How should breast cancer treatment?

Treatment

Surgical treatment of a

Surgical treatment of breast cancer remains the major means of surgical treatment of a variety of options are still lacking a unified views of their general development trend is to minimize the surgical destruction of the equipment under the right conditions allow try to breast-conserving therapy of early breast cancer patients regardless of choice of what form kinds of surgical cure must be strictly controlled in order to retain the main function and appearance, supplemented by the principle of

(A) The first surgical indications Halsted radical mastectomy for breast cancer surgery efficacy of a clear and reasonable treatment of breast cancer over the past century become the standard way followed by nearly half a century since the breast cancer surgery and conducted a number of exploratory modification of the overall trend of no more than a conservative and expansion of both are still debating the breast milk of local resection and the whole conservative surgical resection is the representation of postoperative radiotherapy doses of radiation need to vary generally 30 ~ 70Gy of the limitations of the strict selection of early cancer can receive a better but whether, as the efficacy of conventional treatment for early breast cancer, and how to choose the accuracy of such early cancer harder to draw conclusions

(B) surgical contraindications

1. Systemic contraindications: ① ② tumor metastasis were elderly and the infirm who can not tolerate surgery ③ generally poor showing cachexia who ④ important organ dysfunction who can not tolerate surgery

2. Localized lesions contraindications: Ⅲ patients with one of the following conditions: ① the breast skin, orange peel-like swelling of more than half of the breast area; ② the breast skin and the advent of satellite-like nodules; ③ breast violation of the chest wall; ④ clinical examination sternum lymph node enlargement and confirmed to be transferred; ⑤ ipsilateral upper extremity edema; ⑥ supraclavicular lymph nodes confirmed by pathology for the transfer; ⑦ inflammatory breast cancer are two of the following five conditions: ① tumor ulceration; ② orange peel-like skin, breast edema of the entire breast area is l / 3 or less; ② carcinoma with pectoralis major fixed; ④ maximum length axillary lymph node diameter of more than 2.5cm; ⑤ adhesion to each other or with axillary lymph node skin deep tissue adhesion

(C) surgical method

1. Radical mastectomy: in 1894, and Meger, respectively Halsted radical mastectomy operation method on the surgical principles: ① the primary tumor and regional lymph nodes should be en bloc resection; ② removed all the breast and chest size of the muscle; ③ axillary lymph node for en bloc complete resection Haagensen improved radical surgery of breast cancer should be particularly emphasized the operative main ① thorough and meticulous dissection flap; ② flap completely separated from the chest wall chest will reveal the size of muscle cut out; ③ axillary dissection Chest Long Path of God should be retained, such as axillary lymph nodes had no significant while those thoracodorsal nerve can also be retained; ④ chest wall defect to be skin grafting in all common complications are: ① axillary vein injury: multi-axillary vein due to the anatomy of the surrounding fat and lymph when the anatomy is unclear or because of the organization to cut off when too close to the branch of the axillary vein axillary vein due to exposure and thus clearly is important to retain the branch stump ② pneumothorax: The pectoralis major pectoralis minor cut in the ribs sometimes only the end result of clamp chest wall perforating branches of the small blood vessels too deep under the clamp breaking intercostal muscle and pleura Erzhi touch tension pneumothorax caused by postoperative complications included: ① subcutaneous fluid: Multi-skin graft fixation because of poor or poor drainage due to the skin and chest wall can be used multiple suture between the organization and sustained negative pressure drainage and prevention of skin graft necrosis ②: skin suture too tight and the skin thinner, etc. The cause of their skin defect may be more timely use of skin graft limb ③ ipsilateral upper extremity edema favors limited: The main activity is the reduction of postoperative subcutaneous scarring caused by traction therefore requested an early postoperative functional exercise should normally be about a month after surgery, the basic level can be achieved flattering ease

2. Breast cancer, extended radical surgery: breast cancer, extended radical surgery, including radical mastectomy or radical mastectomy and internal mammary lymph node dissection that is cleared 1-4 intercostal lymph nodes of the time required to have surgical resection of pleural Diersansi rib cartilage in law and The former France great extrapleural wound complications, and they tend to use the latter more than

3. Imitation radical mastectomy (modified radical mastectomy): mainly used for non-invasive cancer or invasive cancer, Phase I Phase Ⅱ clinical no obvious alternative application of axillary lymph nodes Zheyi

