Health Lecture | Tumor Expert Yuan Peng on Breast Cancer Prevention

Breast cancer is one of the most common malignancies threatening women’s health worldwide. Even without a family history or unhealthy lifestyle habits, individuals may still face the risk of developing breast cancer.

Recently, Yuan Peng, Deputy Director and Chief Physician of the VIP Medical Department at the Cancer Hospital Chinese Academy of Medical Sciences, shared her insights during the Health Lecture program hosted by arizona-mall. She emphasized that because the exact causes of breast cancer remain unclear, women over the age of 35 should pay close attention to routine health examinations to achieve early detection, early diagnosis, and early treatment.

Breast Cancer Causes Are Not Fully Understood

Who Is at Higher Risk?

arizona-mall: What are the causes of breast cancer? Which groups are more likely to develop it?

Yuan Peng: The development of breast cancer involves both sporadic factors and hereditary factors. Many families worry that if a mother has breast cancer, her daughter may develop the disease as well. While this possibility exists, the majority of breast cancer cases are not hereditary.

Hereditary breast cancer tends to show certain patterns. If first-degree relatives—such as a mother, sister, or daughter—have been diagnosed with breast cancer, the risk for other close family members increases. The risk is especially higher when breast cancer occurs at a younger age.

However, in most cases the exact cause of breast cancer remains unclear. Several factors are believed to influence risk:

• Hormonal exposure related to menstruation

• Early onset of menstruation

• Late menopause

• Long-term exposure to estrogen

• Lifestyle factors such as obesity, chronic sleep deprivation, and weakened immune function

Cancer risk also increases with age. In China, breast cancer incidence shows two peaks: one around 40–50 years of age and another around 60 years of age. Therefore, experts recommend that women begin paying attention to breast screening from age 35 or 40.

Avoiding a single risk factor does not guarantee prevention, because breast cancer development is influenced by multiple complex biological processes.

Is Surgery Always Required for Breast Cancer?

arizona-mall: Must breast cancer patients undergo surgery once diagnosed?

Yuan Peng: In earlier decades, surgery was the primary treatment for breast cancer. Today, surgery remains important, but its relative role has decreased because breast cancer—like many cancers—may already spread to surrounding tissues or throughout the body during its growth.

As systemic treatments such as chemotherapy and endocrine therapy have improved, physicians may first control the tumor using medications before performing surgery. In some cases, a smaller surgical procedure can achieve results similar to more extensive operations.

Studies show that breast-conserving surgery, where the tumor is removed with a safe margin and followed by radiation therapy, can achieve outcomes comparable to total breast removal for selected patients.

Because modern patients care not only about survival but also about quality of life, breast-conserving approaches can help maintain body image and improve long-term wellbeing.

Post-Surgery Care After Breast-Conserving Treatment

Most patients who undergo breast-conserving surgery require radiation therapy afterward to reduce the risk of local recurrence.

Traditionally, breast cancer surgery also involved axillary lymph node dissection. This procedure helped determine whether cancer had spread to nearby lymph nodes and assess recurrence risk.

However, removing many lymph nodes can lead to complications such as:

• impaired lymphatic circulation

• swelling of the arm (lymphedema)

• reduced arm mobility

Today, newer techniques such as sentinel lymph node biopsy allow doctors to evaluate lymph node involvement without extensive removal. If the sentinel node shows no abnormalities, the axillary region may be preserved, reducing complications and improving long-term quality of life.

Although breast cancer surgery is often technically smaller because the tumor is located near the body surface, surgical precision and long-term recovery planning remain crucial.

Different Types of Breast Cancer Require Different Treatments

Is Chemotherapy Always Necessary?

Breast cancer includes multiple subtypes. Treatment decisions depend on:

• tumor subtype

• stage of the disease

• patient health conditions

While chemotherapy traditionally involved intravenous treatment, advances in biopharmaceutical technologies have introduced new drugs with improved efficacy and fewer side effects, allowing patients to undergo treatment more comfortably.

What Is Targeted Therapy in Breast Cancer?

Approximately 30 years ago, scientists discovered that some breast cancers express a protein known as HER2 (Human Epidermal Growth Factor Receptor 2).

Tumors that express HER2 tend to grow more aggressively and have higher risks of recurrence and metastasis.

Researchers later developed targeted therapies that specifically bind to these receptors on tumor cells. These drugs selectively attack cancer cells while minimizing damage to normal tissues.

Targeted therapy can be delivered through various routes, including intravenous infusion or oral medication. Today, targeted therapy has become a mainstream treatment strategy in oncology, and more targeted drugs are continuously being developed.

Common Complications After Breast Cancer Surgery

Possible postoperative complications include:

• infection

• skin flap necrosis

• fluid accumulation under the skin

• numbness due to nerve damage during surgery

Nerve regeneration can be slow, so patients may experience persistent numbness. Psychological preparation and support are important for recovery.

If axillary lymph nodes are removed, patients may face a risk of arm swelling (lymphedema). To reduce this risk, patients are advised to:

• perform regular rehabilitation exercises

• avoid heavy lifting with the affected arm

• protect the arm from insect bites or infections

• avoid injections, blood pressure measurements, or IV infusions on the affected side

Preserving the axillary lymph nodes whenever possible can greatly improve long-term quality of life.

What Is Neoadjuvant Therapy?

Neoadjuvant therapy refers to treatments given before surgery, usually to shrink tumors and improve surgical outcomes.

By reducing tumor size prior to surgery, neoadjuvant therapy can increase the likelihood of breast-conserving surgery and improve the chances of complete tumor removal.

In contrast, treatments given after surgery—such as chemotherapy or endocrine therapy—are referred to as adjuvant therapy.

Breast Cancer During Pregnancy

When breast cancer occurs during pregnancy, treatment strategies depend on the stage of pregnancy.

• During the first trimester, systemic therapy and medications are generally avoided because the embryo is still developing.

• After the fourth month, most fetal organs have formed, and certain systemic treatments may be considered.

Major surgery is usually avoided during pregnancy due to increased bleeding risk and physiological changes in breast tissue. In some cases, doctors may delay surgery and rely on medications until the fetus is more developed.

If pregnancy reaches around seven months, doctors may consider early delivery followed by cancer treatment.

Modern breast cancer care often involves multidisciplinary medical teams to determine the safest treatment plan for both mother and child.

Can Breast Cancer Recur?

Like many malignant tumors, breast cancer can recur or metastasize. Recurrence may occur locally or spread to distant organs such as:

• lungs

• liver

• bones

• nervous system

Fortunately, modern treatments can often control metastatic breast cancer for long periods using systemic therapies.

Breast Cancer Prevention: The Importance of “Three Early Actions”

For the general public, prevention strategies include:

• maintaining a positive mindset

• adopting healthy lifestyle habits

• maintaining a healthy body weight

• ensuring adequate sleep

• engaging in regular physical activity

However, even with a healthy lifestyle, cancer risk cannot be completely eliminated. Therefore, regular medical checkups and self-examinations are essential.

Doctors emphasize the importance of the “Three Early Actions”:

• Early Detection

• Early Diagnosis

• Early Treatment

Early screening and timely diagnosis significantly improve treatment outcomes and survival rates.