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*For medical professionals only to read and refer to Pink Ribbon Moon DialogueProfessor Fan Lei, Department of Breast Surgery, Fudan University Cancer HospitalWith the advancement of medical technology, breast cancer has entered the era of "chronic disease", 55-year-old Ms.
Gu Yinghua, in the process of breast cancer treatment, not only learned to
live peacefully with breast cancer
。 On a daily basis, she will also help her patients, accompany them, and fight cancer
together.
Professor Fan Lei of Breast Surgery of Fudan University Cancer Hospital has been engaged in comprehensive treatment of breast cancer for many years, coinciding with the pink ribbon month, and the Medical Oncology Channel specially invited Professor Fan Lei of Breast Surgery of Fudan University Cancer Hospital to have a dialogue with Ms.
Gu Yinghua, and doctors and patients had face-to-face communication to unveil the "veil"
of comprehensive treatment of breast cancer.
The full video can be viewed by scanning the poster QR code
according to the patient's molecular classification.
At present, breast cancer is divided into HR positive, HER2 positive, triple negative and other types
.
Patients with HER2-positive breast cancer are generally recommended with chemoradiotherapy and targeted therapy
.
Patients with HR-positive breast cancer, that is, ER (estrogen receptor) or PR (progesterone receptor) positive patients, are very sensitive to estrogen, and estrogen levels can be reduced by endocrine therapy, so chemoradiotherapy combined with endocrine therapy
is recommended.
HR-/HER2-breast cancer, also known as triple-negative breast cancer, is currently recommended for chemotherapy and radiotherapy due to the inability to carry out targeted therapy and endocrine therapy, but recent studies have also shown that targeted therapy
can be used for breast cancer patients with BRCA mutations.
And endocrine therapy uses different drugs due to the different
sources of estrogen before and after menopause.
Before menopause, it is mainly drugs
such as tamoxifen.
After menopause, because the estrogen level in the patient is not very high, aromatase
inhibitors such as letrozole are generally recommended.
The duration of endocrine therapy actually varies from person to person
.
For breast cancer patients with a high risk of recurrence before or after menopause, it generally takes about 10 years, and for patients who are not at high risk of recurrence, 5 years is generally enough
.
At present, the standard time of endocrine therapy is generally between 5-10 years, but the duration of treatment is different for patients with different
risk levels.
, after the patient relapses, we also have such as fulvestrant, pipearcicid and so on such drugs
.
And due to the current cognitive concept of breast cancer has changed, new drug research and development is endless, Luminal breast cancer patients generally recommend endocrine combined with CDK4/6 inhibitors, such as pibocicilib, rebocicillib and other drugs
.
This is because endocrine combined with CDK4/6 inhibitor targeted therapy can achieve better efficacy and improve the quality of life of
patients.
When CDK4/6 inhibitors relapse after treatment, treatments for different targets can be tried
, such as in combination with antiangiogenic drugs.
.
For example, postmenopausal patients are treated with aromatase inhibitors, and the most important side effect of such drugs is osteoporosis, and some patients will also have high blood lipids
.
When dyslipidemia occurs, the oncologist will recommend you to go to the cardiology department for professional evaluation, and the cardiology department will classify dyslipidemia into low-risk, intermediate-risk, and high-risk
.
Patients at high risk require drug therapy; Intermediate-risk patients are accompanied by other risk factors that need to be judged on the need for drug treatment on the advice of a doctor; Low-risk patients do not require drug therapy and can be modified by lifestyle changes to adjust for dyslipidemia
.
And postmenopausal patients also need bone density examination, as well as gynecological testing, regular review, early detection of adverse reactions, early treatment
.
Question: Breast cancer is special, patients will have different degrees of psychological disorders during treatment, resulting in the recurrence of breast cancer, Professor Fan, what do breast cancer patients need to pay attention to during treatment? Reduce the risk of breast cancer recurrence? Professor Fan Lei: For many breast cancer patients, when they learn that they have breast cancer, there will be fear, and even many who have been treated for more than ten years will also have a state
of fear when they come to the hospital for reexamination.
Especially breast cancer has entered the era of "chronic disease", when patients have a state of fear, they can communicate with patients, relatives, and peers more, and do not be overly anxious
.
Among them, each person's treatment method and state is different, when encountering abnormal indicators of people around you, do not worry too much, communicate with doctors in time, and the current comprehensive treatment of breast cancer is becoming more and more standardized, and even domestic treatment has been in line with international standards, I believe that with the joint efforts of doctors and patients, breast cancer will be defeated and returned to society
in a healthy state.
Expert profiles
Gu Yinghua, in the process of breast cancer treatment, not only learned to
live peacefully with breast cancer
。 On a daily basis, she will also help her patients, accompany them, and fight cancer
together.
Professor Fan Lei of Breast Surgery of Fudan University Cancer Hospital has been engaged in comprehensive treatment of breast cancer for many years, coinciding with the pink ribbon month, and the Medical Oncology Channel specially invited Professor Fan Lei of Breast Surgery of Fudan University Cancer Hospital to have a dialogue with Ms.
Gu Yinghua, and doctors and patients had face-to-face communication to unveil the "veil"
of comprehensive treatment of breast cancer.
The full video can be viewed by scanning the poster QR code
Accurate classification of stratified treatment is very important!
Host: How to delay the recurrence time of breast cancer patients after surgical treatment? Professor Fan Lei: Breast cancer patients need post-operative treatment
according to the patient's molecular classification.