(1) Ⅰ Type: Retention of pectoralis major pectoralis minor principle of separation of the skin incision and skin flap surgery with radical mastectomy do first (together with removal of pectoralis major muscle fascia surgery) will be the whole milk to the axillary dissection axillary lymph node-side and then OK Clear cleared the scope of the basic tracks with radical mastectomy chest God should be retained as the final will all be milk and en bloc resection of axillary lymph tissue

(2) Ⅱ type: Retention pectoralis major pectoralis minor muscle resection of steps such as the skin incision prior to the breast with the dissociation to cut off the pectoralis major pectoralis major muscle after section 456 the outer edge of rib attachment point and turned to expand the surgical field to the top of the Department of scapula coracoid pectoralis minor muscle attachment points off the following steps should be noted that with the radical mastectomy, but retain the chest nerve and accompanying vessels Finally, the whole breast and the pectoralis minor muscle en bloc resection of axillary lymph tissue

4. Breast surgery alone: As an old-style operation which had been replaced by radical mastectomy of breast cancer biology in recent years with the development of mastectomy renewed attention to its indications: First, non-invasive or axillary lymph node metastasis of early cases of postoperative radiotherapy can be no partial late second period after resection of breast cancer with radiotherapy alone, if from the growing demand in all of the beauty school still need mastectomy breast reconstruction surgery will be a complex unsuitable for young women in the early disease and therefore its main indications should be limited to old and feeble person or some only in advanced cases of palliative resection

5. Less than the whole milk surgical excision: In recent years due to advances in radiotherapy equipment found in early lesions than in the past and the patient's postoperative quality of life and therefore require increased reporting of less than full mastectomy, many conservative surgical procedure Since the partial resection of the way up to l / 4 Some applications mastectomy radiotherapy

Breast-conserving surgery is not suitable for all breast cancer cases and could not replace all of the radical operation but a way of improved treatment of breast cancer should be taken to avoid recurrence of their indications as follows: ① less suitable for clinical T1 tumor and part of T2 (less than 4 cm) the following lesions; ② around the tumor is located under the areola are often inappropriate; ③ solitary lesion; ④ well-demarcated tumor, such as the naked eye or under a microscope, the borders are often not see clearly inappropriate; ⑤ axillary lymph node no clear effect of treatment of metastasis to the following factors: ① tumor resection margin must have a normal border, if there is sufficient margin of normal organizers a better prognosis; ② primary tumor size and histological grade; ③ postoperative radiotherapy postoperative radiation therapy if not for a higher rate of local recurrence

2 Radiation Therapy

Radiation therapy is a major component of treatment for breast cancer is one of the means of local therapy, compared with the surgical treatment of patients less susceptible to anatomical factors such as physical limitations, but radiation treatment is being affected by the impact of the biological effects of radiation with the current commonly used in radiotherapy facilities more difficult to achieve "full kill" the purpose of effect of tumor surgery less than thus present, most scholars do not advocate line of incurable breast cancer radiotherapy over radiotherapy alone for the comprehensive treatment, including radical surgery, either before or made after adjuvant treatment of advanced breast Palliative treatment of cancer over the past 10 years, the earlier breast cancer with partial excision of the comprehensive treatment of the increasing efficacy and no significant difference between radical mastectomy radiotherapy in narrowing the scope of surgery played an important role in

(A) Preoperative radiotherapy

1. Indications

(1) The larger the primary tumor is estimated that there are those in the direct operation

(2) the rapid tumor growth, significant growth in the short term those who

(3) The original skin lesion marked edema or adhesions by chest

(4) axillary lymph nodes or with large skin and surrounding tissues were significant adhesion

(5) Application of preoperative chemotherapy in cancer patients not ideal retreat

(6) to seek surgery in patients with inflammatory breast cancer

2. The role of preoperative radiotherapy

(1) can increase the rate of surgical resection in patients with inoperable so that part of the opportunity to re-operation

(2) Since the radiation inhibit tumor cell activity can reduce the recurrence rate and metastasis rate and thus increase the survival rate

(3) The observation of preoperative radiation extended periods so that some existing subclinical cases of distant metastasis to avoid an unnecessary surgery

3. The shortcomings of preoperative radiotherapy

Increase the impact of surgical complications after a correct determination of stage and hormone receptor

4. The application of methods of preoperative radiotherapy

Preoperative radiotherapy should be as far as possible high-energy rays to better protect normal tissue complications in radiation technology, reduce the current conventional split the majority of moderate-dose radiation in general do not have fast or super-fractionation radiotherapy 4 to 6 weeks after the end of an operation more desirable

