Medical care of breast cancer

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Extract from the article: Breast cancer is one of the most serious cancers with a significant mortality rate. In Togo, reducing mortality from this cancer is a major public health challenge. The management of breast cancer has been greatly improved over the

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Breast cancer is one of the most serious cancers with a significant mortality rate. In Togo, reducing mortality from this cancer is a major public health challenge. The management of breast cancer has been greatly improved over the years with the progress of therapeutics and diagnostic tests. Today, it is possible to cure it in the vast majority of cases.

Breast cancer is a disease that can manifest itself through several signs. « It can be a change in the skin of the breast. The skin becomes shrunken, it can be reddish, ulcerated or have the presence of small dots that look a bit like the skin of an orange; and we classically speak of the orange peel appearance. Breast cancer can also manifest itself by a change in the nipple, which can be retracted. It looks as if it has gone into the breast. It can also be the presence of pain in the breast, the presence of a lump or a mass that can be found in the breast », says Dr Solange Adani-Ifè, Medical Oncologist.

Sometimes breast cancer can also be manifested by « nipple discharge which can be bloody or pinkish or simply an abnormal discharge, when the patient is not a breastfeeding woman. The presence of a lump or mass in the stool, the change in volume of one breast that may appear larger than the other are manifestations that can announce the presence of breast cancer », says Dr Solange Adani-Ifè. 

Diagnosis of breast cancer

The diagnosis of breast cancer is based on several steps. The first is a consultation with the specialist, who carries out a clinical examination of the breasts and an interrogation. In the event of a suspicious anomaly, the practitioner requests a mammogram and a breast ultrasound. Depending on the results of these imaging tests, a biopsy of the observed mass is scheduled. This examination allows for the analysis of a sample of tissue and cells taken directly from the abnormal area visualised on imaging. The analysis takes place in a pathology laboratory.

If the doctor deems it necessary, he or she may prescribe other complementary examinations. All of these examinations make it possible to diagnose a malignant tumour and to determine its type, stage or extension. These elements are essential for deciding on the type of breast cancer treatment for each patient.

Choosing the right breast cancer treatment

The choice of cancer treatment is made during a Multidisciplinary Consultation Meeting (MCM). These meetings bring together several specialities, including oncology, radiotherapy, gynaecological surgery and anatomopathology. They take place at regular intervals to examine the files of diagnosed patients. The specialists then agree on a treatment plan adapted to the type of tumour and the patient's general state of health, personal and family medical history, and associated treatments and pathologies. When a decision is made, the doctor will provide a Personalized Care Plan (PCP) detailing the next steps.

Medical treatment of breast cancer

The management of breast cancer can be based on one or more of the treatments delivered alone or in combination to optimise results. Every situation is different. You may not receive the same treatment as another patient. These treatments are offered according to the disease profile and the stage at which the disease was diagnosed. « There is chemotherapy, which is a set of drugs that can be injected or taken orally and kills cancer cells. There are also what we call targeted therapies, which are drugs such as antibodies that target specific abnormalities on the cancer cells. We also have anti-hormonal drugs which we classically call hormone therapy. These are drugs that block hormone receptors that may be present on the surface of cancer cells. Finally, among the medicinal or medical treatments, there is immunotherapy, which is a set of drugs that stimulate the patient's immune system so that the immune system itself fights against the cancer that is developing in the body », explains the oncologist.

In addition to the therapeutic treatment of breast cancer, supportive care is available to provide additional support and help combat the clinical signs caused by the treatments. Several specialities are offered: massage therapy, physiotherapy, nutrition, psychology, pain management, and help with administrative procedures. The aim of this care is to improve the quality of life of patients during the treatment of breast cancer and afterwards by addressing each problem encountered. These may include pain, fatigue, anxiety, social difficulties and sexual problems.

Healing from breast cancer

« Yes! Breast cancer can be cured when detected at an early stage. After the cure, no further treatment is instituted but periodic monitoring is instituted », Dr Adani-Ifè insists. Once the tumour has been treated, post-cancer follow-up is maintained to ensure that there is no recurrence and that possible side effects are controlled. Consultations will be scheduled at regular intervals with each specialist involved in the therapeutic process throughout the disease.

William O.