O breast cancer it is the main type of cancer to affect women (excluding non-melanoma skin tumors), with an estimate of more than 66 thousand new cases each year according to the National Cancer Institute (Inca). Of these, it is estimated that about 35% are already diagnosed at an advanced stage.
One in three cancer cases can be cured if caught early enough. Fear, misinformation and lack of access to health services contribute to delaying diagnosis. Every year, the campaign Pink October raises awareness of the public health problem.
The disease is characterized in different stages: 0 to IV, the last being the most severe. At this stage, cancer can be found in other parts of the body and is called metastatic cancer. The most likely places to be affected are the liver, bones and lungs. Metastatic breast cancer is an incurable condition. The median survival of a patient with metastatic disease is approximately two years, which may vary from one person to another.
“Although it is difficult to hear this diagnosis, it is important to note that today there are several treatment options available that will help patients to have a better quality of life and increase their overall survival time, even when the presence of cancer is confirmed” , says Lenio Alvarenga, medical director of Innovative Medicines at Novartis Brazil. “The important thing is to always talk to your doctor to understand the best path to take with regard to your treatment”, he adds.
According to Inca, breast cancer can be detected in the early stages, in most cases, through the following signs and symptoms:
- Lump (lump), fixed and usually painless
- Red, tight, or orange-peel-like breast skin
- Changes in the nipple (nipple)
- Small lumps in the armpits or neck
- Spontaneous discharge of abnormal fluid from the nipples
O The Ministry of Health recommends performing mammography as a screening method for breast cancer, that is, a routine examination, for women without signs and symptoms in the age group of 50 to 69 years, every two years.
“We currently do not recommend self-examination for early identification of breast cancer, studies have shown that this strategy did not reduce mortality. The recommendation is that women are aware of breast health, know how to recognize suspicious signs and symptoms and have quick access to health services for investigation. Palpation of the breasts can occur whenever the woman feels comfortable”, says breast specialist Viviane Esteves, from the Mastology Service of the Fernandes Figueira National Institute of Women’s, Children and Adolescents’ Health (IFF/Fiocruz).
Different types of breast cancer
Breast cancer results from the multiplication of abnormal cells in the breast, which forms a tumor with the potential to invade other organs. According to Inca, there are several types of breast cancer. Some develop quickly and some do not. Most cases respond well to treatment, especially when diagnosed and treated early.
According to the Oswaldo Cruz Foundation (Fiocruz), breast cancer is classified into three main subtypes. The categories are associated with the presence or absence of molecular markers, or proteins, for hormone receptors (HR) and the so-called “human epidermal growth factor 2” (or HER2).
When both proteins are present, the tumor is classified as RH+ and HER2+. Now, when they are absent, the tumor is classified as RH- and HER2-, which can also be called triple negative. There is also the possibility that only one of the proteins is present, leading to two distinct possibilities: RH+ and HER2- or RH- and HER2+.
In Brazil, it is estimated that 20% of cases correspond to the HER2 positive type (average of 13,400 cases per year), of which 80% are treated in the SUS, around 10,700 patients. The most common type is RH+ and HER2-, which affects around 69% of women.
What are metastases and why do they happen?
Metastasis can happen when breast cancer cells break away from the main tumor and enter the blood stream or lymphatic system. In this way, cells that are separated are moved to other parts of the body, sometimes away from the original tumor.
When these cells cluster in a certain region, they can grow and form new tumors in that new location.
Although the tumor has spread to other regions of the body, its characteristics are still that of a breast cancer. For example, regardless of whether the tumor has spread to the bones, it is the breast cancer cells that are in the region, which are different from the cells of a tumor that starts directly in the bone. Therefore, the treatment remains the same.
How does cancer treatment work?
In the last years, advances in the management of breast cancer brought benefits to patients, with positive impacts on quality of life. Treatment varies according to the extent of the disease, the biological characteristics of the tumor, and the conditions of each patient, such as age, menopausal status, comorbidities, and personal preferences.
The prognosis also depends on the extent of the disease, as well as the characteristics of the tumor. When the disease is diagnosed early, treatment has the greatest curative potential. When there is evidence of metastases, treatment aims to prolong survival and improve quality of life.
According to Inca, the modalities of breast cancer treatment can be divided into local treatment, which includes surgery and radiotherapy (in addition to breast reconstruction), and systemic treatment, which involves chemotherapy, hormone therapy and biological therapy.
Physicians from the Unified Health System (SUS) use the Diagnostic and Therapeutic Guidelines (DDT) in oncology to guide the best procedures for cancer treatment. The set of documents based on scientific evidence assist professionals in choosing the appropriate therapy for each patient.
In September, the Ministry of Health incorporated into the SUS the drug trastuzumab emtansine, or TDMI-1, indicated for the treatment of patients with HER2-positive breast cancer in a monotherapy regimen, a method in which the therapy is performed using only one drug or procedure.
advanced breast cancer
With technical and scientific advancement, there are treatment options even for patients with cancer diagnosis advanced and in the stage of metastasis.
In this case, care starts to focus on increasing the overall survival time, as the total time living with breast cancer metastasis, or progression-free, is called, which considers the amount of time that the cancer has not grown or advanced during the course of life. treatment, in addition to promoting quality of life.
Health professionals can be guided by several factors to assemble an action plan, such as the characteristics of the cells, the other sites that were affected, which symptoms the patient presents, in addition to other breast cancer treatments performed previously.
Source: CNN Brasil
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