The Solti Oncology Research Group This Mars celebrates an online scientific meeting in which the New Diagnostic Techniques and Treatments for Early-Stage Breast Cancer in Hospitals. Dr. Raquel Andrés, oncologist at the Lozano Blesa Clinic in Zaragoza, who coordinates the conference together with Dr. Joaquín Gavilá, clinical head of the Medical Oncology Service of the Valencian Institute of Oncology (IVO), affirms that this disease has been less affected by the covid pandemic than other oncological pathologies, although it recognizes that patients “have faced great isolation” during this health crisis, especially in the first wave.
During 2020, 8,591 new cases of cancer have been diagnosed in Aragon, of which 981 are breast, specified from the Spanish Association against Cancer in Aragon. By type of cancer, according to the AECC data, the colorectal continues to lead, with 1,201 new cases, followed by the prostate (1,001). Next is the breast. It is the type of cancer, says Dr. Andrés, “with the highest incidence and prevalence in women.”
The Spanish Society of Medical Oncology (SEOM) estimates that last year one out of every five cases of cancer in Spain was stopped last spring due to health saturation produced by the covid. “The pandemic -according to Raquel Andrés- decreased the number of confirmed cases compared to previous years, especially in March and April, and from that date, those diagnosed were more advanced because they had not been able to benefit from a early diagnostic”. There was a delay in diagnoses, some treatments were suspended and therapeutic guidelines were modified, “but the situation that cancer patients have suffered the most has been isolation.” However, it clarifies, “in breast cancer, possibly the impact has been less than in other oncological pathologies” because, among other reasons, he says, “the prevention program was not stopped in a significant way”. And furthermore, this type of surgery does not require a stay in the ICU: “Thanks to this, it decreased little in that period. Except for March and April, I think the care has been the same as in the pre-covid era. In fact, the diagnoses have not varied with respect to other times “. At the Clinic about 200 new cases of breast cancer are confirmed per year: “We have been working normally since May.”
For Dr. Andrés, “In general, cancer patients have suffered from being isolated from family and friends” because “from the psychological point of view they need to be closely accompanied”. At first, he says, face-to-face and telematic visits alternated. He also recalls that a home medication dispensing system was set up from the Clinical Hospital, which was organized by the Pharmacy service, “which had great collaboration, so that no one saw their treatment interrupted and there was continuity” .
The Solti Outreach Aragón meeting, to which more than 200 participants have registered, will be entitled ‘Early breast cancer in 2021: What have we learned so far?’. The objective of these conferences, which are organized in virtual format, will be to reflect on the new diagnostic techniques and treatment of breast cancer in early stages since, thanks to the screening programs, tumors are detected much earlier and the therapies are much less aggressive, pharmacological and also surgical.
Dr. Andrés explains that since 2018 in Aragon “Most women with the most common type of breast cancer, luminal hormone receptor-positive and diagnosed early, benefit from genomic testing to determine if they can avoid chemotherapy after surgery.”. This test, called Oncotype, is included in the portfolio of Health services, he indicated. Furthermore, and according to the results of a study at the San Antonio breast cancer symposium held in December: “We will shortly extend the indication of the test to a greater number of patients, those who also present lymph node involvement and who, likewise , they could save having to undergo chemotherapy treatment. ” His goal is to “avoid unnecessary treatment.”
The usual practice in the past was for breast cancer patients to have all the lymph nodes in the armpit removed when a breast tumor was operated on. For more than a decade, By performing sentinel lymph node biopsy, a minimally invasive technique, it has been possible to significantly reduce the number of axillary lymphadenectomies that were previously done routinely. In Aragon there are multidisciplinary committees made up of specialists in Gynecology, Breast Surgery, Plastic and Reconstructive Surgery, Medical and Radiation Therapy Oncology, Radiodiagnosis, Pathological Anatomy and Nuclear Medicine, which study each case and decide individually and personally which are the best options diagnosis and treatment for each patient. “The performance of the sentinel node has been optimized, incorporating new detection techniques, which benefit a greater number of patients”, Explain. The meeting will also deal with the practice of intraoperative radiotherapy: “It is aimed at the concept with which we work: being less aggressive but giving what each patient needs, and avoiding overtreatments”.
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