Breast cancer, early stage diagnosis remains a challenge

Breast cancer is one of the most recurrent types of carcinoma in the female population, both in developed and underdeveloped countries. Analyzing the global panorama of the disease, cases of breast cancer continue to increase, which is why public and private entities insist that early detection and diagnosis are key to increasing the prognosis of life in patients with breast cancer. In addition to allowing the stage of the disease to be determined and thus being able to guarantee a better quality of life for patients with timely treatment.

With the advancement of science, the diagnosis and treatment of the disease has also evolved, concluding that it is not the same in each person who suffers from it. Breast cancer has different characteristics, defined according to the particularities of the tumor and the patient. In some types of cancer, the presence or absence of estrogen or progesterone receptors, or biological markers, such as proteins called HER2 or PDL1, can be identified. “These receptors and proteins allow us to determine the type of cancer, its aggressiveness, and the medical approach that each woman requires to achieve greater survival,” the medical manager of breast and gynecological cancer at Roche Central America told La Estrella de Panamá. Caribbean, Vanessa Campos.

Despite these advances, Campos mentioned that early-stage diagnosis continues to be one of the main challenges, as well as providing a greater opportunity for a cure to patients with this disease both in Panama and in the Central American and Caribbean region.

“In early stages, a patient has more than a 95% chance of surviving up to five years after being diagnosed, than a metastatic patient whose probability drops to 27%; this is what makes us work on raising awareness about the importance of an early diagnosis”, explained Dr. Campos.

“If a woman is diagnosed with breast cancer at the age of 50, then her daughter should start the control 10 years earlier, that is, at the age of 40, to identify any anomaly in the breast in order to make a timely diagnosis, since breast cancer in most cases occurs due to hereditary factors”, said the doctor.

Another of the risk factors identified as precursors of breast cancer is age, having had breast cancer, women who have not had children or those who have children over the age of 45, obesity, use of oral contraceptives, environmental pollution, hormone replacement therapy, alcohol, among others.

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In turn, Campos stressed that breast cancer is the most frequent malignant tumor in the female population. “It originates when breast cells begin to grow uncontrollably and form a tumor that can often be seen on a mammogram or can be felt as a mass and that unfortunately in many of these cases is already of a considerable size (2 centimeters). ) and what is required is to detect it before that size,” he said.

She added that most breast lumps are benign, however, any lump or change should be examined by a health care professional to see if it is benign or malignant.

“Hence the importance of early detection with mammography and if it is not at the right age there is also a breast ultrasound. “In Panama, mammograms are done both in the Social Security Fund (CSS) and in government health clinics. It is important that people from 40-45 years of age ask their primary care doctor or general practitioner for a referral to have their mammogram done once a year from 40-45 years of age and if they have a family history, they should not be left out. aside that rapprochement”, Campos insisted.

Luis Francisco Sucre, Minister of Health, pointed out in a press release that every year about half a million women in the world are diagnosed with breast cancer and at least a third of these die from this disease, being the second cause of death in the Americas region.

Between 2019 and 2020, more than 1,700 new cases of breast cancer were registered in Panama, very significant figures that account for the magnitude of the problem. In this sense, Sucre explained that a multidisciplinary communication system is important for the early detection of cancer and thus prevent the evolution of the disease.

In addition, he highlighted that since 2021 an emergency palliative care program has been installed in the Metropolitan Health region, the Ngäbe Buglé region and the province of Colón, and that around 4,073 patients have been treated with this program.

what it takes

According to the Breast Cancer Revealed focus group, an initiative that worked with multidisciplinary teams from all over Latin America to identify the main challenges and opportunities for cancer patients, it found that:

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1. Although some countries have developed programs, most are implemented in certain institutions, with a focus on prevention or detection, and are implemented or reinforced in short periods of time, for example, in October as it is awareness month.

In this sense, Dr. Campos emphasized that not only in October should awareness be raised about breast cancer, since this disease is diagnosed every day.

2. Regarding detection in primary medical care, he explains that it is necessary to increase the training and capacity of the teams at that level. It is vital to strengthen institutions with more equipment, resources, supplies and personnel to provide adequate care, especially at the first level of care and in rural areas.

2. In the countries of the region, more tools are needed for, for example, the implementation of mammograms, ultrasounds, and biopsies.

3. Local policies must be established that allow access at the public level and promote early diagnosis through programs that facilitate mammography as a fundamental test, from the age of 45, and leave self-examination as another method of breast exploration. preventive.

4. There is a small number of oncologists, who care for patients with different types of cancer. It also highlights that they are mostly found in national or reference health centers and this affects access to treatment.

5. Although there are therapies for hormone receptor positive, HER2 positive and triple negative, some countries do not have access to all therapies.

6. Programs must be generated that contribute to the objective of controlling the disease, providing emotional or psychological support and rehabilitation, as a complementary aid to the disease process.

In this regard, Héctor Tapia, interventional radiologist, explained that all countries in the region must have different health ecosystems; however, it is vital that breast cancer early detection plans be promoted within each one, starting with education about the disease that, despite multiple campaigns, is still largely unknown; but it is also of utmost importance that the medical tools and studies available are accessible to the entire population and thereby contribute to better and longer life prognosis.

“Early diagnosis allows for better health outcomes. A timely mammogram can save your life,” Minister Sucre stressed in the statement.

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