Hong discovered a lump in her right breast last year but didn't seek medical attention. When the lump grew larger and began to ooze, she went to Tam Anh General Hospital in Ho Chi Minh City. An ultrasound revealed extensive damage to her right breast (BIRADS 5). BIRADS is a breast imaging reporting and data system used to classify mammogram results for breast cancer diagnosis, ranging from levels 0 to 5.

As Hong had high blood pressure, doctors first stabilized her blood pressure before taking a breast biopsy. The results confirmed stage 3 breast cancer with hormone receptor-positive cells (ER+), which account for approximately 65-75% of breast cancer cases.

Doctor Huynh Ba Tan, from the Breast - Head and Neck Surgery Department, explained that hormone receptor-positive breast cancer responds to hormone therapy. In this type, breast cancer cells have receptors (a type of protein) that bind to the hormones estrogen and progesterone, causing the mutated cells to multiply uncontrollably, leading to breast cancer. In women, these hormones are primarily produced by the ovaries.

Hong's breast cancer was diagnosed at an advanced stage, with lymph node involvement. The tumor in her right breast had grown to 20 cm, affecting the entire breast skin and spreading under her collarbone, causing swelling. A full-body CT scan to check for metastasis revealed a small tumor in her right ovary, which doctors suspected was a benign teratoma.

According to Doctor Tan, due to the advanced stage of Hong's breast cancer, radical surgical treatment wasn't feasible. Instead, doctors opted for a treatment plan to suppress ovarian function and prevent disease progression. There are three main suppression methods: surgical removal of both ovaries, ovarian radiation to destroy their function, or hormone injections. Laparoscopic removal of the ovaries is a permanent solution with a short treatment time and lower cost, making it suitable for women who have completed their families, have children, and have an ovarian tumor like Hong.

To mitigate side effects of ovarian removal, such as hot flashes, vaginal dryness and irritation, depression and anxiety, decreased libido, and dry skin, patients should supplement with calcium and vitamin D to prevent osteoporosis and consider antidepressants.

Post-surgery, Hong recovered well and was discharged after two days. She continues hormone therapy and treatment with a new-generation CDK 4/6 immune checkpoint inhibitor. This medication can help prevent cancer recurrence and metastasis, prolonging life expectancy. After treatment, patients are advised to exercise to prevent weight gain, improve sleep, reduce stress, and maintain a balanced diet.

Hong's laparoscopic ovarian removal surgery. Photo: *Thanh Luan*

According to 2022 statistics from the Global Cancer Organization (Globocan), Vietnam had over 24,000 breast cancer cases and over 10,000 deaths from the disease. Compared to 2020, both new cases and deaths have increased.

Early detection of breast cancer allows for simpler, more effective treatment, improving quality of life and extending lifespan. Doctors recommend women regularly perform breast self-exams using the palm of their hand to detect any lumps, bumps, or nipple discharge and seek immediate medical attention if any abnormalities are found. Regular health check-ups and breast cancer screenings, such as mammograms and ultrasounds, can facilitate early detection and improve treatment outcomes.

Minh Tam

*The patient's name has been changed.