Breast cancer: Early stage = curable

Breast cancer: Early stage = curable

Believe it or not, more than seventy percent of breast cancer is early stage and curable. Work efficiently

Therefore, the author would like to tell the story as “Patient Journey” or “Patient Journey” according to the popularity of the patient manual that the author has studied and compiled as a simple principle for you to read.

Initially, breast cancer was considered a female cancer, but the “habit” of this type of cancer is courageous. Symptoms usually occur at an early stage, have not yet spread, and rarely hide and then show symptoms in a metastatic stage at the beginning of diagnosis. Therefore, most patients find the disease by palpation, or some are screened according to the recommendations according to the cancer screening guidelines. Screening can be done at the age of 35 by doing a mammogram, the reason why it starts at the age of 35 is because the incidence of cancer in the 35-40 years old is quite high, which is the age when you are working. Income There is a family to take care of, and many of them are also “mothers”, which is a huge responsibility. Mamma-mogram is an examination in which the body is inserted into an X-ray machine, which is a breast patch. As a result, the sensitivity to find lumps is also high and the detection accuracy is also more than ninety percent. However, all tests have limitations. A mammogram will also be a torment for our women. The author is not going to be lazy, but he is going to tell the reader that if you are young in the 25-30 years old, you have a family history of breast cancer genes that have been detected like The screening needs to be done faster. The breast area is quite dense, making it difficult to examine with mammogram and quite painful while doing it. Another screening method is to do a special MRI breast by entering the tunnel and lying still. Examined at least once a year until the age of 70-75 years old. The skin on the breast looks abnormal, or it may also cause a lump in the armpit.

Conclusion: In the first paragraph, it is emphasized that you should start paying attention to your own breast care and screening from the age of 35 because cancer can happen to anyone.

When entering the examination room. If you have not done a mammogram before, the doctor will recommend you to go for a mammogram to determine the location. And if the lump in the breast has a high probability of cancer, the doctor will “puncture” the breast biopsy to examine it, which the author uses the word puncture because the surgeon or radiologist will perform an ultrasound to accurately locate the lump and then inject anesthesia and use a dark leaf that looks like a tube and is the same size as a regular water tube to press down on the location of the breast tumor and withdraw the hand. We will get a quality biopsy for accurate diagnosis.

After 2-10 days, the doctor will make an appointment for the patient to hear the results. The doctor will begin to ask about concerns. Expectations of treatment Many patients, including the patient’s doctor, often talk about a cure. Medication and surgery currently include breast preservation surgery and radiation therapy, or surgery to remove the whole breast with additional radiation depending on the stage and nature of the cancer biopsy. All the patient’s concerns and treatment aspirations will be brought together through a meeting of multidisciplinary doctors, and the doctor will provide an overview of the guidelines and lead the way in each breast cancer treatment process because early breast cancer is also sub-stage and there are many different types of cancer. One of the author’s patients jokingly said that breast cancer is like a dog. Each breed has a different habit of asking and needs to be raised in a different way. Readers who have raised some glasses and cute fluffy ones may not agree. The author would like to draw everyone back to the type of breast cancer again.

1. Breast cancer with a hormonal receptor (Luminal subtype) but not HER2 negative receptors (HER2 negative) is given by the author as a shy girl. If the lump is larger than one centimeter, Even without distribution to the lymph nodes. Your doctor may discuss sending a biopsy for cancer genetics to see if there is a chance of recurrence (recurrent score). To see the need for chemical drugs. If you don’t need chemotherapy or chemotherapy, it’s simply like predicting how likely the malignant cancer is to recur. If you scold, the high score calculator compares the picture. The patient also needs to be given chemotherapy for three months or 4 cycles, but if the lump is very large to 2 centimeters or more, or has spread to the lymph nodes. Patients need to receive chemotherapy to prevent recurrence. After that, the cancer is not over, and it is still necessary to continue taking hormonal drugs for another 5-10 years so that the chance of coming back is less than 10 percent.

2. Breast cancer with a hormonal receptor (Luminal subtype) and HER2 positive (HER2 positive) is given by the author as a shy and conditional girl. In the past, 10 years ago, it was still a very aggressive disease and had a bad prognosis, with a relatively high chance of recurrence. But if you get the right drug, it binds to the Hertu receptor. The condition of the ferocious Hertu will become a docile dog and be given anti-hormonal drugs for another 5-10 years like type 1, that is, if the disease is in its early stages, and the lump is very large to 2 centimeters or more, or has spread to the lymph nodes. Chemotherapy and targeted drugs are treated before surgery, which may cause the phenomenon that the cancer disappears before surgery, which is called pathological complete remission, which is considered a very good phenomenon that reduces the chance of recurrence and is safer from cancer. But the Hertu conditions of type 2 and 3 breast cancer are The availability of both chemotherapy and preoperative drugs depends on the meeting of the multidisciplinary medical team. But what is really mandatory of the condition of getting anti-Hertu drugs is to give the drug for 1 year.

3. Breast cancer with HER2 positive receptors is a condition for the girl because it cuts off the hormonal receptors, leaving it up to the whole team to consider whether to administer drugs aimed at only anti-hertu receptors or whether one or two drugs must be given. If you give anti-hormonal drugs and there are lumps left. If the cancer does not disappear after surgery, it may be considered to give a drug called TDM-1, which is an ADCC drug, for another year to keep us from relapse even more, or if it meets the standard of treatment in Thailand, we can pay for trastuzumab for a period of 1 year.

4. Basal subtype breast cancer is the name given to this type of breast cancer. The bad thing is the prognosis. Doctors have long known that she has the most aggressive habits, and only chemotherapy can defeat her. In the past, it was the easiest because there were no other drugs to consider. If a genetic test of blood or biopsy reveals a mutation that is likely to lead to breast cancer, called BRCA1, or a targeted drug that is an oral PARP inhibitor can be given as an adjunct treatment for 1 year in addition to chemotherapy. This has made the patient group safer from the disease by more than 40%.

Side effects of treatment, aesthetics, safety of medication, surgery, and radiation With the current technology, there are drugs to reduce nausea and vomiting that will reduce the side effects of eating without bloating. There are medical supplements that patients can take to increase protein and reduce the chance of low leukocytes, making it possible to get the drug on time. Surgery with a cold-based knife heals the wound faster. Reduce the time spent in the hospital. Radiation therapy is a three-dimensional projection aimed at a precise point that the author now hardly turns. Another option to prevent hair loss during chemotherapy is a cold hat that reduces hair loss, allowing cancer patients to live a lifestyle that even if they have to make adjustments, they do not have to change themselves completely.

Patient readers come to the decision to choose a complicated drug here. The important hook message that the author wants to emphasize is not to worry or be discouraged by the huge amount of information. Because the doctors in the team have spent more than ten years learning together in breast cancer treatment. If any reader is suspicious, thinks that his family history is at risk, or thinks that he or she needs counseling, please see a doctor immediately for consultation for further examination. Of course, with current technology, it can heal you. At least if it is in the early stages, it can be cured and prevent recurrence. Metastasis can also be treated, and if the author has the opportunity to present to readers the new treatment science of modern medicine with various options, please stay tuned for the next part.

Source : NCCN Guideline, ESMO Guideline.

Dr. Panuch Eiamprapaporn, Oncologist