Breast cancer is a life-threatening disease that women should never overlook, regardless of age. At Thainakarin Hospital, we have a specialised Breast Center, staffed by a team of doctors, nurses, and medical personnel with extensive expertise in breast diseases. To aid in primary prevention, it’s vital that women avoid certain risk factors, including an unhealthy diet, obesity, alcohol consumption, and physical inactivity. Steering clear of these can help maintain a robust immune system and balanced hormones.
When it comes to diagnosing breast cancer, especially in patients with genetic abnormalities, precision is key. Here’s a breakdown of high-risk groups for genetic abnormalities in breast cancer patients:
- Diagnosed with breast cancer under 50 years of age
- Diagnosed with triple-negative breast cancer
- Male breast cancer patients
- Family history of breast cancer
- Diagnosed with breast cancer at 46-50 years old along with:
- Unknown family history of genetic abnormalities
- Diagnosed with bilateral breast cancer
- At least one first-degree relative with breast, ovarian, pancreatic, or prostate cancer
- Diagnosed with breast cancer at 51 years or older along with:
- At least one first-degree relative diagnosed with breast cancer at 50 years or younger, or male breast cancer
- Ovarian cancer
- Pancreatic cancer
- Metastatic prostate cancer
- At least two first-degree relatives with breast or prostate cancer
- At least three first-degree relatives with breast cancer
For individuals with a family history of breast cancer:
- A family history similar to the criteria above
- No family history but with an assessed likelihood of BRCA gene abnormalities greater than 5%, determined using models like Tyrer-Cuzick, BRCAPro, or CanRisk.
4 Methods for Breast Cancer Diagnosis:
- Breast Cancer Screening with a Digital Mammogram: This method uses radiation levels similar to a regular chest X-ray and provides a detailed overview of the breast. It’s effective in detecting small calcium deposits that may suggest early-stage breast cancer. However, in younger women with dense breast tissue, a digital mammogram might not be sufficient, and a breast ultrasound may be needed.
- Breast Cancer Screening with a Breast Ultrasound: Ultrasound, which is radiation-free, is ideal for children and pregnant women. It offers an accurate distinction between lumps, cysts, and lymph node abnormalities. While it’s excellent for evaluating lumps, it may not detect calcium deposits as efficiently as a digital mammogram.
- Breast Screening with Magnetic Resonance Imaging (MRI): Though highly sensitive, MRI does not offer greater accuracy in diagnosing breast cancer compared to mammograms or ultrasounds. It’s mainly used for difficult diagnoses or screening individuals with genetic abnormalities.
- Diagnosis and Biopsy: When a suspicious lesion is detected, a biopsy is the most precise method to determine its nature. If an abnormality is found via ultrasound, an Ultrasound-Guided Core Needle Biopsy is performed by a radiologist. If detected via mammogram, a Stereotactic-Guided Biopsy is conducted, typically used to examine small lesions often consisting of calcium deposits. Both methods ensure the biopsy results are available within 24 hours.
Personalised Medicine Treatment and Surgery:
Treatment at Thainakarin Hospital involves a multidisciplinary approach for surgical and non-surgical treatments:
- Breast Conserving Surgery: Suitable for small tumors without widespread calcification, or cases with 2-3 tumors treatable with breast conservation surgery. Oncoplastic techniques are applied to maintain aesthetic appearance, possibly involving fat relocation or breast size adjustment for symmetry. Sometimes, chemotherapy is administered before surgery to reduce tumor size.
- Mastectomy with Reconstruction: When conserving the breast isn’t feasible, a mastectomy (complete removal) is followed by reconstruction using implants or the patient’s tissue.
- Sentinel Lymph Node Biopsy: This method examines the first lymph node to check for cancer spread, minimizing the need for extensive lymph node removal and associated complications. Special dyes like Isosulfan Blue or Indocyanine Green increase accuracy.
Systemic Treatment and Radiation Therapy:
Treatment options include chemotherapy, immunotherapy, hormonal therapy, or targeted therapy. Radiation therapy, guided by advanced equipment like the Vitalbeam system, ensures precise targeting. Each patient’s treatment plan is tailored to their specific cancer type, stage, hormone receptor status, age, and personal preferences.
