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BREAST CANCER, MAMMARY GLAND CARCINOMA

GENERAL

Etiology	Emotional problems are by far the most important cause in Chinese Medicine. Worry, pensiveness, sadness, anger, frustration, resentment, hatred, guilt can all cause stagnation of Qi which in the long run may lead to blood stasis which forms masses. Great sorrow or grief Excess crying A long period of worry Desperation Ingesting carcinogenic substances Smoking
Clinical Manifestations	Tumor in the breast Usually one side Tumor is often the first symptom Tumor is firm or hard It starts small (bean-sized) and grows larger Usually no pain It is in a fixed location The edges are uneven There is dimpling Located in the center of the nipple or at the edge of the breast tissue The tumor gradually generates a dull pain The pain becomes more severe The nipple becomes retracted The areola becomes distorted or a distorted breast contour The breast becomes red and swollen It becomes pitted like an orange There are enlarged supraclavicular or axillary lymph nodes Advanced nodules become ulcerated Stage 1: The lump is less than 3cm with no metastasis Stage 2: The lump is less than 5cm with slight adhesions and a few enlarged submaxillary lymph nodes on the same side. Stage 3: The lump is over 5cm with wide adhesions to the overlying skin which often becomes ulcerative or sticks to the muscles of the thorax. The submaxillary or clavicular lymph nodes coalesce into a lump or metastasis to the lymph nodes beside the sternum is discovered. Stage 4: There is widely spread metastasis to the skin or the lump sticks to the muscles of the thorax and chest wall. the supraclavicular lymph nodes and distal organs are involved.
Treatment Principle	Primarily treat the first stage before fixation. Do not treat after biopsy
Herb Formulas	Early-stage: Breast Cancer #8 Breast Cancer #50 Shi Liu Wei Liu Qi Yin (usually added to other anti-cancer formulas) Middle-stage: Ru Xian Ai Tang Advanced: Breast Cancer #21 For brain metastasis: 1. For tumors due to Qi Deficiency with Blood Stagnation: Breast Cancer #47 2. For tumors due to Yin Deficiency: Breast Cancer #48 For Stomach metastasis: Wei Ai Sheng Xue Tang Chinese Patent Medicines: Liu Jun Zi Tang (6 caps, tid)+ Xuan Fu Hua Dai Zhe Zi Tang (3 caps, tid)+ Li Ge Tang (3 caps, tid) For Liver metastasis: Gan Ai Tang Breast Cancer #49 Chinese Patent Medicines: Chai Ling Tang (3 caps, tid) Chai Hu Qing Gan Tang (3 caps, tid) For Colon metastasis: Fu Fang Ban Zhi Lian Tang Da Chang Ai Tang For Lung metastasis: Fei Ai Er Hao Fang For the elderly: Fu Zheng Yang Yin Fei Ji Tang Chinese Patent Medicines: Chai Hu Shu Gan Tang (3 caps, tid) + Zi Gen Mu Li Tang (1-3 caps, tid) For Bone metastasis: Due to Toxic Damp-Heat: Breast Cancer #54 + Hua Yu Tang Due to Kidney Qi Deficiency: Breast Cancer #55 Due to Kidney Yang with Qi and Blood Deficiency: Breast Cancer #56 Grind 30-60g of the shell or kernel of Fr. Trapae Bispinosae Ling Jiao into a powder. Take 6g raw or with honey at a time. Grind 30-60g Rx. Wikstroemiae Pu Yin into a fine powder and mix with boiled water or millet wine. Take daily. Pound Pseudobulbus Cremastrae/Pleiones Shan Ci Gu, mix with vinegar and apply to the lesion. Press 90g of fresh asparagus Tian Men Dong into a juice and take with yellow wine once a day. (30g of fresh peeled asparagus can be substituted.) Decoct 30g Hb. Viola Zi Hua Di Ding, 90g Flos Lonicera Jin Yin Hua and 9g Rx. Lithospermi Zi Cao. Decoct 10 pcs. Scolopendra Wu Gong, 90g Flos Lonicera Jin Yin Hua and 9g Rx. Glycyrrhizae Gan Cao in water, divide in two and take twice a day. Blend Fol Hibisci Fu Rong