Early detection of breast cancer can be important not only for prognosis but also for the scope and intensity of treatment. What are the differences between self-examination, diagnostics, and screening? What does modern radiotherapy look like? What should you do if you feel a disturbing change? Konrad Zasadziński, a physician from the Department of Radiotherapy at the Maria Skłodowska-Curie National Institute of Oncology, answers the most important questions.
Reserve a place for your health
As part of the nationwide Pink October campaign, "This place is reserved for your health," the Rakiety Oncological Foundation is reminding people about breast cancer prevention where everyday life takes place – in cafes, libraries, cinemas, theaters, beauty salons, yoga and Pilates studios, workplaces, and public institutions. Special signs symbolically reserving chairs and armchairs for health have been placed in over 230 locations across Poland. This is a simple reminder that between work, meetings, responsibilities, and moments of relaxation, it's also worth finding time to get to know your body, get appropriate preventative checkups, and consult with any disturbing changes. The campaign is under the honorary patronage of the Minister of Health.
The pink pendant starts a conversation, but its symbol should be backed by solid knowledge. That's why, as part of the campaign, we're giving the floor to experts and answering questions that may arise during prevention, diagnosis, and treatment. Below, we publish the full interview with doctor Konrad Zasadziński.
Why does the timing of breast cancer detection matter for the possibilities and scope of treatment?
Breast cancer diagnosed at an early stage is a disease that can be completely cured and is treated with this intention. In the era of modern oncological treatment, long-term disease-free survival rates of 90-95% are achieved in early breast cancer, and even higher in some groups of patients with very early changes.
Early diagnosis, however, is important not only for prognosis. It also typically allows for less burdensome treatment for the patient – a smaller surgical scope and shorter and better-tolerated systemic therapy. Small tumors can usually be removed while sparing the breast, and increasingly, we can limit the scope of surgery to the axillary lymph nodes, and in some patients, even avoid chemotherapy. It's important to remember that tumor size alone isn't everything. Nowadays, its biology also plays a significant role – the presence of hormone receptors, the HER2 receptor, or the so-called triple-negative subtype of breast cancer. Therefore, even small tumors sometimes require intensive systemic treatment.
How to explain the difference between self-examination, diagnostics and screening?
Self-examination, which involves self-examination and palpation, is a fundamental method for learning about one's own breasts. Regular self-examinations help women become aware of how their breasts look and feel, making it easier to notice any new changes in their appearance or firmness. The most obvious symptom that can be detected during a self-examination is a new, palpable lump or thickening in the breast or armpit. Other symptoms should also prompt an urgent medical consultation, such as: a change in the shape or size of one breast, localized indentation of the nipple or a section of skin on the breast, bloody or spontaneous nipple discharge, thickening of the skin or an "orange peel" appearance, persistent redness, or a non-healing lesion on the nipple.
It's important to remember that self-examination is not a screening test and does not replace mammography performed as part of breast cancer prevention. Detecting a lesion during self-examination and/or a medical examination leads to diagnosis, a process that begins with patients exhibiting specific symptoms. Appropriate imaging tests are performed, such as mammography, breast and axillary ultrasound, and in some cases, magnetic resonance imaging. Based on their results, a decision is made about a potential biopsy of the lesion to ultimately confirm its nature with a microscopic examination. It should be clearly emphasized that NO each detected Change breasts means tumor mean Many changes felt in the breast are benign—these may be cysts, fibroadenomas, or hormonal changes. Diagnostics are therefore used to definitively determine the type of change we are dealing with.
Returning to screening tests, in the case of breast cancer they are part of the so-called secondary prevention, i.e. they serve early detection diseases at patients, which NO May none symptoms, but they belong to the population most at risk of developing the disease. The goal is to detect early-stage cancer before it becomes palpable, to increase the chance of a complete cure while limiting the scope of necessary treatment. In Poland, the cornerstone of the breast cancer screening program is a free mammogram, generally performed every two years for women aged 45–74. You can schedule a screening at any facility participating in the program (a list of locations is available on the National Health Fund website); no referral is required; all you need is an ID card.
