EN
According to WHO, about 1.5 million women worldwide get diagnosed with breast cancer every year. In developing countries, breast cancer accounts for approximately 20% of all cancers. Women’s mortality from breast cancer is in third place after heart and vascular diseases and accidents. How can modern medicine help us? What methods of treating breast cancer are used by the best doctors in the world to rid women of this disease?
Listen to the article:
Modern breast cancer surgery
The basis of the treatment in breast cancer is the surgical removal of the tumour. For this purpose, a lumpectomy or mastectomy is performed, depending on the stage.
A lumpectomy is an organ-preserving surgery. Such a procedure is possible if the tumour is less than 2 cm in size and the surgeon can access it. This type of operation removes the neoplasm itself, a small area of tissue near it and armpit lymph nodes.
After this lumpectomy, the patient quickly recovers. The breasts keep the natural look and sensitivity. But this procedure has a disadvantage. After the lumpectomy, the area where the tumour was located needs to be irradiated to get rid of all the cancer cells precisely. This therapy lasts another 7 weeks.
Also, when comparing a lumpectomy and mastectomy, the risk of relapse after the first one is significantly higher.
Israeli experts believe that 75-80% of patients from developing countries could have organ preservation surgery instead of mastectomy. However, this requires effective radiation therapy. In Israel, such treatment is provided by Professor Schlomo Schneebaum.
Mastectomy is the total removal of the mammary gland and axillary lymph nodes. In this type of surgery, radiation therapy is usually not prescribed, and patients also have a reduced risk of relapse. However, breast loss can be a huge stress factor for women. That is why reconstructive plastic surgery is at a high demand in the world’s best clinics, and a lot of attention is paid not only to fighting cancer but also to preserving the quality of life of the patient.
Recovery of breasts after mastectomy
Today, breasts can be restored using tissue from another part of the body or with silicone and physiological implants. The reconstruction takes place at the same time as the mastectomy or in gradually so that the skin can stretch and blood flow can resume. Special expanders are used for stage-by-stage reconstruction, which is gradually filled with fluid, increasing their volume and reducing tissue trauma.
When breasts are restored with their tissues, the necessary ‘material’ is taken from the abdominal, thigh or buttocks area. These are microvascular surgery methods called DIEP and SGAP. This type of procedure is quite complex. It must be performed by an experienced surgeon who will minimise the risk of ‘vascular mismatch’ and tissue rejection. Innovative methods are being developed today that try to avoid this “mismatch”, such as SADIE (a method that has combined the two previous techniques).
Some of the most successful specialists in lumpectomy and breast reconstruction mastectomies are practising in clinics in Israel, Germany and Turkey. These are Prof. Schlomo Schneebaum (Ichilov Clinic, Israel), Prof. Mordechai Gutman (Assuta Medical Centre, Israel) and others. These doctors have success rates of 85-90% in treating breast cancer.
The cost of mastectomies with reconstructive plastics abroad is approximately:
| Procedure |  Turkey |  Germany |  Israel |
|---|---|---|---|
| Mastectomy with reconstructive surgery | from $10,000 | from €16,000 | up to $14,000 |
Radiation Therapy for Breast Cancer
Radiation of the tumour is prescribed to the patient to reduce the neoplasm before surgery, to influence the remaining cancer cells after surgery or as palliative care in the final stages.
Under what conditions is radiation therapy not required?
Radiotherapy is not required if:
The size of the tumour is less than 2 cm and the cancer cells are sensitive to hormones – then hormone therapy is performed.
If there are no cancerous cells in the lymph nodes.
Radiation therapy is contraindicated for pregnant women before the birth of their child and for patients over 70.
Ultra-modern radiotherapy units are used to treat breast cancer at all stages:
RapidArc – provides variability and speed of dosage,
Intrabeam – radiation during the surgery,
IMRT – modulation of radiation intensity,
Hypofraction stereotactic radiation therapy – high dose of cancer cells without affecting healthy tissue.