Recovery and Reducing Complications:
Physical Medicine & Rehabilitation (PM&R) helps minimize post-treatment complications such as arm swelling or frozen shoulder. The goal is to restore normal daily functionality, preserve body image, and reduce anxiety, ensuring the best possible recovery.
Highlights of the Excellent Breast Cancer Center at Thainakarin Hospital:
- Tissue Biopsy: Performed by specialized radiologists with results within 24-48 hours.
- Breast Conserving Surgery: Not contraindicated even with 2-3 nearby lesions, utilizing oncoplastic techniques, and coordinated with a radio-oncologist for comprehensive planning.
- Medical Oncologists: A dedicated team plans adjuvant therapy as needed, before or after surgery.
- Physical Medicine & Rehabilitation: Postoperative programs ensure patients maintain a quality life close to normal.
- Vitalbeam Radiation Therapy System: Enables targeted radiation, reducing complications and the need for extensive lymph node removal.
Article by Dr. Puttiporn Naowaset, Surgery, Surgical Oncology at Thainakarin Hospital.
This article is encouraging, but the fact remains that women still aren’t getting regular screenings. Education alone isn’t enough if access to screenings remains limited.
Exactly! There are many areas, especially in rural communities, where access to comprehensive breast cancer screenings is virtually nonexistent.
Perhaps mobile screening units or telehealth consultations could bridge the gap until more permanent solutions are in place.
True. More needs to be done to ensure low-income women can access these services without the financial burden.
Interesting point about MRI not being more accurate than mammograms or ultrasounds. I’d assumed MRI would be the gold standard for all diagnosis.
MRIs are indeed highly sensitive, but they can lead to false positives, which might result in unnecessary procedures and anxiety.
Exactly! That’s why a balanced diagnostic approach is imperative. Each method has its pros and cons, depending on the patient’s specific situation.
Preventive measures like diet and exercise should receive more attention. Many cases could be prevented with lifestyle changes alone.
While I agree, it’s not always that simple. Genetic factors play a significant role that lifestyle changes can’t mitigate.
But surely, combining lifestyle adjustments with genetic testing and medical oversight can provide the best outcomes overall.
True, but promoting a healthier lifestyle can have benefits beyond just reducing cancer risk. It’s a win-win.
Is anyone else concerned about over-diagnosis? Too much screening could lead to unnecessary treatments.
That’s a valid concern. Over-diagnosis can indeed cause more harm than good in some cases.
Over-diagnosis is a well-known issue, but the key lies in balancing screening with careful, individualized care.
The article didn’t mention the emotional toll of breast cancer diagnosis and treatment. It’s not just about the physical, you know.
Cutting-edge technologies like the Vitalbeam system are impressive. They really show how far cancer treatment has advanced.
It’s great to see a specialized approach for male breast cancer too. Often, men’s issues get overshadowed in discussions about breast cancer.
One thing the article missed is the importance of mental health support during and after treatment. This can make a huge difference in recovery.
Absolutely, mental health is crucial, and hospitals need to integrate these services more comprehensively.
The environmental impact of medical waste from such treatments is rarely discussed. We need more sustainable medical practices.
Isn’t relying on high-tech solutions like the Vitalbeam system limiting accessibility for lower-income countries?
True, but technological advances often trickle down, making earlier models more affordable for those regions.
Indeed, which is why international collaborations and donations of older equipment could be a game-changer.
Thainakarin Hospital seems to have a very comprehensive approach. It’s a model worth replicating globally.
Easier said than done. Many healthcare systems are underfunded or lack the infrastructure to implement such comprehensive care.
I agree it’s challenging, but incremental steps can be taken. No one is suggesting a complete overhaul overnight.
Why is there no mention of alternative treatments? Many people swear by natural remedies to complement their medical treatment.
While some alternative treatments can be supportive, they should never replace conventional methods. Always consult with your oncologist.
I’m glad they are emphasizing the importance of a quick biopsy turnaround. Waiting weeks for results can be agonizing.
The role of personalized medicine in breast cancer treatment is truly revolutionary. One-size-fits-all approaches are becoming obsolete.