«The incidence of breast cancer in the Algarve is 130 cases per 100 inhabitants, one of the highest in the world», revealed Gabriela Valadas, clinical coordinator of the Breast Center at the Algarve University Hospital Center (CHUA).
«This incidence rate increases considerably with age up to 70 years, with around 60% of cases occurring between the ages of 45 and 69», adds the person responsible, citing data from the 2018 National Oncological Registry.
CHUA treats more than 420 cases of breast tumors per year. «There is no other cancer with numbers of this magnitude in the Algarve. We are the 4th center with the highest number of cases in the country», highlights the medical specialist.
Breast cancer is by far the most diagnosed cancer in women worldwide. In Portugal, around 7 new cases of breast cancer appear every year
On this, which is National Breast Cancer Prevention Day, the Algarve Center dedicated to this disease highlights the importance of screening, which has been carried out in the region since 2005, on the initiative of the Algarve Oncological Association and ARS Algarve, alternately, every other year, in Sotavento and Barlavento.
Women between the ages of 50 and 69 are screened every two years. The devices used are digital mammography machines, but, more recently, with tomosynthesis, which, according to Gabriela Valadas, «makes breast screening in the Algarve the screening with the most advanced equipment in the country, with the emission of very little radiation».
Around 60% of women who are invited actually undergo screening, and in some places, compliance reaches “close to 80%”.
Data from 2019, the last year without Covid, indicate that “around 30 women were invited for screening, with around 18 showing up”.
But screening is indeed important: «the detection rate corresponds to around 4 cancers diagnosed for every 1.000 mammograms», reveals the person responsible for the CHUA Breast Center.
Furthermore, because «cases of tumors referenced by screening normally correspond to cases in the initial stages of the disease, therefore more favorable in terms of treatment and prognosis».
However, adds Gabriela Valadas, screening as it is currently done leaves many women out. «We are seeing more and more cases in women aged 40, 50 or over 70, who are not covered by screening», she reveals.
“Many of these women, when they receive a diagnosis, are lost,” he admits. If they don't have a family doctor or can't get a mammogram in a timely manner at the National Health Service, they often “don't know what to do next”.
It is also to be able to provide them with greater support that the Breast Center was created a year and a half ago at CHUA.
This Center «receives women who are not negative in the screening, as well as all breast pathologies identified by the attending physician, whether benign, suspected of being malignant or already with a biopsy for a malignant disease».
One of the innovations that the CHUA Breast Center wants to create is «a welcoming and easily accessible physical space, dedicated to Senology, in Faro and Portimão, with offices and a space where experts can meet to discuss cases».
The project also includes «a space dedicated to a Breast “Day Clinic”, for a faster diagnosis, a senology consultation followed by an evaluation by a Breast Radiologist, being able to perform a mammogram and/or breast ultrasound, a biopsy with histological evaluation by pathological anatomy, all in a space of proximity», explains Gabriela Valadas, in her interview with Sul Informação.
«This space dedicated to breast pathology, when established, will be at the highest level and equal to what is already done in Europe, preparing this Center for its national and international accreditation», guarantees the specialist.
Then, in a logic of monitoring everyone, from the beginning to the end of the process and in all possible phases, Gabriela Valadas explains that «all cases with suspected malignancy or already diagnosed by biopsy are evaluated by a multidisciplinary team, or In other words, the main specialists are from Surgery, Radiology, Oncology and Radiotherapy, who meet weekly to discuss case by case».
At this meeting, “the best sequence of treatments for each specific person is determined. Whether the case benefits from prior chemotherapy, surgery or not, as well as whether the breast can be treated with oncoplastic surgery that preserves the breast or whether the case requires removing everything, with a proposal for immediate or later reconstruction, are matters to be established in these multidisciplinary meetings”.
The support areas are equally important, namely Physiatry/Physiotherapy and Psychiatry/Psychology.
There is also «a dedicated Nursing team that accompanies people at all stages, as well as a secretariat that supports the management of Senology consultations, complementary diagnostic services and the management of necessary exams». The objective is to simplify, as much as possible, a situation that is already difficult for women.
The CHUA Breast Center “has surgeons qualified to perform all types of surgery, from oncoplastic surgery, using all breast plastic surgery techniques to treat the disease and preserve the breast, as well as practically all immediate reconstruction surgery using implants”, says its clinical coordinator.
«Research for disease in the armpit is carried out at the Center with state-of-the-art equipment, using superparamagnetic iron oxide nanoparticles, a reliable and safe method for collecting lymph nodes for prognostic assessment of the disease».
Also in terms of equipment, CHUA is well served in the Algarve: «Radiology, in Faro, has a recently acquired state-of-the-art mammogram, and the one in Portimão, starting this December, will also replace its mammography with a state-of-the-art one, with the capacity to perform tomosynthesis and contrast mammography».
The project for a CHUA Breast Center was developed by those responsible for the Senology Centers of the hospital centers in Faro and Portimão of CHUA and the person responsible for the Breast Imaging area at the Faro, corresponding to an aspiration that they hope to see come true.
The objective is to create a multidisciplinary unit specialized in breast cancer, which avoids compartmentalization into isolated services, which makes it difficult to have a more global and interdisciplinary approach than the treatment required for this cancer, which is the most diagnosed in the Algarve.
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