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Breast cancer is one of the most common cancers in women, and the number of cases in our country is constantly growing every year and currently amounts to as much as 18. cases, of which 6 thousand. results in death. Fortunately, breakthrough therapeutics are increasingly helping to fight breast cancer. The Ministry of Health has just announced the reimbursement of pertuzumab in the early stage of the disease – a drug that helps fight the extremely dangerous subtype of HER2-positive cancer. This gives many Polish women a chance for effective treatment.
The material was created in cooperation with the campaign “Heal breast cancer HER2 +”
Prophylactic research, advances in medicine and the introduction of new drugs have changed the perception of breast cancer from a fatal disease to a chronic and even curable disease. It is true that cancer is an insidious, quick and dangerous disease that causes us many fears and we often displace it from our awareness “because it does not concern us”. We must not, under any circumstances, give in to it. Getting to know the disease, risk factors, prophylaxis, diagnostics and the latest methods of treatment significantly increases the chance of an effective fight against the disease.
Factors that increase the risk of developing breast cancer
The most important factor is the history of breast cancer. In women with a history of breast cancer, the risk of developing cancer in the other breast is threefold. Age is another important factor. Women over 50 are most vulnerable. In Poland, about 80 percent. all cases of the disease concern women over 50, but the increase in the number of cases in the 25 to 49 age group is also very worrying. Another risk factor is a family history of breast cancer, especially in first-degree relatives (mothers, sisters). Among the non-modifiable factors, i.e. those that are beyond our control, apart from genetic determinants, also hormonal factors should be mentioned. The risk of developing the disease increases in women with long exposure to estrogen (menstruation started before the age of 12 and menopause after the age of 55). Modifiable factors include: hormonal contraception, obesity, early childhood and late first pregnancy, drinking alcohol and smoking, and insufficient physical activity. Avoiding the above-mentioned factors reduces the risk of disease, but does not completely guarantee that it will not occur. Regardless of whether we are at increased risk or not, we must remain vigilant and systematically perform preventive examinations.
Preventive examinations
Detecting breast cancer at its early stage and promptly initiated therapy give a great chance for a complete cure, which is why prophylactic breast examination is so important. Unfortunately, statistically in Poland, breast cancer in women is detected at a later stage than in Western European countries. The basic and easiest method of breast examination is monthly self-examination. It consists of a careful examination of the breasts in order to detect any changes such as: local reddening of the skin or an orange peel symptom, fluid leakage from the nipple or its puffing, ulcerations or the difference in size between the breasts. The next stage of self-examination is pressing the breasts with your fingers in search of any lumps or lumps. Women should perform such an examination once a month, a few days after the end of the menstrual cycle. Other tests performed in the prevention of breast cancer are ultrasound and mammography. Mammography is an X-ray examination. Its performance is recommended every two years from the age of 40. Breast ultrasound works well in younger and pregnant women and is recommended from the age of 30, once a year. It should be remembered that negative results of mammography and ultrasound do not release us from systematic breast self-examination, and all disturbing symptoms should be immediately consulted with a gynecologist or oncologist who, if necessary, will order specialist examinations.
Treatment of breast cancer
Treatment of breast cancer is a combination therapy that combines radiotherapy, chemotherapy and hormone therapy with surgery. Surgical removal of breast cancer may involve the removal of the lump itself, or it may be more radical, involving the removal of the entire breast (mastectomy). The prognosis in the treatment of breast cancer depends on many factors, the most important of which are the stage of the cancer and its type. In the early stages of breast cancer, that is, where the tumor is relatively small and has no distant metastasis, surgery may be used. In women whose tumor does not exceed 0,5 cm, the average prognosis for complete recovery is 99%. When the tumor is larger and the axillary lymph nodes are involved, the prognosis is 75%. effectiveness. The prognosis for the treatment of breast cancer also depends on the biological subtype of the cancer, which is determined by molecular testing.
The tri-negative subtype and HER2 + are the worst prognostic ones. HER2-positive cancer is highly aggressive, even in its early stages. It develops and spreads quickly and is resistant to traditional treatment. But here too, medicine is not helpless. Studies in the treatment of HER2016 + double blockade, published in 2, showed an improvement in treatment outcomes of 20 to 30 percent. Dual blockade is based on adding pertuzumab to previously used chemotherapy and trastuzumab. The use of double blockade in patients in the early stage of HER2 +, even before surgery, reduces the size of the tumor even to such an extent that the initial indication for mastectomy can be changed to surgical removal of only the tumor, saving the entire breast.
In Western Europe and the USA, double blocking is used at an early stage of the disease. In Poland, the use of double blockade has so far been reimbursed only in patients with advanced disease, when the prognosis for complete recovery was already small. Fortunately, the light in the tunnel also shone at our place. Since September, the Ministry of Health has been extending the reimbursement indications for pertuzumab in the early stage of cancer. – Taking into account the growing trend of mortality among Polish women from breast cancer, we – doctors must have as many effective drugs as possible in our arsenal. Knowing the benefits of using pertuzumab in early HER2 positive breast cancer, I could not imagine that he would not get reimbursed. It is a drug with a proven effect that has been used successfully in many countries. Studies have shown that the use of a double lock by 16,8 percent. increases the percentage of complete pathological responses in the breast compared to trastuzumab therapy. Almost half of the patients obtained such an answer, i.e. the lack of cancer cells in the breast after neoadjuvant therapy with trastuzumab and pertuzumab, which translates into long-term treatment results, i.e. disease progression-free time and overall survival – says Agnieszka Jagiełło-Gruszfeld, MD from the Oncology Center. Institute of Maria Skłodowskiej-Curie in Warsaw.
The effect of the drug is well illustrated by the case of Ms Ola, who was diagnosed with HER2-positive breast cancer. The patient received chemotherapy and 6 doses of pertuzumab with transtuzumab. Another test showed the absence of cancer cells in the body. – This is wonderful information and I am very happy. I really wanted to do something for the benefit of other patients and I wrote a letter to the Minister of Health with an appeal to make the double blockade available to patients. I do not know if it had any influence on the decision of the Minister, but I am very glad that I added a pebble to this great success.
The material was created in cooperation with the campaign “Heal breast cancer HER2 +”