News about breast cancer

Operate without cutting
Prof. dr. Dr. Elsken van der Wall: “At UMC Utrecht, we are conducting a study into burning away a tumor in breast cancer using ultrasound waves, i.e. without cutting. This is already happening in prostate cancer. Worldwide, UMC Utrecht is the first hospital to investigate whether this method can be applied to breast cancer. The patient does not have to be under anesthesia but is given a sedation. If the technique proves to be safe, a quarter of breast cancer patients will probably be eligible in a few years’ time. These are women with relatively small, metastatic tumors.” Benefit for the patient: “No surgery, no general anesthesia.”

Better diagnosis
“The imaging techniques for determining what is wrong with a breast are getting better and better. This applies to digital breast photos as well as MRI and PET-CT scans to see if there are metastases. We expect that the imaging In the next ten years, techniques will become so good that we can say with certainty on the basis of images whether an abnormality we see is malignant and how large it is.

There is also a group of patients with a form of breast cancer that does not spread. They are finished with the treatment when the tumor has been removed from the breast, and do not need follow-up treatment with chemotherapy or hormone therapy. We can’t properly recognize this group yet, so they get treatments that they don’t need, including the side effects. With the new scans, we will be able to identify them in a few years’ time.” Benefit for the patient: “Early detection, less overtreatment.”

More precise therapy
“More and more drugs are being introduced that specifically target cancer cells and not healthy cells as well. Chemotherapy has an effect on all rapidly dividing cells, including hair and taste cells, for example. That is why people usually become bald and lose their taste. That there are more therapies that only attack the cancer cells is related to the fact that we are increasingly able to distinguish different types of breast cancer, for example new therapies for hormone-sensitive breast cancer (the kind that affects about 60 percent of women) and for Her-2-positive breast cancer, which affects about 20 percent of patients.” ​Patient benefit: “Greater survival rate and fewer side effects.”

Shorter irradiation
“Two years ago, after an operation, women had to have radiation every day for five weeks. For the majority of women, that is now only three weeks. And it will probably be even shorter. We can now offer MRI-guided radiation in Utrecht. we are more successful in irradiating only the area where the tumor was located, and not also the healthy tissue around it, so there is less ‘scatter damage’ at the edges of the irradiated tissue. the breast immediately after surgery. It will take several years before it is clear whether such a single irradiation is just as effective as a few irradiations a week.” Patient benefit: “Three weeks instead of five weeks in the hospital every day, and less damage to the surrounding tissue.”

Chemo in tablet form
“Actually, we want to move towards targeted therapy that only destroys the cancer cells. But so far we still combine most therapies with chemotherapy. An improvement is that some chemotherapy is available in tablet form instead of an infusion. For some people it makes a big difference stress if they don’t have to go to the hospital every week for an IV.” Benefit for the patient: “You do not have to travel to the hospital for chemotherapy.”

Good intention 2013
Daily exercise, moderate with alcohol
Elsken van der Wall: “Overweight after the menopause is a major risk factor for breast cancer. With a BMI above 30, the risk is 20 percent higher. Exercising intensively for at least half an hour a day reduces the risk. Active women are 20 to 40 percent less likely to develop breast cancer than women who do not or hardly exercise. Wine also increases the risk of breast cancer. Stick to no more than three glasses a week.”