(B) postoperative radiotherapy

The need for radiotherapy after radical resection is the treatment of breast cancer has been the most debated issues in recent years, more the author acknowledges that postoperative radiotherapy can reduce the rate of local regional recurrence of breast cancer since the Fishor put forward a new view of breast cancer after the treatment has gradually shifted from local turned to a comprehensive treatment of postoperative adjuvant chemotherapy for the treatment widely used in postoperative radiotherapy after radical resection is no longer as a routine treatment but the selective application of

1. Indications

(1) simple mastectomy

(2), radical surgery with axillary in the pathology report on the group or group of axillary lymph node metastasis

(3) confirmed by pathology after radical resection of metastatic lymph nodes accounted for more than half the total number of lymph nodes examined or have four or more lymph node metastasis

(4) pathologically confirmed cases of internal mammary lymph nodes (supraclavicular irradiation area)

(5) The primary tumor is located in the central or the inside of the breast for radical surgery, particularly those who had axillary lymph node metastasis

2. Radiotherapy principles

(1) Ⅰ Ⅱ breast cancer after radical surgery or radical imitation of the original lesion in the outer quadrant of breast pathological examination of axillary lymph node-negative patients without radiotherapy; axillary lymph node-positive after irradiation when the internal mammary area and clavicle down areas; primary foci in the breast area or within a quadrant of the central pathological examination of axillary lymph node negative, only radiation within the breast area after axillary lymph node-positive when the area increases from top to bottom according to the subclavian

(2) Ⅲ breast cancer radical surgery, whether positive or negative axillary lymph node irradiation be the upper and lower internal mammary area and clavicle areas in light of the number of the number of positive axillary lymph nodes and chest wall involvement may wish to consider the situation with or without chest wall irradiation

(3) axillary lymph nodes after radical mastectomy has been cleared and no further exposure to the armpit area unless the surgical removal of incomplete or residual lesions before considering exposure to additional axillary area

(4) should the post-operative radiotherapy 4 ~ 6 weeks began to have skin graft can be extended for 8 weeks

(C) radiation therapy-based treatment

In the past for locally advanced tumors without surgical indications for radiation therapy are often palliative in nature in recent years, along with improvements in radiation equipment and technology, as well as radiation biology research and to enhance the progress of local tumor can receive a higher radiation dose and the surrounding normal tissue Damage less treatment markedly improved and are proceeding in minor surgery plus radiation therapy for early breast cancer research so that radiation therapy in the treatment of breast cancer with radical shift from palliative majority of authors believe that the original lesion is less than 3cmN0 or N1 patients may wish to consider minor surgery plus radiotherapy for locally advanced breast cancer radiation treatment is still an effective means of local radiation therapy before resection of all tumor or for a simple mastectomy may improve the curative effect

(D) of radiation therapy recurrent metastasis

Postoperative recurrence of breast cancer is a bad sign, but not without hope

The appropriate local treatment can improve the quality of life to extend the lifetime of radiation exposure in Ono Ono, good curative effect than exposure should maximize the use of irradiation for recurrent cases Ono radiotherapy with chemotherapy should be used especially for the rapid development of integrated treatment of relapse of breast cancer, distant metastasis occurs when the first consideration chemotherapy with radiotherapy may be appropriate to relieve symptoms, such as to alleviate the suffering of patients with bone metastases patients who were pain and reduce or disappear after radiotherapy for patients with thoracolumbar spinal metastasis radiation can prevent or delay the occurrence of paraplegia

3 hormone receptor determination and the relationship between endocrine therapy

Hormone receptor determination and a clear relationship between the efficacy of breast cancer: ① Application of estrogen receptor-positive endocrine therapy response rate was 50% ~ 60% while the negative effective less than 10% simultaneous determination of progesterone receptor may be more accurate estimate the effects of endocrine therapy for both positive and efficient up to 77% or more receptor is the relationship between concentration and effect are related to the higher level the better the treatment effect is also ② receptor-negative cells are often poorly differentiated receptor-negative Postoperative patients tend to have a recurrence regardless of lymph node metastasis receptor-negative prognosis worse than the positive-positive people are often subject to recurrent skin and soft tissue or bone tend to shift negative ones tend to visceral metastasis ③ Determination of hormone receptor has postoperative adjuvant therapy used to develop the program, especially receptor-positive cases can be applied to post-menopausal hormonal therapy as a postoperative adjuvant therapy and pre-menopausal or hormone receptor-negative may lead to adjuvant chemotherapy based

