Curing breast cancer: Here are the odds

Almost unthinkable just a few years ago: today the chances of a cure for breast cancer are 90 percent. When women take the right precautions.

The fear was always there, since I was 17 years old. Back then, 22 years ago, my aunt Annegret was diagnosed with breast cancer. I knew from magazines that I had a slightly increased risk of getting a tumor myself. But I was sure: not you! You won’t get this terrible disease! Every month I felt my breasts in the shower. I went to regular screenings, ate healthier than most of my friends. I just took care of myself.”

knots after weaning

Nevertheless, Marita T., a primary school teacher from Frankfurt, was left cold. Two years ago she had a daughter. “After weaning, I felt a lump in my left breast. I couldn’t believe it, I kept hoping until the last second that it was a harmless cyst.” A mammogram plus an ultrasound confirmed a bad suspicion.

The doctor even discovered two knots. Both just under 1 centimeter tall. “The world stopped. I ran like through cotton wool, there was only an oppressive silence around me. Never before have I felt so vulnerable and vulnerable. I wanted my old life back – and yet I knew that I had to fight now. Cancer has no place in my life. That my daughter and my husband need me!” A detailed examination of the removed tissue then brought definitive, malignant clarity. Just four days later, Marita T. got an appointment for an operation in the University Clinic in Frankfurt am Main.

High chance of recovery

High chance of recovery

Breast cancer is still the most threatening disease for women. More than 57,000 suffer from it every year. Doctors will discover breast cancer in about every tenth woman during her lifetime. 19,000 patients per year die from the disease. But the bitter diagnosis is increasingly losing its fright. “The chances of recovery from breast cancer that is detected early are now over 90 percent,” says Hilde Schulte, national chairwoman of “Frauenself-help after Cancer e. V.” And the procedure becomes more gentle from year to year. Thanks to new therapies and surgical methods, the breast can now be preserved in 70 percent of cases. Amputations will soon be the exception: “The rate of breast preservation has increased by 6 percent in recent years,” confirms Dr. Mahdi Rezai, Director of the Düsseldorf Breast Center at the Luisen Hospital.

Prevention is everything

“The best method for early detection of malignant changes in the breasts of women between the ages of 50 and 69 is currently quality-assured mammography screening,” says Prof. Dagmar Schipanski, President of the German Cancer Aid in Heidelberg. “Every second woman in this age group uses such a check-up. A good number. But 70 percent and more would be desirable. Seen across Europe, German women are still well below the average.”

Eat a low-fat diet

But diet can also help prevent it. A connection between certain diets and breast cancer has been suspected since the early 1980s. But only now has a study by the Potsdam Institute for Nutritional Research with 15,351 participants shown: If women eat too much high-fat food such as butter, margarine, cold cuts, sausages, hamburgers and processed fish, but not enough wholemeal bread and fruit juices, they develop over the course of six years, about twice as many breast cancer cases – regardless of weight, hormone replacement therapy or menopause.

Check clinic

check clinic

Choosing the right clinic is alsoTolfioow. Studies show that the chances of survival increase in a breast center with its specialization and high operation rate. In fact, a third of women still prefer to go to a nearby smaller county hospital that has very little experience, e.g. B. only treats 20 cases a year. Hilde Schulte: “It is important to ensure that the breast center is certified.” Because the term “breast center” is not protected. The quality is only assured if the clinic e.g. B. is certified according to the guidelines of the German Cancer Society (DKG). A certified breast center must prove that it treats at least 150 new cases per year and that each surgeon performs at least 50 operations per year.

Gene Detectives

In addition to improved early detection, breast cancer is also losing more and more of its secrets. Doctors can now obtain information about practically all genes that are active in the tumor from the tissue removed. “This genetic fingerprint reveals which tailor-made therapies can be used to fight the tumor most effectively,” says gynecologist Prof. Christian Singer, Breast Center at the University Clinic for Gynecology, Vienna. Is Cancer Hormone Dependent? Does he react to an anti-hormone therapy, for example with the yew extract and estrogen blocker “tamoxifen”? All of these questions can now be clarified before an operation. This has advantages: the chances of recovery increase, the side effects decrease.

Lower risk of relapse

Just a few years ago, the motto “first surgery, then chemo” still applied, but surgeons around the world are now rethinking it. Because the use of cell toxins before an operation, which are also combined with antibodies or, in rare cases, with antihormones, alone leads to a complete regression of the tumor in about 40 percent of cases. However, surgery is still required. Because there is no reliable method that can reliably detect whether the cancerous tumor has completely disappeared. But almost all tumors shrink in this way before they are removed, and the breast can be preserved in more and more cases. There are also significantly fewer secondary tumors (metastases). This greatly reduces the risk of relapse. This “systemic therapy” is used, which acts on the entire body, if the tumor is larger than 2 centimeters, is growing aggressively and involves lymph nodes. Experts estimate that this treatment will soon be even more successful. Promising attempts are already being made to power them up with active ingredients such as “biologicals” or “small molecules”. In other words, with drugs that directly intervene in the metabolism of the tumor cell and starve it out.

Immaculate breasts after surgery

Immaculate breasts after surgery

It is not just the diagnosis of breast cancer that frightens the women affected. They also fear that their breasts will no longer be attractive after the procedure. Wrongly, because the reconstruction of the operated breast is becoming more and more perfect. A study is currently examining the new technique of “lipofilling”. This is an injection with the smallest amounts of the body’s own fatty tissue, which is already firmly established in cosmetic surgery. “The surgeon sucks fat from the abdomen, hips or knees and injects it into the operated area in the chest,” explains reconstructive surgeon Dr. Mario Rietjens from the European Institute of Oncology in Milan. Advantage: Until now, irregularities in the breast – e.g. B. by large-area tumor removal or radiation-damaged tissue – to be operated on again under general anesthesia. With hospital stay and the risk of additional scarring. The autologous fat injection, on the other hand, is more of an outpatient procedure under local anesthesia – no worse than an injection of the lip folds.

New life

Marita T.: “I would love to say: ‘It’s behind me!’ But the scars still bother me. I also find it difficult to raise my arm. For the first few weeks after the procedure, I felt deeply exhausted. But then it slowly went uphill. Certainly also through the sources of strength that I was looking for. I regularly relax with yoga and qigong, sing in a church choir and work through my fears with a psycho-oncologist. But I also know that the statistical odds of beating cancer are on my side. I will live!”

Expert Interview & Tips

“Operations are becoming gentler”

dr Mahdi Rezai is director of the Düsseldorf Breast Center at the Luisen Hospital.

Tolfioow: Is life without a breast finally a thing of the past – even after an amputation?

DR. REZAI:Today, breast reconstruction is almost always possible. This can be done with modern silicone prostheses that are harmless to health. But also with autologous tissue from the stomach and back – or with a combination of both methods. Newly developed permanent expanders with an inner chamber that can be filled with saline solution and adjusted to allow gradual stretching of the tissue are also promising. In this way, the breast can be rebuilt immediately after the operation. Where do you see further progress towards a better quality of life for breast cancer patients? Operations today are generally gentler than they were just a few years ago. Doctors have rethought therapies with strong side effects such as chemotherapy. Today, the highest possible tolerable dose is no longer but the minimally most effective used. Another breakthrough is that the lymph nodes in the armpit are no longer removed so radically. As a result, patients are spared major problems such as painful lymphedema.

Crystal Waston MD

Crystal Waston has a degree in Cross Media Production and Publishing. At vital.de she gives everyday tips and deals with topics related to women's health, sport, and nutrition.

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