Breast cancer, high incidence in Friuli-Venezia Giulia

Friuli-Venezia Giulia holds a sad record, one of the first in Italy for the incidence of breast cancer. Every year, in fact, over 1,300 diagnoses are recorded: 170 for every 100,000 women, a higher rate than the national average. The possible reasons? The greater longevity compared to other Italian regions and the good adherence to screening tests can certainly raise the numbers, but among the risk factors to consider there is also excessive alcohol consumption.

Know the risks

This was underlined by the oncologists gathered in Udine on the occasion of the twentieth edition of the Focus on Breast Cancer conference, which will see the participation of over 500 experts. “Alcohol is one of the most important risk factors for breast cancer, even if there is a tendency to underestimate it”, explains Saverio Cinieri, President of the Italian Association of Medical Oncology (Aiom) -. The consumption of wine and beer should absolutely not be criminalized, however numerous scientific publications have highlighted the connection with breast cancer”. Certainly, alcohol is not the only important risk factor on which it is possible to intervene: a sedentary lifestyle also plays a role. From this point of view, however, the rate of sedentary people in the region is estimated to be lower than the national average: 18% against 31%, respectively.

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Data from Friuli-Venezia Giulia

“Since 2000, we have observed a gradual increase in survival, and today over 22,000 women live in Friuli-Venezia Giulia with a diagnosis of breast cancer – says Fabio Puglisi, full professor of Medical Oncology at the University of Udine, Director of the Department of Medical Oncology at the IRCCS CRO of Aviano and Scientific Coordinator of the conference -. It is a figure in line with the national one, and the prognosis of women who fall ill is constantly improving thanks to the introduction of innovative drugs and the increase in early diagnoses, also thanks to screening”. In fact, in the Region, the mammography screening program proved to be efficient and quickly made up for the tests not carried out due to Covid-19: 6 out of 10 women regularly undergo mammography. “The disease – continues Puglisi – still has a strong impact on our regional health system and we must act to facilitate treatment pathways and to improve primary prevention”.

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The “Focus” on 20 years of progress

The Udine conference represents an opportunity to review the scientific advances of the last two decades. “In the early 2000s, five-year survival was just over 76% while now we have reached almost 90% – underlines Michelino De Laurentiis, Director of the Department of Breast and Thoraco-Pulmonary at the Pascale Cancer Institute of Naples -. The credit for this extraordinary success is to be found in our greater ability to define and identify the various subtypes of breast cancer. From this passes the strong growth of our therapeutic arsenal even for the most serious forms of the disease”.
At the same time, therefore, the role of the anatomo-pathologist has grown strongly, which has assumed fundamental importance: “International research, also thanks to important Italian contributions, has managed to identify specific biomarkers for the various forms of breast cancer ”, clarifies Giuseppe Viale, Director of the Department of Pathological Anatomy and Laboratory Medicine of the European Institute of Oncology (IEO) in Milan -. These represent targets for new therapies that have been shown to be effective in both advanced and early disease. There are at least seven different biomarkers for as many treatments”.

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Precision surgery

But if medical oncology has become increasingly ‘precision’, breast surgery has not been outdone: “Interventions are increasingly personalized based on the characteristics of the patients and the disease. In many cases, axillary lymphadenectomy can be avoided, at the breast level we are increasingly conservative, reconstructive surgery allows us to achieve excellent results and, where the clinical context allows it, intraoperative radiation treatment can be proposed”, explains Samuele Massarut, Director of Breast Surgical Oncology of the CRO of Aviano.

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The multidisciplinary approach for metastatic disease

There have also been improvements for the metastatic phase of the disease: “There are about 14 thousand new cases that we register every year throughout Italy and for these women it is essential to define a treatment path that is as personalized as possible and which always falls within a multidisciplinary management of neoplasm – concludes Lucia Del Mastro, Full Professor and Director of the Medical Oncology Clinic of the IRCCS San Martino Policlinico Hospital, University of Genoa -. Therapeutic decisions must not be taken only by the oncologist, but in concert with professionals from the various disciplines”.