According to the degree of cell differentiation and clinical manifestations, breast cancer can be divided into two categories: hard cancer (about 70%), medullary cancer (rare), acute breast cancer (inflammatory breast cancer) and glial cancer (rare); Patients with low malignancy include papillary carcinoma, ductal carcinoma (acne carcinoma), adenocarcinoma, papillary eczema-like carcinoma (paget's disease) and lobular carcinoma.
Breast cancer first infiltrates the breast, and then spreads outward through lymphatic vessels and blood circulation. 60% ~ 70% of breast cancer metastasized to the target axillary lymph nodes at 1 station, 30% to the parasternal lymph nodes, and then to the supraclavicular lymph nodes. The common parts of blood circulation and diffusion are lung, pleura, liver, bone, ovary, brain and breast.
clinical picture
1. Breast lump: Painless breast lump is the 1 symptom of most patients. The lump is mostly single, which is as big as mung bean or soybean at first, and then gradually increases. Most of them are irregular and tend to be round or oval masses with unclear edges. Touch it flat with your hand, and the lump bulges above the palm of your hand. The lump is hard and tough, and a few are as hard as stone, gelatinous or sexy. When the tumor infiltrates and adheres to the pectoral muscle, it has poor mobility or even immobility. Few breast cancers are difficult to reach the primary focus in the breast, but there are regional lymph nodes and visceral metastasis. Only after mastectomy can tiny cancer foci be found in pathological sections, which is called "occult breast cancer".
2. Pain: Early breast cancer is mostly painless, with pain as the first symptom, accounting for about 1/3. Most of them are sporadic or paroxysmal, showing dull pain, traction pain or tingling, and some late cases may have persistent severe pain.
3. Skin changes: Skin changes on the surface of breast cancer are related to the depth of swelling and pain and the degree of invasion. Tumor deep, early and normal skin; Invasion of skin and subcutaneous tissue and adhesion with it, resulting in "dimple sign" due to inward contraction of traction. Gently lift the breast with your hand and pinch the affected skin with your hand, which is especially obvious when it is difficult to lift it. In the late stage, the subcutaneous lymphatic vessels are blocked by cancer cells, causing skin edema, and the sweat pores of the skin are clearly visible, showing the "orange peel" sign; When the breast cancer mass exceeds 1.5cm, the skin temperature of the corresponding part is higher.
4. Breast contour change: normal breasts are symmetrically curved on both sides. Because of mass occupying, traction adduction, breast hanging uplift, arc defect or morphological change.
5. Nipple morphological changes: Due to the invasion of cancer, the ligament connecting the nipple is shortened and pulled inward, which makes the nipple contract, deepen and fix.
6. nipple discharge: nipple discharge is bloody, serous and watery, mostly benign tumors, and a small part is breast cancer.
7. Metastatic lymphadenopathy: It is common in the ipsilateral armpit, followed by single or multiple lymphadenopathy in supraclavicular fossa, and a few can be transferred to the opposite side.
8. Systemic symptoms: emaciation, anemia or cachexia, late imbalance of yin and yang (see TCM classification for details). Metastasis to lung, pleura, liver, bone, brain, etc. Symptoms include pain, cough, shortness of breath, fever, pleural effusion, ascites and intracranial hypertension.
Diagnosis Through the comprehensive analysis of medical history, signs and symptoms, the accuracy of breast cancer diagnosis can reach more than 85%.
1. Physical examination: Take sitting position, prone position or supine position, and touch bilateral mammary glands, armpits and supraclavicular lymph nodes in turn. If a lump is found in the breast, it should be differentiated from other benign breast diseases.
2. Biopsy:
(1) Needle aspiration biopsy: simple and easy, the positive rate is about 90%.
(2) Excision and biopsy: it is suitable for small tumors, and frozen sections are made after resection to obtain pathological diagnosis and determine the scope of operation.
(3) Biopsy: It is suitable for large tumors, where a piece of tissue is cut for pathological examination.
(4) Clamp biopsy: It is suitable for ruptured tumor, and the tissue is clamped at the edge of the ruptured tumor.