Ye with 25% Vaseline, make into an adhesive plaster and apply to the affected area once or twice daily. Drink a decoction of Fol. Trifolii San Xiao Cao daily. During early stages, pound the leaves and roots of Hb. Taraxaci Pu Gong Ying into a juice to be taken orally with wine. Decoct 0.9g Calculus Bovis Niu Huang with 60g-90g Spica Prunellae Xia Ku Cao and take orally. Stomach Cancer #5 Take a decoction of 120g Hb. Hedyotis Diffusae Bai Hua She She Cao and 120g Rz. Curculiginis Xian Mao daily. Take a liquid extract of Hb. Erodii/Geranii Lao Guan Cao daily. Post surgery: Breast Cancer #5 Yi Qi Yang Rong Tang During chemotherapy: Sheng Xue Tang Yi Hao For pain: Breast Cancer #51 For exudative carcinoma cutis: Breast Cancer #53 Ulcerative mammary carcinoma: Dry the fresh leaves of Fructus et Folium Solani Indici Huang Shui Qie, sterilize by autoclave, sprinkle on the ulcerous lesion and cover with sterilized gauze. Before reapplying, wash the lesion with normal saline. Do not use on normal skin to prevent eczema on the area. Wan Shan Wan To resolve depression, resolve Phlegm and soften hardness: Xiao Yao San + Xi Huang Wan To gradually break down the cancer nucleus: Jia Wei Xiao Yao San To remove the cancer nucleus in people with low vitality: Li Zhong Tang (large amounts) For chronic bursting and cancerous skin exuding an odorous fluid: Gui Pi Tang For post-operative recurrence of the tumor: Breast Cancer #45 + 2 g of powdered Bul. Fritillariae Cirrhosae Chuan Bei Mu and 1.35g powdered Pseudobulbus Cremastrae/Pleiones Shan Ci Gu. With uterine cancer: Uterine Cancer #7 Topical: 1. Dry fresh Hb. et Rx. Ranunculi Mao Gen at low temperature, pulverized into a powder and mixed with ox oil to make an ointment for external use. 2. Distill the volital oil from the root of Hb. et Rx. Ranunculi Mao Gen, mix with three equal portions of the whole herb decoction and take orally. Start with a small dose and gradually increase. 3. Distill the volital oil from the root of Hb. et Rx. Ranunculi Mao Gen, mix with two equal portions of the powder of the whole herb and make into a solid plaster with lard to be applied topically. With severe pain: Ru Ai Xi Ji Chinese Patent Medicines: Ci Tao Wan Zhen Ai Wan
Points	Needle LU-9, PC-6, moxa SI-1 Needle GB-21 and have it radiate to the chest. (Do not needle if the patient has angina, palpitations or Heart weakness.) Needle ST-16, moxa REN-17, indirect moxa on lump If the lump is fixed, moxa needle PC-7, LU-5, ST-36, UB-40, GB-44 For primary breast cancer: LI-4, REN-17, SI -11, ST-18, ST-36, UB-15, UB-18, UB-20 Extraordinary Channels: PC-6 - SP-4, KI-6 - LU-7 Divergent Points: SI-1, ST-36, GB-12, PC-3 For brain metastasis: DU-20, GB-37, GB-39, LI-6, SP-6, UB-1, UB-10 Extraordinary Channels: SI-3 - UB-62, GB-41 - SJ-5 Divergent Points: GB-1, GB-34, UB-1, UB-40 For Stomach metastasis: LI-11, LIV-3, PC-6, REN-12, SP-6, ST-21, ST-36, ST-40, UB-20, UB-21 Extraordinary Channels: KI-6 - LU-7, PC-6 - SP-4 Divergent Points: ST-1 - ST-36 or ST-1 - SP-9 For Liver metastasis: DU-26, LIV-3, LIV-5, SP-6, ST-44, UB-18, UB-19 Extraordinary Channels: PC-6 - SP-4 Divergent Points: GB-1, GB-34, or GB-1, LIV-8 For Colon metastasis: LI-4, LI-5, LI-11, REN-12, ST-25, ST-36, ST-40, UB-25 Extraordinary Channels: KI-6 - LU-7 Divergent Points: LI-11, ST-2, SI-1, ST-36 For Lung metastasis: LI-4, LU-1, LU-2, LU-7, REN-17, ST-40, UB-11, UB-13, UB-15, UB-43 Extraordinary Channels: KI-6 - LU-7 Divergent Points: LU-5, ST-12 With ureine cancer: DU-4, KI-3, LI-4, LIV-3, LIV-5, REN-3, REN-4, SP-10, ST-36, UB-17, UB-23 Extraordinary Channels: PC-6 - SP-4, KI-6 - LU-7 Divergent Points: KI-10, UB-1, GB-1, LIV-8

