually a modified radical operation. In addition to mastectomy, axillary lymph node dissection is usually required. Axillary lymph node dissection will affect the venous and lymphatic reflux of the arm and damage the function of the affected arm to some extent. Therefore, in order to restore the function and self-care ability of the affected arm as soon as possible, it is necessary to carry out functional training of the arm by yourself. According to the recovery situation, you can start with wrist flexion, shoulder joint movement and wall climbing movement, and gradually return to normal housework. The recovery of motion of the affected limb is a long process, so you must not rush or do strenuous exercise to prevent the wound from tearing. After postoperative recovery, you can also gradually increase routine physical exercise to enhance immunity.
3. Post-operative healthy psychological construction
After mastectomy, it is understandable that people will fall into a state of depression under the dual influence of the diagnosis of cancer and the appearance change of breast loss. Literature shows that the incidence of anxiety, depression and psychological pain in breast cancer patients is relatively high. Therefore, in addition to paying attention to physical recovery after surgery, psychological construction is also very important. First of all, we should build up confidence, read more successful cases of anti-cancer and encourage ourselves to beat tumor jun bravely. Secondly, we should learn from patients, find a suitable way to make up for our physical defects, dress ourselves up and improve our self-esteem awareness. Finally, communicate with family and friends more, get their encouragement and support, and feel that you are concerned. Return to society normally, resume certain jobs, participate in social activities, divert attention and get more social support. If it is difficult to adjust your mentality by yourself, you can also seek the help of a psychologist.
4. Regular postoperative review.
Tumor diseases, like chronic diseases such as hypertension, need our regular monitoring and review after treatment. After surgery and adjuvant therapy, we should not take it lightly. The methods of monitoring and reexamination include self-examination and going to the hospital for examination.
Self-examination: it is necessary to pay attention to whether there are abnormal lumps in the chest wall, armpit and neck after operation, whether there are lumps in the healthy breast and armpit, and whether there is abnormal nipple discharge. If there is any abnormality, you need to see a doctor in time.
Hospital examination: The specific reexamination time requirements are as follows: every 3 months within 2 years after operation, every 3-6 months after operation 1 time, and every year after 5 years after operation 1 time. Although reexamination is time-consuming and laborious, it is very important to find out whether the tumor has recurred or metastasized in time. The reexamination usually requires blood routine, blood biochemistry and tumor markers detection. If necessary, breast axillary color Doppler ultrasound, neck color Doppler ultrasound, liver ultrasound, lung CT and bone scanning are also needed.
In addition to the above important points, the postoperative diet of breast cancer should be regular, diversified and balanced. In order to supplement nutrition, we should eat high protein and try to avoid foods rich in fat, sugar and estrogen.
To sum up, the road to anti-cancer is long and arduous, and scientific and standardized postoperative treatment and review can make us take fewer detours. In the face of tumor jun, only by taking the initiative, actively treating and re-examining can we have a chance to defeat it. For the rest of your life, please hold your destiny and life firmly in your own hands.
Good wishes!
1. Patients and their families face the disease with a positive attitude. Breast cancer is a very effective disease. Avoid panic or fear.
2. Actively cooperate with the attending doctor to communicate well, carry out regular treatment on time with good quality and quantity, and don't be superstitious about the so-called "magic doctor" and "secret recipe".
3. Establish a correct attitude, "neither too serious nor too serious".
4. Regular review after treatment is also a necessary means to improve the survival rate and quality of life.
5. You can support and encourage each other with positive and optimistic patients and share your anti-cancer experience.
It is suggested to make a follow-up treatment plan according to postoperative pathology and staging, pay attention to rest and light diet after operation, and avoid spicy food.
Need to adjust their mentality.
Mentality is very important,
conventional therapy
Regular review,
pay attention to the diet
sports
Need maintenance, good maintenance can reduce the chance of recurrence or metastasis. There's still a chance to get it back.