What role does radiotherapy currently play in the treatment of breast cancer?
The role of radiotherapy in breast cancer treatment is evolving significantly, but its primary indication—adjuvant radiation following breast-conserving therapy—remains unchanged. Radiotherapy significantly reduces the risk of cancer recurrence in the treated breast and, consequently, contributes to improved long-term treatment outcomes.
Modern radiotherapy is very different from that of a dozen or even decades ago. Thanks to new techniques, such as 4D radiotherapy with deep, breath-hold irradiation, we can precisely control the dose distribution, down to the millimeter. This allows us to minimize radiation doses to healthy tissues, and consequently, possible side effects of radiotherapy. This approach is now standard, especially in the treatment of the left breast, where we want to minimize the dose received by the heart.
A huge change in recent years is also reduction time treatment. Just a dozen or so years ago, radiotherapy for breast cancer patients was standard about five weeks. Later, three weeks became the standard, and now in many patients the entire radiotherapy can be completed In five 10-minute sessions irradiation In during one week of treatment.
Radiotherapy is also playing an increasingly important role in the treatment of regional lymph nodes. In some patients with mild sentinel node involvement, extensive removal of all axillary nodes can now be avoided. Depending on the specific clinical situation, irradiation of the appropriate area may replace more extensive surgery. This is important because complete axillary lymphadenectomy (lymph node removal) carries a risk of chronic lymphedema of the arm.
What do patients fear most about radiotherapy and which of these fears result from outdated knowledge?
Many concerns about radiotherapy date back to the days when treatment techniques were significantly less precise, and when irradiating the treated area also deposited the dose in a significant volume of normal tissue. Treatment came at the cost of significant side effects on healthy organs such as the skin, heart, and lungs. Today, there is no radiotherapy facility in Poland that uses such techniques to treat breast cancer patients. Modern procedures based on advanced algorithms for dose planning within the patient's body are used, significantly reducing treatment toxicity by delivering the radiation dose only where necessary.
For example, patients often ask if they will "radiate" after radiotherapy. With standard radiotherapy, the answer is: NO. After completing the radiation therapy session, the patient is no longer exposed to radiation and can normally interact with children, pregnant women, and other family members. Another common concern is hair loss. During breast radiation therapy, scalp hair does not fall out because it is located outside the treatment area.
The most common side effects are much more prosaic: temporary redness and irritation of the skin, mild breast swelling, and fatigue. These usually subside within a few weeks of completing treatment.
What should a person do if they have just sensed a disturbing change and don't know where to start?
First of all, don't panic, but also don't put things off for a few months and not wait for the next scheduled screening test to observe the change.
The first step should be to consult your family doctor, gynecologist, or a breast cancer clinic. The doctor will examine the breast and decide which imaging test is appropriate: mammography, ultrasound, or possibly breast MRI; sometimes a combination of these tests may be necessary. After these tests, it is assessed whether the lesion requires further examination or a more in-depth diagnosis. If the image raises suspicion of cancer, the next step is usually a core needle biopsy guided by ultrasound. A histopathological examination allows for the final diagnosis of the lesion.
It is worth remembering one thing: majority perceptible changes NO it turns out myself cancer, but any new, persistent change should not be ignored. In breast cancer, time can truly impact not only the prospects for a full recovery, but also how intensive treatment will be needed.
Prevention doesn't end with October
Pink October is an opportunity to start a conversation about breast health, but oncological awareness should be maintained year-round. Getting to know your body helps you notice changes, but it doesn't replace screening tests or diagnostics by a doctor.
If you notice or feel a change that worries you, don't delay your consultation. Remember, however, that detecting a change doesn't automatically mean you have cancer.
– its nature can only be determined in the course of appropriately selected diagnostics.
For more information about breast cancer prevention, testing, and responding to disturbing symptoms, please visit www.rozowypazdziernik.pl
Don't postpone yourself. Make room for your health.
The material is educational in nature and does not replace an individual medical consultation.stick.