3.X-ray examination: The accuracy of X-ray diagnosis of breast tumors can reach 90% at the highest, and it can find out whether there are lesions in the breast, distinguish benign from malignant and tumor size, and find tiny tumors that can't be touched clinically, but it is more difficult to diagnose those with less breast fat. Examination methods include: mammography or mammography; Mammography. The X-ray manifestations of breast cancer are mostly lobulated irregular masses with irregular edges and burrs of different lengths. About 1/3 cases have fine sand calcification in the center or around the tumor, which is one of the characteristics of breast cancer.
4. Near-infrared scanning: Near-infrared wavelength is 600~900μm ... It is easy to penetrate soft tissues. Near infrared rays penetrate breast tissues with different densities and present different gray shadows. The more infrared rays are absorbed, the lower the gray shadow. The light absorption capacity of the nucleus is stronger than that of the cytoplasm, while the nucleus of cancer cells is larger than that of normal cells, so it shows a low gray shadow; The tissues with high hemoglobin level have strong absorption of near infrared rays, and the blood supply of cancer focus is rich, and the nearby blood vessels become thicker. The low gray scale also shows the blood supply and blood vessel distribution. According to the general rule, the lower the gray shadow, the more malignant the cancer is. According to the image contrast of near infrared absorption, breast masses with vascular shadows can be displayed, which is helpful for clinical diagnosis.
5. Ultrasound imaging examination: It is valuable to apply ultrasound imaging to those with dense breast tissue, which is mainly used to distinguish whether the tumor is cystic or solid. Cystic tumor can be suctioned out by ultrasound guidance to avoid surgery. Ultrasound has a low accuracy for tumors with a diameter below 1cm. Ultrasound is more accurate in judging the size, location, shape and curative effect of non-surgical treatment.
6.CT and MRI examination: CT examination is not routine, but it can be used to locate breast lesions that cannot be palpated before biopsy, and to check whether the posterior region, armpit and internal mammary lymph nodes are enlarged, which is helpful to formulate treatment plans, but it is not routine; Nuclear magnetic resonance examination has no special benefits and is generally not used.
7. Papillary secretion smear examination: This method is helpful for early diagnosis of cancer cells, but the positive rate is not high. The negative case is undeniable. Avoid over-squeezing.
8. Determination of estrogen receptor (ER) in breast cancer tissue: When the target tissue of a hormone becomes cancerous, it shows changes in hormone metabolism in different degrees, and the breast is one of the target tissues of estrogen. 197 1 year, Jensen injected a highly specific radioactive isotope 3H (deuterium) labeled estriol into the body, which confirmed that there was a protein in the cytoplasm of the target tissue cells of estrogen, called estrogen receptor (ER). Breast cancer can be classified as er negative (; 10 fmol/ mg). A negative ER test means that there are almost no hormone-dependent cells in breast cancer tissues (
9. Detection of progesterone receptor (PR): The synthesis of progesterone receptor (PR) basically depends on the stimulation of estrogen, and detection of PR is usually to improve the accuracy of ER. Most PR-positive cancer tissues are er-positive, and 40% ER-positive cancer tissues are PR-positive.
It has been recognized that estrogen receptor is an important reference index for breast cancer prognosis and endocrine therapy choice. It is reported that the total effective rate of endocrine therapy for breast cancer without receptor determination is about 30%, the receptor is positive >: 100 fmol/mg, the effective rate is 87%, the 3 ~ 100 fmol/mg is 45%, and the negative rate is 13%, indicating that the receptor level is positively correlated with endocrine effect. It is also closely related to prognosis. Patients with positive er and PR have better prognosis, while those with negative ER and PR are better than those with negative ER and PR.
differential diagnosis
1. Cystic hyperplasia of breast and fibromatosis of breast: this disease occurs mostly in young women aged 20-30, with clear, smooth, active and soft masses, sometimes multiple or nodular, most of which have no pain, and a few have pain before menstruation.
2. Ductal papilloma: 50% may have bloody or lymphatic secretions, no obvious mass, multiple and diffuse nodules.
3. Tuberculosis of the breast: It is mostly spread by tuberculosis of the chest wall, which can rupture and flow out caseous pus. Often coexist with tuberculosis in other parts; Appearance is sometimes difficult to distinguish from cancer, so biopsy or anti-tuberculosis treatment is often needed to observe its effect.
4. Breast ductal dilatation or plasma cell mastitis: It occurs during non-lactation period, and the breast suddenly feels pain and fever, and sometimes chills. At this time, the breast is generally edema, the skin is red, there is obvious tenderness, the nipple can be sunken and there are milky secretions, and there are many axillary lymph nodes that can be relieved after anti-inflammatory treatment. If it turns to subacute stage (limited stage), its signs are quite similar to those of breast cancer, and it completely disappears after about 3 months, and pathological examination shows inflammatory changes.
