– Breast cancer does not always mean a mastectomy. This is very important information for thousands of women who hear the diagnosis every year: breast cancer – writes prof. dr hab. n. med. Zoran Stojčev, Head of the Oncological Surgery Department of the Radom Cancer Center. This is another article in our new series, «The Doctor’s Eye».
- – Only one in three women suffering from breast cancer should undergo a mastectomy – says the expert
- In Poland, a large number of 100 people qualify for prophylactic mastectomy. and 300 thousand women – so many Polish women are carriers of mutated BRCA1 and BRCA2 genes
- You can find more such stories on the TvoiLokony home page
Breast cancer does not always mean a mastectomy
As much as 70% of breast cancer surgeries should be conserving operations – these are the guidelines of the European Society of Senology and world oncological surgery societies.
- Be sure to read: WHO: breast cancer is the most common cancer in the world. It was ahead of lung cancer
Prof. dr hab.n.med. Zoran Stojcev, medical director of the Radom Cancer Center, has been performing breast-conserving surgeries for over 20 years. They involve only cutting out the tumor itself, rather than removing the entire breast. In advanced cases, it is necessary to remove the breast.
However, there are many situations where it is possible to remove the breast and reconstruct it at the same time during one procedure.
— Only one in three women with breast cancer should lose a breast, i.e. undergo mastectomy, as a result of this disease – believes prof. Stojcev.
Unfortunately, in Poland, the diseased breast is still amputated too often. This has huge consequences for the patient’s psyche. Not only does she suffer the trauma of developing cancer, but also the loss of one of the attributes of femininity. This causes a loss of self-esteem, family and work problems. For many people, this is more traumatic than losing hair during chemotherapy. The procedure with breast reconstruction allows the woman to return to normal life faster.
Professor Stojcev recalls a patient who after mastectomy lost not only her breast and self-confidence, but also her husband who did not bear the mental burden of seeing his wife after mastectomy. After two years, the woman underwent breast reconstruction, mentally strengthened, met another partner and started a new family.
28-year-old Milena came for surgery with simultaneous breast reconstruction in early July, taking her leave from work. After four weeks, she returned to the office without informing anyone but her immediate family that she had both breasts amputated, but got new ones during the same procedure. Only slight scars remain, visible only to the initiated.
Prophylactic mastectomy in Poland
Another issue that is still little talked about is prophylactic mastectomy, a procedure that actress Angelina Jolie underwent in 2013. She did it after she was found to have a mutation in the BRCA1 gene, which gave her an 87% chance of developing cancer.
- See also: Angelina Effect in Polish. «I know families that were dying out. More women waited for their turn »
In Poland, such treatments have been performed under a contract with the National Health Fund for two years, but few centers do it. Why? Because there is a shortage of specialists who can perform such procedures. Large cancer centers have a lot of work to do in the treatment of malignant neoplasms and the problem of prophylactic mastectomy is of secondary importance. Especially during the coronavirus pandemic, when surgical procedures in many centers were significantly reduced.
Meanwhile, as calculated by prof. Stojcev, in Poland, a huge number of women qualify for prophylactic mastectomy – between 100 and 300 thousand, because so many Polish women are carriers of mutated BRCA1 and BRCA2 geneswhich cause breast and ovarian cancer. However, few women are aware of this, because in our country such tests are not routinely performed. The carriers of these genes have 70 percent. the risk of developing malignant breast cancer and ovarian cancer.
Prophylactic mastectomy is most often chosen by women who go to oncological surgeons diagnosed with breast cancer. Then they perform genetic tests and decide on a prophylactic bilateral mastectomy with simultaneous breast reconstruction. A large group are women with a family burden – if the mother or grandmother suffered from cancer, the pedestrians, the daughter or granddaughter perform a genetic test and decide on a prophylactic mastectomy.
The youngest patient of Professor Stojcev, who decided to undergo such a procedure, was just over 20 years old. The professor also recalls a 79-year-old breast cancer patient who was getting ready for the wedding and could not imagine having a mastectomy after which she would not feel like a woman. Doctors decided to undergo a simultaneous reconstruction.
Who is to decide if a patient can undergo conserving surgery? Each patient diagnosed with breast cancer should undergo diagnostic tests, and then a council consisting of oncologists, surgeons, radiotherapists and radiologists decides on the treatment method.
The COVID-19 pandemic is likely to delay the diagnosis of breast cancer and increase the number of patients with advanced cancer through delayed diagnosis. Treatments in such patients are usually much more difficult and crippling. Then the most important thing is to save lives.
Head of the Oncological Surgery Department of the Oncology Center in Radom, Head of the Oncological Surgery Clinic of the Medical University of Silesia, Professor of the CMKP in Warsaw, General and Oncological Surgery Specialist. He is a member of scientific societies: European Society of Surgical Oncology; Society of Polish Surgeons; Member of the board of the Polish Society of Oncological Surgery; and a member of the Polish Breast Cancer Research Society. During over 30 years of professional experience, he has performed over 15 major operations in the field of oncological surgery and general surgery.
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