The statistics collected by the World cancer research fund demonstrates that breast cancer remains to be the most common form of oncology in women and the second most common cancer overall. Due to high risk factor alertness and extensive prevention measures, Germany is on the 20th line in the world’s breast cancer rate. In addition, women who are diagnosed with this disease can undergo minimally invasive and plastic surgeries, receive novel targeted drugs and immunotherapeutic agents. All of these keep 5-year survival rate as high as 98% in patients with localized tumors and up to 80% in patients with advanced tumors.
Screening and extensive diagnostics
German specialists believe that both women and healthcare professionals need to have comprehensive information about benefits and risks of breast cancer screening procedures before making any medical decisions. These include information about false-positive and false-negative results, overdiagnosis, and overtreatment. However, screening tests are now believed to be the most efficient measure of early cancer diagnosis.
Range of procedures that are required for the precise diagnosis making includes:
- Mammography. This is an X-ray examination of the breasts that can reveal tumor or other abnormalities. Screening mammography is recommended for women in the age of 50-74 years. The examination is considered to be more informative than hand-held or automated whole-breast ultrasound.
- Digital breast tomosynthesis. This is an imaging technique that reconstructs picture of the whole breast. It uses the low-dose X-ray irradiation in combination with computer processing of the received images.
More extensive diagnostics in suspicion for metastatic breast cancer includes contrast-enhanced MRI and core needle biopsy with immunohistochemical and genetic analyses.
Breast cancer surgery
As a rule, early breast cancer treatment starts from the surgical intervention. Breast-preserving surgery is aimed at partial removing of the breast and includes segmental mastectomy, quadrantectomy, and lumpectomy. Total mastectomy implies removing of the entire breast. The axillary dissection of nearby lymphatic nodes is now performed less frequent, as patients usually receive adjuvant systemic treatment.
Oncoplastic surgery is an essential component of an integrated treatment scheme. Using plastic surgery techniques during the tumor removal allows achieving safe resection margins (this means that there are no malignant cells in the margins of removed tissue) and aesthetic breast shape.
Oncoplastic interventions are focused on adequate shaping of soft tissues, hiding or avoiding scars, choosing the suitable reconstruction technique, and reconstructing the healthy breast in order to achieve symmetry. Successful reconstructive surgery requires preliminary planning in the interdisciplinary tumor board before performing the surgical procedure.
It has been demonstrated in the clinical trials that there is no difference between survival rates in women who have received neoadjuvant chemotherapy and women who have received the adjuvant one. Thus, the chemotherapy regimen is mainly determined by the genetic characteristics of the tumor.
HER2-positive women always receive HER2-directed therapy as part of neoadjuvant scheme. In addition, the NeoSphere clinical trial has demonstrated that combination of pertuzumab, trastuzumab and docetaxel acts like a “dual blockade”. It is highly recommended for women with high risk for the disease recurrence.
In women with N+ or HR-/HER2/neu positive tumors such combined therapy may last for a total of 52 weeks after the surgical intervention. The clinical trial GeparTrio has demonstrated benefits of the response-guided treatment, so German specialists carefully monitor women’s state and adjust the treatment scheme appropriately.
Endocrine therapy remains one of the most efficient treatment options in all forms of breast cancer. The adjuvant endocrine therapy is used in all women with HR-positive tumors, as well as in those with low HR-positive tumors.
If chemotherapy is administered as well, German doctors start endocrine therapy right after the cytotoxic one. According to the time frame, we distinguish the “initial therapy” (it lasts for up to 5 years after the start of treatment) and “extended adjuvant therapy” (it lasts from 6th to 15th year). Endocrine therapy during 5 years is the standard of care. Extended adjuvant therapy is indicated in women with the increased individual relapse risk.
Planning treatment in Germany
When patients from other countries decide to undergo breast cancer treatment in Germany, it is more convenient for them to entrust organization of the medical program to Booking Health. Booking Health is the certified medical tourism provider and official partner of German clinics that helps in:
- Choosing the most suitable hospital for breast cancer treatment in Germany.
- Preparing the diagnostic or therapeutic medical program in advance.
- Booking the outpatient appointment or hospitalization date.
- Providing favorable costs for medical services, saving up to 50% due to excluding overpricing.
- Independent control of final calculation, return of unspent funds.
- Additional monitoring of the treatment process by our experts.
- Help in purchasing innovative medicines, if necessary.
- Communication with the attending physician after program completion.
- Organization of follow-up examinations and distant consultations, if necessary.
- Taking care about hotels and tickets booking, transfer.
- Offering services of interpreter and translator, personal medical coordinator.
Leave your request on the Booking Health website and be ready to discuss your situation in detail with the specialist the same day.