Pink October Breast Cancer Awareness Month 2019

Pink October Breast Cancer Awareness Month Press Release

On behalf of the Antalya Branch of the Turkish Association for Cancer Research and Control:

• Prof. Dr. Mustafa Özdoğan
• Prof. Dr. Ömer Özkan

On behalf of the Antalya Breast Diseases Association:

• Prof. Dr. Cumhur Arıcı

Each year, October is recognized worldwide as Breast Cancer Awareness Month, with various activities to raise awareness. Civil society organizations, health workers, patients, the press and society come together to raise awareness of causes, protective factors, early diagnosis and treatment advances.

Breast cancer mortality among women, particularly in developed countries, fell from 1989 to 2016 by 40%. Early diagnosis through screening and increased awareness played the greatest role. Educating women to be proactive about breast health is a priority.

Breast Cancer Statistics

Breast cancer is the most common cancer among women, affecting 2,1 million worldwide annually, and is also their leading cause of cancer death. In 2018, an estimated 627.000 women died from breast cancer, accounting for approximately 15% of all female cancer deaths.

New breast cancer diagnoses are increasing in nearly every region worldwide. Today, among every 8 women, one faces a lifetime breast cancer risk (13%); among every 38, one faces a risk of death from breast cancer (2.6%).

In developed countries, greater awareness, interest in screening and accessible treatment options have brought 5-year survival, or recovery rates, close to 95%. In our country, approximately 20.000 women are affected annually. Considering risk factors, we expect diagnoses to increase over time.

An important finding for our country is occurrence at younger ages. In Western countries, among women under 40 the proportion diagnosed is 5-7%, versus around 20% in our country. Although mainly a disease of older age, in our country 50% of patients are under 50. Therefore, especially here, breast cancer at younger ages awareness, and after age 40, mammography screening, are extremely valuable.

It should not be forgotten that early diagnosis allows greater preservation of breast appearance with minimal surgery, less chemotherapy and exposure to related treatments, less distress for patients and families and, most importantly, longer survival.

Breast Cancer Risk Factors

Numerous studies confirm that alcohol increases breast cancer risk by approximately 7-10% for each daily drink on average. Women drinking 2-3 alcoholic drinks daily have a 20 percent higher risk than nondrinkers.

Obesityincreases postmenopausal breast cancer risk. Obese women have approximately 1,5 times the risk of lean women.

Growing evidence shows that regularly active women have a 10% to 25% lower breast cancer risk than inactive women.

Limited but accumulating research suggests smoking may increase breast cancer risk, particularly with long-term heavy smoking and among women starting before their first pregnancy.

Breast Cancer Symptoms

Common symptoms include nipple and skin changes, breast asymmetry, a painful or painless palpable lump, and nipple discharge. Cancer may also occur without signs or symptoms. Population screening and mammography are therefore very important.

• Related Topic: What Are Breast Cancer Symptoms Other Than a Palpable Lump?

Early Diagnosis of Breast Cancer

Every woman should examine her breasts in a mirror once monthly after age 20 for deformity, loss of symmetry and changes in breast skin or nipples. After age 40, she should undergo annual mammography.

Biopsy and Surgery in Breast Cancer

Minimal surgery and approaches causing the least harm have gained importance recently. Breast surgery should therefore be performed by qualified physicians, and before surgery is planned, a breast biopsy must establish tumor biology and, if cancer is diagnosed, its stage or extent of spread. Unnecessary extensive axillary surgery should be avoided as much as possible. To plan appropriate surgery, multidisciplinary teams should assess patients from initial diagnosis.

Excessive surgery has recently been a major problem in breast cancer treatment. When patients arenotevaluated by multidisciplinary teams, anxiety increases, sometimes leading to unnecessary removal of both breasts and complete emptying of breast tissue. Excessive axillary surgery is also increasing because of incomplete or incorrect identification of the sentinel lymph node. Breast cancer should be evaluated only by qualified multidisciplinary teams, and the most appropriate treatment planned.

Breast Reconstruction

Plastic surgery is extremely important in breast cancer surgery. Preserving a woman’s sexual identity is as important as preserving her life. Breast cancer is among the fields with the greatest growth in plastic surgery techniques. Plastic surgery is now a key member of multidisciplinary treatment teams. With plastic surgery approaches, operations producing poor cosmetic results in multifocal cancer, large breast masses and proven hereditary cancers have almost become history.

Major Advances in Medical Breast Cancer Treatment

Over the past 10 years, targeted treatments and immunotherapies have been among 12 new cancer drugs receiving, for breast cancer, FDA (US Food and Drug Administration) approval and making important contributions to patients’ lives.

At this week’s European Oncology Congress (ESMO 2019) , important breast cancer study results were announced, contributing substantially to survival. At ESMO 2019, adding immunotherapy to chemotherapy in locally advanced triple-negative breast cancer—an aggressive type with limited options—was observed to increase pathological complete response rates from 51% to 65%. In hormone-sensitive metastatic breast cancer, adding CDK4/6 inhibitors to conventional hormonal therapy brought survival to nearly beyond 4 years. In Her2-positive breast cancer, multiple targeted therapies combined with chemotherapy have made this difficult disease much easier to manage. Hereditary breast cancer types have shown promising results with specific targeted treatments.

A major congress topic was increasing costs and difficulty accessing treatment. Like our country, all countries struggle under rising costs. Patients should therefore be informed about clinical trials, physicians, authorities and health institutions should focus on them, and trial numbers should increase. Our country has 14 active international breast cancer trials. Increasing both trial numbers and participating centers in the coming years is extremely important.