Clinical stage
The primary tumor was confined to the breast, less than 3cm in diameter, without adhesion to skin, chest muscle and chest wall, and without local lymph node metastasis.
In the second stage, the tumor is less than 5cm in diameter, and in the active stage, there is skin adhesion, the adhesion area is smaller than the tumor diameter, and there is no adhesion with the chest wall of the chest muscle. There are 1 ~ 2 active swollen lymph nodes in the ipsilateral axilla, and there is no adhesion with the surrounding tissues of the skin.
In the third stage, breast lymph node metastasis, local skin ulcer, orange peel degeneration of skin and local skin adhesion with a diameter of more than 5cm appeared. The tumor is firmly adhered to the pectoral muscle or there are active swollen lymph nodes in the supraclavicular area and armpit on the same side.
Stage ⅳ tumor has spread to the whole breast skin and its surrounding tissues, and satellite nodules appear in the skin. The contralateral axillary lymph nodes or breasts are involved, and lung, pleura, liver and bone have metastasized.
The treatment of breast cancer includes surgery, radiotherapy, chemotherapy, traditional Chinese medicine, immunotherapy, endocrine and so on. Clinical indications should be selected according to different stages of the disease. Because each treatment method has its own advantages and disadvantages, it is necessary to treat it from a holistic perspective, which can not only discard or inhibit cancer cells, but also protect the body's anti-cancer ability.
1. cooperation between surgery and traditional Chinese medicine: surgery is still the main method of comprehensive treatment at present. According to the different conditions and stages, different surgical methods are selected.
(1) Simple total mastectomy (hereinafter referred to as total mastectomy): Only the breast is removed, and the pectoralis major and minimus muscles are reserved, without axillary lymph node dissection. It is suitable for local palliative resection of extremely early breast cancer (including carcinoma in situ) and late breast cancer rupture to relieve pain.
(2) Total mastectomy plus axillary lymph node dissection: Preserving pectoralis major and pectoralis minor can improve postoperative function, reduce complications and adapt to stage I-II and III breast cancer.
(3) Radical mastectomy: total breast+pectoralis major+axillary lymph node dissection, and the starting point of axillary arteriovenous branches was cut off and ligated. Adapt to stage ⅰ ~ ⅱ and a few stage ⅲ cases.
(4) Radical operation combined with parasternal lymph node chain dissection (extended radical operation): indications are the same as 2 and 3.
In the past, it was traditionally believed that the more tissues surgically removed, the more thorough and safer lymph node dissection. However, recent research shows that there is no significant difference in 5-year 10 survival rate and recurrence rate between radical mastectomy and total mastectomy, and the effect of postoperative radiotherapy in the two groups is similar. Radical mastectomy has many side effects, many complications and great functional damage. Therefore, it is considered that radical mastectomy is not necessary for early breast cancer. For early stage ⅱ and ⅲ cases, total mastectomy plus regional lymph node dissection plus radiotherapy is also feasible, which can preserve the function without reducing the curative effect.
Injury and extrusion during operation will definitely increase the chances of blood circulation and lymphatic metastasis; Surgical trauma will reduce the immune function of the body, so that cancer cells that spread during surgery can take advantage of it and escape supervision.
It is generally not appropriate to irradiate immediately after operation. Chemotherapy immediately after operation can inhibit residual cancer in systemic circulation, but it will also reduce immune function, which is often counterproductive; Therefore, the best adjuvant treatment after breast cancer surgery is to cooperate with traditional Chinese medicine to enhance the body's resistance and fight cancer in time. Traditional Chinese medicine can protect or enhance the ability of natural killer cells in the body. Combined with traditional Chinese medicine, it can not only promote the early recovery of surgical trauma, but also improve the immune function of the body and inhibit the residual cancer cells.
Common basic prescriptions:
Prunella vulgaris 15g Angelica 9g Lycium barbarum 15g Shā rotto Katakuri 12g Lonicera japonica 12g Panax notoginseng 1.5g (research) Agrimonia pilosa 20g Poria 15g dried toad 10g Placenta Hominis/kloc-.
