7 Questions About Early Stage Breast Cancer

Acıbadem Altunizade Hospital Medical Oncology Specialist Prof. Dr. Gül Başaran answered the 1 most frequently asked questions about early stage breast cancer within the scope of 31-7 October Breast Cancer Awareness Month.

What are the symptoms of breast cancer?

Any physical change in the breast, discharge from the nipple and a palpable mass in the breast are the main symptoms of breast cancer. The most common symptom among these is the feeling of a mass coming into the hands of the patients.

What standard methods are used for diagnosis?

The standard screening method in breast cancer is mammography. Although this method is an easy method, it may need to be supported by breast ultrasonography (USG) in women with very dense breast structure. In women with hereditary breast cancer, that is, women with an increased risk of breast cancer due to damaged genes in the family, magnetic resonance imaging (MRI) of the breast is scanned.

How can early diagnosis be made?

After the age of 20, every woman should examine her breast once a month, preferably while in the bathroom; It is important to check for a different appearance and asymmetry than normal. After the age of 40, we recommend it to be done by the physician once a year. Again, after the age of 40, we recommend mammography once a year. In special cases, for example, people who received radiotherapy to the chest area during adolescence or who are known to have a harmful gene disorder in their family should start screening for breast cancer at an earlier age and be followed up with breast MRI.

What does early diagnosis provide in breast cancer?

When breast cancer is detected early, the disease can be completely cured. In addition, most of the patients who present with a palpable mass receive a systemic treatment after diagnosis, whereas local treatments such as surgery and radiotherapy are sufficient in the treatment of tumors that are detected and diagnosed during routine follow-up before the tumor is palpable. In addition, 5 years of oral endocrine therapy is sufficient as systemic treatment in most of the patients with early diagnosis. In advanced stages, the duration of endocrine treatment given after chemotherapy and radiotherapy is longer than 5 years.

How is staging done in breast cancer?

Staging in breast cancer begins with understanding whether the axillary lymph nodes, which are the regional lymph node network where the tumor can go first, are involved. This examination is done by breast ultrasonography. Other radiological examinations such as abdominal ultrasonography, lung or abdominal tomography, bone scintigraphy, brain magnetic resonance (MR) or positron emission tomography (PET) are used to understand whether breast cancer has spread to other organs of the body, that is, whether it is metastatic stage 4. Which of these examinations we choose is determined by the size of the tumor, whether it involves the axillary lymph nodes, and the type of tumor.

What should be considered to prevent cancer?

There is no special nutrition method to prevent cancer. All practices necessary to maintain a healthy life, such as a balanced diet, maintaining a healthy weight, not consuming alcohol, not smoking and avoiding processed foods, are also valid for cancer prevention. Providing the required amount of sleep, regular exercise (such as brisk walking) protects against cancer as well as other chronic diseases. In addition to these, it is necessary to avoid unnecessary vitamins or similar supplements unless the doctor recommends it.

How is medical treatment organised?

Breast cancer is divided into three subtypes according to the estrogen/progesterone receptors and the presence of the protein called Her-2 in the pathological examination of the tumor. The first group includes hormone receptor positive (estrogen and progesterone receptors), the second group includes hormone receptors and Her-2 negative (triple negative group) and the third group includes Her-2 positive (Her-2 positive) breast cancers. Treatment modalities are primarily organized according to which of these subtypes the tumor is. The second important factor is the stage of the disease.

The most important decision in the early stage is whether to do first systemic medical treatment (chemotherapy+/- targeted smart drugs), then “surgery”, or vice versa, “first surgery and then systemic oncological treatment”. This is closely related to the stage and type of the tumor. In the metastatic stage, the most important parameter determining the treatment is to analyze whether the disease is in a life-threatening condition and to choose chemotherapy or endocrine therapy +/- targeted smart drugs depending on the type of tumor. Other aspects that are important when determining treatment are the patient's general condition, whether he is in menopause, whether his cancer is hereditary, the severity of other chronic diseases he has, and the patient's own desire for treatment.