More breast cancer treatment, including surgery, radiation therapy, chemotherapy, endocrine therapy, immune therapy, traditional Chinese medicine treatment. Clinical pairs of early and mid-term of patients with surgery as the first choice in the treatment of terminally ill patients are properly integrated.
According to clinical stage of breast cancer, the general adoption of the following treatment plan:
Stage Breast Cancer: The main radical surgery. Postoperative pathological examination, such as the axillary lymph nodes metastasis who should be added to the supraclavicular and parasternal lymph nodes regional radiotherapy. Recently, some scholars advocate of breast cancer at an early stage breast only partial resection or simple excision and axillary lymph node dissection group, or a modified radical mastectomy with preservation of pectoralis major way, or the same time, supplemented by postoperative radiotherapy.
Phase II breast cancer: use of radical surgery. Such as the medial quadrant of breast cancer in those who could be considered for extended radical mastectomy. Postoperative radiotherapy and endocrine therapy or chemotherapy.
Phase III breast cancer: in principle should be applied in a comprehensive radiation therapy-based treatment. Some have argued before for radiotherapy, re-surgery. Aikuai to have ulcers could be considered as a simple mastectomy. Supplemented by postoperative chemotherapy, endocrine therapy.
Phase IV Breast Cancer: The endocrine, chemical medicines and Chinese herbal medicine treatment mainly to alleviate suffering, prolong life.
1 surgical treatment
(1) radical mastectomy: removal of the entire breast, including the 3-5 cm around the tumor of the skin and fatty tissue around the breast and chest large and small muscles, and axillary and subclavian all of the adipose tissue and lymph nodes. Promote thin flap surgery as much as possible to avoid the squeeze Aikuai in order to avoid the proliferation of cancer cells.
(2) extended radical surgery: In addition to the above-mentioned organizations, radical surgical resection, the breast ipsilateral to the second, third and fourth costal cartilage, internal mammary artery and vein, and the size of parasternal lymph nodes and chest muscles and breasts together en bloc resection . Mainly used in the medial quadrant of breast cancer and the central area.
(3) modified radical mastectomy: applicable â… , â…¡ patients with early stage, mode of operation with the radical type, mainly divided into reserves while preserving the pectoralis major or the pectoralis minor muscle, the general radical mastectomy with axillary dissection.
2 radiation therapy
Electron accelerator, and cobalt 60 therapy unit for external radiation, aimed at killing Aikuai primary and metastatic cancer cells within lymph nodes. After radiotherapy, some Aikuai reduced, so that the original can not be converted into breast cancer surgery may be surgery. More commonly used clinically in more than 3 axillary lymph node metastasis of postoperative patients, or medial, the central lesion with axillary lymph node into the post-operative patients. For patients with bone metastases, radiation therapy is more effective to reduce local pain.
3 endocrine therapy
Since the thirties of this century, Palliative endocrine therapy in advanced breast cancer with surgery-based, such as the ovary, adrenal gland, pituitary gland removed, in order to achieve some of the symptoms subsided. Eighties endocrine therapy in order to replace the operation of drug trends. Most of endocrine therapy for palliative treatment of advanced breast cancer can also be associated with axillary lymph node metastasis as a medium-term adjuvant treatment of patients with one of the methods. Commonly used drugs briefly as follows:
(1) tamoxifen (TAM): estrogen receptor inhibitor. Estrogen receptor (ER), progesterone receptor (PR)-positive patients effects of Jia. For postmenopausal women in advanced breast cancer. Treatment of soft tissue transfer is superior to bone metastases, the general 20mg / day.
(2) amino sleep can lead (AG): to be adrenalectomy drugs, plus with hydrocortisone, indication, op. On bone, viscera metastasis have a certain effect, the general 50mg / day.
(3) a in one word: bone, soft tissue, visceral metastasis in postmenopausal patients with advanced application, particularly ER (+), PR (+), dose of 20mg / times, four times a day.
(4) medroxyprogesterone acetate: indications with the former, this is more than the pharmacological drugs commonly used doses of 500mg-1000mg / day. Endocrine therapy can be combined with chemotherapy, the treatment of advanced breast cancer. Endocrine drugs can also be combined with surgery as an adjuvant therapy to use, have a certain toxicity, we must strengthen observation. As for the ER (+), PR (+) post-menopausal patients.
4 chemical substances
Applicable to patients with lymph node metastasis of ER, PR-negative patients or patients with advanced palliative surgery. Or in the preoperative, intraoperative or postoperative applications, due to surgery to prevent the proliferation caused by squeezing. Clinical often used chemotherapy CMF, CMFVP, CAF program. CTX100mm / day × 14 days, oral, (or CTX600mg/m2, the first intravenous injection of 1,8 days), MTX40mg/m2, the first intravenous injection of 1,8 days, 5Fu600mg/m2 the first intravenous injection of 1,8 days, every 28 Repeat, sharing 6 – 12 cycles. CMFVP Program Department of CMF program plus VCR1mg/m2 / week diluted intravenous drip, Pred 30mg/m2 / day, decreasing after 15 oral. CAF Program: CTX400mg/m2 No. 1, intravenous injection, 5Fu400mg/m2 the first intravenous injection of 1,8 day ADM40mg / m2, day 1 intravenous injection, every 28 duplication, a total of eight treatments. Note during chemotherapy chemotherapy drug-induced local and systemic toxicity, in particular should pay close attention to drugs on bone marrow suppression, fewer than 4000 white blood cells, platelets less than 80000 withdrawal, chemotherapy, supportive care should be strengthened during the period.
