AD: Shocked! The peak value of plasma Aβ42/Aβ40 began to decline 41 years before the deposition of brain Aβ! Alzheimer's diseases: New discovery on plasma Aβ42/Aβ40. AD: Shocked! The peak value of plasma Aβ42/Aβ40 began to decline 41 years before the deposition of brain Aβ! Amyloid β (Aβ) plaque deposition and phosphorylated tau (p-tau) protein tangles are two important pathological features of Alzheimer's disease (AD), and there are many kinds of AD biomarkers derived around them, Knowledge of the longitudinal trajectories of key markers could not only help improve the selection and monitoring of participants in clinical trials, but also help identify those at high risk for neurodegenerative changes and cognitive impairment. Although research on AD biomarkers has increased substantially in recent years, research on longitudinal changes in biomarkers is relatively limited. Studies have shown that the levels of plasma Aβ 42 /Aβ 40 , p-tau181 and glial fibrillary acidic...
Breast cancer has become the world's most common cancer, and screening starts at the age of 40!
Screening for breast cancer from the age of 40.
Recently, the International Agency for Research on Cancer of the World Health Organization released the latest global cancer burden data for 2020, which estimated the latest morbidity, mortality, and cancer development trends of 36 cancer types in 185 countries around the world. Data show that in 2020, breast cancer will replace lung cancer as the world's most common cancer.
On January 8, 2021, the Chinese Journal of Preventive Medicine "Chinese Journal of Cancer Prevention and Treatment" published online the Chinese Women's Breast Cancer Screening Standards (hereinafter referred to as "standards"). Regular screening and early intervention are important measures to effectively reduce the risk of breast cancer death.
Why do we need to be screened?
Screening can reduce breast cancer mortality
According to the latest global cancer burden data in 2020, there will be approximately 19.3 million new cancer patients worldwide in 2020, of which female breast cancer accounts for 11.7%, which has surpassed lung cancer (11.4%) in number for the first time, becoming the world's most newly diagnosed cancer. The number of newly diagnosed breast cancer patients reached 2.26 million, of which 410,000 were in China, accounting for 18%. In terms of fatality rate, there are about 10 million deaths caused by cancer in 2020, of which 685,000 deaths from breast cancer, including 110,000 in China (accounting for 16%), rank fifth.
The occurrence of breast cancer is the result of a combination of internal and external factors. Pan Bo, deputy chief physician of the Department of Breast Surgery of Peking Union Medical College Hospital, said in an interview with the media that internal factors, namely genetic factors, as well as environmental factors such as environment, biology, and lifestyle, interact with external factors to induce and promote breast cancer; while external factors It is mainly lifestyle, such as infertility, late birth, non-feeding after giving birth, obesity, smoking, alcohol addiction, aimless estrogen supplementation, unhealthy diet, staying up late for a long time, irregular life, stress, anxiety and depression, etc. .
Although breast cancer has a high incidence, breast cancer is one of the few malignant tumors that can be screened to reduce mortality. Currently, the World Health Organization clearly lists early breast cancer as a curable disease. After European countries, the United States, Japan and other countries achieved early screening, the 5-year survival rate for breast cancer has increased to 89%. Pan Bo introduced that diseases suitable for screening have some characteristics, such as high incidence, simple and effective detection methods, clear treatment methods, and early intervention can improve the prognosis. Breast cancer is just a disease suitable for screening. . The above standards provide recommendations for the population, measures, results and management of breast cancer screening in China.
Who needs to be screened?
Screening for high-risk groups starts at the age of 40, and screening for the general population between the ages of 45 and 70
Now that early detection and intervention can effectively control the progression of breast cancer, how should we check it? The standard recommends that people at high risk of breast cancer should be screened at the age of 40, and people at general risk (all women of the right age except high-risk groups) should be screened for breast cancer between 45 and 70 years old.
So, who are the high-risk groups? The standard points out that women who meet any of the following conditions 1, 2, and 3 are all at high risk of breast cancer.
