Specialties: Laparoscopic cholecystectomy, laparoscopic hernia repair (including inguinal hernia, umbilical hernia, etc.), resection of benign breast tumors, breast cancer-related surgeries, thyroidectomy, subcutaneous tumor resection, laparoscopic emergency surgeries for appendicitis, intestinal perforation, intestinal obstruction, etc.

1. Introduction: From Tumor Removal to Precision Medicine

Breast cancer is the most common cancer among women worldwide and has long held the top spot for female cancer incidence in Taiwan. However, thanks to rapid medical advancements, breast cancer is no longer an incurable disease. Modern breast surgery has evolved from simply "removing the tumor" to a "precision medicine" approach that balances survival rates, quality of life, and physical appearance. This guide provides detailed information to help you establish the right screening habits and understand today’s diverse treatment options.

2. Latest Screening Guidelines: The Key to Early Detection

Early-stage breast cancer often has no symptoms. Cases found through regular screening are mostly Stage 0 or Stage 1, which have a 5-year survival rate of over 90%.

• Free Government Screening Policy:
• Who: Women aged 40 to under 75.
• How often: One free mammogram every two years.
• Professional Imaging Tools:
• Mammography: Uses X-rays to detect "microcalcifications," the most critical method for diagnosing early-stage carcinoma in situ.
• Breast Ultrasound: Asian women often have denser breast tissue. Ultrasound effectively identifies solid lumps or cysts that mammograms might miss. Doctors often use both together to ensure the most accurate results.

3. Understanding Breast Cancer Subtypes

Before creating a treatment plan, doctors use biopsy samples (IHC staining) to identify the "personality" or subtype of the tumor. This determines which medications will be most effective:

• Luminal A: Hormone receptor-positive, HER2-negative. These grow slower, have the best prognosis, and are primarily treated with hormone therapy.
• Luminal B: Hormone receptor-positive with a faster growth rate (Ki-67). Often requires chemotherapy in addition to hormone therapy.
• HER2-Positive: Highly aggressive but responds very well to targeted therapies.
• Triple-Negative: Negative for both hormone receptors and HER2. While traditional options were fewer, immunotherapy and new drugs have significantly improved outcomes today.

4. Modern Surgical Treatments: Eradication Meets Aesthetics

Modern treatment is "tailor-made," combining surgery, radiation, and systemic drugs into a comprehensive defense.

• Sentinel Lymph Node Biopsy (SLNB): A precise assessment that removes only the first few lymph nodes likely to be affected. If there is no spread, a full axillary dissection is avoided, greatly reducing the risk of arm swelling (lymphedema).
• Breast Conserving Surgery (BCS): Removes the tumor while preserving as much healthy breast tissue as possible. Combined with radiation, the survival rate is the same as a full mastectomy.
• Minimally Invasive Technology: For patients needing a full mastectomy where the nipple and skin are not affected, we offer advanced endoscopic or robotic-assisted surgery. These use hidden incisions (under the arm or breast fold) to preserve the nipple and skin for better cosmetic results.
• Immediate Reconstruction: We offer implants or "autologous" (your own tissue) reconstruction. The "DIEP flap" uses excess fat and skin from the lower abdomen via microsurgery and is a popular choice for autologous reconstruction.

5. Systemic Drug Therapy: Precision Strikes

Medication is the key to preventing recurrence and fighting cancer spread:

• Chemotherapy: Given before surgery (neoadjuvant) to shrink tumors and increase the chance of breast preservation, or after surgery (adjuvant) to clear remaining cancer cells.
• Hormone Therapy: For receptor-positive patients, this blocks estrogen from fueling the cancer; treatment usually lasts 5 to 10 years.
• Targeted Therapy & Antibody-Drug Conjugates (ADCs) : Targeted drugs are used for HER2-positive cases. ADCs act like "biological missiles," delivering drugs directly into cancer cells to reduce side effects.
• Newer Treatments: Including CDK4/6 inhibitors for advanced stages and immunotherapy for triple-negative breast cancer.

6. Post-Surgery Follow-up and Lifestyle

Long-term monitoring is essential after treatment.

• Frequency: For the first two years, follow-ups are recommended every 3 to 6 months.
• Content: Includes physical exams, breast imaging, and blood marker tests.
• Lifestyle: Maintain a balanced diet, limit high-fat and processed foods, and exercise regularly. High body fat can increase the risk of recurrence.

7. Conclusion: Early Detection Brings Hope

As breast surgeons, we see every patient as a complete person, not just a diagnosis. Advances in treatment allow us to save lives while protecting your quality of life. Please take advantage of free government screenings. Even if diagnosed, trust in the power of modern medicine and our multidisciplinary team. Let’s work together for a healthy future.