2. Combination of radiotherapy and traditional Chinese medicine: Radiotherapy for breast cancer, like surgery, belongs to local treatment, but the indications of radiotherapy are wider than surgery, and all cases can be performed, but the effect of early breast cancer is not as good as surgery. Radiotherapy for breast cancer can be divided into radical, adjuvant and palliative. Years of practice have proved that radical radiotherapy is not only ineffective, but also has many complications. The residual rate of cancer cells is 80% ~ 100%, so it is rarely used at present. Adjuvant radiotherapy is mostly used before or after operation. The purpose of preoperative radiotherapy is to shrink the tumor and create conditions for surgery. On the other hand, radiotherapy can partially or completely occlude the lymphatic vessels around the tumor and weaken the vitality of cancer cells, thus reducing lymph node metastasis and the survival rate of residual cancer cells in the surgical field. The purpose of postoperative radiotherapy is to eliminate metastasis or residual cancer cells in lymphatic drainage area during operation. However, according to ROSSI's report, the curative effect of postoperative radiotherapy was slightly higher than that of the control group, and there was no significant statistical significance. Palliative radiotherapy is mainly suitable for patients with stage Ⅲ and Ⅳ, which can relieve symptoms and prolong life.
Radiotherapy will lead to the degeneration and necrosis of a large number of cancer cells, the storage of metabolites and toxins in the body, and the damage of heat rays to body fluids and body fluid consumption, thus reducing the immune function of the body. If it can be combined with traditional Chinese medicine, it can not only protect the body, but also degrade toxins. A small amount of drugs for promoting blood circulation and removing blood stasis can improve the sensitivity of radiotherapy.
Common basic formulas:
Dandelion 15g honeysuckle 10g salvia miltiorrhiza 12g radix Pseudostellariae 15g poria cocos 15g licorice 3g asparagus 10g wolfberry fruit 15g peony bark 9g atractylodes macrocephala 15g ganoderma lucidum/kloc-0.
3. Chemotherapy combined with traditional Chinese medicine:
(1) Chemotherapy drugs and schemes: Although there are many kinds of chemotherapy drugs for breast cancer, there is no ideal drug so far, among which doxorubicin, cyclophosphamide, cisplatin, doxorubicin and colchicine are better. There are also fluorouracil, methotrexate, mitomycin, vincristine, paclitaxel, vinorelbine, phenylalanine nitrogen mustard and so on. According to Carter, chemotherapy combined with CMF regimen after radical mastectomy in premenopause can obviously improve the curative effect, but chemotherapy after radical mastectomy in late menopause is not effective.
Commonly used combination chemotherapy schemes:
①CMF scheme:
Cyclophosphamide 400 ~ 500 mg/㎡, intravenous injection, 1, 8 days.
Mitomycin 10mg/㎡, intravenous injection, 3rd, 5th,1,13rd day.
Fluorouracil 400 mg/㎡, intravenous drip, on the 3rd, 5th, 1,13rd day.
28 days is 1 cycle, and if it is used as adjuvant chemotherapy after radical operation, it lasts for 3 ~ 4 cycles; Repeat 3 ~ 4 cycles in 3 ~ 6 months. For advanced cases, the course of treatment and dosage should be determined according to the patient's tolerance and curative effect.
② CAP scheme:
Cyclophosphamide 200 mg/㎡, intravenous injection, 2 ~ 5 days.
Adriamycin 400 mg/㎡, intravenous injection, 65438 days +0.
Cisplatin 80 mg/㎡, intravenous injection, the next day. 4-week repetition 1 time.
③PA scheme:
Adriamycin 400 mg/㎡, intravenous drip, daily 1.
Paclitaxel 175 mg/㎡, intravenous injection, the next day. 2 1 day is 1 course of treatment.
(2) Collaborative treatment of traditional Chinese medicine: refer to the third section of Chapter VI.
(3) During chemotherapy, the treatment of strengthening the body resistance of western medicine: digestive tract reaction, bone marrow suppression, infection and fever, liver, heart and kidney function damage, etc. See the third section of chapter 6 of the general introduction.
4. Endocrine therapy: Breast cancer is related to endocrine gland dysfunction, especially ovarian dysfunction. Ovariectomy therapy and androgen restriction and balance can achieve certain results, especially the positive effect on estrogen receptors.
(1) Endocrine organ resection: At present, surgical resection of endocrine glands is gradually decreasing, and it is no longer used after menopause except for ovariectomy before menopause.