SPLEEN DEFICIENCY WITH PHELGM-DAMPNESS

Clinical Manifestations	Breast lump Pallor Lassitude General weakness Anorexia Shortness of breath Slightly loose stools T: Slightly pale C: Thick and white P: Wiry, slippery and thready
Treatment Principle	Strengthen the Spleen Transform Phlegm Soften hardness Disperse nodules
Herb Formulas	Xiang Sha Liu Jun Zi Tang + Er Chen Tang modified
Points	PC-6, SJ-6, SP-6, SP-9, ST-40, UB-13, UB-20, UB-23

SPLEEN YANG DEFICIENCY WITH PHLEGM

Clinical Manifestations	Breast lumps are relatively soft In severe cases the breast may feel tender to the touch A feeling of heaviness A feeling of oppression of the chest Tiredness Feeling cold Loose stools T: Pale, swollen and wet C: White P: Deep, week and slippery
Treatment Principle	Tonify Qi Strengthen Yang Nourish the Blood Strengthen the Spleen Eliminate Phlegm
Herb Formulas	Shi Liu Wei Liu Qi Yin Ren Shen Yang Rong Tang Breast Cancer #32
Points	REN-12, SP-3, ST-36, ST-40, UB-20, UB-21, UB-22 + general points

HEART AND SPLEEN DEFICIENCY

Clinical Manifestations	Palpitations Insomnia Much dreaming Easily startled Poor memory Four limbs tired and lethargic Loss of appetite Distention and fullness of the epigastrium and abdomen Loose stools Sallow complexion Copious, pale menses Uterine bleeding or Light menstrual flow or Amenorrhea T: Pale P: Thready and weak
Treatment Principle	Reinforce and Benefit the heart and Spleen
Herb Formulas	Breast Cancer #27
Points	HT-7, REN-4, SP-1, SP-6, ST-36, UB-15, UB-20

LIVER QI STAGNATION

Clinical Manifestations	Anxiety Easily angered Breast full and painful Dry mouth Dry pharynx Dizziness T: Dark C: White or Light yellow P: Wiry
Treatment Principle	Benefit the Liver Regulate Qi Dispel Phlegm Eliminate the tumor
Herb Formulas	Breast Cancer #1 Xiao Yao Sanmodified With Phlegm: Xie Ding Ru Ai Tang Gua Lou San With fever and chills: Xiao Yao San modified With Spleen Qi Deficiency: Breast Cancer #22 With thirst: Breast Cancer #24 With hard nodules: Breast Cancer #52
Points	GB-40, GB-41, LIV-2, LIV-3, LIV-4, LIV-5, LIV-13, LIV-14, PC-6, SJ-6, SP-6, UB-18 + general points

LIVER QI STAGNATION WITH HEAT

Clinical Manifestations	Large breast lump like a heap, adhering to the skin Inverted nipple Orange-skin effect Irritability Dry mouth Bitter taste Headache Red face T: Red C: Dry-yellow P: Wiry and rapid
Treatment Principle	Clear the Liver Drain Fire Eliminate Stagnation Resolve Phlegm Clear Toxic Heat
Herb Formulas	Qing Gan Jie Yu Tang Ru Xian Ai Tang Er Shi San Hao With Phlegm-Heat: Breast Cancer #17 Breast Cancer #28 Middle-stage: Ru Xian Ai Tang
Points	GB-41, LI-11, LIV-2, LIV-3, LIV-14, PC-6, SJ-6, SP-4, SP-6, ST-18 + general points

LIVER AND STOMACH DISHARMONY

Clinical Manifestations	Breast distention and pain before and during menses Pain in the breast and nipple Dislike of having them covered Small nodules Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea/Vomiting Anorexia Epigastric distention Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Jia Wei Xiao Yao San Chai Hu Shu Gan Tang Shen Xiao Gua Lou San Xiao Yao San Shu Gan Tang Mu Xiang Cheng Qi Wan
Points	ST-12, ST-36, ST-40, ST-30, LIV-3, LIV-14 + general points LIV-3, LIV-14, PC-6, REN-12 + general points