Brachytherapy is also a type of radiation therapy. This type of therapy involves placing a radioactive substance in the tumour area.
Modern radiotherapy facilities, as well as qualified radiologists, are available:
The cost of Intrabeam therapy during surgery is:
| Country | Cost |
|---|---|
| Israel | from $7,000 |
| Germany | from €8,000 |
at Turkish clinics Liv Hospital, Memorial, Medical Park;
in the Israeli Ichilov Clinic;
German Rechts der Isar Hospital and other leading clinics worldwide.
Hormone therapy for breast cancer
Hormonal therapy is used:
as preventive therapy for breast cancer;
in addition to surgical treatment at an early stage;
in the metastasizing form of cancer.
With effective hormone treatment, the risk of recurrence can be reduced by 40%. The essence of hormone therapy is to inhibit the production of estrogen, on which cancer cell growth depends. Hormonal therapy uses anti-estrogens, aromatase inhibitors (for women in menopause), drugs to suppress ovarian function, and ovarian ablation procedures.
Chemotherapy for breast cancer
Chemotherapy drugs destroy cancer cells. This is necessary:
before the operation, to reduce the tumour volume;
after surgery to reduce the risk of recurrence;
as palliative care.
Chemotherapy can be avoided if a tumour is diagnosed at an early stage when it does not exceed 0.5 cm in size. At one of the best clinics in Turkey, Liv Hospital, the latest generation of chemotherapy treatments costs from $1,500.
Read: Targeted therapy for breast cancer
One of the innovative treatment methods for breast cancer is targeted therapy using special drugs – monoclonal antibodies. Such a drug is Trastuzumab (Herceptin), which has demonstrated revolutionary efficacy in HER2-positive breast cancer. The drug finds this receptor and blocks it. Thanks to Trastuzumab, 15% of patients with metastatic breast cancer have remission in the final stages within 13 months.
Trastuzumab refers to conjugated monoclonal antibodies that are combined with radioactive substances or chemical preparations. Once the drug has bonded with the cell, it releases radio- and chemical elements that destroy the tumour. These monoclonal antibodies combine 3 methods in one: immunotherapy, radiotherapy and chemotherapy.
In 2020, the FDA approved another drug for the treatment of severe breast cancer – Тukysa. It is prescribed to patients with HER-2 positive breast cancer with metastases. The two-year survival rate of women treated with this drug is 44.9% – almost twice as high as with alternative treatments.
Proton therapy for breast cancer
Proton therapy is a modern alternative to radiation therapy, which is used in the treatment of breast cancer. Instead of X-rays, a focused proton beam affects the tumour. It influences the healthy tissue around the tumour to a lesser extent, which reduces the risk of second cancer and also causes fewer side effects. The three-year survival rate of patients with metastasis-free breast cancer after proton therapy is 97.2%.
There are still around 20 proton therapy clinics in Europe. Among the most accessible is the Quironsalud Proton Therapy Centre in Madrid, Spain. Approximately 800 patients are treated there every year.
The cost of the proton therapy course at the Quironsalud Centre is about €60,000
Resume
Foreign clinics practice effective breast cancer treatment methods that are often unavailable in less developed countries: organ-preserving surgery, modern radiation and proton therapy, gentle courses of chemotherapy, hormonal therapy and targeted therapy. The survival rate for breast cancer in underdeveloped countries is 60-70%, while in wealthier areas it is 97%.
Expert doctors who treat international patients believe that 75-80% could have organ preservation operations instead of mastectomies.
Among the clinics that specialise in the treatment of oncological diseases, the Quironsalud Hospitals Network in Spain, the Rechts der Isar Clinic in Germany, the Ichilov Hospital in Israel, the Medical Park Clinic in Turkey and others have been particularly successful in treating breast cancer.
Leave your phone number on the website to get more detailed information about modern breast cancer treatment methods and their cost from our coordinating physician.
