As of this month of February, patients diagnosed with breast cancer in its early phase have a therapeutic solution in the country that provides a better quality of life to the patient by reducing the risk of relapse or recurrence of the disease by approximately 1 in 30%
Breast cancer is a disease caused by the abnormal multiplication of breast cells that form a malignant tumor. On a global scale, it is the most diagnosed type of cancer in women: 1 out of 8 female individuals suffer from breast cancer. It is also the leading cause of cancer-related death in women worldwide. Even since 1990, the worldwide incidence of breast cancer has increased annually by 1.44%.
Worldwide, it is estimated that 1.7 million people contract breast cancer each year, and that 522,000 die from it5. In Costa Rica in 2020, 1,624 new cases of breast cancer were diagnosed, which gives us an average of almost four women diagnosed daily with this disease. 6. 56% of the deaths from breast cancer registered in 2020 are located in the age group of 30 to 69 years, classified as premature mortality, since the death is registered at an early age of 7 years.
The treatment of breast cancer will depend on the location in which it is found. While the disease is in the breast, with or without involvement of the axillary lymph nodes, treatment will include surgery of the tumor and of the axilla, with the addition of post-surgical (adjuvant) or pre-surgical (neoadjuvant) therapies that aim to reduce the possibility of tumor relapse and promoting healing; these therapies include radiotherapy, chemotherapy, hormone therapy, therapies directed at the presence of a gene, etc.
Treatment selection will be made by your oncologist and will be based on different parameters (tumor type, size, lymph node involvement, hormone receptors, among others, positivity for any gene) that determine personal risk.
Unfortunately, some patients are diagnosed with disease that has spread to other organs (metastasis) or their initial disease may progress to this condition sometime after their primary treatment; in this instance, the objective of the treatments will be to prolong the survival time and improve the symptoms related to the advanced disease, achievingbetter quality of life. Here again, treatments include chemotherapy, hormonal therapy, therapies directed at molecular targets, and, in some cases, palliative radiation therapy.
However, there are unmet needs and gaps in the current treatment approach. There are certain subtypes of breast cancer that have a higher risk of recurrence. 20% of patients can experience a recurrence of the disease in the first 10 years, so they need the support of additional treatments.
Introduction of new drug to approach breast cancer differently
This innovative medication presented by Asofarma S.A, acts by inhibiting the cell cycle, preventing the proliferation of tumor cells and the reproduction of malignant cells. It is a medication for patients with early stage breast cancer who have already undergone the indicated treatment: surgery, chemotherapy, endocrine therapy and/or rays. In addition, it presents toxicity that is different from classical therapies such as chemotherapy, thus causing other adverse effects.
Its function is to inhibit the cyclins CDK4 and CDK6, regulatory proteins of the cell cycle. In this way they stop cell proliferation and therefore the development of tumor cells.
The approval in Costa Rica is similar to that of the European Health Agency (EMA), being able to offer 2 years of this treatment in conjunction with hormone therapy, to those patients with positive hormone receptors, HER2 negative, positive axillary nodes and other high-risk factors of relapse, such as tumor size and high histological grade.
It should be noted that, in 2019, the use of this drug to treat metastatic cancer had already been approved, which was positive news for patients because it meant a therapeutic alternative to grant greater survival, without leaving aside the improvement in quality of life, often avoiding chemotherapy. Unlike that advance, this new indication is used to treat cancer in a non-metastatic stage. The treating oncologist will assess the risk of disease relapse in each particular case and the need to incorporate this innovative medication into the standard treatment prescribed for his patient.
Causes of breast cancer
There are different types of breast cancer, depending on which breast tissue cell it originates from (ducts, lobules, etc.). It can affect any woman and a very low percentage (approximately 1%), men. The chances of it appearing increase with age, especially after the age of 50. Early detection of breast cancer increases the chances of cure, for this the recommended method is mammography. All women between the ages of 50 and 69, with no personal or family history of breast cancer, should have a mammogram every one to two years8.
Risk factors and prevention
Although the causes of breast cancer are unknown, it is recognized that some factors increase the risk of developing it:
• Be older than 50 years.
• Family history of breast cancer.
• Previous treatment with radiotherapy directed to the thorax.
• Hormone replacement therapy.
• First menstruation at an early age and/or late menopause.
• Advanced age at the time of the first childbirth or never having had children.
• Being overweight, sedentary, and excessive alcohol consumption are factors that can be avoided to reduce the risk of breast cancer. Hereditary breast cancer represents only about 5-10% of all cases.
Symptoms
Palpable nodule(s), nipple retraction, changes in breast skin texture and color, itching or scaly lesions on the nipple, nipple discharge; many of these are sometimes asymptomatic.
Diagnosis and early detection
We cannot “avoid” the formation of breast cancer, but we can diagnose it early or in its infancy, achieving very high cure rates. Mammography can detect breast cancer when the nodule is not yet or minimally palpable. Early detection of breast cancer increases the chances of a cure.
It is recommended that all women from ages 40 to 69 get at least one mammogram every 1 to 2 years along with a physical examination of the breasts by a health professional. Both women under 40 and over 69 should consult with their doctor about whether or not to have a mammogram. Before a mammogram with an image suspicious for cancer or a physical examination that detects a visible and/or palpable lesion in the breast, a biopsy should be performed to define the treatment. A biopsy is the removal of cells and tissues that are viewed under a microscope by a pathologist to check for signs of cancer.
