Breast cancer is the most common tumor in women in the West. In fact, according to the Spanish Association Against Cancer, in Spain it is estimated that about 26,000 cases are diagnosed per year. That is why it is very important to breast self-examination and to go to the specialist before any warning signs. With a diagnosis and early treatment the probability of cure is very high.
Breast self-examination and early detection of breast cancer
There are certain warning signs that deserve to go to a breast specialist to ensure that it is not due to a tumor: any "lump", color change, nipple retraction or abnormal secretion. Although, in most cases, they are not cancer-related symptoms, they are warning signs that may allow an early diagnosis. The chance of cure for breast cancer is very high if diagnosed in its initial stage.
On the other hand, it is advisable to perform mammograms on a regular basis as a way to detect early breast cancer, before it causes symptoms. Mammography is recommended in women over 40 years of age, since below that age should be evaluated by each woman with the gynecologist.
Likewise, it is convenient to perform a breast self-examination on a monthly basis, to know the breasts and detect changes that may occur in them. This allows detection of about 50% of breast tumors early. However, it should be complemented by mammography.
Rapid Diagnosis of Breast Cancer
The diagnosis of breast cancer begins with imaging tests: mammography (x-ray) and ultrasound (ultrasound). If these tests confirm the cancer, a biopsy will be necessary to establish a definitive diagnosis.
In the case of a biopsy, it will be done under ultrasound control, to ensure that the cells are removed from the appropriate area. The analysis of the cells is done by a specialist in pathological anatomy and will reveal whether they are cancerous or not. If so, it will also determine what type of cancer is involved.
In specific cases the medical oncologist may request additional diagnostic imaging tests if he / she deems it appropriate to check whether the cancer has spread to other tissues or organs, as well as a complete blood test.
The rapid diagnostic circuit allows to reduce to 24 hours the time between the first consultation of a patient for suspicion of breast cancer and the completion of the biopsy. The result of this, to know if it is cancerous or not, is obtained between 48 and 72 hours. Identifying the type of cancer in concrete requires between 4 and 7 days from the time of the biopsy.
Personalized Breast Cancer Treatment
Accurate diagnosis is essential, as there are more than 50 different types of breast tumors , and this will influence the best treatment for each patient.
There are genetic analyzes that, in a pioneering way, allow to characterize in detail each tumor and to find out the most indicated treatment. The treatment will be decided according to the result of these analyzes, which indicate the specific type of tumor that the patient has and the advanced disease during the diagnosis:
- In cases where the cancer is diagnosed before it has spread to other organs or tissues (the majority), the indicated treatment is surgery to remove the tumor .
- In two thirds of the patients the surgery allows to remove the tumor and preserve the breast .
- In the remaining third, where the breast is required, a plastic surgery specialist participates in the reconstruction of the breast, in the same operating room. In this reconstruction, the skin of the original breast is preserved, whenever possible, as well as the areola-nipple complex, with good results and minimal psychological impact on the patient.
Depending on the type of tumor, the surgery will be complemented with chemotherapy , hormone therapy and / or pharmacological treatments directed against specific molecular targets of tumor cells. In each patient it will be necessary to evaluate if it is advisable to start these treatments before surgery or postpone them until after. The need for radiotherapy after surgery should also be considered.
Breast cancer chemotherapy treatments usually last between three and six months. They attack the cells that reproduce fast, among which are the cancerous but also some healthy. Treatments against molecular targets usually last a year and target specific tumor cells. Finally, hormone therapy should be maintained between five and ten years, and blocks the action of female hormones on tumor cells. In addition, in cases where radiation therapy is required, it usually lasts between four and eight weeks, although the duration varies and is individualized according to the patient.
Once the treatments are completed, patients are followed up with a visit every three months for the first two years and a visit every six months in the following years. These follow-up visits include: physical examination, blood test, annual mammogram, and individualized imaging tests.
Breast cancer unit, multidisciplinary team to address the disease
The Breast Cancer Unit serves patients with symptoms of possible breast cancer that require diagnosis, but also patients already diagnosed, to receive treatment. It also offers a second opinion medical service to guide the decision making individualized to each patient, according to genetic and molecular characteristics of tumor cells.
Patients who come to the Breast Cancer Unit are assisted by a multidisciplinary team. It consists of medical oncologists, breast surgeons , pathologists, radiotherapists, specialists in radiology and nuclear medicine and nurses. The specialists will take, in a coordinated way, the decisions for each patient, so that the sequence of the treatments is planned individually. Likewise, being in one place will make it easier for patients to receive all the tests and treatments without the need for displacement.