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.
The CHEK-2 gene
Besides the BRCA-genes, mutations occur in other genes that protect the individual from cancer development. Usually, these mutations have lower penetrance, which means that there is a lesser chance of developing cancer from these mutations. One of the most studied mutations besides BRCA-1 and BRCA-2 is the CHEK2-gene variant. CHEK2 is a gene located on chromosome 22, that encodes for a protein helping us to repair damaged DNA. A mutation in the CHEK2-gene inherited from one of the parents increases the breast cancer risk 2-fold. However, if the mutation exists in both the paternal and maternal inherited genes, the risk increases 6-fold. The gene mutation seems to be more frequent in the northern European populations, with 3% of people carrying the mutation (Finish, Dutch), than in southern European populations (0.5%). Although more rare than the BRCA-mutations, and incorporating a lesser risk for breast cancer, CHEK2 is currently considered the third most important breast cancer susceptibility gene.
References:
1) Apostolou P1, Fostira F. Hereditary breast cancer: the era of new susceptibility genes.. Biomed Res Int. 2013;747318. doi: 10.1155/2013/
2) D. Easton. CHEK2 ∗1100delC and susceptibility to breast cancer: a collaborative analysis involving 10,860 breast cancer cases and 9,065 controls from 10 studies,” The American Journal of Human Genetics, 2004;74:1175–1182.
3) Liu C1, Wang Y, Wang QS, Wang YJ. The CHEK2 I157T variant and breast cancer susceptibility: a systematic review and meta-analysis.. Asian Pac J Cancer Prev. 2012;13:1355-60
4) S. Narod et al. Estimating survival rates after ovarian cancer among women tested for BRCA1 and BRCA2 mutations. Clinical Genetics 2012; 83:3:232–237
5) M. Gage, D. Wattendorf, and L. R. Henry. Translational advances regarding hereditary breast cancer syndromes. Journal of Surgical Oncology. 2012;105:5. 444–451
6) C. Cybulski, B. Gorski, T. Huzarski et al. Effect of CHEK2 missense variant 1157T on the risk of breast cancer in carriers of other CHEK2 or BRCA1 mutations,” Journal ofMedical Genetics 2009; 46:132–135.