Mammary cancer is one of the most commonly-seen malignant tumor in women. Asthenia in origin and sthenia in superficiality coexist after radical operative cure or chemotherapy and radiotherapy. At the late stage, visceral functions decline increasingly and a series of symptoms of healthy qi deficiency may occur such as deficiency of the spleen yang, deficiency of qi and blood, and yin deficiency of the liver and kidney.
1. Syndrome differentiation and treatment
(1) Blood and water obstructing collaterals
It manifests swelling and distension of unilateral upper limb as well as certain degree of disturbance in movement after the operative treatment of mammary cancer, deep red tongue, thready and unsmooth pulse. It is advisable to promote blood circulation and promote diuresis. The prescription used is Huoluo Xiaoling Pill (Effective Collateral-Activating Pill) with additional Fuling (Poria), Jianghuang (Rhizoma Curcumae Longae), Guizhi (Ramulus Cinnamomi), Sangzhi (Ramulus Mori), Chishaoyao (Radix Paeoniae Rubra) and Chuanxiong (Rhizoma Ligustici Chuanxing). Learn more about female diseases, please click here to read Hyperplasia of Mammary Glands in TCM.
(2) Qi stagnation and phlegm stasis
It manifests hard swelling lump of breast with normal color, thoracic stuffiness, inclination to sigh, deep red tongue with thin fur, thready and taut or thready and unsmooth pulse. It is advisable to regulate qi, resolve phlegm and dispel stasis. The prescription used is the modified Chaihu Shugan Decoction (Bupleurum Decoction for Relieving the Liver Qi). In the case of severe mammary distending pain, add Chuanshanjia (Squama Manitis), Wangbuliuxingzi (Semen Vaccariae), Gualou (Fructus Trichosanthis) and Danshen (Radix Salviae Miltiorrhizae); in the case of hard lump with gradual enlargement, add Tubeimu (Rhizoma Bolbostemmatis), Sancigu (Rhizoma Pleionis), Kunbu ( Thallus Laminariae seu Eckloniae) and Haizao (Sargassum). Learn more about female diseases, please click here to read Causes of Hyperplasia of Mammary Glands in TCM.
(3) Accumulation of toxic heat
It manifests gradual enlargement of mammary lump with congestion and pain, even severe ulceration, filthy water with foul odor, vexation, dry mouth, constipation, yellowish urine, deep red tongue with yellowish greasy fur, taut and rapid pulse. It is advisable to clear away heat, remove toxic substance and dispel accumulation. The prescription used is the modified Lianqiao Jinbei Decoction with additional ingredients. In the case of diabrotic lump with flowing blood and fluid, it is advisable to add Shenghuangqi (unprepared Radix Astragali seu Hedysari), Bailian (Radix Ampelopsis), Pugongying (Herba Taraxaci) and Lianqiao (Fructus Forsythiae). Learn more about female diseases, please click here to read Symptoms of Hyperplasia of Mammary Glands in TCM.
(4) Adverse qi flow due to qi deficiency of the middle energizer
Adverse qi flow due to qi deficiency of the middle energizer It manifests anorexia after the radiotherapy and chemotherapy, nausea, vomiting, abdominalgia, reddish tongue or with dental marks, thready and taut pulse. It is advisable to supplement qi and lower the adversely rising qi. The prescription used is the modified Xiangsha Liujunzi Decoction (Decoction of Cyperus and Amomum with Six Noble Ingredients). In the case of severe vomiting, it is advisable to use the modified Xuanfu Daizhu Decoction (Decoction of Inula and Hematitum), or add Jiangbanxia (prepared Rhizoma Pinelliae), Zisuye (Folium Perillae) and Huanglian (Rhizoma Coptidis).
(5) Obstruction of dampness due to asthenia of the spleen
It manifests general tiredness with heavy sensation, thoracic and epigastric mass, anorexia, edema of the face or lower limbs, tender and enlarged tongue, white, thick and greasy or white and slippery fur, thready and slippery pulse. It is advisable to warm the spleen and promote diuresis. The prescription used is the modified Shiwei Liuqi Decoction. Learn more about female diseases, please click here to read TCM Diagnosis for Hyperplasia of Mammary Glands.
(6) Deficiency of both qi and blood
It manifests lusterless complexion lassitude, hypodynamia, spontaneous sweating, palpitation, short breath, or prolonged healing of wound after the operation, pale tongue, thready and weak pulse. It is advisable to supplement qi and tonify blood. The prescription used is the modified Shiquan Dabu Decoction (Decoction of Ten Powerful Tonics). In the case of prolonged healing of wound due to deficiency of qi and blood, add Danshen (Radix Salviae Miltiorrhizae), Xueyutan (Crinis Carbonisatus) and Ercha (Catechu).
