New therapeutic targets, a “revolution” in precision medicine against breast cancer

The results thanks to the new therapeutic targets in the treatment of breast cancer represent a “true revolution in precision medicine against this disease that mark a before and after in its approach”, as indicated by the head of the Medical Oncology service from the Hospital Quirónsalud Córdoba, María Jesús Rubio, who recalled that it is the most common type of tumor in women, of which more than 26,000 new cases are diagnosed a year in Spain and two million worldwide.

Dr. Rubio explained, on the occasion of the celebration tomorrow of the International Day Against Breast Cancer, that early diagnosis is the “fundamental piece to increase survival to breast cancer, together with advances in research and personalized treatments . In this sense, he pointed out that the year 2020 has been marked by the Covid-19 pandemic, which has affected many women with breast cancer due to the fear of going to a hospital, so this day dedicated to cancer of breast “we must remember the importance of reviews for early diagnosis.”

The specialist has emphasized that in 2021 there have been great advances in research, so “we must be optimistic as we have more elements for the treatment of breast cancer in a personalized way, with a precision and specificity that allows us to address the disease in an integral way and with more possibilities of cure ”. One of the most significant advances since last year focuses on the study of DNA that allows predicting the response to treatment, since knowing, in addition to the histology of the tumor, its biology, “gives us the opportunity to perform precision medicine, that is, to apply the right treatment at the right time ”.

The knowledge of the existence of different biological subtypes of breast cancer has allowed the development of drugs aimed at these molecular alterations, which has improved the quality of life of patients through the use of personalized treatments. He added that today “it is considered that there are no cancers, there are people

with cancer, each one with different characteristics, with personalized therapies that make medicine more effective ”.

The survival of women who suffer from this disease has improved a lot in recent decades, so it is essential, Dr. Rubio stressed, to carry out screening in the population and that in the event of any injury women should go to the hospital for mammography and all the explorations that allow diagnosing the disease and ensuring the best treatment strategy.

Dr. Rubio has indicated that between 5 and 10% of breast tumors are hereditary, so in cases where this is suspected – women under 40 years of age, triple negative tumors or with a family member who has had breast cancer- it is advisable to carry out a genetic study. This study allows us to know the risk of suffering from breast cancer throughout life, which gives the possibility of establishing differentiated preventive measures, as well as being able to receive treatment aimed at these genetic mutations. In addition, if it is confirmed that the tumor is hereditary, the study would also be carried out in direct relatives.

For her part, Esther Velasco, gynecologist at Hospital Quirónsalud Córdoba, has insisted that breast cancer is the most frequent gynecological cancer, but, at the same time, the possibility of surviving this disease has increased a lot in recent years. For this reason, it is “essential to speak with the gynecologist about the suitability of the screening tests to decide which is the most appropriate strategy in each case.”

In addition, Dr. Cristina Márquez, a breast radiologist at the Quirónsalud Córdoba Hospital, has insisted on the importance of detecting and diagnosing breast cancer before it shows symptoms, since the stage of the tumor at the time of diagnosis continues to significantly affect to overall survival. Therefore, “the goal is to treat cancer early to improve survival and reduce the need for more aggressive treatments.” In addition, it has highlighted that mammography is the only test that has proven its effectiveness in reducing mortality from this disease by up to 30%.

Increase in conservative surgeries

Another fact of great relevance in recent years has been the increase in conservative surgeries and less intervention on the armpit with the use of the sentinel node, avoiding complications and improving the quality of life of women with breast cancer. Of every 100 interventions for breast cancer, 85 do not require axillary dissection thanks to selective biopsy of axillary sentinel nodes, and 80% preserve the breast thanks to new surgical techniques (oncoplastic surgery) and preoperative chemotherapy. In addition, coordination with plastic surgeons allows, in the case of mastectomy, to perform a reconstruction of the breast in the same surgical act, as indicated by Dr. Guillermo Bascuñana, general surgeon of the Comprehensive Breast Unit.

Comprehensive Breast Unit

The Quirónsalud Córdoba Hospital has a Comprehensive Breast Unit, which offers patients a multidisciplinary approach in making decisions about breast disease with special attention to early diagnosis of breast cancer, as well as comprehensive treatment (local and systemic), genetic counseling if necessary, and follow-up of the disease.

The Diagnostic Imaging service plays a key role in the early detection of breast cancer. The Quirónsalud Córdoba Hospital has a 3D mammography equipment with tomosynthesis, which increases the sensitivity of the mammographic study, especially in dense breasts, allowing the detection of smaller cancers, in earlier stages, and thus reducing the aggressiveness of the treatments in patients, both from the surgical and oncological point of view.