QI AND BLOOD STAGNATION

Clinical Manifestations	Red face Chest pain Ulceration of the tumor Maybe a bloody secretion Foul odor Short urine T: Reddish purple C: Little or Yellow P: Wiry and rapid
Treatment Principle	Move Qi Invigorate the Blood Break up Stasis Clear Heat Resolve toxicity
Herb Formulas	Breast Cancer #3 Breast Cancer #11 With Phlegm-Heat: Breast Cancer #20
Points

QI, BLOOD AND PHLEGM STAGNATION

Clinical Manifestations	Noxious swellings Abscesses Flat abscesses Red face Chest pain Ulceration of the tumor Maybe a bloody secretion Foul odor Short urine T: Reddish purple C: Little or Yellow P: Wiry and rapid or Flooding or Tight or Thin
Treatment Principle	Move Qi Invigorate the Blood Break up Stasis Clear Heat Resolve toxicity
Herb Formulas	Shi Liu Wei Liu Tang With Qi and Blood Deficiency: Breast Cancer #40 Breast Cancer #41
Points

QI AND BLOOD DEFICIENCY

Clinical Manifestations	Tumor has existed for a long time Tumor has ulcerated Cauliflower like tumor Pale or yellow face Fatigue Weakness Listlessness Dizziness Blurred vision Shortness of breath Anorexia Indigestion T: Pale C: White P: Thready and weak or Deep, thready and weak
Treatment Principle	Nourish Qi and Blood Supplement dispersal of tumor
Herb Formulas	Breast Cancer #4 Breast Cancer #35 Breast Cancer #46 With Qi and Blood Stagnation: Breast Cancer #9 Breast Cancer #10 With Heat: Tao He Cheng Qi Tang With Qi and Blood Stagnation and Phlegm-Heat: Breast Cancer #42
Points

BLOOD STAGNATION

Clinical Manifestations	Pain that is fixed, stabbing and /or severe Pan is worse with pressure Dark complexion Fixed, palpable masses Bleeding with clots Purple lips Purple nails Dry skin Blue, dark or purplish discoloration of skin in small or large areas, Varicose and spider veins Cold hands and feet Tendency to hemorrhage dark blood or clots T: Purple, possible purple or red spots Red purple if there is Heat Blue purple if there is Cold C: White P: Choppy or Wiry and choppy
Treatment Principle	Invigorate the Blood Break up Stagnation
Herb Formulas	With burning and pain due to Cold Stagnation: Breast Cancer #7 With Cold Stagnation and Phlegm: Xiao Jin Dan With Toxic Damp-Heat: Breast Cancer #30 With Qi Stagnation and Toxic Heat: Breast Cancer #39 For obese women in menopause with severe Blood Stagnation in the Lower Jiao: Gui Zhi Fu Ling Wan With Toxic Heat and Phlegm: Yan Zhong Wan Yi Hao
Points	SP-6, SP-10, ST-36, UB-17, UB-40

BLOOD HEAT

Clinical Manifestations	Initial stage Chronic, stubborn skin lesions Sores Enlarged lymph nodes Nodules Malignant abscesses and sores Syphilitic sores Red itching skin Hardness T: Pale with red spots P: Rapid and pecking
Treatment Principle	Clears Heat Cool the Blood Dissipates swellings Dispels noxious sores Disperses nodules and hardness
Herb Formulas	Zi Gen Mu Li Tang
Points

BLOOD DEFICIENCY WITH HEAT

Clinical Manifestations	Tumor has existed for a long time Tumor has ulcerated Cauliflower like tumor Pale face Fatigue Weakness Listlessness Dizziness Blurred vision Chronic, stubborn skin lesions Sores Enlarged lymph nodes Nodules Malignant abscesses and sores Syphilitic sores Red itching skin Hardness T: Pale with red spots C: White P: Thready and weak or Deep, thready and weak or Rapid and pecking
Treatment Principle	Nourish the Blood Clear Heat Invigorate the Blood Inhibit the growth of cancer cells
Herb Formulas	Breast Cancer #43
Points

PHLEGM-HEAT (RE TAN)

Clinical Manifestations	Cough with sticky, yellow, difficult to expectorate sputum Rapid breathing with a harsh voice Restless fever Sore throat Constipation Dry stools Mania Shortness of breath Dyspnea Nausea Vomiting Chest and/or epigastric fullness Pain in the ribs T: Scarlet C: Yellow or Yellow and greasy or Yellow and smooth P: Rapid and smooth or Slippery and rapid
Treatment Principle	Clear Heat Resolve Phlegm
Herb Formulas	Wan Shan Wan Breast Cancer #15 Breast Cancer #26 Breast Cancer #29 Hua Cheng Kao Breast Cancer #33
Points	LI-11, LU-5, ST-40, UB-13

