an initiative to make breast cancer visible and support patients at risk of recurrence and metastasis.

Protect the Queen Initiative‘, launched by Lilly in collaboration with the Spanish Federation of Breast Cancer (FECMA), the Spanish Association of Metastatic Breast Cancer (AECMM), the Spanish Society of Medical Oncology (SEOM), the Breast Cancer Research Group GEICAM and the SOLTI Cancer Clinical Trials. The group’s goal is to make visible two realities of breast cancer that cause great uncertainty among patients: the high risk of recurrence and metastasis.

With the support of the Spanish Chess Federation, the meeting drew a parallel between the queen piece in the popular game of chess and breast cancer patients. The meeting is taking place within the framework of the “Among Them” movement. Two Realities of Breast Cancer, One Help,” which supports the dissemination of quality medical information and aims to improve the quality of life of patients. At the time of its opening Alejo CassinelloDirector of Lilly’s Oncology Medical Division, testified that the company understands that each patient is an individual with a unique story. “Our goal is to improve the lives of patients and their families.“,” he said. “Women with early-stage breast cancer and a high risk of recurrence face uncertainty and doubt that require special care,” he said. “With this premise, the Protect the Queen program was created to bring greater awareness to these patients and create a forum for them to share their experiences,” he added. In addition, she noted that “it is important to talk about breast cancer without taboo, offering a safe space for every woman to express her situation.”

The meeting, consisting of two round tables with the participation of health professionals, addressed various topics related to this pathology. The roundtable “Where We Are in Breast Cancer: Understanding Recurrence and Metastasis” discussed the key differences between both realities. Cesar Rodriguez, president of the Spanish Society of Medical Oncology (SEOM), noted that in 2024, more than 36,000 cases of breast cancer will be diagnosed. “We must contribute to better training of oncologists as well as patients, since it is also extremely important to share information that contributes to prevention as well as early diagnosis campaigns,” he stressed. “Patients need to be knowledgeable about their disease, and initiatives like these are necessary because empowerment and information help oncologists do their jobs better,” he said.

Isabel EchavarriaAssistant Physician of the Medical Oncology Service of the Gregorio Marañon Hospital and Scientific Secretary of SEOM, recalled that when a patient is faced with this disease, she goes through a complex and lengthy process that is influenced by various factors. “Early breast cancer with a high risk of recurrence and metastatic breast cancer are different conditions, so resolving doubts and understanding the differences between the two is critical for patients,” he said. In addition, he recalled that not all recurrences are due to metastases, although most metastases are recurrences of previous breast cancer.

At the moment, patients with hormone receptor-positive (HR+) and HER2-negative breast cancer, which affects 70 percent of women with breast cancer15 percent are at high risk of relapse, and approximately 25 percent of these patients relapse within the first five years. The second most common type is HER2+, which affects 15 to 20 percent of patients, with a similar risk of recurrence in the first five years after treatment. The third type, triple negative breast cancer, accounts for 10 to 15 percent of cases, and up to 30 percent of patients diagnosed in the early stages may develop metastases three to five years after diagnosis.

During his speech Alfonso Lopez de Saoncologist from the San Carlos Clinical Hospital and member of GEICAM, noted that sometimes the disease affects people who have not previously had contact with it, which causes great stress. “As oncologists, we need to clarify concepts. While there are patients who are very informed from the start, there are also cases where this is not the case,” he explained. He further assured that collaborative research groups play a key role in advancing cancer research. However, he stressed that there are many unmet treatment needs for metastatic breast cancer and a high risk of recurrence that could be addressed through clinical trials, which are not being conducted due to lack of funding.

Regarding metastatic breast cancer, Rodrigo Sanchez Bayonaoncologist at 12 October Hospital and founding member of SOLTI Young, stressed that advances in research are the only way to make the disease chronic. Controlling and transforming metastatic breast cancer into a chronic form is one of the main goals of oncology, and for this it is important to promote areas of research that improve the quality of life of patients. “Research is turning precision medicine into personalized medicine and is the only way forward, because without it we would still be treating cancer the same way we were 20 years ago,” he said.

Communication between doctor and patient

During the round table “Two Realities, One Concern,” the importance of adequate communication between patients and health care workers was emphasized. Paula Gonzalezrepresentative of FECMA, stressed that reliable information is key, especially in situations such as relapses or metastases. “Information and education are key to being effective decision-makers. In addition, it is extremely important to gain support, be it from associations or the medical team,” he insisted. For my part, Pilar FernandezPresident of the AECMM, explained that it is important to analyze the reality of metastatic breast cancer, taking into account the difference between recurrence and metastasis, as well as the emotional and psychological experiences of patients. “This requires that they be in an atmosphere of trust and empathy to be able to ask any questions regarding their illness and anything that affects their physical or emotional well-being.”

Gema RodriguezVice President of the AECMM, recalled that “we are a group with a high demand for medical and psychosocial resources.” “Over the years, treatments accumulate toxicity in the body, and we need equipment that treats us holistically,” he explained. In his speech Vanessa Jorgeresponsible for psychosocial care at the Spanish Association Against Cancer (AECC), said that among the recommendations for personal care, regular exercise and a healthy diet are essential for both physical and emotional well-being. “It is also important that patients address any concerns with the healthcare team and remain committed to treatment by following the instructions of their oncologist to ensure maximum effectiveness of therapy and minimize side effects,” he said.

Anabel Ballesteros, Department of Medical Oncology at La Princesa University Hospital, stated that “Although breast cancer is more common in overweight women who don’t exercise, it can’t always be prevented by doing the right thing.“. “We know that women who exercise are less likely to relapse and tolerate treatment better, but we can’t blame patients,” he added. Finally, Teresa Millan, Lilly’s director of corporate communications concluded the day by saying the event was a space for dialogue and collaboration, clarifying that “we cannot solve these problems without collaboration.” “Research has come a long way, but there is still room to go. At Lilly, we believe in the importance of research to further improve treatments,” he concluded.

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