(2) Androgen therapy: it is suitable for those before, during and within 5-7 years after amenorrhea.
① Testosterone propionate: intramuscular injection of 50mg 1 time, every other day 1 time, 5 times in total, and then twice a week. Maintain it for about 4 months or longer, and then the dose will gradually decrease. If it takes six weeks to give up without effect.
② Testosterone dimethyl dihydropropionate: The side effect is small, and the dosage and course of treatment are the same as that of testosterone.
③ Dimethyl testosterone: 50mg, four times a day. It has a good curative effect on soft tissue and metastatic cancer in chest and abdomen.
④ Fluorinated androgen: 5mg, 4 times a day, with good effect and no side effects.
(3) Anti-estrogen therapy: tamoxifen "Nolvadex" is an anti-estrogen drug, with the curative effect of 45% ~ 87% for tumor tissues with positive estrogen receptor and 8% ~ 13% for tumor tissues with negative estrogen receptor, each tablet 10mg, each time 1 tablet. 1996 The American Society for Cancer Therapy (ASCO) thinks that five years is better than two years, while others think that two years is enough and five years is meaningless. Experiments show that tamoxifen can promote endometrial hyperplasia and destroy the DNA of endometrial epithelial cells, which may be the driving factor of endometrial tumors. If tamoxifen is taken for a long time, the endometrium should be examined by B-ultrasound/kloc-0 every 2 months.
(4) Progesterone treatment: Megestrol acetate (MPA) or Megestrol acetate (MA) is the representative drug, and the effective rate is 30% ~ 40% at high dose, which is better for patients with positive er and PR. It can be used before and after menopause. The longer the menopause, the better the curative effect. The curative effect and pain relief of bone metastases are better than tamoxifen. Usage and dosage: radiotherapy is dose-related, and the effective rate of low dose is 20. Most people think that MPA 500~ 1 000mg 000 mg, intramuscular injection, 1 time, four times a day, and MA 160 ~ 200 mg are high dose standards.
(5) Estrogen therapy: The mechanism is unknown, which may be the inhibition of pituitary gonadotropin secretion. Suitable for amenorrhea for more than 7 years, with good curative effect. Commonly used are:
① Diethylstilbestrol, taking 10 ~ 20 mg daily.
② Diethylenetriol, daily 10mg.
③ Ethinyl estradiol, intramuscular injection of 5mg twice a week, usually takes effect after 4 ~ 6 weeks. However, estrogen is also used in clinic to make the condition worse, but androgen is effective. Therefore, if estrogen is ineffective and the condition worsens, you should stop taking drugs immediately or switch to other drugs.
(6) Corticosteroid therapy: This drug is also effective for those who are effective in sex hormone therapy, and its mechanism may be to inhibit the secretion of pituitary corticotropin. The commonly used medicine is prednisone or prednisolone, 30 ~ 60 mg per day. Dexamethasone or hydrocortisone can also be injected intravenously.
5. TCM syndrome differentiation and treatment:
(1) Liver depression and qi stagnation type: it is common in early stage I-II hard cancer, stage II medullary cancer and low-grade malignant breast cancer.
Main symptoms: often manifested as upset, boredom, depression, chest pain, breast caking, hard, movable or fixed. Sometimes the mouth is bitter, dry or dizzy and insomnia, the tongue is pale, reddish or reddish, the coating is thin, white or yellowish, and the pulse is smooth or flat.
Treatment: soothing the liver and regulating qi, softening and resolving hard mass.
Prescription: Radix Bupleuri 9g Radix Angelicae Sinensis 9g Radix Paeoniae Alba 12g Radix Curcumae 12g Poria 12g Fructus Trichosanthis/0/0g Pericarpium Citri Reticulatae Viride 9g Prunellae 18g Bulbus Fritillariae Cirrhosae 9g Rhizoma Dioscoreae 15g Atractylodis Rhizoma 9g Radix Pseudostellariae 15g Shā rotto Katakuri.
(2) Heat toxin accumulation type: equivalent to acute breast cancer or advanced breast cancer, festering and oozing purulent blood, local and systemic metastasis, combined with infection.
The main symptoms: rapid swelling of the mass, accompanied by pain, occasional swelling or even bursting, flowering, extravasation of blood or foul smell, accompanied by local lymph nodes and distant metastasis, emaciation and fatigue, occasional fever, constipation, dry mouth, dark red tongue, yellow-white or thick tongue coating, thin or slippery pulse.
