Prevention
Modern medicine is increasingly transitioning towards preventive care. This shift towards prevention has also been observed in breast cancer care in recent years, particularly with the discovery of the BRCA gene. Subsequently, multiple genes and risk factors have been identified. Depending on these factors, a personalized screening strategy can be chosen. Therefore, it is crucial to understand these genetic and risk factors.
Diagnosis
I was diagnosed with cancer ... This website serves as a portal designed to assist you and your loved ones in accessing personal information and finding solutions to your concerns.
The primary goal of this website is to offer guidance and support to patients as they navigate their journey toward recovery and improved quality of life. The "Diagnosis" section of our website is divided into two main categories. Firstly, under "Anatomy and Physiology," we provide fundamental knowledge about the breast. Secondly, in the "Tumors and Disorders" section, we delve deeper into various breast-related conditions.
Moreover, we aim to provide information to women who may be concerned about potential breast issues but are hesitant to seek immediate medical advice. Knowledge and information can often offer immediate reassurance if a woman is able to identify the issue herself and determine that no specific treatment is necessary. Conversely, we also strive to educate women who have received a diagnosis of a serious breast condition, such as breast cancer, and wish to approach their doctor well-informed and prepared.
Treatment
The treatment for breast cancer should immediately include a discussion about reconstruction. Our foundation has no greater goal than to raise awareness of this among patients and oncological surgeons. By making an informed decision beforehand, we avoid closing off options for later reconstruction while still considering the oncological aspect. Of course, survival is paramount, and the decision of the oncologic surgeon will always take precedence.
The "Reconstruction or not?" page contains all the information you can expect during an initial consultation before undergoing tumor removal. This page is comprehensive, and your plastic surgeon will only provide information relevant to your situation.
"Removing the tumor" details the surgical procedure itself. This is the most crucial operation because effective tumor removal remains paramount. We guide you through the various methods of removal, a decision often made by a multidisciplinary team comprising oncologists, radiologists, pathologists, radiotherapists, breast nurses, gynecologists, oncological surgeons, and plastic surgeons.
The "Breast Reconstruction" section includes information and illustrations of the different reconstruction options along with corresponding steps.
Revalidation
Those treated for cancer often need a long period to recover.
Cancer is a radical illness with a heavy treatment. Often, people have to deal with psychosocial and/or physical problems afterwards, such as stress, anxiety, extreme fatigue, painful joints, reduced fitness, lymphedema... This can have a major impact on general well-being.
There are rehabilitation programmes offered by most hospitals. We cover some of the major topics here.
Quality of life
Quality of life is a key factor in coping with breast cancer. Therefore, it is important to find coping mechanisms that work, which will be different from patient to patient. For some, it may be finding enjoyment in activities they engaged in prior to diagnosis, taking time for appreciating life and expressing gratitude, volunteering, physical exercise... Of prime importance, studies have shown that accepting the disease as a part of one’s life is a key to effective coping, as well as focusing on mental strength to allow the patient to move on with life. In this section we are addressing some topics that patients experience during and after treatment and we are providing information to address them.
Family history as a risk factor for breast cancer
A positive family history is the strongest predictor of a woman developing breast cancer. The more family members diagnosed, the closer their relationship and the earlier the age of onset, the higher the chance of other women in the family also developing the disease.
It is estimated that approximately 20 to 30% of all breast cancer patients have at least one 1st degree relative with the same condition and 5 to 10% of patients have a strong genetic predisposition (more than one relative with breast cancer).
The following factors increase the risk of a woman developing breast cancer:
number of family relatives affected by breast or ovarian cancer,
ratio of affected to non-affected individuals,
how closely related affected relatives are,
the age of onset of the disease,
whether the breast cancer affects one or both breasts (bilateral disease),
the incidence of male breast cancer in the family.
The number of these elements determines whether the risk is high, moderate or low. We also use this data to identify families in whom it may be useful to perform genetic analysis.
The criteria used for genetic analysis are shown in Table 1. These only tend to act as guidelines because occasionally the analysis is also performed in families which do not strictly meet the criteria. For example, if extenuating circumstances exist, such as a family tree that is difficult to assess (a small family or one that includes a large number of male relatives) or where there are significant clinical implications of a positive result. An exception may also be made in the case of extremely anxious patients for whom a genetic test is the only source of reassurance.
Table 1: Inclusion criteria for molecular genetic analysis of the BRCA1 and BRCA2 genes:
families with three first degree relatives* affected by breast and / or ovarian cancer.
families with at least two first and / or second degree relatives ** with breast and / or ovarian cancer occurring in patients who are younger than 50 years of age.
all patients who develop breast and / or ovarian cancer before the age of 35.
relatives belonging to a family in which the mutation has been identified.
male patients with breast cancer.
* First-degree relatives: mother, daughter or sister
** Second-degree relatives: grandmother, grandchild, aunt or niece