Migraines and chest pain could be "breast cancer bone metastasis"? Doctors remind young patients: "Significant decrease" in female hormones is the most dangerous
According to statistical results from the Taiwan Ministry of Health and Welfare in 2021, the incidence rate of breast cancer in women not only ranks first, but also ranks fourth in the cancer mortality rate. If symptoms are underestimated or treatment is delayed, resulting in distant metastasis, it may be harmful to women. pose a serious threat to the patient’s life. Director Zhang Yuanqing of the Breast Center of Mackay Memorial Hospital said that about 65-75% of breast cancer patients are complicated by distant metastasis in the bones, which deserves the attention of female breast cancer patients. Early treatment is one of the keys to protecting the patient’s quality of life and prognosis!
More than 70% of breast cancer metastases occur in “bones”? Falling female hormones are a warning sign
Among distal breast cancer metastases, why are “bone metastases” the most common? Director Zhang Yuanqing explained that estrogen in women can inhibit the activity of “osteoclasts” in bones and reduce bone destruction and absorption. However, due to various reasons such as medical treatment, menopause, or age, hormones decline and osteoclasts The activity of osteoblasts is gradually greater than that of “osteoblasts.” When breast cancer occurs, cancer cells will release special factors to stimulate the growth of osteoclasts, and osteoclasts will in turn release growth factors to cancer cells. The two “mutually influence each other.” Forming a vicious cycle!" As for the locations most commonly affected by breast cancer bone metastasis, they are mostly in the “axial bones” with good blood circulation and more bone marrow, such as the skull, spine, pelvis, shoulder bones, and ribs.
Director Zhang Yuanqing pointed out that breast cancer bone metastasis may have no obvious symptoms at first; after worsening, it may manifest itself as persistent severe pain in the affected area. In addition, different parts of the body may have different symptoms. For example, if it transfers to the ribs, it will cause lower chest pain, if it transfers to the skull, it will cause migraines, etc.; if it transfers to the spine, even a minor fall may cause a compression fracture, and sometimes you need to rely on a doctor. Differential diagnosis can clarify the condition.
Is bone metastasis likely to occur in “this” type of breast cancer? Doctor: The risk is 4-5 times higher than other breast cancers!
One in four breast cancer cases will relapse or metastasize after 5-10 years of treatment; among them, more than half of those with “hormone positive/HER2 negative” (luminal A/B types) will relapse and metastasize after 5 years of treatment. Director Zhang Yuanqing explained that more malignant subtypes of triple-negative, HER2-positive breast cancer often metastasize to important organs in a short period of time and require less nourishment by osteoclasts; relatively less malignant hormone receptor-positive breast cancers often metastasize to bone. The risk of transfer is 4-5 times that of the other two.
In addition, in addition to hormone receptor-positive breast cancer, past studies have pointed out that risk factors for breast cancer bone metastasis include larger breast cancer tumors, tumor grade (such as luminal type A), differences in histological types (such as breast lobular carcinoma), and cancer cell invasion. Lymph nodes, age and genetic factors to name a few. Director Zhang Yuanqing emphasized that the public can also make good use of the online breast cancer assessment tool to predict their own risks and understand the disease status in advance.
Is it possible for breast cancer to undergo “secondary metastasis”? Intensive tracking may lead to “false positive” problems
After treatment for breast cancer bone metastasis, is there a risk of “secondary metastasis”? Director Zhang Yuanqing believes that the higher the stage of breast cancer, the more likely it is for bone metastasis. “Even if bone metastasis does not occur now, it does not mean that it will not metastasize at all in the next five or ten years! Once metastasis occurs, the treatment goal will change from ‘cure’ to Shifting to “prolonging survival”, we focus on maintaining the patient’s basic quality of life.”
On the contrary, if patients underestimate the symptoms or effects of bone metastasis, the first thing they will suffer is a decrease in activity and quality of life, and a consequent loss of life expectancy. In particular, bone loss accelerates in women after menopause, and the risk of bone metastasis increases significantly, which not only causes bone pain, but also induces fractures, spinal compression, hypocalcemia and other problems, making breast cancer more difficult.
However, Director Zhang Yuanqing also emphasized that if patients with early-stage breast cancer recover, it is not recommended to check too intensively for bone metastasis: first, the test may have “false positives”, which may cause unnecessary worry to the patient; second, in order to According to treatment guidelines from various countries around the world, regular bone scans and X-ray examinations are not suitable for breast cancer recovery patients who do not show symptoms, because even if detected early, the survival rate will not be improved.
What are the treatments for breast cancer bone metastasis? If you don’t pay attention to oral health, beware of “2 major complications”
Director Zhang Yuanqing said that breast cancer treatment has made good progress in recent years; there are currently two types of treatment drugs, including: monoclonal antibody drugs and bisphosphonate drugs, which can be used by doctors to create personalized treatment courses according to the needs of patients. According to large studies, regular treatment of bone metastases can effectively reduce the risk of recurrence of skeletal complications.
However, both of the above two types of drugs may cause jaw bone complications, especially for patients who take the drugs for a long time, fail to pay attention to oral hygiene, and undergo tooth extraction or dental implant surgery. They are a high-risk group for jaw bone complications. Therefore, patients who undergo bone metastasis medication should not only check their dental health before treatment and actively keep their mouth clean during treatment; they can also make good use of health insurance policies and apply fluoride treatment every 90 days to reduce tooth decay while Oral examination after medication can also be performed at the same time.
“During treatment for breast cancer bone metastasis, patients should pay attention to oral hygiene, moderate calcium supplementation, and receive regular oral examinations!” Regarding the problem of hypocalcemia, Director Zhang Yuanqing recommended that patients supplement sufficient calcium every day, through calcium tablets , spinach, milk and other foods actively supplement calcium; vitamin D also helps the gastrointestinal tract absorb calcium. It is recommended to ingest it through natural methods such as exposure to sunlight and eating dried mushrooms. Most of them can reach an intake of 1000 mg. It is recommended that no additional Health supplements.
What are the daily precautions for patients with breast cancer bone metastasis? Should young breast cancer patients “plan ahead”?
Finally, Director Zhang Yuanqing reminded that the bone structure of patients with breast cancer bone metastasis is relatively fragile, so special attention must be paid to avoid injuries during daily activities. Normally, moderate exercise can be done under the supervision of professionals to strengthen bones and muscle tissue. Furthermore, maintaining oral health is equally important. After receiving medication for breast cancer bone metastasis, you must receive regular oral examinations to pay attention to jaw bone complications or hypocalcemia.
In addition, for young breast cancer patients, the estrogen in the body may decrease significantly after receiving hormonal treatments (such as anti-estrogens, estrogen receptor controllers), which may significantly increase the chance of bone metastasis; therefore, you can discuss it with your doctor. , consider receiving drugs such as bisphosphonates in advance to avoid distal bone metastasis in the future.
“We appeal to the public not to listen to rumors on the Internet or buy drugs or health care products from unknown sources while undergoing treatment for breast cancer bone metastasis. As long as you continue to take medication according to the doctor’s instructions, and maintain good habits such as oral health care and regular exercise, it will help The survival period is extended and the quality of life is expected to be greatly improved!”
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This health education information is provided with the assistance of Taiwan Amgen
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