To explore TCM physique characteristics and individual treatment of patients at high risk for breast cancer.
|Beijing University of Traditional Chinese Medicine
|Traditional Chinese Medicine
|Breast Cance Risk Stratification TCM Constitution
This paper consists of a literature review and a clinical research.Literature review:the article reviews the information about the recurrence risk assessment of breast cancer in recent years. At first, it lists some common prognostic indicators from two aspects, including the current more recognized and generally accepted evaluation index. Then it separately discusses the triple negative breast cancer. At last it simply summarizes the current researches about the correlation of Traditional Chinese Medicine (TCM) constitution and oncology, especially the correlation of TCM constitution and tumor recurrence risk, hoping to get a better treatment to prevent tumor relapse from the perspective of TCM, especially from TCM constitution. But the amount of researches which are about the relationship of tumor recurrence factors and TCM constitution is still relatively small. The clinical use of constitution in prevention of tumor recurrence, especially in the prediction and prevention of breast cancer recurrence remains to be further research.Clinical research:Objective:this article tries to analyse the characteristics of TCM constitution types among patients with breast cancer, especially of the high-risk patients, to research the relationship between several prognostic factors and TCM constitution types, and to explore the individualized treatment of breast cancer from the perspective of constitution. Methods:this article collects TCM constitution types by the way of questionnaire survey, collects the clinical and pathological data by referring to medical records and according to the results summarizes the patient’s risk of recurrence. Then it uses SPSS19.0statistical software, using description, crosstab test, logistic regression analysis, etc., to study the characteristics of TCM constitution types among breast cancer patients, especially in high-risk patients, as well as several the relationship between prognostic factors and TCM constitution types. Results:211cases were included in accord with the standard set. Among them, biased constitution is in the majority, and the Constitution types in Yang-deficiency constitution, Qi-depression constitution, and mild constitution have the highest proportion. High-risk patients are commonly Yang-deficiency constitution, Qi-depression constitution, and Qi-deficiency constitution. The non-high-risk patients are given priority to Yang-deficiency constitution, Mild constitution and Qi-depression constitution. Furthermore Constitution types can be divided into three groups:weak group (Yang-deficiency, Yin-deficiency, Qi-deficiency constitution), pathogenic group (Phlegm-damp, Damp-heat, Blood-stasis, Qi-depression constitution), and health group (Special-quality, Mild constitution). Then it can be found that breast cancer patients as a whole are given priority to weak physique, and high-risk groups are more commonly pathogenic constitution, and less general constitution. TCM constitution type has some correlation with the prognostic indicators, including Yin-deficiency constitution associated with tissue classification (P=0.003), Qi-deficiency associated with pathologic types (P=0.003), Phlegm-damp associated with lymph node metastasis situation (P=0.043), Mild constitution with organization classification (P=0.000) and hormone receptor expression (P=0.032). After regrouping TCM constitution types in three groups, it can be found that weak constitution is related to lymph node metastasis (P=0.006) and risk stratification (P=0.014), pathogenic constitution is associated with vascular invasion (P=0.030), lymph node metastasis (P=0.005) and hormone receptor expression (P=0.045), and general constitution has relationship with vascular invasion situation (P=0.013). Conclusion:①Patients with breast cancer are given priority to biased constitution, and the most common types of constitution is Yang-deficiency, Qi-depression and Mild constitution.②Breast cancer patients as a whole are given priority to weak physique, and high-risk patients are more commonly pathogenic constitution, and less general constitution than non-high-risk patients.③TCM constitution types have some correlation with the prognostic indicators. Yin-deficiency is related to organization classification, the higher the grade, the greater the chance of Yin deficiency constitution appearance. Qi-deficiency is related to pathologic types, different pathologic types having different probability of Qi-deficiency constitution. Phlegm-damp is associated with lymph node metastasis, the more the number of lymph node metastasis, Phlegm-damp quality appearing more likely. Mild constitution is associated with organization classification and hormone receptor expression, the higher the grading, hormone receptor expression of negative Mild constitution appearing more likely. Dividing Constitution types into three groups, like weak, pathogenic and general, then it can be found that weak constitution is related to lymph node metastasis and risk stratification, and the more the number of lymph node metastasis or the higher the dangerous degree, the greater the chance of weak constitution appears. Pathogenic constitution is associated with vascular invasion, lymph node metastasis and hormone receptor expression, and vascular invasion, more lymph node metastasis or negative hormone receptor expression gives greater chance of pathogenic constitution to appear. General constitution has relationship with vascular invasion situation, besides, if one has vascular invasion, he has a greater chance to be general constitution.