Nearly 12,000 women are diagnosed with breast cancer every year
The best experts and scientists screen the most common diseases among people over 50. What are the most hopeful developments in diagnosis and treatment? We ask Prof. Elsken van der Wall about the developments surrounding breast cancer.
Digital Breast Photos
Elsken van der Wall: “A new system is being introduced nationally in which digital breast photos are taken instead of analog. This allows us to magnify suspected abnormalities, so that we now see things that we did not see with the analog photos.”
Patient advantage:
“Even earlier breast cancer detection. A disadvantage: more chance of a biopsy for a spot that turns out not to be cancerous.”
Improved biopsy
“Most women receive chemotherapy and/or hormone therapy after breast surgery to reduce the chance that they will develop metastases later on. However, a quarter of breast cancer patients will not develop metastases and therefore undergo unnecessary chemotherapy or hormone therapy. With the MammaPrint we now seem to be able to determine much better how aggressive the detected tumor is, and whether or not a woman needs chemotherapy. The MammaPrint is a biopsy in which the tumor tissue is screened for 70 genes that play a role in the formation of metastases. We will know within ten working days whether you have a low or high risk of metastases. It is then better for you to decide for yourself what you want, and to discuss with the doctor whether chemotherapy or hormone therapy is really necessary. The definitive scientific evidence for this test is yet to come, but we expect it to come.”
Patient advantage:
“Much less chance of unnecessary chemotherapy or hormone therapy. If you have little chance of metastases, you can consider omitting these additional therapies in consultation with your doctor. A disadvantage: not all insurance policies currently reimburse the MammaPrint.”
Single irradiation
“Radiation is always necessary after breast-conserving surgery; every day for five to six weeks. We are now investigating the effect of single irradiation in the operating room immediately after the removal of the tumor (intraoperatively). In about five years’ time, we will be certain that the results will be good.”
Patient advantage:
“Much less tax.”
Targeted irradiation
“On the basis of a CT scan, we place a computer-controlled radiation beam very precisely on the risk area (intensity modulated radiotherapy). In this way we limit damage to other organs, such as the heart, lungs and nerves. You can never completely prevent this damage with conventional radiation. The new method is already widely used and is expected to be common in most hospitals within two years.”
Patient advantage:
“No additional complaints due to damage to surrounding organs.”
Burn away with sound waves
“We can burn small tumors away instead of cutting them away. We do this using a thick needle with very high sound waves. Now only in research situations, within five years we will know what its value is.”
Patient advantage:
“No cut, so no scar.”
Better breast reconstruction
“There are many new options, such as immediate reconstruction, where the plastic surgeon creates a new breast immediately after an amputation. If possible, only the inner breast tissue is removed and the so-called skin envelope is preserved. Silicone fillings can be used for the new breast, but if you have sufficient own fat tissue, a beautiful, natural prosthesis is also possible. A reconstruction can also be done at a later time. In addition, the own nipple can sometimes be replaced. Otherwise, a nipple reconstruction can be done in which we fold a piece of skin around a very small piece of bone (for example from the thigh). We apply color to it with a tattoo.”
Patient advantage:
“The result is often beautiful. But not all hospitals can offer all forms of reconstruction. It is also not all possible for every woman, and unfortunately the possibilities of reconstruction are not always discussed with older women. So always ask for it yourself if you want it.”
Good intention 2010
Immediate action when you feel something in the chest
Prof. dr. dr. Elsken van der Wall: “Don’t engage in ostrich politics: if you feel anything or notice changes in your chest, go to the doctor immediately. Above all, look for a doctor you trust and feel safe with. The sooner you get there, the better. You no longer have to die of breast cancer and can live for years in good health. Breast cancer mortality has decreased by 5 percent per year since 2000!”
Every woman has access to all treatments – also mentioned in this article – that are under investigation. Ask your doctor whether you could qualify for this and where you can go. Would you like to know more about (experimental) treatments? View on www.kankeronderzoek.info
Prof. dr. dr. Elsken van der Wall is an internist-oncologist and professor of internal medicine at the University Medical Center Utrecht (UMCU), professor at Utrecht University and at Johns Hopkins University in Baltimore (USA).
Sources):
- Plus Magazine
