The patient has stage IV breast cancer (lymph node metastasis, lung and chest nodules should also be considered for metastasis). If the patient is physically fit, chemotherapy should be given, because metastatic breast cancer should have the concept of systemic treatment, regardless of radiotherapy. No matter how high the dose, it is still only a local treatment. Not only the micro-metastases throughout the body cannot be controlled, but also the multiple nodules in the lungs and chest cannot be solved by radiation alone. Therefore, systemic treatment should be carried out, including chemotherapy, endocrine therapy, targeted therapy, biological immunity and traditional Chinese medicine treatment, etc. The choice depends first on the patient's physical tolerance. Cyclophosphamide, pirarubicin, paclitaxel and oxaliplatin have been used as chemotherapy drugs. There are still many drugs to choose from, such as capecitabine, vinorelbine, gemcitabine, ixabepilone, fluorouracil, docetaxel, etc. Etc., anthracyclines can also be used, and the regimen can be single drug or combined, depending on individual choice. In addition, if radiotherapy is continued, it is recommended to combine it with single-agent chemotherapy. If you cannot tolerate chemotherapy, you can use endocrine therapy. Tamoxifen and letrozole have been used. The range of options is smaller, and progesterone drugs can be used. As for the cost of targeting is too high, and the possibility of high expression of HER-2(+) and FISH is small, Herceptin is not suitable. If the economic conditions are good, Avastin, Endo, etc. can be tried. Stage IV breast cancer (lymph node metastasis, lung and chest nodules should also be considered for metastasis), if the body is suitable, chemotherapy should be given, because metastatic breast cancer should have the concept of systemic treatment, and radiotherapy, no matter how high the dose, is still only a local treatment, not only Micro-metastasis throughout the body cannot be controlled, and multiple nodules in the lungs and chest cannot be solved by radiation alone. Therefore, systemic treatment should be carried out, including chemotherapy, endocrine therapy, targeted therapy, biological immunity and traditional Chinese medicine treatment, etc. The choice depends first on the patient's physical tolerance. Cyclophosphamide, pirarubicin, paclitaxel and oxaliplatin have been used as chemotherapy drugs. There are still many drugs to choose from, such as capecitabine, vinorelbine, gemcitabine, ixabepilone, fluorouracil, docetaxel, etc. Etc., anthracyclines can also be used, and the regimen can be single drug or combined, depending on individual choice. In addition, if radiotherapy is continued, it is recommended to combine it with single-agent chemotherapy. If you cannot tolerate chemotherapy, you can use endocrine therapy. Tamoxifen and letrozole have been used. The range of options is smaller, and progesterone drugs can be used. As for the cost of targeting is too high, and the possibility of high expression of HER-2(+) and FISH is small, Herceptin is not suitable. If the economic conditions are good, Avastin, Endo, etc. can be tried.

What is the degree of decrease in white blood cells during radiotherapy? If the bone marrow condition is not good, we should also pay attention during chemotherapy. In addition, the cough is severe. Is it due to lung metastasis or radiation pneumonitis? Symptomatic treatment is required. It is recommended to use traditional Chinese medicine for nursing care, which has a certain effect on the toxic and side effects of radiotherapy and chemotherapy.

(Dr. Zhu Jingyan solemnly reminds: Because we cannot see patients face-to-face, we cannot fully understand the condition. The above suggestions are for reference only. Please be sure to go to the hospital for specific diagnosis and treatment under the guidance of a doctor!)

Weifang Traditional Chinese Medicine Hospital Zhu Jingyan/