Four endocrine therapy

Endocrine therapy for breast cancer cure in nature but for non-hormone-dependent breast cancer, but it can receive different levels of palliative effect of the cytoplasm and nuclei of cancer cells of estrogen receptor (ER) content is also stronger the more of its hormone-dependent and should be bearing in mind the amenorrhea and amenorrhea occurred before the breast cancer occurred after a difference in the treatment of breast cancer

(A) pre-menopausal (or amenorrhea after one year) treatment of patients with

1. Androgen deprivation therapy

Including surgery and radiation castration castration the former is better for the body effect of endocrine therapy are urgently needed; the latter is difficult for the body of poor tolerance to surgery patients who were not selected the efficient application of ovariectomy and 30% to 40% The hormone receptor-positive cases were effective up to 50% ~ 60% at present mainly used for preventive removal of ovaries before menopause (in particular 45 to 50 years) more extensive lymph node metastasis in patients at high risk of recurrence of the same time, determination of hormone receptor-positive cases of post-menopausal or younger are not suitable for preventive removal of ovaries

2. Endocrine therapy

(1), testosterone propionate: 100mg intramuscular injection used in conjunction five times a day, after a time reduced to 3 times a week to defuse the situation, as the symptoms and the use of systemic reaction can be sustained reduction of about 4 months if ineffective drugs could be six weeks out

(2) fluorine Oxymesterone: the testosterone effects similar but relatively low androgenic oral dose for 10 ~ 30mg / day and 10mg three kinds of drug formulations minutes 2mg5mg

(3) dimethyl testosterone: the role of testosterone derivatives stronger than testosterone for oral administration of 2.5 times 150 ~ 300mg / day

(B) post-menopausal (amenorrhea more than 1 year) treatment of patients with the choice of the following drugs

1. Tamoxifen (TAM): an anti-estrogen drugs with cancer cells of estrogen receptor-binding inhibiting the proliferation of cancer cells commonly used as a 10mg oral dose of 2 times / day a further increase in the dose not improve the efficacy of the main side effects are: ① the stomach gut reactions: loss of appetite, nausea, vomiting and diarrhea to individual; ② reproductive system: genital itching menopause vaginal bleeding; ③ neuropsychiatric symptoms: headache, dizziness depression; ④ skin: facial flushing rash; ⑤ blood count: occasional white blood cells and thrombocytopenia used with caution, as the lower blood; ⑥ individual patients abnormal liver function; ⑦ pregnancy, lactation affect the fetus Jiyong ⑧ are harmful to the retina that can affect vision

2. Ammonia Glutethimide: 125mg orally 4 times / day of oral hydrocortisone at the same time 25mg2 times / day or strong pine 5mg2 times / day increments until a week after ammonia Glutethimide 250mg2 times / day hydrocortisone 25mg4 times / day or strong pine 5mg3 times / day

3. Medroxyprogesterone acetate 200 ~ 300mg intramuscular injection of 2 times / day

4. Diethylstilbestrol 1 ~ 2mg orally three times / day

5. Ethinylestradiol (ethinylestradiol) This product is a strong synthetic estrogen activity 0.5 ~ 1mg orally 3 times / day

5 chemotherapy

(A) the principle of the majority of adjuvant chemotherapy for breast cancer is a systemic disease has been a large number of experimental studies and clinical observations confirmed as breast cancer developed into more than lcm in clinical tumor often can be touched is the existence of systemic diseases that can be distant micrometastasis only used the current inspection methods still can not find just the purpose of surgical treatment is to make the primary tumor and regional lymph nodes are the greatest degree of local control and reduction of local recurrence after tumor resection to improve survival in vivo, but there are still remnants of tumor cells Based on the time of diagnosis of breast cancer is a systemic disease, the concept of systemic chemotherapy is aimed at the eradication of residual tumor cells in the body to improve the cure rate of surgery

(B) neoadjuvant chemotherapy

1. The significance of preoperative chemotherapy

(1) early control of micro-metastasis

(2) to enable the primary tumor and its surrounding the proliferation of cancer cells or in part, by the degeneration of kill in order to reduce the recurrence and metastasis

(3) in advanced breast cancer, and inflammatory breast cancer limits the implementation of surgical treatment of preoperative chemotherapy can shrink tumors so that surgery

