There are factors which increase the risk of breast cancer beyond the woman’s control. For example, ages and the resulting hormonal changes. There are also those that we can control to a much greater extent, such as obesity, smoking or lack of physical activity. Dr. Bogumiła Czartoryska-Arłukowicz, MD, PhD explains what the treatment of breast cancer in Poland looks like today.
- Low physical activity, obesity, excessive alcohol consumption, and smoking may all contribute to an increased risk of breast cancer
- Contrary to, for example, genetic factors, we have an influence on these behaviors
- In 20 – 25 percent women are diagnosed with HER2 + breast cancer – it is an aggressive tumor that metastasizes rapidly
- More information can be found on the Onet homepage.
Breast cancer is the most common malignant neoplasm in women. What’s more, the number of patients is constantly growing. Why is this happening?
Bogumiła Czartoryska-Arłukowicz, MD, PhD: The risk of developing breast cancer is not related to one specific cause. However, factors related to the hormonal status of a woman (reproductive factors, age of puberty and menopause, number of children born, use of hormonal drugs) seem to have the greatest influence. This increased risk is associated with a prolonged adverse effect of oestrogens, which are a recognized mutagenic factor on breast epithelial cells.
Other risk factors include age, with over 50% of women over 80. all breast cancers. Another is the presence of mutations in the BRCA1 or BRCA2 genes.
Lifestyle also has an impact on increasing the risk of breast cancer. We often forget about it, and behaviors such as low physical activity, obesity, excessive alcohol consumption, and smoking can increase the risk of breast cancer and other cancers. We have no influence on most of the factors described, but we have a lifestyle and we can do a lot in this regard, for example by increasing physical activity, maintaining a proper body weight, etc.
What is the HER2 + subtype and what is the treatment of this cancer?
In HER2 + cancer, the HER2 receptor is overexpressed on the surface of the neoplastic cells. It affects about 20-25 percent. women. It is characterized by an aggressive course and a high risk of distant metastases.
A major breakthrough in the treatment of HER2 + breast cancer was the introduction of HER20-blocking drugs such as trastuzumab into common clinical practice over 2 years ago. In recent years, the treatment outcomes of patients with this cancer subtype have improved significantly through a completely different therapeutic approach. Many of them have a chance of being fully healed.
Is there a risk that the disease will come back after surgery? Are there postoperative therapies that minimize the risk of relapse?
Unfortunately, breast cancer is a disease that, despite surgical treatment, may return in the form of distant metastases to organs such as: lungs, liver, skeleton and central nervous system. Therefore, treatment of breast cancer, including HER2-positive breast cancer, is combined. In recent years, treatment more often begins with chemotherapy in combination with drugs blocking the HER2 receptor, followed by surgery. Apply after the procedure complementary treatment with the use of anti-HER2 drugs and, where necessary, radiotherapy. Adjuvant treatment is aimed at reducing the risk of relapse.
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Do Polish patients have access to any form of treatment? What are the deficiencies in the drug program?
At the turn of the last few years, enormous progress has been made in the access to methods of breast cancer treatment. Nevertheless, some therapeutic options are still lacking, mainly in adjuvant or adjuvant therapy.
Neratinib (small-molecule tyrosine kinase inhibitor of HER receptors) is still not reimbursed in Poland, recommended in patients with luminal HER2 + breast cancer in prolonged adjuvant treatment, i.e. after a one-year treatment with trastuzumab for the next 12 months. This applies especially to the group of patients in whom, after preoperative treatment, not all the neoplastic cells were destroyed, i.e. the so-called complete remission as assessed by postoperative histopathology.
At the Białystok Cancer Center, you conduct many pro-patient activities. How does the center try to care for patients?
The Breast Cancer Diagnostics and Treatment Center, the so-called Breast Cancer Unit. The comfort of the treated patients has improved significantly thanks to the coordinators who guide patients through the entire treatment process. What is also important, the diagnostic path leading to the decision about the treatment at the consilium has been significantly shortened. Indeed, patients seem to benefit enormously from the program.
We try to carry out many activities in our Breast Unit – our website has recently been launched, we encourage patients to report to mammography despite the ongoing epidemic, which gives a chance for early cancer detection and effective treatment through various campaigns in the local media and on the website. In October, the massive “I Breast Run” took place with over 200 participants. It was aimed at drawing attention to the problem of breast cancer and the need for preventive examinations.
We have also published a guide for patients treated for breast cancer.
The best prevention of breast cancer is through regular examinations. It is also worth performing a genetic test that will assess the risk of cancer. Now you can make them in the form of shipping.
Also read:
- More and more Polish women die of breast cancer. Money from the government is not helping
- It develops quickly, it is easy to mistake it for something else. It’s an insidious tumor
- Paulina Młynarska has undergone a prophylactic mastectomy. Up to 300 people qualify for it. Polish women
- They know they are dying. How do I talk to cancer patients?
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