Treatment: detoxification and blood stasis, strengthening body resistance and blood stasis.
Prescription: honeysuckle 12g dandelion 15g hedysari 20g rehmannia root 10g Ophiopogon japonicus 10g Dendrobium nobile 10g Euryale seed 15g hibiscus leaves 15g poria cocos/kloc-0.
(3) Yin deficiency of liver and kidney: it is more common in breast cancer after surgery or radiotherapy and chemotherapy, qi and blood failure, or late local ulceration, or recurrence after comprehensive treatment.
Main symptoms: dizziness, restlessness, insomnia, sometimes upset and hot, dull complexion, backache and leg weakness, emaciation or anemia, bitter or dry mouth, thin or thready pulse, red or crimson tongue with no or little coating.
Treatment: nourishing liver and kidney, strengthening body resistance and fighting cancer.
Prescription: Ophiopogon japonicus 12g Radix Glehniae 10g Poria 12g Rhizoma Atractylodis Macrocephalae 10g Radix Pseudostellariae 25g Radix Glycyrrhizae 3g Cornus officinalis 9g Rhizoma Alismatis 10g Radix Rehmanniae 10g Lotus Root 18g Cortex Moutan18g.
6. Single prescription:
(1) Angelica sinensis 10g dried toad 12g Prunellae Spica 15g Fritillaria thunbergii 12g Shā rotto Katakuri 12g Coicis Semen 30g Semen Vaccariae 15g Radix Glehniae 10g Poria.
(2) Decocting 20 grams of Angelica sinensis, 60 grams of Acanthopanax Senticosus and 20 grams of Prunella vulgaris. 3 ~ 6 toads (stewed and boneless) mixed with medicinal soup. Daily 1 dose, continuous 30 ~ 100 dose, has good effect on hard cancer and elderly breast cancer.
(3) Six flavors of Liu Qi drink. Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix Ginseng, Radix Platycodi, Rhizoma Chuanxiong, Fructus Aurantii, Cortex Magnolia Officinalis, Radix Angelicae Dahuricae, Folium Perillae, Radix Saposhnikoviae, Radix Linderae, and Arecae each 65438±00g, Radix Astragali 20g, Cortex Cinnamomi, Caulis Akebiae 4g, and Radix Glycyrrhizae 6g, and decocted. This prescription is more suitable for early breast cancer with qi stagnation and liver depression and deficiency of both qi and blood.
(4) Longdan Xiegan Decoction. Radix Gentianae 15g Radix Scutellariae, Fructus Gardeniae, Radix Angelicae Sinensis, Radix Bupleuri, Radix Rehmanniae, Rhizoma Alismatis and Semen Plantaginis 10g Radix Akebiae 6g Radix Glycyrrhizae 5g, and decocted in water. This recipe can clear liver and purge fire, and treat breast cancer, tumor swelling and pain, red tongue, red urine and dysphoria.
(5) Take the leaves of the plant "Solanum purpurea" and dry them and grind them into powder, then sieve them with 60 meshes to get powder, and sprinkle them on the ulcerated parts to remove putrefaction and deodorization, remove necrotic tissue and clean the wound. Once the carrion is removed, the drug should be stopped immediately, and the powder should not be coated on the clean granulation tissue, otherwise it will cause pain or enlarge the wound. The decay mechanism of this drug is unknown, which is probably the function of chlorophyll. The author has applied more than 20 cases in clinic, which has special effect on removing carrion and odor.
(6) External use of sodium humate powder to treat local decay after radiotherapy.
(7) Radix Astragali 30g Radix Angelicae Sinensis 20g Atractylodis Macrocephalae 10g Radix Glycyrrhizae 10g Radix Salviae Miltiorrhizae 30g Flos Chrysanthemi Indici 8g blood stasis phlegm 10g Catechu 10g decoction, and the wound healed after operation.
(8) Lexus capsule, 3 capsules, taken after meals, is suitable for the late stage of breast cancer, lung and bone metastasis, fever, body pain, cough, asthma, anorexia, insomnia and other symptoms, and has a good effect on relieving recent symptoms. With diabetes and severe ulcers, use with caution or not.