(4) The removal of the tumor samples based on evaluation of effects of preoperative chemotherapy as postoperative chemotherapy or recurrence of the selection of a reference

2. The method of preoperative chemotherapy

(1) preoperative chemotherapy: Shanghai Medical University Cancer Hospital since 1978, pairs of 96 cases of breast cancer patients before oral administration of benzene, pyrimidine mustard 15mg daily serving ld stop taking the total amount of 45mg after 2d surgery and 94 cases of control group stage Ⅲ patients with 5-year survival rate in the treatment group was 56.3% in the control group 39.3%

(2), preoperative intra-arterial infusion chemotherapy: There thoracic artery and the subclavian artery in two ways

(C) adjuvant chemotherapy

1. The indications for postoperative adjuvant chemotherapy

(1) axillary lymph node-positive pre-menopausal women, regardless of how estrogen receptors are required to use has been combined with chemotherapy should be used as a standard treatment scheme

(2) axillary lymph node-positive and estrogen receptor-positive postmenopausal women should be the preferred anti-estrogen therapy

(3) axillary lymph node-positive and estrogen receptor-negative postmenopausal women could be considered as a standard program of chemotherapy, but not recommended

(4) axillary lymph node-negative pre-menopausal women do not generally recommend adjuvant therapy for certain high-risk patients, but adjuvant chemotherapy should be considered

(5), axillary lymph node-negative postmenopausal women with estrogen receptor, regardless of their level of non-adjuvant chemotherapy but some indication of adjuvant chemotherapy should be considered high-risk patients

The high-risk node-negative breast recurrence factors are the following points: ① hormone receptor (ERPR)-negative tumors ② ③ high percentage of S phase cells aneuploid tumors ④ CerbB-2 oncogene overexpression or amplification of those who have

2. For the modern view of Adjuvant Chemotherapy

(1) of early postoperative adjuvant chemotherapy should strive to apply no later than 2 weeks after no more than one month after lesion If we wait until then to use will reduce the effect of significantly

(2) adjuvant chemotherapy in combination chemotherapy compared with single-agent chemotherapy for good

(3) adjuvant chemotherapy to achieve a certain dose to achieve the original planned dose of 85% of better-performing

(4) The treatment period should not be too long advocate of breast cancer after 6 consecutive cycles of chemotherapy

3. Recommended regimen

(1) CMF program: It is a classic program of breast cancer chemotherapy

Cyclophosphamide (CTX) 400mg/m2 intravenous d1d8

Methotrexate (MTX) 200mg/m2 intramuscular d1d8

Fluorouracil (5-Fu) 400mg/m2 intravenous infusion of dl-5

Repeated every three weeks

(2) CAF Program

Cyclophosphamide (CTX) 400mg/m2 intravenous d1d8

Adriamycin (ADM) 300m8/m2 intravenous d1

Fluorouracil (5-Fu) 400mg/m2 infusion d1-s

Repeated every three weeks

(3) Cooper Program

2.5mg/kg per day of oral cyclophosphamide

Used in conjunction 0.7mg/kg intravenous injection of methotrexate per week for 8 weeks

5 - fluorouracil after intravenous injection of 12mg/kg every other week, Week 1

New alkaline Changchun used in conjunction 34mg/kg per week 4 to 5 weeks

Strong Pine 0.75mg/kg per day after the l / 2 volume, together with the 10d5mg / d used in conjunction 3 weeks

4. Breast cancer second-line chemotherapy

(1) CEF Program

D1d8 intravenous cyclophosphamide 500g/m2

Epirubicin 50mg/m2 intravenously d1

5 - fluorouracil 500mg/m2 intravenous d1-3;

(2) DCF program

M due anthraquinone 10mg/m2 intravenously dl

Cyclophosphamide 500mg/m2 intravenous d1

5 - fluorouracil looomg/m2 intravenous d1

(D) of bone metastases chemotherapy combined with chemotherapy on the brain and other soft-tissue transfer hepatopulmonary bone metastasis than good results but there are also

Reported a strong combination chemotherapy with bone metastasis foci completely disappear so brilliant ADM (MTH) could inhibit the role of clinically for the treatment of osteolytic bone metastasis of osteolytic destruction caused by the hypercalcemia frequently used programs: AMO Program: Adriamycin (ADM) 40mg/m2 intravenous injection of the first l8 days; vincristine intravenous injection of alkaline 1.4mg/m2 the first 18 days; brilliant ADM (MTH) 2mg soluble 200m15% glucose drip for 2 hours End Cap l81522 days; a course of treatment every 28 days for a total of three courses of disease with radiation therapy may limit

