Disease prevention strategies for breast cancer based on the"pathogenic deficient evil"theory in Huangdi Neijing

Zhang Weijia; Chang Lei; Lu Wenping

doi:10.3760/j.issn.1673-4777.2026.03.023

Abstract：Breast cancer is one of the most common malignant tumors in women.Although comprehensive treatment has significantly improved the survival rate,how to advance the prevention and control threshold and construct a disease prevention strategy with traditional Chinese medicine(TCM)characteristics remains a clinical difficulty and research hotspot.The"pathogenic deficient evil"theory in Huangdi Neijing holds that the onset of disease is a process in which the body's healthy Qi is insufficient to resist the invasion of pathogenic factors.Breast cancer is also the result of the mutual restriction and confrontation between healthy Qi and cancer toxin,and"pathogenic deficient evil"is one of the important pathogenesis of its occurrence and development,which is highly consistent with the immune escape and immunosuppressive microenvironment in modern tumor immunology.By systematically searching and sorting out the relevant literatures on"pathogenic deficient evil"and disease prevention in Huangdi Neijing and medical scholars of all dynasties,combined with clinical and basic research data on breast cancer epidemiology,molecular typing,tumor immune microenvironment and TCM intervention at home and abroad,this study adopted the methods of parallel reading,induction and theoretical integration to conduct isomorphic docking between the core propositions such as"deficiency as the root cause,pathogenic factors arising from deficiency,and deficiency complicated with excess"and the processes of immunoediting and immune escape.On this basis,the disease prevention strategies for breast cancer were systematically discussed from three levels:preventing disease before its onset,preventing disease progression after its onset,and preventing recurrence after recovery.A hierarchical prevention and control idea was proposed,which is based on constitution regulation and intervention of high-risk groups,and takes strengthening healthy Qi and eliminating pathogenic factors to improve the systemic and local immune microenvironment as the core.By sorting out the relevant studies on representative Qi-invigorating Chinese medicinal herbs such as Astragali Radix and Ganoderma,the possible mechanism by which they intervene in the"pathogenic deficient evil-immune escape"process through pathways such as programmed cell death protein 1/programmed cell death ligand 1 and transforming growth factor-β was explored.This study aims to construct a breast cancer prevention and treatment framework with isomorphic relationship between the"pathogenic deficient evil"theory and modern tumor immunology,and provide theoretical basis and ideas for building an integrated traditional Chinese and western medicine disease prevention model that can be embedded in the existing comprehensive treatment pathways.