Breast health management

Don’t trust the unblocking massage in beauty salons, don’t take random health supplements with unknown ingredients, and do the three things of “regular and standardized screening, daily comfortable care, and timely medical treatment for abnormalities”, already more than 90% of people will do this.

I just received a 32-year-old patient at the breast clinic last week. A 1cm benign breast nodule was found during the physical examination. I heard from the beauty salon that "massage can disperse the nodules". She went for dredging twice a week, and also used a bottle of hundreds of yuan of dredging essential oil. After three months, I came back for a review. The nodule had grown to 2cm, and there was inflammatory exudation around it. It was so painful that it was difficult to lift my arms. To be honest, we clinicians have seen too many examples of this. Breast tissue itself is like a bunch of soft grapes. If you press and knead hard, if there are small cysts or nodules, it will easily burst and stimulate abnormal proliferation. The so-called "dredging and expelling residual milk" is even more nonsense. The body itself can absorb the residual milk, and external squeezing can easily induce inflammation.

At this point, someone must ask, will drinking soy milk and eating soy products stimulate breast hyperplasia? There are indeed different voices in the academic community on this issue: the mainstream view is that the phytoestrogens in soybeans are two-way regulated. When the estrogen in the body is high, it will seize the receptors to help you reduce the level. When the estrogen is low, it can also help you supplement it. Normally drink 250ml a cup a day. Soy milk can actually reduce the risk of breast disease; there are also a few small sample studies that show that people who already have grade 4a or above nodules may have a slight risk of irritation if they drink more than 1L of thick soy milk a day or take soy isoflavone supplements for a long time. The general advice we give in clinical practice is that it is perfectly fine to eat tofu and drink soy milk normally, but don’t just buy soy isoflavone health pills that cost hundreds of dollars.

I once wore an underwired bra that squeezes my breasts for an event. I wore it for 12 hours. When I took it off at home, there were red marks on my breasts. I wanted to throw the bra three meters away. Don’t compromise your breasts for the so-called “pull-up” and “prevention of expansion”. There is no clinical evidence to prove that wearing adjustable bras can improve expansion and prevent sagging. On the contrary, wearing tight steel bras for a long time will affect local blood circulation and aggravate the pain of breast hyperplasia. When choosing underwear, just choose one that has enough support and does not tighten your breasts. You don’t have to wear it at home or when sleeping, whatever makes you feel comfortable.

Regarding screening standards, in fact, guidelines in different regions also differ: European and American guidelines generally recommend that those over 40 years old have a mammography once a year, while Asian women generally have denser breasts and it is not easy to see small lesions with a mammography. Our domestic clinical practice generally recommends that those over 35 years old have a breast ultrasound every year and a mammography every 2 years. If there is a family history of breast cancer, or people who carry BRCA gene mutations, it is recommended to start annual screening at the age of 30, and don't wait until you feel uncomfortable.

Oh, by the way, there is another question that has been debated for many years: Is breast self-examination useful? The opposing view is that self-examination has no medical basis, and ordinary people tend to regard normal breast tissue as nodules and become anxious; the supporting view is that self-examination can help people become familiar with their breast status. I personally feel that self-examination does not need to be a must-complete task, but there is no harm in touching it a few times while taking a shower. You are familiar with the soft state of your breasts. If one day you suddenly feel a hard, painless, and unmovable small lump, just go to the hospital as soon as possible. It is better than not knowing anything and only discovering it in the late stage. Last month I saw a 26-year-old girl who found a small hard lump while taking a shower. She didn't take it seriously at the time and waited for half a year before she came in for a check-up. She found out that it was early-stage breast cancer. Fortunately, it was not discovered too late, and the prognosis is still very good.

Don’t touch those breast enhancement health products and breast care pills that boast of being amazing. 99% of them are secretly added with artificial estrogen. Short-term consumption may cause breast swelling and skin improvement. Long-term consumption will greatly increase the risk of breast cancer. Last year, a girl took breast enlargement pills sold through Wechat for half a year and was found to have atypical breast hyperplasia, which is a precancerous lesion. Fortunately, she had it removed in time, otherwise she would have had cancer and would not have a place to cry.

Actually speaking, breast health management is really not that important. Don't worry about "whether there are nodules" or "whether you will get cancer" every day, and don't ignore it at all and not have a check-up for several years. Just like you usually protect your face, don't mess around, check regularly, and go to a regular hospital doctor if you have any questions. That's enough.