October is Breast Cancer Awareness and Screening Month. Therefore, today’s guest blog post is written by an oncologist – Oleksii Aksonov. He has dedicated his entire life to the diagnosis and treatment of breast cancer, and he is proud to be a part of this fight. Oleksiy considers it his duty to bring you important information that can save your health and maybe even your life. Each case of breast cancer is a unique story and a challenge for the patient and the doctor. He sees such struggle, determination, and strength every day. It hurts him to look at cases when the patient, who first sought help, has an advanced stage of the disease. Unfortunately, for some reason, such cases are not rare. He urges you to love yourself and take care of your health. You should also remember that early detection of breast cancer can save your life.
Table of contents
- Statistics and relevance
- The importance of early detection
- Asymptomatic period of cancer
- Breast cancer screening
- Myths and Truths
- Myth #1. Stress causes breast cancer
- Myth #2. Surgery to remove breast cancer leads to significant aesthetic disturbances
- Myth #3. Breast cancer does not occur in men
- Myth #4. There is no such diagnostic method capable of detecting cancer whose size does not exceed 1 mm.
- This post was written by
This blog post was written by a Ukrainian oncologist – Oleksii Aksonov.
Statistics and relevance
Every year, about 20 million new cases of cancer are registered in the world, and approximately 8.8 million people die. In fact, one in six deaths in the world is related to cancer, which far exceeds the number of deaths from HIV infection, malaria, and tuberculosis combined. It is important to note that there is a tendency to increase the number of cancer cases in the world from year to year, scientists believe that by 2035 the incidence of cancer will double. Breast cancer accounts for 2.2 million cases per year and more than 680,000 deaths from this disease. In addition, among the female population, breast cancer ranks first in terms of morbidity and is also the main oncological cause of death in women.
No, I don’t want to scare you, just look at these numbers again and realize the importance of the problem. Timely access to medical care and population screening programs makes it possible to detect cancer at an early stage and significantly improve treatment outcomes. Unfortunately, countries with medium and low levels of economic development are unable to provide their population with adequate breast cancer screening and medical care. In such countries, we observe a significant increase in the number of visits to the doctor in the advanced stage of the disease, when it is almost impossible to cure the disease. In addition, the public is not sufficiently informed about how to recognize cancer, what factors provoke it, and what steps should be taken for early detection of breast cancer.
The importance of early detection
Early detection of breast cancer can be compared to early detection of a fire, the earlier the fire was detected, the less destruction it caused. With time on the clock, the earlier cancer is detected, the more time you have to make the right medical decisions. In my opinion, these comparisons clearly show that the health and life expectancy of the patient directly depend on the early detection of the disease. This is confirmed by the US National Cancer Institute, evaluating the five-year survival of patients with breast cancer depending on the prevalence of the disease. Thus, with a local form of breast cancer (without metastases), the 5-year term overcomes 99% of patients. The situation with widespread (presence of metastases) breast cancer is more complicated, only 31% of patients overcome the 5-year term.
Early detection of cancer significantly reduces the number of treatment methods used and the duration of treatment. On the contrary, with metastatic cancer, the treatment is aimed at prolonging the patient’s life, since it is impossible to completely cure the patient.
Asymptomatic period of cancer
The insidiousness of any cancer is that it does not manifest itself in the period from the appearance of the first malignant cell to the first symptom. A woman’s well-being and blood laboratory indicators do not signal the onset of the disease and its development during this period. Breast cancer is no exception and also has its symptom-free period. This period lasts 1–5 years, depending on the type and aggressiveness of the tumor, but detecting cancer in this period is important for the doctor and especially for the patient. Today, the only reliable way to fight against breast cancer is early detection: “Start the fight against breast cancer when your enemy is still weak.” How to do it if there are no symptoms? Only screening – regular examination of the mammary glands will help you detect early cancer.
Breast cancer screening
Breast cancer screening is the selection of patients from a large number of women who do not have symptoms. In fact, these are the rules invented by doctors to find early cancer, the rules that apply in the symptom-free period. Most of you own a car, screening can be compared to car maintenance. A scheduled inspection of the car will allow you to prevent irreversible damage and continue to use it for a long time. As with health, you need to systematically diagnose the mammary glands even when there are no symptoms and this will ensure early detection of breast cancer. The results of numerous medical studies prove the importance of such a systemic approach.
For example, in Sweden, among women aged 40 to 69 who underwent screening mammography, breast cancer mortality decreased by 44%. This is an excellent result that demonstrates the importance of such an approach for the early diagnosis of breast cancer. Remember a simple rule – you need to perform a mammogram every year from 40 to 84 years old, this will save your health and life.
Myths and Truths
Myth #1. Stress causes breast cancer
As a matter of fact, there is no scientific evidence that stress itself is the cause of the first malignant cell in the body, but… Stress can lead a person to bad habits, such as smoking, drinking alcohol, etc., and we know that people with bad habits are more likely to get breast cancer than people who lead a healthy lifestyle. Chronic (long-term) stress suppresses a person’s immunity, which weakens the immune mechanisms of detecting and destroying cells that tend to become cancer. For example, according to my Ukrainian experience, I noticed a noticeable rejuvenation of breast cancer and the appearance of more aggressive forms of this disease in women who were in the territories where military operations during the war in Ukraine were taking place for a long time (more than 1 year).
Myth #2. Surgery to remove breast cancer leads to significant aesthetic disturbances
Indeed, the radical treatment of breast cancer is based on surgical removal of the organ. These operations were developed in the period 1889-1973 and the result was aimed at the treatment of the disease, the aesthetic factor was not taken into account. Today, surgical developments in a complex with modern technologies make it possible to achieve both a therapeutic and an aesthetic result at the same time. Reconstructive techniques using own tissues and silicone implants are able to provide a woman with the radicality of the operation and preserve the aesthetic appearance of the mammary gland.
