Tertiary prevention of breast cancer (a) of the etiology of breast cancer prevention is the cause for the measures taken for the primary prevention. At present the cause of breast cancer is not very clear, but there are some risk factors for breast cancer, we can reduce the level of exposure risk factors to achieve the purpose of preventing breast cancer.
1. Endogenous estrogen: The study found artificial menopause can reduce the risk of breast cancer risk. Age and frequency of delivery and risk of breast cancer is related to the age of 20 before the first full-term risk of women is not producing women or> = 35-year-old full-term women's half. Menarche age and a certain relationship between the occurrence of breast cancer, 11 years old or younger women with menstrual risk of breast cancer than women after the age of 14, 20% higher. Multiple birth factors may interfere with these risk factors. However, in women with familial breast cancer in these phenomena is not obvious. Therefore, interference by multiple pregnancy or hormone to regulate to prevent premature or early menopause effects, but for familial breast cancer is invalid. Human milk feeding can also reduce the risk of breast cancer.
2. Genetics: BRCA1 and BRCA2 have been clear to carry mutations will increase breast cancer risk to life. Estimated BRCAI family risk of breast cancer was 65%, BRCA2 families was 45%. Other genes and non-genetic factors may affect the BRCA genes, but it is still unclear. BRCA2 mutations carry BRCAI and young women the risk of breast cancer than other women, especially BRCAI mutation. Both have ovarian cancer, breast cancer risk of familial breast cancer was significantly higher than the only breast cancer families.
3. Abortion: the risk of breast cancer may be related, but there is not enough evidence.
4. Environmental factors: occupation, environment, the impact of chemotherapy on breast cancer thing, little evidence. Possible chemical substances are organic chloride compounds. Ionizing radiation increases the incidence of breast cancer, especially for adolescent women at higher risk.
5. Diet and vitamins: the low fat diet breast cancer through hormonal mechanisms of risk. Fruits and vegetables may reduce the risk of breast cancer related. Also play a role of micronutrients, such as Hu Luoka factors, folic acid, vitamin A, vitamin C.
6. Primary prevention of chemical intervention; Fenwei A plastic (a vitamin A analogues) may be able to reduce the carcinogenic effects. Use of tamoxifen in hormone intervention can reduce estrogen receptor positive breast cancer incidence, but the clinical side effects and impact the quality of life, there is no widely used. Endogenous sex hormones by reducing the method (to maintain an ideal body weight, postmenopausal women should be low in fat intake, moderate exercise such as young women), could reduce the incidence of breast cancer worthy of study.
Tertiary prevention of breast cancer (b) prevention of the pathogenesis of secondary prevention, including early detection, early diagnosis and early treatment. As an obvious short-term effect of prevention, early detection it hopes to achieve the purpose of early diagnosis. Monthly self-breast examination and a medical examination in clinical breast cancer early detection can increase the rate.
1. Early diagnosis methods; indium target X-ray examination of the sensitivity of women under the age of 40 to 54% _58% 81% 65 _94%. B-in the role of the census is still controversial. The sensitivity of MRI is superior to indium target for X-ray examination, but costly, difficult to promote.
2. Secondary prevention method: triple check method. That all women self-breast examination once a month; clinical breast examination once a year; 40 years of age 1 to 3 years for each woman to conduct a breast ultrasound B, while women over 40 years of age 1 to 3 years for each breast imprison a target X ray examination. Establishment of women's breast screening project, through the census work (including clinical examination, B-, infrared, X-ray examination of aluminum target, etc.) to reduce breast cancer mortality.
Tertiary prevention of breast cancer (c) rehabilitation, prevention or tertiary prevention. As the domestic found mostly in advanced breast cancer, most do radical surgery, prevention of recurrence and metastasis of breast cancer is the focus of tertiary prevention.
1. Tertiary prevention the primary means through the surgery, chemotherapy, radiotherapy, endocrine therapy, Chinese medicine to prevent cancer recurrence and metastasis, to consolidate the curative effect, promoting rehabilitation and extension of survival.
2. Improve the quality of life for children through breast-conserving surgery, minimally invasive surgery, breast reconstruction after surgery, postoperative psychological counseling, pain levels in patients with such advanced to improve the quality of life of patients.
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