China News Service, Beijing, October 30 (Luo Chunhao) On October 29, the social account "cookie" published an obituary. The obituary showed that anti-cancer blogger Yueyue passed away peacefully on October 27 this year, and her life was finally fixed at the age of 27.
Public information shows that Yueyue is a medical student and an "anti-cancer blogger." She was diagnosed with triple-negative breast cancer just when she was about to graduate from her master's degree and had just received her PhD offer.
In the early stages of the disease, she mistakenly thought that the lesion was just a fibroid tumor and did not take it seriously. It was not until she found palpable swollen lymph nodes in her armpit that she realized the seriousness of the problem. After a series of examinations and needle biopsy, she was finally diagnosed with triple-negative breast cancer.
The obituary said: "She liked Stellar and the little rabbit. The little rabbit was afraid of pain and the dark, but as long as someone held it, it dared to take a step forward - she was the little rabbit. As she said when she was seriously ill, she just went there to build a house and plant flowers. In the garden over there, there were jumping rabbits and endless flowers. There were no pungent potions or heartbreaking illnesses. She could finally sleep peacefully and wake up naturally."
Breast cancer is a malignant tumor with a high incidence in women in my country. How to distinguish breast cancer from fibroids in daily life? How to achieve early detection and early treatment? Sino-Singapore Health invited Li Yanshuang, deputy chief physician of breast surgery at Beijing Chaoyang Hospital affiliated to Capital Medical University, to answer your questions.
It feels like fibroid, but why does it turn out to be cancer? Can fibroids become cancerous?
Yueyue initially thought it was just a fibroid tumor and ignored it.
What everyone often calls "breast fibroma", the standard name is "breast fibroadenoma", is a common benign tumor in young women. Li Yanshuang believes that simple fibroadenoma usually does not significantly increase the risk of breast cancer. "At first I thought it was fibroma, but later I was diagnosed with breast cancer" should not be understood as "fibroadenoma turned into cancer."
Specifically, typical fibroadenomas tend to have a smooth surface, clear boundaries, and good mobility; breast cancer tumors may have a hard texture, unclear boundaries, and poor mobility. Li Yanshuang told Sino-Singapore Health that these are just common symptoms and are not reliable criteria for judging benign or malignant. Some breast cancers can also have clear borders and good mobility. The possibility of malignancy cannot be subjectively ruled out just because the tumor is “pushable” or “not painful”.
What should you do if you find a lump in your daily life?
Li Yanshuang suggested that after a breast lump is discovered, it should be evaluated by a breast specialist in conjunction with physical examination and ultrasound, and if necessary, the nature should be clarified through a needle biopsy. For fibroadenomas that are evaluated to be benign, they can be followed up as directed by the doctor; if they increase significantly or have suspicious imaging findings or symptoms, they need to be re-evaluated for biopsy or treatment. Not all fibroadenomas need to be removed.
What are the dangers of triple-negative breast cancer?
Yueyue was diagnosed with triple-negative breast cancer. From the time of diagnosis to her death, she fought cancer for only more than a year.
Triple-negative breast cancer (TNBC), the so-called "triple-negative" here, means that the three indicators of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) are all negative in pathological testing. This is a type of breast cancer and does not equate to advanced stage.
Triple-negative breast cancer, which accounts for about 15% of all breast cancers, typically grows and spreads faster than most other types and has a higher risk of recurrence. Li Yanshuang believes that the conditions of different patients vary greatly, and the outcome of all patients cannot be inferred from the course of the disease of individual patients.
Currently, endocrine therapy and conventional anti-HER2 therapy for HER2-positive breast cancer are not suitable for triple-negative breast cancer due to the lack of corresponding targets. But this does not mean that there is no cure.
At present, doctors will choose comprehensive treatments such as surgery, chemotherapy, and radiotherapy based on staging and other conditions. Patients who meet the conditions can also combine immunotherapy.
Li Yanshuang said that with standard treatment of early-stage triple-negative breast cancer, there is still a chance to achieve long-term disease-free survival. Whether to receive neoadjuvant treatment first, when to operate, and how to treat after surgery should be decided by the doctor based on the condition. The prognosis depends not only on the type, but also on the stage at the time of discovery, treatment response and other factors.
Breast cancer was diagnosed at the age of 27. How should young women get checked out?
Routine screening is recommended for ordinary women to start at the age of 40, but Yueyue is only 27 years old.
In this regard, Li Yanshuang suggested that we must first distinguish between "screening" and "medical treatment." Screening is mainly targeted at people without symptoms. For women at average risk, my country usually recommends regular screening starting around the age of 40. The specific inspection methods and intervals should be determined based on individual circumstances. If a lump or abnormality has been felt, you need to see a doctor in time, and there is no restriction on the starting age of screening.
On a daily basis, young women should pay attention to changes in their breasts that are different from those in the past. New breast or armpit lumps, significant enlargement of existing lumps, sunken breast skin, new nipple inversion, unilateral spontaneous bloody discharge, etc. should be promptly seen by a breast specialist. Self-examination can help detect changes, but it cannot replace imaging examinations, nor can it rule out breast cancer based on "no abnormalities".
For women under the age of 30 with newly discovered breast lumps, breast ultrasound is usually performed first; if necessary, it is combined with further evaluation such as mammography. Ultrasound can help distinguish cystic and solid lesions, but "solid" does not mean malignant, and "ultrasound looks benign" does not mean that a pathological diagnosis has been obtained.
If the examination indicates BI-RADS category 4 or 5, a needle biopsy is usually required to confirm the diagnosis. BI-RADS category 3 lesions that are suitable for follow-up after comprehensive evaluation should be reviewed regularly as directed by the doctor; if the mass continues to increase, or the physical examination and imaging results are inconsistent, the review should be carried out in advance and should not wait until the next review mechanically.
People with a family history of breast or ovarian cancer, especially those whose relatives developed the disease at a young age, have multiple relatives with the disease, are known to carry pathogenic variants in breast cancer susceptibility genes such as BRCA1/2, and have received chest radiotherapy when they were young, should receive specialist risk assessment as early as possible. High-risk women generally need to start screening earlier, including breast MRI with contrast, if necessary.
Doctors remind that young people and no family history cannot completely rule out the possibility of breast cancer. It is more prudent to seek medical treatment promptly when abnormalities are discovered, and after evaluation, follow-up, follow-up or treatment according to the doctor's orders.