At present, breast cancer is divided into HR positive, HER2 positive, triple negative and other types
.
Patients with HER2-positive breast cancer are generally recommended with chemoradiotherapy and targeted therapy
.
Patients with HR-positive breast cancer, that is, ER (estrogen receptor) or PR (progesterone receptor) positive patients, are very sensitive to estrogen, and estrogen levels can be reduced by endocrine therapy, so chemoradiotherapy combined with endocrine therapy
is recommended.
HR-/HER2-breast cancer, also known as triple-negative breast cancer, is currently recommended for chemotherapy and radiotherapy due to the inability to carry out targeted therapy and endocrine therapy, but recent studies have also shown that targeted therapy
can be used for breast cancer patients with BRCA mutations.
And endocrine therapy uses different drugs due to the different
sources of estrogen before and after menopause.
Before menopause, it is mainly drugs
such as tamoxifen.
After menopause, because the estrogen level in the patient is not very high, aromatase
inhibitors such as letrozole are generally recommended.
The duration of endocrine therapy actually varies from person to person
.
For breast cancer patients with a high risk of recurrence before or after menopause, it generally takes about 10 years, and for patients who are not at high risk of recurrence, 5 years is generally enough
.
At present, the standard time of endocrine therapy is generally between 5-10 years, but the duration of treatment is different for patients with different
risk levels.
New drug development, more treatment options
Host: For patients who recur after surgical treatment of breast cancer, how should the best treatment plan be selected clinically? Professor Fan Lei: There is a certain probability of breast cancer recurrence, but more and more studies are exploring the treatment of advanced breast cancer, for example, HR-positive breast cancer patients now commonly used endocrine therapy drugs, such as tamoxifen, letrozole, etc.
, after the patient relapses, we also have such as fulvestrant, pipearcicid and so on such drugs
.
And due to the current cognitive concept of breast cancer has changed, new drug research and development is endless, Luminal breast cancer patients generally recommend endocrine combined with CDK4/6 inhibitors, such as pibocicilib, rebocicillib and other drugs
.
This is because endocrine combined with CDK4/6 inhibitor targeted therapy can achieve better efficacy and improve the quality of life of
patients.
When CDK4/6 inhibitors relapse after treatment, treatments for different targets can be tried
, such as in combination with antiangiogenic drugs.
Maintain a pleasant mood and actively face adverse reactions
Host: How should clinical adverse reactions in drug treatment be avoided? Professor Fan Lei: Because each person's constitution is different, and different drugs have different mechanisms of action, the side effects will be different
.
For example, postmenopausal patients are treated with aromatase inhibitors, and the most important side effect of such drugs is osteoporosis, and some patients will also have high blood lipids
.
When dyslipidemia occurs, the oncologist will recommend you to go to the cardiology department for professional evaluation, and the cardiology department will classify dyslipidemia into low-risk, intermediate-risk, and high-risk
.
Patients at high risk require drug therapy; Intermediate-risk patients are accompanied by other risk factors that need to be judged on the need for drug treatment on the advice of a doctor; Low-risk patients do not require drug therapy and can be modified by lifestyle changes to adjust for dyslipidemia
.
And postmenopausal patients also need bone density examination, as well as gynecological testing, regular review, early detection of adverse reactions, early treatment
.
Question: Breast cancer is special, patients will have different degrees of psychological disorders during treatment, resulting in the recurrence of breast cancer, Professor Fan, what do breast cancer patients need to pay attention to during treatment? Reduce the risk of breast cancer recurrence? Professor Fan Lei: For many breast cancer patients, when they learn that they have breast cancer, there will be fear, and even many who have been treated for more than ten years will also have a state
of fear when they come to the hospital for reexamination.
Especially breast cancer has entered the era of "chronic disease", when patients have a state of fear, they can communicate with patients, relatives, and peers more, and do not be overly anxious
.
Among them, each person's treatment method and state is different, when encountering abnormal indicators of people around you, do not worry too much, communicate with doctors in time, and the current comprehensive treatment of breast cancer is becoming more and more standardized, and even domestic treatment has been in line with international standards, I believe that with the joint efforts of doctors and patients, breast cancer will be defeated and returned to society
in a healthy state.
Expert profiles
Professor Lei Fan
Deputy Chief Physician of Department of Breast Surgery, Cancer Hospital of Fudan University
Ph.
D.
in Oncology, Fudan University, Master SupervisorDeputy Chief Physician, Department of Breast Surgery, Fudan University Cancer Hospital
Member of the Youth Committee of the Breast Cancer Professional Committee of the Chinese Anti-Cancer Association
Member of the Youth Committee of the Breast Science Group of the Oncology Branch of the Chinese Medical Association
Vice Chairman of the Youth Committee of the Tumor Target Molecular Branch of Shanghai Medical Association
Member of the International Medical Exchange Branch of the Chinese Anti-Cancer Association
Member of the Breast Professional Committee of China Research Hospital Association
Member of the Youth Committee of the Breast Cancer Special Committee of Shanghai Anti-Cancer Association
Member of the Psychosomatic Medicine Committee of Shanghai Medical Association
Member of the Science Popularization Committee of Shanghai Women Doctors Association
Fellow, Cancer Center, Massachusetts General Hospital, Harvard Medical School
He has presided over and participated in a number of national and Shanghai municipal funds
SCI has more than 20 papers and more than 10 articles by the first and corresponding authors, including "Lancet Oncology" and "JAMA Oncol"
