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From screening and surgical interventions to reconstruction and clinical trials, breast cancer treatment and prevention have evolved significantly over the years. These advancements offer a range of options tailored to meet the individual needs of patients. In this blog post, we will explore the various surgical options, the role of prophylactic surgeries, the benefits of oncoplastic surgeries, and the critical importance of clinical trials in breast cancer treatment, featuring insights from leading specialists.
Surgical options for breast cancer treatment
Cancer treatment is highly individualised, taking into account the cancer's characteristics, as well as patient-specific factors. Dr. Francesca De Lorenzi, Director of the Innovation, Development and Organization Unit at the Department of Plastic and Reconstructive Surgery, European Institute of Oncology, Milan, explains:
“Cancer treatment is tailored to each patient, according to cancer characteristics and stage, patient characteristics and comorbidities and breast volume and shape. The conservative treatment is the first choice whenever possible; in addition, oncoplastic surgery has broadened the indication for breast conservation. However, conservative mastectomies are very popular and performed even in healthy high-risk women.”
What is referred to as prophylactic breast surgery?
Prophylactic breast surgery, now more commonly known as risk-reducing surgery, is a preventive measure for those at high risk of developing breast cancer. Dr. Alberto Rancati, Medical Director and Founder of the Centro Rancati de Cirugía Plástica in Argentina, provides insight:
“Nowadays, the term used is risk-reducing surgery. When breast surgery first began, it was performed on palpable lesions. With advancements in technology and radiology, we started operating on images of lesions that were not yet palpable. And today, we operate on lesions that do not yet exist. Why? Because we know through genetic testing, like the BRCA I and BRCA II tests, that these patients who carry this gene, which is the absence of a protective gene, will suffer a 90% chance of developing breast cancer at some point in their lives. Therefore, the recommendation is a mastectomy and often an oophorectomy. So, risk-reducing surgery is aimed at these patients who test positive or who have sufficient clinical history to undergo this operation.”
What is oncoplastic surgery and what are its benefits?
Oncoplastic surgery combines oncology techniques with plastic surgery to provide the best treatment outcomes for breast cancer patients. Dr. Rancati elaborates:
"As described by Dr. Maurizio Nava, today specialties are more focused on specific organs. That is, the vertical surgeon who performs breast surgery must know oncologic surgery, plastic surgery, and breast aesthetic surgery. The combination of oncology techniques with plastic surgery allows us to provide the best treatment to these patients, who often have pre-existing asymmetries or previous breast operations. Therefore, it is necessary to combine oncological knowledge with aesthetic knowledge. This specialty is called oncoplastic surgery.”
Why and when should you consider a clinical trial?
Clinical trials play a vital role in advancing medical practices and treatments. Prof. Marco Bernini, MD PhD, General Surgery Associate Professor and Breast Surgeon at the AOU-Policlinico di Modena in Italy, emphasizes their importance:
“Clinical trials are in every medical field the equivalent of fuel for vehicles, they permit progression. That’s why we, as clinicians and scientists, should always think about a trial in order to obtain a change and evolution in our daily practice. Just to summarize some surgical examples, it was through clinical trials that breast conserving surgery was introduced. Similarly, a clinical trial permitted to avoid ALD in selected cases of axillary node infiltration. Therefore, whenever we feel the need to improve a procedure or to improve our results, a clinical trial should be the right way to prove an idea, a material, a new technique or whatever is deemed worth to be investigated and spread in the international breast surgical community.”
Conclusion
The landscape of breast cancer treatment is continuously evolving, with advancements in surgical techniques and the critical role of clinical trials. By understanding the various options and their benefits, patients can make informed decisions about their treatment plans. Expert insights from specialists like Dr. Francesca De Lorenzi, Dr. Alberto Rancati and Prof. Marco Bernini highlight the importance of personalized care and ongoing research in improving outcomes for breast cancer patients.
To continue learning and supporting breast cancer awareness, make sure to read our other blog posts and follow our social media efforts throughout October.