Breast cancer is the most common malignant tumor affecting women. Currently, its optimal treatment is associated with a multidisciplinary approach in which surgeons, oncologists, pathologists, radiologists, nuclear medicine specialists, plastic surgeons and radiotherapists are involved.
Breast cancer is the most frequent malignant tumoral process in women. In the Western world it is a worrying process, as it is the second leading cause of death because of cancer among women 40 to 44 year-old. Radical surgery and the treatment in the hands of just one specialist were abandoned long ago. In our Hospital, we have understood that breast cancer needs a multidisciplinary unit formed by oncologists, surgeons, gynecologists, plastic surgeons, radiologist, pathologists and nurses trained in surgical care and drainage management. This team must respond to the development of measures with the aim of updating the state-of-the-art advances in breast cancer treatment. This unit must guarantee that the patient receives the treatment recommended by scientific studies and professionals all over the world that are involved in this type of illness.
The diagnostic and therapeutic process begins with the acquisition of samples of the tumoral tissues following the standard (but not obsolete) biopsy techniques: core needle biopsy and mammotome.
The study of each specimen allows an individual study of each tumor according to the histological pattern (size of the tumor, vascular invasion, degree of histological differentiation, immunohistochemical pattern), which is the form of certain molecules: Ki 67, Her-2/neu, p53, estrogen and progesterone receptor and hormone patterns, and finally, the acquisition of an genetic profile inherent to the tumor.
The individual treatment involves the work of oncologists and surgeons.
Neoadjuvant chemotherapy is offered to patients with local advanced illnesses or those with big tumors which reduce their size and are therefore subsidiary to conservative surgery.
Conservative surgery is the standard technique as long as the proportion of the tumor and the size of the breast is suitable. In case of local advanced or multicentric illnesses, we offer mastectomy and immediate breast reconstruction techniques. Thus, we follow the principles of oncologic radicalism without forgetting cosmetics. The sentinel node biopsy with techniques from nuclear medicine is used as a routine, therefore axillary lymphadenectomy is restricted exclusively to patients with the illness located in the axilla. Nuclear medicine is also used to help the doctor in the exeresis of suspicious or not palpable lesions instead of the classic needle localization, and therefore the positive margins of the specimen are reduced significantly. Finally, our portfolio of services includes the surgical exeresis of distant metastasis (lung, liver) when recommended.
Indeed, in the case patients with a number of liver metastases that limit the surgical resection, they can benefit from radiofrequency and ultrasonography, and radiation surgery (external radiotherapy focused exclusively in liver metastases).
The adjuvant treatment for breast cancer (a systemic illness) is, without any doubt, one of the most relevant medical actions. The oncologists in our Hospital apply the best regimens combining anthracyclines, taxanes, hormonal therapy and monoclonal antibodies (trastuzumab) in breast cancer (whether with axillary affectation or not) in high-risk genetic profiles. Radiotherapeutic adjuvant treatment reduces, in certain cases, risk of relapse, and also the increase of chances of recovery from the illness.
There is a psychological counselling office available, in case the patient needs it.
Finally, relatives can find genetic advice, and thus they will be able to reduce the anxiety that sometimes surpass the logical level.