TOXIC HEAT

Clinical Manifestations	Tumor develops quickly Fluid inside the breast with a lump inside it Long-standing illness Pain Redness Ulceration Discharge of yellow or bloody, foul-smelling fluid Fatigue Fever Anxiety Dry mouth Thirst Dark urine Bitter taste Red eyes Insomnia T: Red C: White or Yellow and greasy or Thick, sticky, dry and yellow P: Wiry or Rolling and rapid or Wiry, overflowing and rapid
Treatment Principle	Clear Heat Relieve toxicity Strengthen Zheng Qi
Herb Formulas	Breast Cancer #2 Xing Xiao Wan Wu Wei Xiao Du Yin + Xue Fu Zhu Yu Tang Breast Cancer #6 Breast Cancer #13 Breast Cancer #14 Breast Cancer #19 Huo Xue Jie Du Tang Xi Huang Wan Cancer #6 Breast Cancer #31 Breast Cancer #36 Breast Cancer #37 Breast Cancer #44 Early-stage: Breast Cancer #8 For a massive tumor with fever, pain and swelling: Breast Cancer #12 For advanced breast cancer with dripping Blood due to dysbiosis: Breast Cancer #16 For a fever with reddish swelling: Breast Cancer #18 With Phlegm Accumulation: Breast Cancer #38 With Phlegm Accumulation due to Phlegm-Damp: Hua Yan Tang With Blood Stagnation: Breast Cancer #34 Breast Cancer #57 With Qi and Blood Stagnation: Breast Cancer #39 Topical: Gao Tie Fa Breast Cancer #25 Cancer #11
Points	GB-41, LI-4, LI-11, LIV-2, PC-5, REN-12, SI-1, SP-10, ST-18

DISHARMONY BETWEEN THE CHONG AND REN CHANNELS

Clinical Manifestations	Breast distention and pain before and during menses Pain in the breast and nipple Dislike of having them covered Small nodules Epigastric pain (worse when emotionally upset) Belching with acid regurgitation Nausea / vomiting Anorexia Epigastric distention Distention and pain in the sides or flanks Suffocating sensation in the chest Tendency to sigh Melancholy Depression Irritability Inappropriate anger Irregular menses Dysmenorrhea T: Pink C: Thin and white P: Wiry
Treatment Principle	Soothe the Liver Harmonize the Stomach
Herb Formulas	Jia Wei Xiao Yao San Chai Hu Shu Gan Tang Shen Xiao Gua Lou San Xiao Yao San Shu Gan Tang Mu Xiang Cheng Qi Wan
Points	ST-12, ST-36, ST-40, ST-30, LIV-3, LIV-14 + general points LIV-3, LIV-14, PC-6, REN-12 + general points

CHEMOTHERAPY/RADIOTHERAPY SUPPORT

Clinical Manifestations
Treatment Principle
Herb Formulas	Damp-Heat in the Stomach: Xiao Ban Xia Jia Fu Ling Tang Ban Xia Xie Xin Tang Xuan Fu Hua Dai Zhe Shi Tang Xiang Sha Liu Jun Zi Tang Huo Xiang Zheng Qi Tang Spleen Yang Deficiency: Si Jun Zi Tang Liu Jun Zi Tang Xiao Jian Zhong Tang Da Jian Zhong Tang Bu Zhong Yi Qi Tang Qi and Blood Deficiency: Ren Shen Yang Rong Tang Ba Zhen Tang Shi Quan Da Bu Tang Kidney Deficiency: Liu Wei Di Huang Wan Ba Wei Di Huang Wan Zuo Gui Wan You Gui Wan Niu Che Shen Qi Wan Radiotherapy: Mai Men Dong Tang Gan Lu Yin Dang Gui Yin Zi Qing Zao Jiu Fei Tang Topical: Zi Yun Gao
Points	KI-7, LI-4, LIV-2, PC-6, REN-12, SP-6, ST-36, UB-11, UB-17, UB-18, UB-23, UB-40 Extraordinary Channels: PC-6 - SP-4, KI-6 - LU-7 Divergent Points: GB-1, LIV-8, ST-1, ST-36, UB11, UB-40