Breast Cancer: You should have a mammogram after the age of 40

Breast cancer is such a common cancer that it affects 1 in 5 women with cancer. Moreover, the number of patients is increasing every year, making it the number one cancer for women.

Saturday Vlog: 4/2/22 (Breast Cancer Benefit) 2022

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Breast Cancer

Breast cancer is such a common cancer that it affects 1 in 5 women with cancer. Moreover, the number of patients is increasing every year, making it the number one cancer for women.

Fortunately, however, the treatment is well developed and the survival rate is higher than that of other cancers because it is often detected early. The 5-year overall survival rate after surgery is over 90%, and in the case of intraepithelial cancer, the 5-year survival rate is close to 99%.

However, in the case of stage 4 cancer patients, even with standard treatment, the 5-year survival rate is only 30%. Therefore, regular check-ups for early detection are important. Seon Woo-young, a professor of breast surgery at the Catholic University of Korea Daejeon St. Mary’s Hospital, learns about breast cancer with the help.

Many are detected in the early stage without symptoms through a health check-up

Breast is made up of lobules that make milk, mammary gland tissue that is the path through which milk comes out, connective tissue that maintains the shape of the breast, and fat that acts as a cushion.

Most cancers occur in the mammary gland tissue, and 80% of them occur in the ducts, so breast cancer is generally referred to as ductal cancer. According to the extent to which the cancer has spread to the surrounding area, it can be divided into intraepithelial cancer and invasive cancer.

Intraepithelial cancer is a stage 0 cancer that does not spread to other sites because it grows only in the epithelial cells of the ducts, and does not undergo chemotherapy. Invasive cancer is a cancer that has penetrated the basement membrane surrounding these epithelial cells and can spread to other parts and organs by invading blood vessels or lymphatic vessels outside the basement membrane.

The age group in which breast cancer occurs the most is in the 40s, and the incidence frequency is in the order of 50s, 60s, 30s, and 70s. About one-third of patients are asymptomatic in the early stages, so that they are detected during examination without any symptoms.

Common symptoms include lumps, nipple discharge, and skin changes. A lump is the most common symptom and is usually a painless lump that does not change in size with the menstrual cycle. However, there are many cases where a solid area without abnormalities is mistaken for a lump.

An abnormal discharge, or blood, may come out of the nipple. The nipple secretions suspected of cancer are mainly from one side, and even in one nipple, chocolate color or blood comes out from one specific duct rather than several ducts.

Not all of the bleeding is cancer, but it is a symptom that requires medical attention. Skin changes also occur, with symptoms such as redness of the skin, as thick as an orange peel, or bruising without injury. Symptoms of nipple or skin depression are also related to breast cancer.

Other symptoms may include palpable lumps in the armpits, which are enlarged lymph nodes due to metastases. Although less than 5% of breast cancer patients complain of breast pain as the main symptom, it is important to differentiate it if breast pain persists.

You should have a mammogram after the age of 40

There are many causes of breast cancer, including hormones, diet, obesity, heredity, a history of radiation therapy, and environmental factors.

The longer the exposure to the female hormone estrogen, the higher the risk. Early menarche, when menstruation occurs before the fifth grade of elementary school, and late menopause, which occurs after the age of 55, are risk factors due to the long exposure period.

In postmenopausal women, female hormones are no longer produced from the ovaries, but a component called androstenedione is made from the abdominal fat into female hormones, which is a risk factor.

Genetic factors are also considered important, but genetics do not account for 5-10% of all cancers. The risk of developing breast cancer is higher if an immediate family member has breast cancer, if the disease develops at a young age, or if a sister has breast cancer rather than the mother.

The Korean Breast Cancer Society recommends clinical examination and mammography every 1 to 2 years after age 40, and biopsy is performed if abnormalities are found. Biopsy methods include fine needle aspiration cytology or nuclear needle biopsy. When cancer cells are observed under a microscope, it is finally determined as breast cancer.

Magnetic resonance imaging (MRI) is used to more accurately measure the extent of a lesion when planning a surgery after being diagnosed with breast cancer and to determine the presence of multiple lesions or bilateral breast cancer.

Breast cancer treatment is largely divided into surgery, chemotherapy, antihormonal therapy, radiation therapy, and targeted therapy. Recently, immunotherapy has been added and is being used in breast cancer patients. These treatments are tailored to each patient by varying the treatment regimen, sequence, and duration in consideration of the patient’s characteristics and cancer characteristics.

Surgery is divided into breast surgery and axillary lymph node surgery, and breast surgery is largely divided into partial mastectomy (breast-conserving surgery) and total mastectomy. Breast-conserving surgery is performed in 60-70% of all breast cancer patients as early detection of breast cancer increases.

Although the number of breast-conserving surgeries is increasing, about a third of them perform total mastectomy. Since 2015, health insurance has been applied to breast restoration, and the number has recently increased.

Breast reconstruction helps patients to regain confidence in their own body by making them similar to the original breasts using breast implants or their own tissues in patients who have had their breasts removed.

It is mainly performed in patients with early breast cancer, and depending on the timing of surgery, there are immediate reconstruction, which is performed simultaneously with mastectomy, and delayed reconstruction, which is performed 2-3 years after breast cancer surgery. Recently, with the development of surgical methods and technologies, the number of cases being performed simultaneously with cancer removal surgery is increasing.

Professor Seon Woo-young said, “Breast cancer is difficult to prevent even if known risk factors are corrected because only one-third of all breast cancer patients have breast cancer risk factors.

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