CONDITIONS
Breast cancer is the most common cancer in women worldwide. Progress in oncology has decisively reduced mortality, and today early diagnosis and personalised treatment lead most women to a cure.
Which women are at higher risk
The likelihood increases with age, with most diagnoses between 50 and 70, and falls again after 70. Beyond sex and age, certain factors weigh on some women more than others.
- Personal history previous cancer or precancerous lesions of the breast
- Family history breast or ovarian cancer in first-degree relatives
- Hormone replacement for more than 10 years after the age of 50
- Hormonal profile early first period or late menopause
- Childbearing no children or a first pregnancy after 35
- Lifestyle obesity and heavy alcohol consumption
When the family history is strong, genetic counselling assesses whether there is an inherited predisposition, such as mutations in the BRCA1 and BRCA2 genes, and which preventive measures apply to you and your relatives.
How the diagnosis is made
Diagnosis and staging follow specific steps, based on international guidelines and protocols. The last two steps are decisive, because they give the tumour board the characteristics of the tumour on which the personalised treatment is designed.
- History and clinical examination
Full personal and family history, palpation of the breasts and armpits.
- Imaging
Mammography and breast ultrasound. MRI when needed.
- Biopsy
Histological examination with a core needle (core biopsy). More rarely, surgical biopsy.
- Staging
CT scan of the rest of the body and tumour marker tests.
- Tumour profile
Histology and immunohistochemistry: hormone receptors, HER2, proliferation markers.
The types of breast cancer
Pathological classification distinguishes tumours by where they start and by whether they invade the surrounding tissue. The frequency of each type varies greatly.
| Type | Frequency | What it includes |
|---|---|---|
| Ductal carcinoma | 80 to 85 % | Non-invasive (in situ) or invasive. Invasive carcinoma of no special type is the most common type. |
| Lobular carcinoma | 10 to 15 % | Non-invasive or invasive lobular carcinoma. |
| Invasive, special types | under 5 % | Papillary, tubular, mucinous, medullary, comedo. |
| Rare types | under 1 % | Paget's disease of the nipple, inflammatory and metaplastic carcinoma. |
| Of mesenchymal origin | under 1 % | Melanoma, lymphoma, haemangiosarcoma, lymphangiosarcoma. |
The sentinel lymph node
Invasive cancer cells use the lymphatic network to spread, moving towards the armpit on the same side. The first lymph node that filters them is called the sentinel. If cancer cells are found in it, the disease has begun to spread beyond the breast.
The sentinel node, usually one to three, is removed and examined under the microscope. The crucial thing is to identify the right node and not one of the other nodes in the armpit. There are three ways.
Whichever method is used, successful identification requires a specialised and experienced surgical team.
Treatment
Surgery remains the mainstay of treatment, because it removes the primary tumour, and is combined as appropriate with drug therapy and radiotherapy. New drugs allow physicians to tailor treatment even more individually.
In the coming years new drug treatments are expected, given immediately after diagnosis or after the first phase of treatment, further reducing the risk of recurrence.
Your care at the 4th Oncology Clinic
Every case is discussed at the Clinic’s tumour board, where medical oncologists, surgeons, radiation oncologists, radiologists and pathologists jointly design the personalised treatment plan. The Clinic’s Director, Dr Helena Linardou, has a special focus on breast cancer and hereditary cancer. Our patients have access to new treatments through the Clinical Trials Centre and, where there is a family history, to genetic counselling. Meet our team or contact us for an appointment.
Book an appointment
Appointments: 210 48 09 150, 210 48 09 160
Daily 08:00 to 16:00
oncology.clinic4@gmail.com