“7% of those who come for the first time already have metastases”

October 19 next year is World Breast Cancer Day, a disease that, according to the latest data from the Spanish Society of Medical Oncology (SEOM), will be diagnosed in 36,395 patients in 2024. Despite the high mortality rate, more and more women are surviving these malignancies thanks to prevention, timely diagnosis and new treatments scientific and medical.

This is achieved, among others, by great researchers, one of them is Dr. Eva Ciruelos, coordinator of the breast department of the 12 October Hospital in Madrid, vice president of Solti (leading group in iclinical cancer research in Spain) and an associate member of the IVF Foundation, who tries to improve the lives of patients through his perseverance and work with science and medicine.

– Why did you decide to specialize in breast cancer?

– Breast cancer is the most common tumor among women in the West and the leading cause of death in women in our country aged 40 to 55 years. This is very important. Therefore, I sought to use my medical profession to make an impact on something as serious and widespread as malignancy in general and breast cancer in particular.

On the other hand, breast cancer clinical research has always been fantastic, and thanks to the care of doctors like me who have had the opportunity to research drugs and new diagnoses, significant progress is being made. Everything came together. On the one hand, the intention to help many people, and on the other hand, the possibility of conducting clinical research, because breast cancer has always been a reference point for this.

– You talked about the investigation. At Solti, you are dedicated to researching new methods to give patients more options. What are you developing now?

– We have a lot of them. On the one hand, we are dealing with clinical trials, that is, treatments or diagnostics for patients that are trying to demonstrate their usefulness in the clinic. They are compared to what is done traditionally and must demonstrate a benefit or advantage. This is the most traditional clinical trial.

On the other hand, we have translation projects. They focus on discovering new changes in tumors or biomarkers that help us determine which treatment is best in each case. These are usually laboratory projects. I do all this both in my Solti cooperative group and in my own molecular oncology laboratory at the Octubre Hospital.

– Are patients ready to undergo these clinical trials or is everything like in the past when they were afraid?

– No, quite the opposite. The sense of being a guinea pig that patients might have had when entering clinical trials due to possible side effects was lost. It’s all over and of course now everyone wants to participate. People come from different parts of Spain to take part because they know that a rehearsal is always an opportunity.

– Nowadays, thanks to research, there are various treatment methods such as targeted therapy, chemotherapy, radiation therapy… Which ones are best for breast cancer patients?

– The different treatments depend slightly on each diagnosis. Not all tumors are the same. They are divided into three or four broad groups: hormonal tumors, triple-negative tumors, and HER2 tumors. Within it there are many other, more specific subgroups. So, depending on the type of tumor or changes in each tumor, treatment is directed towards one or another type of drug.

An example of this is immunotherapy, which particularly plays a role in triple negative disease. On the other hand, there are hormonal treatments that target only those hormonal types that make up 70% of the patient population.

Despite all this, the first thing you need to do is to make an accurate diagnosis and classify very well where your patient is, so that you can then prescribe the most appropriate treatment.

– A few days ago was World Metastatic Breast Cancer Day, and tomorrow is World Breast Cancer Day. Why are these days so important? What should the general population learn from this?

– In particular, with regard to metastatic breast cancer, we must understand that more or less every fourth patient, even diagnosed in the early stages, can recur throughout his life and that, on the other hand, about 7% of women. Those who come for a consultation for the first time already have metastases.

Both those who relapse and those who already have metastases from the beginning constitute the group of affected people in Spain and lead to approximately 6,000 or 6,500 deaths each year.

With breast cancer the situation is not so rosy, not so optimistic, because they also die, progress and suffer a lot. That’s why we wanted to highlight days like tomorrow and patient associations like the Metastatic Breast Cancer Association, which specifically represents this group of patients that more efforts need to be made, given that in most cases it is an incurable and fatal disease. .

I would tell a person who has early stage breast cancer that the chances of a cure today are very high.

– What should “inclusion in society” look like for a patient who has already been cured of breast cancer?

–100%, but gradually, because although after five years 85% of women do not relapse, which is amazing, they also experience side effects and often emotional and psychological impacts.

This requires very important efforts on the part of society to enable these women to gradually adapt to the working environment. These are women who continue to be themselves and their studies and professional lives are unaffected. They just need time and somewhat flexible structures to allow this adaptation to occur. I say the same thing about patients with metastases.

– What would you, as a doctor, give to a woman who has just been diagnosed with this disease?

– To a person with early breast cancer, I would say that today the possibilities of cure are very high, that you need to undergo treatment, often surgical, radiation therapy and medication, that it has its consequences, that you need to take a break from it. crazy life we ​​lead, but the goal is healing and we can achieve that in most patients. However, we must continue to undergo very careful evaluation to identify possible relapses that require early treatment.

I would say that a patient with advanced breast cancer has a disease that, fortunately and thanks to improvements in diagnosis and treatment, can now be considered chronic in terms of the fact that most patients live for years with good quality of life. life and good health, and that they can partially resume their previous lives. Logically not 100%.

To ensure that this continues to become a reality, we are working hard and healthcare providers must support professionals and patients as much as possible in this integrative and interdisciplinary approach that people who survive for so long with such a chronic and serious disease need.