Breast cancer: 11,000 cases a year are under 40 and 20,000 over 74
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How old are the women in Italy who fall ill with breast cancer every year? 20% (about 11,000) are under the age of 40, 35% (20,000) are over 74. We are therefore talking about 31,000 cases out of the total 55,000 that are diagnosed every year in our country. This means that more than half of the patients are not included, by age, in the national mammography screening program. Here’s why, second Adriana Bonifacinopresident of the Incontradonna Onlus Foundation, it is essential to reformulate primary and secondary prevention interventions as soon as possible, taking into account which prevention investigations may be most suitable for young women, to encourage early diagnosis and, consequently, increase the chances of healing.
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From nutrition to emotions: increase attention to quality of life
The appeal was launched during the national conference “CURA.RTE Alimentation, Research, Therapy, Emotion”, underway in Rome. “Breast cancer is an increasingly transversal disease, as every year it affects women of different age groups and even 500 men – says Bonifacino -. The progress we are making is evident and currently the five-year survival is 88%. The probability of living another four, conditional on having passed the first year after diagnosis, is as much as 91%. Beyond the positive epidemiological data, however, the impact on the patient is still very strong. As well as for the entire social and health system that you have to provide for the assistance of an increasing number of people ”. Hence the need – even for clinicians – to give due attention to aspects that until recently were considered secondary. Like nutrition and physical activity, which instead play an important role and are always the subject of research. They do not only represent primary cancer prevention factors but support to face the disease and therapies in the best possible way. “Even the emotional side needs to be treated more – continues Bonifacino – starting right from the delicate moment of communication of the diagnosis”.
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Treatment must be personalized
For its part, research today provides important tools for improving the quality of life of those affected by breast cancer, and which can be summed up in one word: personalisation. “The personalization of treatments is the real key to understanding the successes achieved in the fight against breast cancer – she underlines Anthony Russo, member of the Aiom National Executive – Italian Association of Medical Oncology -. Starting from the patient’s age, which influences the choice of the treatment path. Furthermore, therapies are increasingly targeted thanks to very complex genetic and genomic studies and thanks to the application of artificial intelligence”.
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Less invasive and more effective therapies
One of the greatest successes of the last decades is the evolution of adjuvant therapy, i.e. administered after surgery. “We are reducing the chances that the oncological pathology will recur with a recurrence or with metastases – he says Andrea Botticelli, Medical Director at the Umberto I Polyclinic, La Sapienza University of Rome – Also thanks to this, mortality in the last decade has significantly decreased despite the constant increase in the number of new cases. The greater precision of the drugs also manages to guarantee less invasive treatments and therefore more suitable for both a young and an elderly woman”.
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Mammography and screening
Diagnostic technologies have also evolved. Today it is possible to obtain an early diagnosis thanks to simple and above all minimally invasive tests. “Digital mammography uses a third less X-rays than traditional devices and allows the acquisition of high quality breast images that are transferred to dedicated monitors for viewing – he says Nicolette Gandolfo, President Elect SIRM – Italian Society of Medical and Interventional Radiology – As far as screening is concerned, the increase in ‘juvenile’ cases poses the objective problem of expanding the number of women to undergo free mammography. Reducing the start of secondary prevention programs throughout the national territory to 45 is a possible solution, as some Western countries are hypothesizing”.
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In Italy, several regions have already autonomously increased the age of screening. But a problem remains: the low participation of women, above all in the Centre-South. “It is above all a cultural battle – concludes Bonifacino – which must be carried out to encourage as much as possible participation in tests that can avoid serious consequences for thousands of potential patients”.
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