1. Have a genetic family history, that is, women who have any of the following: ①First-degree relatives (mother, daughter, and sisters) have a history of breast or ovarian cancer. ② Among the second-degree relatives (aunt, aunt, grandmother, and grandmother), 2 people and above have breast cancer before the age of 50. ③ Among the second-degree relatives, 2 people and above suffer from ovarian cancer before the age of 50. ④At least one first-degree relative carries a known pathogenic genetic mutation of BRCA1/2 gene, or owns a pathogenic genetic mutation of BRCA1/2 gene.
2. Those who have any of the following: ① Menarche age ≤ 12 years old. ②Menopausal age ≥55 years old. ③Have a history of breast biopsy or operation history of benign breast disease, or a history of atypical hyperplasia of breast (lobular or duct) confirmed by pathology. ④ Use hormone replacement therapy combined with estrogen and progesterone for no less than half a year. ⑤The mammography examination after the age of 45 showed that the type of breast parenchyma (or breast density) was uneven compactness or compactness. The type of breast parenchyma can be divided into fatty type, scattered fibroadenous body type, uneven and dense type (may cover small lumps) and dense type (reduce the sensitivity of breast cancer detection).
3. Possess any two of the following: ① No history of breastfeeding or breastfeeding time shorter than 4 months. ② No history of live birth (including never giving birth, miscarriage, stillbirth) or age of first live birth ≥ 30 years old. ③ Hormone replacement therapy using only estrogen is no less than half a year. ④ Abortion (including spontaneous abortion and artificial abortion) is not less than 2 times.
How to screen?
The general population is checked once every 1 to 2 years, and the high-risk population is checked every year
The people who need to be screened are clarified, so what checks do we need to do? What time period to check? In fact, the symptoms of early breast cancer are very mild, because it is relatively hidden and does not have too many clinical symptoms, so it is easy to be ignored by people.
In an interview with the media, Li Yafen, chief physician of the Breast Disease Diagnosis and Treatment Center of Shanghai Ruijin Hospital, said that the symptoms of breast cancer can be diverse. The common ones are: breast lumps, skin changes, nipple changes, nipple discharge, breast pain, and axillary lymphadenopathy. At the same time, with the promotion and application of screening technology, more and more patients are seeking treatment because of breast calcification, and most of these patients have early breast cancer with a good prognosis.
However, it should be noted that it takes 2 to 3 years from the onset of breast cancer to the onset of clinical symptoms. Most breast carcinoma in situ, early invasive carcinoma and some invasive carcinomas do not have any symptoms and signs, mainly It is found through mammography, so the examination plays an important role in the secondary prevention of breast cancer.
The standard states that the general risk population should undergo breast ultrasound examination every 1 to 2 years. If you do not have the conditions for breast ultrasound examination, it is advisable to use mammography. High-risk groups undergo breast ultrasound combined with mammography once a year.
Further reading
Self-examination + specialist examination can improve breast cancer diagnosis rate
Qi Xiaodong, Breast Disease Diagnosis and Treatment Center, Seventh Medical Center, PLA General Hospital
80% of breast cancers can be found through self-examination, which is carried out one week after the end of menstruation, and is divided into three steps: seeing, touching, and squeezing:
Look-compare whether the bilateral breasts are symmetrical and equal in size, and whether the breast contours are locally raised or sunken. Whether the nipple is the same height, whether there is indentation, rupture, and discharge.
Touch-Put your index finger, middle finger, and ring finger together, and slowly touch the opposite breast clockwise or counterclockwise with your fingertips, starting at least three times from the periphery of the breast to the nipple, and do not miss any part. Pay attention to whether there are lumps when touching, and also check for swollen lymph nodes under the armpit.
Squeeze-squeeze the nipple to see if there is any secretion. If there is a milk-like, clear secretion, don't worry, but if there is a yellow or bloody secretion, you should seek medical attention immediately.
In addition to self-inspection, combined with specialist examinations, ultrasound and mammography can be done together, and the diagnosis rate can reach more than 95%.