(7) Asthenia of the liver and kidney
It manifests grey complexion, soreness and flaccidity of the waist and knees or pain of the waist and limbs, dizziness, tinnitus, dysphoria with feverish chest, palms and soles, dry and deep red or flaccid tongue, thready and rapid pulse. It is advisable to nourish the liver and kidney. The prescription used is the modified Yiguan Decoction (An Ever Effective Decoction for Nourishing the Liver and Kidney). Learn more about female diseases, please click here to read Chinese medicine Treatment for Hyperplasia of Mammary Glands.
2. Rehabilitation methods
(1) Regulating emotions and recreation therapy
Please refer to the relevant part of the section of "Carcinoma of digestive tract".
(2) Physical training
Start exercising the limb of the affected side three to five days after the operation. At first, exercise the elbow. Then, train the movements of shoulder after a week and increase the amount of exercise gradually. Guide the patients to train the wall-climbing movement with the fingers and comb the hair with the affected limb. The movements of upper limbs in Taijiquan have better effects on limbering up thoracic muscles and joints and eliminating swelling of upper limbs. Therefore, it is advisable to practice the movement repeatedly. Besides, other events like eight-section brocade and five mimic-animal games can be accordingly selected. Learn more about female diseases, please click here to read TCM Treatment Evaluation for Hyperplasia of Mammary Glands.
(3) Acumox and massage
Acumox:
In the case of swelling of upper limbs of the affected side and disturbance of activity, select Jianyu (LI 15), Binao (LI 14), Quchi (LI 11), Waiguan (TE 5), Hegu (LI 4), etc. of the same side. Adopt the simultaneous use of the reinforcing and reducing manipulations, and retain the needles for fifteen to twenty minutes, once a day or once every other day; in the case of deficient qi and blood or prolonged healing of wound, select Guanyuan (CV 4), Qihai (CV 6 ) and Zusanli (ST 36), mainly use moxibustion for ten to twenty minutes each time, once a day or once every other day; in the case of adverse qi flow due to qi deficiency of the middle energizer, select Zhongwan (CV 12), Pishu (BL 20), Weishu (BL 21), Zusanli (ST 36) and Neiguan (PC 6). Adopt the reinforcing manipulation and reducing one simultaneously on Neiguan (PC 6). But use the reinforcing manipulation on all the other acupoints. Click here to learn Lochiorrhea in TCM.
Massage:
In the case of non-operative treatment, all the manipulations are contraindicated on the local part of the mammary lump; in the case of disturbance of activity of the upper limbs of the affected side after the operation, adopt some manipulations to massage the periscapular part such as rubbing and pressing the periscapular part, pressing Jianyu (LI 15), pinching the upper limbs, shaking the shoulder, pushing the three yang meridians of upper limbs and pushing the three yin meridians of forearms; in the case of the patients with late mammary cancer, it is advisable to digitally press Geshu (BL 17), Zhiyang (GV 9) and Zusanli (ST 36), press and knead Danzhong (CV 17), Qimen (LR 14) and Sanyinjiao (SP 6). Click here to learn Causes of Lochiorrhea in TCM.
(4) Dietary therapy
In the case of postoperative deficiency of qi and blood, drink wolfberry tea regularly and ingest Rice of Shenzao (Radix Ginseng and Fructus Ziziphi Jujubae), Gruel of Renshen (Radix Ginseng) and Gruel of Huangqi (Radix Astragali seu Hedysari); in the case of adversely rising qi of the stomach, heat and toxic pathogens consuming yin during the radiotherapy, it is advisable to take Tree-Juice Drink (pear juice, apple juice and a small amount of fresh ginger juice); in the case of severe reaction of digesrive tract during the chemotherapy, eat Gruel of Yiyiren (Semen Coicis) and Gruel of Huaishanyao (Rhizoma Dioscoreae) ; in the case of the patients with late mammary cancer, it is advisable for them to eat Jujube Steamed with Langdu (Radix Euphorbiae Ebracteolatae) [Decoct 250 g of Langdu (Radix Stetterae seu Euphorbiae) in a pot with water and place a food steamer in the pot. Then, put 500 g of jujubes on the food steamer. Steam the jujubes until they are thoroughly cooked. Eat seven jujubes each time, twice or three times a day.
Click here to learn Symptoms of Lochiorrhea in TCM.
In daily life, eat more fresh vegetables and fruits like carrots, water chest nuts, tomatoes, lotus roots, towel gourds, lemons, oranges and tangerines, haws and pears.
(5) External treatment with drugs
In the case of postoperative disunion of wound surface or ulceration of mammary, it is advisable to apply Shengji Yuhong Plaster on the affected part; in the case of skin swelling or blister and erosion, use the decoction of Huajiao (Pericarpium Zathoxyli) and Kufan (Alumen Exsiccatum) to wash the affected part externally, and then apply Ruyi Jinhuang Powder on the part; in the case of erosion, dust the affected part with Jiuyi Pill externally. Click here to learn Chinese medicine Treatment for Lochiorrhea.