Alarming: 1.7 million women with breast cancer

Dr. Hedvig Hricak, Chair of the Department of Radiology at Memorial Sloan Kettering Cancer, New York, USA

The treatment of malignant disease progressed in the last few decades, it has become more efficient and less invasive.

Breast cancer is the most frequently diagnosed cancer among women in 140 of 184 countries worldwide, and its incidence is increasing worldwide.  Today, almost 1.7 million women are affected, says Dr. Hricak from Memorial Sloan Kettering Cancer Center, USA, in interview for Kurir newspapers. The famous doctor was recently in Belgrade, at the oncology symposium organized by Crown Princess Katherine Karadjordjevic.

–      So, breast cancer is widespread throughout the world?

Breast cancer is the most common cancer in women in both the developed and less developed world, with nearly 50% of breast cancer cases and 58% of deaths occurring in less developed countries. Newer screening techniques detect more cancers and yield fewer false-positive results.  It is now recognized that many women with dense breasts need supplemental screening with techniques such as ultrasound, while women at high risk for breast cancer should be screened with MRI as well as mammography.

–      Where are we now? What was like before Crown Princess Katherine started with her activities, and how important those efforts are for the Serbian doctors, as well as for the patients?

In the early 2000s, Serbian physicians provided anecdotal reports to HRH Princess Katherine that the incidence of breast cancer in Serbia was higher than the incidence levels reported by the World Health Organization for other areas of Europe.  Subsequent epidemiological studies found that while the incidence of breast cancer was only marginally higher in Serbia, mortality from breast cancer was substantially higher in Serbia than in other parts of Europe. HRH Princess Katherine was determined to take action, and in 2003-2004 she solicited advice from three radiologists: Dr. Alexander Margulis, who was born in Serbia and served as Chair of the Department of Radiology at University of California, San Francisco for two decades, Dr. Hedvig Hricak, Chairman of the Department of Radiology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and Dr. D. David Dershaw, then the Chief of Breast Imaging at MSKCC.  To enable earlier detection of breast cancer and thus reduce mortality from the disease, Dr. Hricak and Dr. Dershaw developed a comprehensive approach, which included training of radiologists and technologists at MSKCC. HRH Princess Katherine worked with the Ministry of Health in Serbia to implement training practices in Serbia. Dr. Margulis and Dr. Hricak worked with HRH Princess Katherine to submit grant applications for the purchase of much-needed equipment. In total, 15 healthcare personnel from Serbia were trained at MSKCC from 2009 to 2015: six radiologists, three radiation oncologists, four imaging technologists, and two physicists. Three of the radiologists received long-term training at MSKCC through the support of the Breast Cancer Research Foundation, and two underwent training at MSKCC for one-month intervals with support from the Serbian Ministry of Health.

–      Symposiums on breast cancer were also held?

The first Serbian Breast Cancer conference, held September 22-September 23, 2008, marked the beginning of a long collaboration between HRH Princess Katherine, the Ministry of Health of Serbia and the team at MSK. A grant from the Stavros Niarchos Foundation subsequently enabled the purchase of a mobile mammography unit, which was delivered to Belgrade by HRH Princess Katherine’s Foundation in June 2009.  The unit went into full operation on October 1, 2009, the first Breast Cancer Awareness Day.  Funding for technologist training for the mobile mammography program was supported by a grant from Komen International made to HRH Princess Katherine’s charity, Lifeline.

–      Few years ago, the national mammography breast cancer screening program was initiated. What are the results?

In 2012, a national mammography breast cancer screening program was initiated in Serbia as a result of HRH Princess Katherine’s relentless efforts.  In October 2012, a needed ultrasound unit was obtained with funding from the Stavros Niarchos Foundation. Later, an educational program in radiotherapy was developed and supported by a Komen International grant. There is a substantial progress achieved. The national screening program is allowing breast cancers to be detected and treated at earlier stages, when treatment is more likely to be effective. In addition, the radiotherapy program is increasing the quality of radiation treatment offered. Efforts to prevent breast cancer, increase early detection and improve breast cancer treatment must continue, as the incidence of breast cancer is still rising worldwide.

–      How much modern medical treatments are efficient in treatments of patients?

Treatment for breast cancer has improved over the last few decades, becoming both more effective and less invasive.  Additionally, it has been recognized that not all patients benefit from the same treatment, and so more personalized treatment plans have become available.

–      In which age of life there are the greatest number of patients?

Breast cancer incidence and death rates generally increase with age. There are some societies, however, where breast cancer is seen more frequently in women between the ages of 40 and 50 (Japan, Korea, Africa).  Women aged 40 years and older are advised to consider their personal risk factors when making their screening choices.

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