Superintendent of Tri-Service General Hospital Yu Chih-cheng "Hong Chun-pei Culture and Education Foundation" Public Welfare Lecture

(Taiwan Commercial News) Women must learn to cherish themselves. This kind of care is not about wearing a body full of designer brands or carrying a pile of luxury bags, but about caring for oneself both inside and out, body and mind. For women, the breasts are what most need care, and the diseases that attack the breasts are extremely numerous, especially breast cancer, whose incidence has already surpassed cervical cancer, making it the number one killer of women's health.

On April 13, the Hong Chun-pei Culture and Education Foundation and Taiwan Commercial News invited Professor Yu Chih-cheng, Superintendent of Tri-Service General Hospital, to give a talk on "Breast Health, Happy Life." Many women attended and listened on site, gaining a great deal from it.

When many people talk about breast cancer in Taiwan, they mention the "rejuvenation of breast cancer." In fact, breast cancer in Taiwan has mostly occurred in middle-aged women, and this has been the case since early on. It is just that health education in the early days was not as widespread as it is now, and the views on breast cancer written in textbooks all came from Western countries. As a result, most people believe that breast cancer prevention and treatment should mainly target middle-aged and older women. However, breast cancer in the East has many characteristics that differ from breast cancer in the West, so prevention and treatment cannot be carried out entirely according to what the textbooks say.

Superintendent of Tri-Service General Hospital Yu Chih-cheng states that as long as one is a woman, one is in the high-risk group for breast cancer. Breast cancer in Taiwan also tends to occur in young women, so from the time menstruation begins, women should learn to perform self-examinations. In particular, breast cancer is one of the few cancers that may be detected from the body surface, so women should pay even more attention. This is especially true for women with a family history of breast cancer; in Taiwan, breast cancer patients with a family history account for about 10%. Therefore, as long as a woman in the family has had breast cancer before menopause, especially a mother or sister, one is very likely to develop breast cancer at a young age and needs to pay even more attention to oneself. After age 30, one should also ask a specialist physician to examine them once every year.

Professor Yu Chih-cheng, Superintendent of Tri-Service General Hospital, Public Welfare Lecture: Breast Health, Happy Life

For patients who have had breast cancer on one side, the probability of developing breast cancer on the other side increases by 1% each year, so the other breast should preferably be screened once every 3 months. Research has found that about 1/3 of breast diseases are related to diet. An improper diet can trigger breast diseases and worsen the condition. The occurrence of breast cancer in women is related to obesity and a high-calorie diet. Poor dietary habits such as high fat, high protein, high calories, and low fiber, for example liking fried foods, fast foods, and all kinds of pastries, chocolate, and other sweets, loving coffee, while having insufficient intake of coarse grains and vegetables, will greatly increase the risk of breast diseases. In addition, the abuse of hormone-containing tonics will also bring negative effects on breast health. Regardless of age, the earlier it is found, the better the treatment effect.

In some cases of young people who develop breast cancer, the reason it is difficult to cure is not its degree of malignancy, but that it is always discovered too late. Breast cancer in the United States is mostly found at stage 1, but in Taiwan, because the free breast cancer screening provided by the Department of Health is once every 2 years for those aged 50 to 60, many young women ignore the importance of regular examinations. In addition, because young patients may experience breast swelling due to menstruation, pregnancy, or breastfeeding, by the time it is discovered it has on average already reached stage 2 or 3.

There are also physicians who, often out of concern for young patients wanting to preserve the breast as much as possible, do not dare to remove too much breast tissue, making it difficult to strike a balance between preserving the function of the female breast and the potential risk of recurrence. These factors all affect the prognosis of breast cancer treatment.

Fighting Breast Cancer: What You Should Do

To prevent breast cancer, monthly breast self-examination must not be skipped. According to the clinical experience of the medical community at home and abroad and numerous surveys, breast cancers found by women who perform regular self-examinations are indeed at earlier stages, so it is absolutely necessary.

