In theory, prevention can be primary, i.e. preventing the onset of a disease, and secondary, i.e. diagnosing the onset of the disease as early as possible (in its early/initial stage).

“In breast cancer there can be no primary prevention, however there is secondary prevention and in fact it is quite effective as the evidence shows, as despite the increase in breast cancer cases the number of deaths from the disease is decreasing”, points out the Mr. Maroulio Stathoulopoulou Director of the Breast Surgery Clinic at Metropolitan Hospital, President of the Locris Branch of the Hellenic Cancer Society.

“Why is this happening?”, he continues: “In secondary prevention, in the new more advanced treatments, in the increasingly courageous attitude of women towards the disease, in better information and in the effort to identify the risk factors of breast cancer occurrence and activation of some proven protective factors”.

Risk factors

Risk factors from the disease are categorized into reversible and to irreversible.

Factors that are not reversible are family history, genetic factors, personal history, molecular type of breast cancer, onset and cessation of menstruation, and race.

Reversible risk factorsthat is, factors that we can change in various ways to significantly reduce the risk of breast cancer are reproductive history, contraceptive use, hormone replacement therapy, alcohol consumption, obesity and smoking.

Protective factors

Protective factors are: aerobic exercise and weight control. This means that adopting a more correct diet such as e.g. the Mediterranean and by putting exercise into our lives, combined with definitive cessation of smoking and limiting alcohol consumption, we reduce the risk of developing breast cancer (and other cancers as well).

“However, it should be noted”, explains the expert, “that the reversal of risk factors and the application of protective factors reduce the risk but do not ensure that cancer will not develop. This is exactly why secondary prevention is needed, i.e. the early diagnosis of the disease, which can be achieved in specific ways: preventive screening (clinical breast examination, mammography and other imaging tests), as well as breast self-examination.”

The preventive check

Breast cancer has an asymptomatic phase (exists without symptoms), which can be detected by mammography from 1 to 5 years before its clinical manifestation. This fact alone shows not only how important screening is but also why it should not be neglected or postponed. But which women should be screened and when?

“The starting age for screening is 40 years. This includes a mammogram and a clinical examination. Women aged 40 and over should have a full screening every year, while women between 20 and 30 should have a physical exam every three years.

Women at high risk (with a family or individual history or genetic predisposition) should undergo a clinical examination every 6-12 months from the age of 25 years or 10 years before the age of onset of breast cancer in their youngest relative. They should also undergo an annual MRI (magnetic resonance imaging) check-up from the age of 25 or, alternatively, if an MRI cannot be performed, a breast ultrasound and, in addition, an annual mammogram from the age of 30.

Finally, women between the ages of 55 and over 75, i.e. after menopause, should be examined strictly every year, because at these ages breast malignancies appear more often,” emphasizes Ms. Stathoulopoulou.

Can screening be skipped?

No, screening cannot and should not be skipped or neglected for any reason. “Breast cancer is a cancer that is completely curable if it is diagnosed early, and the absolute prerequisite for early diagnosis is preventive screening. If a patient misses/forgets/neglects a mammogram, the consequences may be limited or non-existent, but if she misses more, the impact can be extremely severe with material costs, burden on the health care system and possibly a life lost. lost. Something like this happened, unfortunately, at the beginning of the pandemic, when many women delayed check-ups and mammograms, as a result of which they were not diagnosed in time,” he says.

The self-examination

Self-examination is aimed at the detection by the woman herself of any change in the breast and her visit to the specialist without delay. It is good to do it once a month for every woman and, especially for menstruating women, immediately after the end of the period, because then the breast is smoother, less swollen and painless. If during a self-examination, a woman discovers that there is something, she should not panic, because 7 out of 10 lumps palpated in the breast are not malignant. It is usually a simple cyst or a benign growth.

The best update

Today, the consistency of women regarding the necessary preventive checks for breast cancer is much greater than in the past and the fact that there is information about the benefits of prevention throughout the year (from NGOs, medical groups and from all the media), free screenings are constantly taking place and offers are made that make testing easier, culminating in October, a month dedicated to the prevention of the disease.

The courageous attitude of women towards the disease

A woman who is informed that she has breast cancer certainly panics at first. However, after the initial shock, some women persevere and tell themselves that they will make it. “My 17-year experience “tells” me that the women who were not afraid of the disease, were afraid of the disease, because they faced it with a much better psychology. Good psychology strengthens the body and its immune system and helps to realize that the pain, hair loss and change in the patient’s image are temporary, while the treatment can be definitive. The only thing any woman should fear is going into surgery with a lump on her breast without knowing what it is. This is perhaps the point that requires more strength from women.

Important help in the good psychology of the patient can be provided by her environment, as what is asked of relatives, friends and relatives in such a situation is to support their person. Don’t panic, don’t close your eyes, be close to her. To talk with her, to support her when her image changes. To do whatever is necessary to relieve her, but also to accompany her in the treatments and if they judge that they themselves need psychological support, to seek it. In addition, it is important that children participate in the whole process, if they are old enough to understand. Everyone’s priority should be the person who is sick,” emphasizes the doctor.

Mastectomy ain’t what it used to be

“The new more advanced breast cancer treatment approaches now combine oncological safety with a good aesthetic result. Women who undergo a mastectomy can then have a reconstruction of their breast image, as if they had undergone cosmetic surgery, as long as the surgical team includes a plastic surgeon. This contributes to a very large extent to the quality of life and good psychology after the disease”, concludes Mrs. Stathoulopoulou.

*Experiential stories of the treating physician

“Breast cancer is the most common cancer in women and the second leading cause of cancer death worldwide. In Greece, approximately 6,000 new cases are reported each year, while it is estimated that 1 in 8 women worldwide will develop breast cancer at some point in their lives. These numbers that show the magnitude of the risk give even more value to cases that had a happy outcome, even against late or wrong initial diagnoses like the ones that follow,” he says. Ms. Maroulio Stathoulopoulou Director of Breast Surgery Clinic at Metropolitan Hospital, President of the Locris Branch of the Hellenic Cancer Society. “One is that of a 29-year-old woman who had a supposedly benign lump removed, which later turned out to be malignant and due to one of the most aggressive forms of breast cancer. We put the woman through chemotherapy. After a positive genetic test we did a double mastectomy and reconstruction and despite the difficulties, today this girl has started her own family, has two children and managed to make this whole adventure a strength. Another is that of a woman who, when I informed her that she has breast cancer, panicked so much that she did not come for a long time so that we could proceed with the appropriate treatment. Finally, after a long time she visited me again, we moved on, fortunately without much burden on the prognosis, and, now, this woman is a volunteer in a women’s club urging all women not to neglect preventive screening and empowering them with her personal example”.