Breast cancer is the most common tumor in women and represents 29% of all types of cancer in Spain. At the same time, it is one of those with the most favorable prognosis, thanks to improvements in treatments and early detection. This is what Aleix Prat, an oncologist specializing in breast cancer at the Hospital Clinic Barcelona: “Between 85% and 90% of patients diagnosed with breast cancer are cured.” There are numerous tests for its detection, and they can be used in a complementary way.
The first step is to analyze the symptoms associates and collect information on family history. Next, an inspection and palpation of the breast is performed, as well as an examination of the nodes. Typically, a mammogram is performed, which may be complemented by other tests, such as an ultrasound, magnetic resonance imaging, biopsy, bone scan, or thoracoabdominal scan. Once diagnosed, breast cancer must be evaluated individually to determine the most appropriate treatment for each patient.
Between 85 and 90% of patients diagnosed with breast cancer are cured
“He treatment It always has to go through a multidisciplinary team,” says Dr. Prat. The specialist committee includes gynecological and plastic surgeons, radiologists, pathologists, radiation therapists, oncologists and nurses specialized in oncology and surgery. Breast cancer can be treated through surgical, non-surgical treatment, or a combination of both, depending on the degree of progression of the disease. In the past, treatment began with surgery, followed by chemotherapy or radiation therapy. Nowadays, however, this procedure can be done in reverse order.
The main surgery focuses on removing the tumor from the breast. It can be a radical intervention, known as a mastectomy, in which the entire breast is removed, or a conservative surgery, in which only the tumor is removed and the rest of the breast is preserved as long as the aesthetic result is adequate. It may also be necessary to intervene on the lymph nodes in the armpit, to check if the tumor has spread to that area. The number of lymph nodes removed will depend on whether or not they are affected by the tumor.
Among the most common non-surgical treatments are radiation therapy, a local treatment that aims to eliminate any residual tumor, and chemotherapy, which destroys fast-growing cells. There are other options too. To choose the most appropriate treatment, it is essential to analyze the cells that make up the tumor and the types of receptors present on them. Under normal conditions, healthy cells have receptors that regulate their growth, but in cancer, tumor cells can use these receptors to accelerate their growth.
The good news is that they can be used in favor of treatment by directing drugs against them. There are two types of receivers. The first are hormonal ones, which all women have. If the tumor preserves these receptors, hormone therapy can be used, consisting of pills that block them. The other is the HER2 receptor, a protein that participates in cell growth. This is only overexpressed in one in five breast tumors, but it makes the malignant cell grow much more easily. Anti-HER2 treatments block this receptor and prevent tumor growth.
In the group of patients where we cannot cure the disease, thanks to the treatments we have today, we are making it chronic.
After treatment, there is the option of undergoing breast reconstruction, the technique of which varies depending on whether or not the breast has been preserved. If it is preserved, aesthetic techniques are used using fat grafts from the patient to correct volume defects after tumor removal. If the entire breast has been removed, it is carried out with a silicone prosthesis. After a few months, the areola and nipple are reconstructed. In no case does reconstruction intervene with subsequent reviews, physical examination or radiological tests.
The main recommendation During treatment for breast cancer patients is to maintain healthy lifestyle habits. You can also resort to complementary therapies, although they must always be consulted in advance with the referring doctor. Although there is a small percentage of cases that cannot be cured, Dr. Prat highlights: “In the group of patients where we cannot cure the disease, thanks to the treatments we have today, we are making it chronic.” The emotional support provided by support groups, which are located in the same health center, is of great help.
Symptoms of breast cancer
Self-examination is essential for early detection
1
Appearance of a lump or nodule in the breast.
2
Change in size of any of the breasts.
3
Alteration in the skin of the breast, such as ulcers, color changes and appearance of orange peel (appearance similar to fruit skin).
4
Discharge through the nipple.
5
Pain in the breast on palpation.
6
Irregularities in the contour.
7
Changes in the nipple, such as sagging.
8
Appearance of a nodule in the armpit.
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