Because breast cancer in Taiwan tends to occur before age 40, the Taiwan Breast Medical Association recommended this year that ordinary women should start seeing a specialist physician for examinations from age 35, including palpation and ultrasound or mammography. After that, like with Pap smears, they should have a specialist physician examine them once a year. Those with a family history of young-onset breast cancer should start from age 30.

The accuracy of ultrasound or mammography differs according to age and breast tissue. According to clinical trials conducted by the Department of Health since 1995, it was found that Taiwanese women's breasts are relatively small and their breast tissue is denser, so mammography may not necessarily be a good tool; instead, ultrasound examination may be more accurate. If one is relatively overweight and the breasts are larger, then because under ultrasound the imaging of fat and tumors is very similar, mammography should be used instead.

Almost every woman will have breast fibrocystic changes. If it is confirmed to be a breast cyst, it will not become breast cancer tissue, unless the diagnosis at the time was wrong. Those whose ultrasound report shows breast cysts should preferably continue follow-up. If the examination shows microcalcifications, further examination or regular follow-up must be done, because there is a 20% probability that calcification points are breast cancer.

Working women often face greater work pressure. Their pace of life is tense, and late marriage and late childbearing are more common. Many urban women, because of busy work and wanting to maintain their figure, are unwilling to have children or delay childbearing until after age 30, and the popularity of breastfeeding is also relatively low, with short duration. All of these can affect women's breast health. Many studies show that marriage, whether one has children, and the timing of these have a great relationship with the occurrence of breast diseases. The occurrence of breast cancer is related to being single, marrying late, and a short marriage period. Women whose age at first pregnancy is over 35 have a significantly higher risk of breast disease and breast cancer. Moreover, some women take oral contraceptives for a long time for contraception, which also increases the risk of breast hyperplasia and breast cancer. A woman's first full-term pregnancy can cause a series of changes in the breast epithelium that make it mature, giving the epithelial cells a stronger ability to resist genetic mutation, while also producing a large amount of progesterone; an increase in progesterone secretion is very useful for protecting breast health. Therefore, in order to stay away from breast diseases, the timing of marriage and childbearing should be reasonably arranged. Late childbearing or lifelong childlessness is not encouraged. It is recommended not to use or to use as little as possible oral contraceptives, and at the same time to prevent multiple miscarriages. After the baby is born, breastfeeding should be done as much as possible. Studies show that the risk of breast cancer in breastfeeding women is greatly lower than in women who do not breastfeed, and the longer the breastfeeding time, the lower the risk of breast cancer.

Profile of Superintendent of Tri-Service General Hospital Yu Chih-cheng

Superintendent of Tri-Service General Hospital Yu Chih-cheng is a Bachelor of Medicine in the School of Medicine of the National Defense Medical Center; he has served as Director of the Department of Surgery at Tri-Service General Hospital, Director of the School of Medicine of the National Defense Medical Center, Deputy Superintendent for Medical Affairs of Tri-Service General Hospital, Director of the Medical Affairs Management Division of the Medical Affairs Bureau of the Ministry of National Defense, Supervisor of the Digestive Surgery Medical Association of the Republic of China, Chairman of the Breast Medical Association of the Republic of China, Member of the Audit Committee of the National Health Research Institutes, and Secretary-General of the Breast Cancer Disease Committee of the National Health Research Institutes; he currently serves as Superintendent of Tri-Service General Hospital, attending physician of the Division of General Surgery at Tri-Service General Hospital, and Professor of the Department of Surgery in the School of Medicine of the National Defense Medical Center; his expertise is in breast diseases and breast cancer research and treatment. Superintendent of Tri-Service General Hospital Yu Chih-cheng will share his experience based on many years of engaging in breast disease medical treatment and research, and it is believed that the audience will certainly benefit greatly.

Hong Chun-pei Culture and Education Foundation 103rd Year Public Welfare Lecture