Dr Alexandra Henríquez Linares, specialist in mammary pathology and gynecological oncology.
Today, on 19 October, the International Day against Breast Cancer, we must take the opportunity to look back and remember those people who have or have gone through a difficult stage in their lives as a result of this disease. We express our most sincere appreciation and admiration to them all.
Looking more closely at the disease, I must remind you that making a diagnosis and early treatment are fundamental, since the prognosis of the disease will depend on it. We must not forget that most breast lumps are due to benign causes and that 50-75% of patients diagnosed with breast cancer have no recognizable risk factors. Feeling a lump which is unusual, irregular, hard and immovable (examining your breasts after your period each month without worrying is recommended) should be understood as a warning sign to see a specialist. Other signs include bloodstained discharge from the nipples, dimpling on the skin or retraction of the nipple, unusual lumps in the armpits, or finding something that has appeared recently and is not normally there.
In our field, a mammography remains the only currently accepted study to screen for this disease. It should be the first study to be performed on women over 35 years of age with a suspected history, with the youngest women around this age first to be scanned, as the younger the patient, the higher the breast density which makes mammography detection difficult.
Breast cancer is considered a major health problem in the female population because of its high frequency; it is the most common type of cancer in this population, although it is a biologically heterogeneous disease, and therefore has different clinical behaviours. According to the latest European Cancer Information System (ECIS) report, in 2018 a total of 32,825 new breast cancer cases were diagnosed in Spain; this tumour being the most frequent among women in our country ahead of bowel, uterine, lung and ovarian cancer. In Spain, approximately 30% of cancers diagnosed in women originate in the breast.
Of all breast cancers, 70-75% correspond to sporadic cases, 15-20% to genetically nonspecific familial aggregations and 5-10% to hereditary cases. The probability of developing breast cancer as a woman is 1 in 8 and usually occurs between 35 and 80 years, although the age range of 45-65 has the highest incidence due to all the hormonal changes that occur peri- and post-menopause because 75% of tumours are hormone dependent. The incidence has been increasing in recent years and it is estimated that it will continue to rise due to different risk factors in addition to population increase.
This increase is due to new imaging techniques which increasingly diagnose tumours earlier, and the increase in life expectancy, given that aging is one of the main risk factors. Modifiable risk factors are a sedentary lifestyle, tobacco, alcohol, the obesity epidemic, and the tendency to live in increasingly polluted places.
Therefore we must consider several aspects in our day to day lives: we shouldn’t let daily routine make us eat poor quality food (we must eat fresh seasonal products without chemical additives); we must do sport to keep our cells oxygenated; we must avoid bad habits like tobacco, alcohol, and stress. In conclusion, we must encourage healthy living habits and encourage them in our children, day by day, educating them from childhood so we can try to avoid facing diseases in the future which we could have avoided.
More information at Blue Healthcare’s Gynecology Unit.