A mammogram at Tam Anh General Hospital in Ho Chi Minh City revealed a 3 cm lesion in Thao's right breast, causing skin thickening and nipple retraction. Biopsies of the lump and axillary lymph nodes confirmed breast cancer with lymph node involvement. Doctors diagnosed her with stage IIB, Luminal A breast cancer and recommended surgery. Post-surgery, histological results (invasion, grade, number of metastatic lymph nodes) determined whether she needed adjuvant chemotherapy or only endocrine therapy.

The Breast and Head-Neck Surgery team at Tam Anh General Hospital performed a mastectomy and axillary lymph node dissection. Pathology confirmed breast tissue, nerve, and blood vessel invasion; 2 of 11 lymph nodes showed metastatic cancer cells, but the surgical margins were clear.

Oncologist, Dr. Nguyen Tien Si, prescribed 6 cycles of chemotherapy to eliminate residual cancer cells and prevent recurrence and further metastasis.

Dr. Si examines Thao. Photo: Tam Anh General Hospital

Dr. Si examines Thao. Photo: Tam Anh General Hospital

A subcutaneous port was inserted in Thao's chest wall for safe and convenient drug delivery, minimizing the risk of extravasation (drug leakage) and vein damage. The port also allowed for easier movement during infusions. Thao received chemotherapy every three weeks, each session lasting 4 hours. Following chemotherapy, she underwent radiation therapy and started endocrine therapy to further reduce recurrence risk.

Breast cancer is the most common cancer among women in Vietnam, with over 24,000 cases reported by Globocan in 2022. Symptoms include lumps in the breast or armpit, flaky skin on the breast, unusual nipple discharge, and nipple retraction.

Dr. Si noted that many cases of abnormal nipple inversion are linked to breast cancer, often discovered with lymph node metastasis. This symptom is often overlooked, mistaken for physiological changes or benign issues, leading to delayed diagnosis and treatment.

Malignant tumors forming beneath the nipple tend to increase blood vessel growth for nutrients. As the tumor enlarges, it invades surrounding connective tissue and ligaments, causing skin dimpling and nipple retraction.

Dr. Si cited studies showing high cure rates for early-stage breast cancer with adequate treatment. Stage 0, if treated promptly, offers a chance of complete recovery. For early stages (1-2), the 5-year survival rate is around 90%; for stages 3-4, it's 80-86% and 25-30% respectively. Women should perform regular breast self-exams to detect abnormalities early. If any suspicious signs appear, they should seek specialist consultation for prompt diagnosis and treatment.

Besides self-exams, women should undergo breast cancer screening based on age and risk factors. Women 40 and older should have mammograms and breast ultrasounds every 1-2 years. Those with a family history of breast cancer or carrying mutations in genes like BRCA1 or BRCA2 may benefit from earlier screening, including breast MRIs and specialized tests. Screening not only detects asymptomatic breast cancer but also improves treatment outcomes, reduces mortality risk, and enhances quality of life.

Nguyen Tram

*The patient's name has been changed.