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In today's society, people are busy with their work and often neglect their health. Although breast cancer is the most common cancer in women, its 10-year survival rate can reach 85% after treatment. Early detection of breast cancer is very important for prognosis.

1、which people are at high risk of breast cancer?

High risk group of breast cancer refers to those with obvious genetic tendency of breast cancer, patients with moderate or severe atypical hyperplasia or lobular carcinoma in situ of breast duct or lobule, or patients with previous history of chest radiotherapy.

2、How to detect breast cancer early?

Usually early breast cancer has no symptoms or signs, which. Therefore, breast cancer screening plays an important role in early detection of breast cancer.

3、How to choose screening measures for breast cancer？

1、Breast self-examination
Breast hyperplasia is very common condition. But when time passes, hyperplastic breast forms breast nodules. A breast nodule can change into fibroma or hemangioma. When it grows to a certain extent, the tissue will become necrotic and hard, and early breast cancer can appear. Therefore, self-inspection should be carried out regularly.            
How to check breast hyperplasia

1) Take off your clothes and look at breasts from mirror first. Check whether the size of the breasts are same on both sides, is the color of the breasts on both sides normal, does the nipples look same on both breasts, is the thickness of the skin same on both sides of the breasts (are there dimples or orange skin), and whether the thickness and color of the blood vessels on the surface of the breasts are similar on both sides.           

2)  Palpate after inspection. Put your left hand on the hip. Check the left breast with your right hand using two fingers (the right index and the middle finger). Then put your right hand on the hip. Check the right breast with your left hand using two fingers (index and the middle finger). The fingers should be on the breast skin with gently touch. Never squeeze or grasp the skin with fingers to avoid mistaking breast tissue as a mass.           

3)  Breast palpation order. Proceed clockwise. The breast can be divided into five regions, with the areola as the center: the inner upper quadrant, outer upper quadrant, outer lower quadrant and inner lower quadrant of areola. The examination starts from the inner upper quadrant, passes through the outer upper quadrant, the outer lower quadrant, the inner lower quadrant, and finally the areola.           

4) Check the nipple for any secretion regularly. Pay attention to possible bloody stains on underwear.
2. Mammography
Breast X-ray has poor penetrability to young dense breast tissue, so it is generally used to screen breast cancer for women over 40 years old. Its effect on reducing the mortality of breast cancer (in over 40 years old patients) has been recognized by most specialists.

3. Breast ultrasound

For young women under 40 years old, the breast is relatively dense, so it is more recommended to use breast ultrasound for screening.

4. Breast MRI
Because of the high requirement of MRI equipment and high price, breast MRI is generally used as a supplementary examination method for suspected cases found by the above screening measures. In addition, it can be combined with mammography for breast cancer screening in high-risk groups.
5. Clinical physical examination of breast

Breast clinical physical examination is generally used as a joint examination method with other methods of breast screening. It is not recommended to be used alone as a method of breast cancer screening. SHAPE  \* MERGEFORMAT
4、Recommended time line for breast cancer screening
20-39 years old:

-     It is not recommended to screen non-high-risk groups

-     It is recommended to screen high-risk groups once every six months.

40-49 years old:

-     It is recommended to carry out mammography screening and clinical physical examination once a year. Breast ultrasound examination is recommended for dense breast.           

50-69 years old:

-     It is recommended to have mammography screening and clinical physical examination every 1-2 years. Breast ultrasound examination is recommended for dense breast.           

70 years old or above:

-     It is recommended to have mammography screening and clinical physical examination every 2 years. Breast ultrasound examination is recommended for dense breast.           

In prevention and treatment of breast cancer - in addition to early screening - women should pay attention to the workload and hectic lifestyle. It’s important to pay attention to one’s own health and wellbeing.

5、The occurrence of breast cancer may be related to estrogen level, which can play a role in breast hyperplasia. Below are some known risk factors for breast cancer:

1) Menstruation:
Women whose menstruation started before the age of 13 or whose   menstruation hasn’t ended by the age of 50 may be in a risk group for breast cancer due to long effect of estrogen           

2) Marital status:

Single unmarried women are more likely to suffer from breast cancer than married women. The incidence of breast cancer is higher in late marriage and late childbearing or unmarried women.           

3) Childbirth and lactation:
The risk of breast cancer may be increased if the first childbirth is given late (over 35 years old) or if woman is 40 years old without pregnancy. The risk will also grow if there are several abortions, or if no postpartum breastfeeding.

4) Hormone:

The occurrence of breast cancer is closely related to the level of estrogen. High level of growth hormone increases the risk as well. Long-term supplementation of exogenous hormones, commonly used hormone drugs such as oral contraceptives, may increase the risk of breast cancer.           

5) Genetic and familial history:

Genetic and familial characteristics of breast cancer are one of the risk factors. Women with a family history of breast cancer are more likely to have breast cancer than those without a family history of breast cancer.           

6) Diet:

High fat, high protein and high calorie diet will increase the risk of breast cancer. People who are obese have more breast cancer.           

7) History:

Repeated exposure of the breast to radiation for various reasons will also increase the risk of cancer. Atypical hyperplasia of the breast may progress to breast cancer. History of breast cancer on one side increases the risk to get cancer to the other side 2-5 times higher than that of people without breast cancer history.

8) smoking and staying up late:

Active or passive smokers have a high incidence of breast cancer. Women who have entered menopause and have smoked have increased risk of breast cancer. There is no significant relationship between smoking and breast cancer incidence in postmenopausal women, but the risk of breast cancer increased 2.6 times after smoking or passive smoking in premenopausal women. Studies have shown that staying up late often increases the risk of breast cancer.           
9) obesity and exercise:

Endogenous estrogen is one of the causes of breast cancer. Obesity affects hormone levels. Studies have shown that weight gain or body mass index increase the risk of breast cancer in postmenopausal women. Exercise may reduce the risk of breast cancer, especially in women who have had children.          
Breast cancer mostly occurs in women aged 40-60, or before and after menopause, especially in women aged 45-49 and 60-64.