Myth #3. Breast cancer does not occur in men
I hope this article is read by women because I do not want to upset members of my gender. Indeed, breast cancer also occurs in men, but much less often than in women. Of all 2,261,419 cases of breast cancer detected in the world in 2020, 22,615 cases are men (1%). For men, there are no screening programs for the early detection of breast cancer, and in most cases, they go to the doctor with complaints of lumps. In my practice, there were 3 cases of breast cancer in a man. One of them had a bloody discharge from the nipple, and two men found themselves with a lump.
Myth #4. There is no such diagnostic method capable of detecting cancer whose size does not exceed 1 mm.
I want to refute this opinion because I have a technique that can do it. This is a ductoscopy – a video endoscopic examination of the ducts of the mammary gland, which is used in women with discharge from the nipple. For more than 10 years, I have been doing ductoscopy, this is a crucial technique because 95% of breast tumors originate in the duct. Ductoscopy easily detects a tumor smaller than 1 mm in the duct, which mammography, ultrasound, or MRI cannot detect. Today, during ductoscopy, it is possible to remove a tumor in the duct without using anesthesia and a surgical incision.
Breast cancer is a challenge, but not a hopeless disease. Modern medicine provides us with many innovative methods of diagnosis and treatment, and research continues to expand our knowledge about breast cancer. We are working hard and after some time we will find a way to defeat this disease. You are only required to take care of yourself because screening mammography every year from the age of 40 is self-care. Don’t hesitate to discuss your questions with your doctor and start screening today to ensure a healthy future.
- Niell, B. L., Freer, P. E., Weinfurtner, R. J., Arleo, E. K., & Drukteinis, J. S. (2017). Screening for Breast Cancer. Radiologic clinics of North America, 55(6), 1145–1162. https://doi.org/10.1016/j.rcl.2017.06.004
- 2. Prager, G. W., Braga, S., Bystricky, B., Qvortrup, C., Criscitiello, C., Esin, E., Sonke, G. S., Martínez, G. A., Frenel, J. S., Karamouzis, M., Strijbos, M., Yazici, O., Bossi, P., Banerjee, S., Troiani, T., Eniu, A., Ciardiello, F., Tabernero, J., Zielinski, C. C., Casali, P. G., … Ilbawi, A. (2018). Global cancer control: responding to the growing burden, rising costs and inequalities in access. ESMO open, 3(2), e000285. https://doi.org/10.1136/esmoopen-2017-000285
- 3. Benson, J. R., Jatoi, I., Keisch, M., Esteva, F. J., Makris, A., & Jordan, V. C. (2009). Early breast cancer. Lancet (London, England), 373(9673), 1463–1479. https://doi.org/10.1016/S0140-6736(09)60316-0
- 4. Breast cancer by the numbers. (2014). P & T : a peer-reviewed journal for formulary management, 39(3), 213–214.
- 5. Standish, L. J., Dowd, F., Sweet, E., Dale, L., Weaver, M., Osborne, B., & Andersen, M. R. (2017). Breast Cancer Integrative Oncology Care and Its Costs. Integrative cancer therapies, 16(1), 85–95. https://doi.org/10.1177/1534735416649034
- 6. Lin, D. Y., Feuer, E. J., Etzioni, R., & Wax, Y. (1997). Estimating medical costs from incomplete follow-up data. Biometrics, 53(2), 419–434.
- 7. INGLEBY, H., MOORE, L., & GERSHONCOHEN, J. (1958). A roentgenographic study of the growth rate of 6 early cancers of the breast. Cancer, 11(4), 726–730. https://doi.org/10.1002/1097-0142(195807/08)11:4<726::aid-cncr2820110408>3.0.co;2-2
- 8. Niell, B. L., Freer, P. E., Weinfurtner, R. J., Arleo, E. K., & Drukteinis, J. S. (2017). Screening for Breast Cancer. Radiologic clinics of North America, 55(6), 1145–1162. https://doi.org/10.1016/j.rcl.2017.06.004
- 9. Смоланка І.І., Аксьонов О.А., Білоненко Г.А. Сучасний стан і перспективи розвитку ендоскопічної мамодуктоскопії (огляд літера- тури і власний досвід). Клінічна онкологія. 2015; 4 (20): 11-14.
- 10. Makita M, Akiyama F, Gomi N, Ikenaga M, Yoshimoto M, Ka- sumi F, Sakamoto G. Endoscopic classification of intraductal lesions and histological diagnosis. Breast Cancer. 2002; 9(3): 220-5. doi: 10.1007/ BF02967593.
- 11. Filipe MD, Waaijer L, van der Pol C, van Diest PJ, Witkamp AJ. Interventional Ductoscopy as an Alternative for Major Duct Excision or Microdochectomy in Women Suffering Pathologic Nipple Discharge: A Single-center Experience. Clin Breast Cancer. 2020 Jun; 20(3): e334-e343. doi: 10.1016/j.clbc.2019.12.008. Epub 2020 Jan 27. PMID: 32081573.
- 12. van Tuijl, L. A., Basten, M., Pan, K. Y., Vermeulen, R., Portengen at all (2023). Depression, anxiety, and the risk of cancer: An individual participant data meta-analysis. Cancer, 129(20), 3287–3299. https://doi.org/10.1002/cncr.34853
This post was written by
Oleksii Aksonov is a surgeon-oncologist, a candidate in medical sciences, and an expert in the diagnosis and treatment of breast cancer. He was born in Ukraine and devoted 18 years of his life to fighting breast cancer. For the past 10 years, he has been actively developing new approaches to the early diagnosis of breast cancer to ensure the most effective and early detection of this dangerous disease.