Breast cancer has a cure?

All breast cancer is treatable but not all are curable. Depending on the stage at which the tumor was diagnosed (what we call staging), the doctor will use different strategies to better treat the patient. Depending on staging, the focus of cancer treatment may be curative or palliative.

Treatment for curative purposes: applies when tumors are located in the breast and even with axillary metastasis (regional metastasis), but not have reached other organs (systemic metastasis).

In this circumstance the focus is to cure the patient, and the physician will use the maximum cancer treatment. Surgery is the primary treatment; however, chemotherapy, hormone therapy and radiation therapy are the treatments used depending on the degree of need and the medical indication (not all patients will need all of the above mentioned modalities of treatment). This is the strategy used for patients with systemic metastatic disease (blood spreading from tumor cells originating from the breast to other organs with: bones, lung, pleura, liver, etc.). will aim to take good care of the human being and offer him the best method available so that he can be effectively cured, or for those cases where cure is not possible, that he can live with dignity and quality of life for the longest time

At this stage the disease can hardly be cured effectively, but it can be very well controlled. Very important factor in this topic is the amount of disease that the patient has, that is, the degree of contamination of the involved organs (what we call tumor burden). As an example, the number of metastatic nodules present, the size of these nodules, the number of affected sites (liver, liver + lung, liver + lung + bone) and the clinical condition of the patient. The lower the tumor burden the better the control of this patient. In these cases, the primary focus of treatment is to increase survival, reduce symptoms (pain, shortness of breath, loss of appetite, weight loss), and improve / preserve patients' quality of life. patients with systemic metastatic disease have treatment to offer. The focus here is to chronicle the disease allowing the patient to live as long and as well as possible.

When is a cancer cured?

This issue is quite controversial. Previously there was the idea of ​​the "magic number" of 5 years after treatment, which is often related to the end of hormone therapy (which usually lasts 5 years). It is true that most recurrences occur in the first five years after treatment, but today we understand that the breast tumor may have late recurrences (after five or even 10 years of initial treatment) depending on the biological type of tumor.

Therefore, this five-year number can no longer be applied strictly today, but requires periodic medical examination for life, at least once a year after this five-year period. We emphasize that this annual medical check-up is already the minimum that a woman after 40 years of age needs to perform with the oncologist / oncologist (even without previous diagnosis of cancer), as recommended by the Brazilian Society of Mastology and the Brazilian Society of Oncologic Surgery.

Well, but patients do not have to live with the specter of the possibility of lifetime relapse, since that fear will prevent the full purpose of medical treatment that patients live well. Our current understanding is that the patient should feel cured soon after the end of the surgical treatment and end of the chemotherapy / radiotherapy once there is no evidence of disease. That is, the patient should as soon as possible enjoy the fullness of his life already in the post-treatment phase, and not wait the 5 years to start enjoying life again. But you should always keep a close medical check.

If the tumor returns someday (relapse), depending on whether this recurrence occurred in the breast, the armpit or some other organ, the treatment would be restarted using the treatment strategies discussed at the beginning of the text.

Breast cancer, like all other tumors, will have the greatest chance of cure the earlier it is diagnosed, that is, the smaller the mammary nodule at diagnosis, the absence of metastasis in the axillary ganglia and the absence of metastasis in the others

Another criterion each time more prominently is the subtype of breast cancer. Not all breast tumors are the same. There are more aggressive tumors and less aggressive tumors, what we call the tumor's biological behavior. For tumors with less aggressive biological behavior the chances of cure will be greater, and for those with more aggressive biological behavior, the chances of cure will be lower.

Preventing recurrence

The main care for the tumor does not return (recurrence) consist (surgery, chemotherapy and / or hormone therapy, radiotherapy, etc.) depending on the medical indication. That is, it is the degree of adhesion of the patient to cancer treatment. The main factors related to the reduction of the risk of tumor recurrence associated with the accomplishment of cancer treatment mentioned above are:

Adequate weight control as obesity patients have more relapses than lean patients

Practice of regular physical activity

Adequate diet

Healthy life habits

• No use of oral contraceptive or replacement therapy hormonal
• Reduction or stopping of alcohol consumption
• Reduction or stopping of smoking
• We call attention to pregnancy here. Pregnancy has been previously seen as a factor that worsened the survival of patients who had breast cancer, but nowadays it is already seen as something possible and without worsening the survival of patients. For those patients who strongly wish to become pregnant after breast cancer treatment, a very specific conversation with their physician or physician will be required to understand the primary risk of the disease coming back (based on the initial staging) and the discontinuation of hormone therapy for those who are using this treatment modality. To do this, a multidisciplinary evaluation involving mastology / oncologist surgeon, clinical oncologist and gynecologist / obstetrician will be required.
• In summary, all patients are treatable and this treatment will depend on the stage at which the tumor was diagnosed. The treatment will always aim to take good care of the human being and offer him the best method available so that he can be effectively cured, or for those cases where cure is not possible, that he can live with dignity and quality of life for as long as possible.

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