With the progress of social civilization and the awakening of health awareness, women's health has long jumped out of the category of "private issues" and gradually become an important public health issue of universal concern. From daily gynecological examinations to the popularization of various women's health public welfare projects, people's attention to women's physical health is constantly increasing.
Among many women's health issues, breast cancer, as an important disease threatening women's life and health, has attracted unprecedented attention. This attention is reflected not only in the emphasis on disease prevention and screening, but also in the continuous promotion of the development and breakthroughs in the field of breast cancer treatment. Once a terrifying malignant tumor, it is gradually moving towards a new stage of "preventable, treatable and manageable in the long term."
As a medical service platform that has long focused on global medical innovation and tumor treatment progress, DengYue Medicine also continuously pays attention to the research and treatment trends in the field of breast cancer, hoping to help more people understand this disease more rationally and comprehensively by sharing the latest medical information and treatment progress.
I. Global Breast Cancer: The Importance of Risk Cognition and Screening
In recent years, the global incidence of breast cancer has shown an overall upward trend. In some countries and regions, the incidence of breast cancer has approached 100 cases per 100,000 people. At the same time, some clinical studies have shown that the age distribution of breast cancer patients has a certain degree of younger trend, which also makes the importance of breast health screening continue to increase.
At present, there are still obvious regional differences in the global early diagnosis rate of breast cancer. Through systematic screening programs, the early diagnosis rate in developed countries can reach more than 70%, while there is still room for improvement in some developing countries. Studies have shown that standardized screening can significantly improve the early detection rate, thereby improving patient prognosis.
At present, clinicians generally recommend that women:
● Regularly undergo breast imaging examinations (such as mammography or breast ultrasound)
● Combine daily breast self-examination with doctor's physical examination
A multi-level screening strategy can effectively improve the early diagnosis rate, allowing more patients to obtain treatment opportunities in the early stage of the disease. With the improvement of the screening system, the overall 5-year survival rate of breast cancer in the world has reached more than 80%, and the survival rate of early-stage patients can even exceed 90%.
II. Precision Treatment: The Evolution of Breast Cancer Treatment Models
With the development of molecular biology research, breast cancer is gradually regarded as a highly heterogeneous disease. According to the expression of hormone receptors (HR) and human epidermal growth factor receptor 2 (HER2), breast cancer is usually divided into three main subtypes in clinical practice:
● HR+/HER2- type
● HER2-positive type
● Triple-negative breast cancer
Different subtypes correspond to different treatment strategies, and molecular typing has become an important basis for global breast cancer diagnosis and treatment.
In the treatment of early breast cancer, surgery is still one of the core treatment methods. In recent years, breast-conserving surgery and sentinel lymph node biopsy have gradually become the mainstream, which not only ensures the treatment effect, but also helps reduce surgical trauma and improve the quality of life of patients.
For some patients, doctors will also formulate individualized adjuvant treatment plans according to tumor typing and recurrence risk, including radiotherapy, chemotherapy and endocrine therapy.
For patients with advanced or metastatic breast cancer, the treatment goal has gradually shifted from simply prolonging survival to balancing survival prolongation and quality of life improvement. The emergence of targeted therapy, immunotherapy and new drugs has provided more treatment options for patients with advanced breast cancer.
III. Innovative Drugs: Promoting the Continuous Progress of Breast Cancer Treatment
In recent years, the continuous emergence of innovative drugs has been continuously changing the pattern of breast cancer treatment. Treatment strategies are also constantly optimized according to different subtypes.
1. HR+/HER2- Breast Cancer
HR+/HER2- type is the most common subtype of breast cancer, accounting for about 60%—70% of all cases. For a long time, endocrine therapy has been an important treatment basis for this subtype.
In recent years, the emergence of CDK4/6 inhibitors has significantly changed the treatment strategy for this subtype, such as:
The combined use of these drugs with endocrine therapy can significantly prolong the progression-free survival of patients and has become an important treatment plan recommended by guidelines in many countries.
In addition, some new research directions are constantly being explored. For example, Entinostat, as an HDAC inhibitor, has shown certain therapeutic potential when used in combination with endocrine therapy drugs in some studies by regulating the epigenetic mechanism of tumor cells.
2. HER2-Positive Breast Cancer
HER2-positive breast cancer accounts for about 15%—20% of all cases. With the development of targeted therapy, the treatment effect of this subtype has been significantly improved.
For example, the dual-target therapy regimen of Trastuzumab combined with Pertuzumab has become an important treatment option for HER2-positive breast cancer.
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