(E) the transfer of the central nervous system, chemotherapy

1. Without cerebral edema could be the first x-ray tomography for targeting radiation therapy in patients with cerebral edema should use diuretics mannitol and high-dose corticosteroids control cerebral edema

2. Lesions or can not locate a wide range may easily through the blood-brain barrier with the first fat-soluble chemotherapeutic drugs such as CCNU oral 100mg every 3-4 weeks a time MECCNul25mg orally every 4 to 6 weeks 1 times

(Vi) chemotherapy for malignant pleural effusion pleural effusion and then try to use the net pumping chemotherapy drugs into the chest of the following: ① Xiaoliu mustard 40 ~ 60mg; ② mustard 10mg; ⑦ Thio-Tepa 30mg; ④ mitomycin 6 ~ 8mg; ⑤ fluorouracil looomg; ⑥ chloride cis-platinum chemotherapy drugs for more than 90 ~ 120mg In addition to cis-platinum chloride injection every 3 weeks for a meeting (and body hydration) outside the normal weekly intrapleural injection of 1

6 Chinese medicine therapy

(1) Chinese medicine treatment principles:

① combat poison with poison Law: ancient physicians to treat cancer mostly attacking the use of drugs, mainly the effect of its opening statement Sida gradual elimination of residual cancer cells, but must be carefully managed clinical Enough is enough

② Qingrejiedu law: in the heat-clearing and detoxifying drugs there are many anti-cancer traditional Chinese medicine Qingrejiedu law is the law to treat malignant tumors, one of the most commonly used in advanced breast cancer patients were more commonly associated with toxic hot hot Ecchymosis intrinsic right or wrong, the At this point the symptoms can be present Dafa combination with other methods have been clearly effective in treatment of multi -

③ blood circulation Method: Chinese experts believe that tumors are associated with bleeding related to blood stasis is one of the causes of breast cancer pathology blood circulation drug application will not only improve breast cancer patients, "hypercoagulable state" make cancer cells in the anti-cancer drugs and the patient's own immune cell inhibitory activity and can reduce the platelet aggregation under the reduction of tumor metastasis is conducive to cancer control and removal of foci

④ rousing Law: Chinese medicine, when the body is upright when the evil can be the Minato deficiency that is the role of disease-causing factors can be caused by the occurrence of breast cancer and to the proliferation of tumor invasion and metastasis can be so rousing the basic method of treatment for breast cancer One

⑤ Ruanjian Sanjie law: traditional Chinese medicine theory suggests that the tumor on the surface as hard as stone, "Kennedy who cut the" "those who loose the knot," "guest were Apart from the" This method has been widely used in clinical combination with other therapies may enhance the elimination of carcinoma of the Effects

⑥ phlegm Qushi France: Many tumor is caused by phlegm cohesion in the tumor, therefore phlegm dampness France occupies an important position in Chinese medicine treatment which will not only ease symptoms for some tumors can also be brought under control

Chinese medicine treatment for breast cancer within the rule has always been the method is used according to syndrome differentiation based mainly on the principle of "seeking a result of the trial because of dialectical theory of governance" is divided into disorders Chong and Ren qi stagnation of qi and blood stasis drug resistance failure, type 4 administering treatment, respectively

(2) Differential Treatment of law:

① liver Qi stagnation type:

Main symptoms: the impassioned wish fail to materialize by the injured liver Qi stagnation of qi and blood disorders caused by the body organs dysfunction arising from two breast lumps pain threatened to upset irritability veins bulging string slide a thin yellow or thin white tongue fur

Governing law: Shugan Qi and activating blood Sanjie

Recipe: Angelica 9g peony root 9g Bupleurum 9g orange leaves 9g Angelica 6g Qingpi 6g Trichosanthes 30g Poria 9g Atractylodes 9g

Editor's note: the breast is located in the liver of the fabric for the Xiongxie liver failure Shuxie appeared in pain and the threat of breast fullness feeling pain uncomfortable symptoms of liver depression qi stagnation knot in the course of time caused by bleeding into the milk into a block of orange leaves Fang Bupleurum Qingpi Shugan Qi Sanjie; angelica peony root nourishing Rougan; Trichosanthes Angelica swelling Sanjie pain; Poria Atractylodes spleen dampness Qi