7. Integrated Chinese and Western Medicine Treatment: The integrated Chinese and Western medicine treatment plan for patients in each stage is as follows:
(1) Stage 0 carcinoma in situ underwent partial mastectomy or total mastectomy. After operation, only traditional Chinese medicine was used to strengthen the body resistance or treat it according to syndrome differentiation, and no other treatment was given.
(2) Primary total mastectomy and axillary lymph node dissection. In the late stage of stage I, postoperative radiotherapy or chemotherapy, endocrine therapy and traditional Chinese medicine can be used.
(3) In the second stage, modified radical operation can be performed, and radiotherapy can be performed after operation, including supraclavicular region and internal mammary region, with intermittent multi-course chemotherapy and endocrine therapy within two years. In addition to other therapies, Chinese medicine should persist in treatment for more than 3 years.
(4) Radical surgery was performed in the early stage of stage III, and radiotherapy was given to sternum and clavicle after operation, followed by intermittent multi-course chemotherapy or treatment within 2 years after operation; At the end of the third stage, those who have no indication of radical surgery can be treated with simple total mastectomy, preoperative and postoperative radiotherapy or preoperative arterial intubation radiotherapy, or intermittent multi-course chemotherapy and endocrine therapy within 2 ~ 3 years after operation. In addition to other therapies, we should also carry out long-term strengthening the body resistance and TCM syndrome differentiation and treatment.
(5) Palliative total mastectomy, preoperative and postoperative radiotherapy and palliative radiotherapy for local metastatic lesions can be performed in stage ⅳ; Combined chemotherapy and endocrine therapy, traditional Chinese medicine combined with other therapies, or traditional Chinese medicine combined with long-term treatment of strengthening the body resistance and eliminating evil, hormone-dependent patients can be castrated and adhere to long-term endocrine therapy.
(6) Breast cancer during pregnancy and lactation: termination of pregnancy and lactation, castration and endocrine therapy, radical surgery or total mastectomy after initial tumor control, and radiotherapy, chemotherapy and Chinese medicine treatment at the same time.
(7) Choice of postoperative chemotherapy before and after menopause: Chemotherapy is sensitive to premenopausal cases, and the curative effect after menopause is poor. Generally speaking, before menopause, patients in all stages should receive combined chemotherapy except early postoperative chemotherapy in stage 0 and/kloc-0. After menopause, there is no lymph node metastasis, and chemotherapy is not needed except lymph node metastasis.
(8) Immunotherapy: Biological response regulators, such as human interleukin II, interferon, sapelin (OK–432) and lentinan, are helpful as adjuvant therapy for surgery, radiotherapy and chemotherapy, but their single application is still weak, and few significant cases have been reported. If it is combined with Chinese medicine, it will complement each other.
Prognostic breast cancer can survive for more than 3 years without treatment, 20% can survive for 5 years after onset, and 5% can survive 10 year. There are many factors that affect the therapeutic effect, such as early treatment time, no axillary lymph node metastasis, non-invasive breast cancer and special types of breast cancer, high degree of cancer cell differentiation, elderly patients, non-pregnant breast cancer, thorough treatment for the first time, reasonable comprehensive treatment measures of traditional Chinese and western medicine and long persistence, all of which have good prognosis, and vice versa.
Lingzhi Capsule, the first patented new drug independently developed by China for the clinical treatment of tumor with integrated traditional Chinese and western medicine, was recently listed in Shaanxi, with the number of 0298755113. The drug is a large compound preparation of 16 kinds of traditional Chinese medicines supplemented by 5 kinds of western medicines. It is another scientific research achievement after Professor Ji, a famous oncologist in China, was praised as a "cancer fighter" by the international medical community for his noble medical ethics and superb medical skills.
Lingzhi Capsule is the crystallization of Pan Ming's 50-year clinical experience and his pioneering theory of "strengthening the body resistance and consolidating the foundation" for cancer treatment. This medicine is a combination of traditional Chinese and western medicine, with complementary advantages, simultaneous attack and tonic, economical and convenient, short course of treatment and quick effect. It is suitable for the treatment of various types of malignant tumors in the early, middle and late stages, especially for various pains of cancer in the middle and late stages. As long as you take 1 ~ 2 days, it will take effect and be obvious within one week. Lu Jiaxi, President of China Academy of Sciences, wrote an inscription "To Professor Ji: Integrating Chinese and Western Medicine for the benefit of all mankind".