② Chong and Ren disorder type:

Main symptoms: In addition to the above-mentioned symptoms of liver Qi stagnation outside both menstrual disorders Yaotuisuanruan five upset hot-pulse breakdown unable to cracking little tongue red fur

Governing law: nourishing liver and kidney qi Shugan conditioning Chong and Ren

Recipe: Cyperus rotundus 10g turmeric 10g Fructus Toosendan 10g white peony root 15g orange leaves 10g Chuan Xiong 10g Chinese angelica 10g of 15g of Health Rehmannia Ligustrum lucidum 10g medlar 15g Chinese yam 15g wild chrysanthemum 15g Health Trichosanthes 30g

Editor's note: Liver Depression-fire burns Yin Ye-induced liver and kidney disorders Fong Chong and Ren Chuanxiong Rehmannia angelica peony root conditioning blood; birthplace of Chinese wolfberry child Sadako Ziyin kidney; Cyperus rotundus turmeric orange leaves Fructus Toosendan Shugan qi; Health yam spleen; Daisy Hua Gua Lou detoxification Sanjie

③ toxic Heat Accumulation Type:

Main symptoms: breast lumps are very rapidly increasing pain, ulceration turn flower

Governing law: attack drug detoxification

Recipe: Fern 9g Solanum 30g Siphonostegia 9g vine leaves 15g hive 9g iron snake slough 3g dung beetle pest 9g Hill Maozhaocao 30g Arrow Arrowhead 15g ghost feather 9g

Editor's note: Toxic Heat Accumulation wish to attack drug detoxification Fang Fern Solanum vine leaves Iron Siphonostegia Qingrejiedu; honeycomb snake slough mantis insect Ranunculus Grassy Arrowhead Arrow feather ghost blood circulation Detoxification

④ blood deficiency type:

Main symptoms: Breast fester a long time decay is righteous blood burned by the anemic pale and thin weak dry mouth, see dull red tongue slip pulse number of yellow and white fur

Governing law: rousing blood pairs make up

Recipe: Fried soil Atractylodes 12g Ginseng Poria Rehmannia Chenpi Fritillaria Cyperus rotundus Chuanxiong angelica peony root of the licorice root 6g Campanulaceae 3g

Editor's note: breast cancer presented with advanced disease found in the real situation is imaginary evil governance Turkish side should be rousing Buqi Yangxue fried Ginseng Poria Rehmannia Baizhu Chuanxiong Angelica spleen Qi tonic blood circulation; Chenpi Cyperus rotundus Campanulaceae qi Sanjie; licorice reconcile rousing various drugs

(3) The ancient medical side for example: the literature of ancient Chinese medicine treatment of breast cancer herbs lot of governance within the extraterritorial Morokata a few cases of the following cite for reference

① Health crab shells on a baking Jiao Yan Mo watt red wine 6g per serving in order to eliminate early breast cancer for the degree of governance, such as a hard tumor as big as beans

② River Rose 10g turmeric 10g each 8g Qingpi Citrus Hill orange leaf Arrowhead Jiangcan of red peony root 10g Chinese angelica 15g serving Trichosanthes 30g decoction minutes early indications of breast cancer or breast cancer post-operative treatment

③ 16 mei gas stream to drink: angelica peony root white ginseng Campanulaceae Chuanxiong Citrus aurantium Magnolia Zhisu wind Lindera aggregata betel leaves 20g of 10g Astragalus Guangui Akebia 4g licorice 6g Jianfu the treatment of breast cancer liver depression qi stagnation of qi and blood deficiency were

④ Ji Zhi carp Cream: Live carp fresh yam (peeled) of the equal parts of trace and a little drunk, such as musk, painted on the perception of nuclear itch not to scratch a very moving one for seven days since the beginning of topical administration Ruyan

⑤ Rong whip cream: Phellodendron Huang Cen Furong Kanozawa Lan Ye Berberine all equal parts of rhubarb were too heavy to fine research into the basket into the borneol 6g tune into the 20% with Vaseline ointment indications of inflammatory breast cancer also frequently used to treat breast cancer medicine cancer are: Arrowhead mountain soil orange leaf dandelion Fritillaria Trichosanthes Loulu pangolin days left Yukiko ambrette Long Kwai Tsing Hua Pi Fu Rong Aescin a flower