#MSPOncología l En el marco del Congreso Internacional de Seno en Puerto Rico, el Dr. Atilla Soran destacó los avances más recientes en el tratamiento del cáncer de seno, así como la importancia de la detección temprana para lograr un diagnóstico oportuno, ya que esto permite determinar a tiempo el tipo de terapia más adecuada para cada paciente.
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#MSP: El lugar donde médicos, pacientes y profesionales de la salud pueden entrar. #SomosCiencia
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00:00Hola, le saluda el doctor Bolívar Arboleda Osorio, presidente de la Sociedad Puerto
00:29Riqueña de Cenología. Nos encontramos en el 22º Congreso Mundial de Cáncer de Seno de la Sociedad
00:37Internacional de Cenología, la CIS, y me acompaña el doctor Attila Soran, secretario general de la
00:45Sociedad Internacional de Cenología. How are you, Attila? I'm good. How are you? Oh, we're doing
00:51fine. I was introducing you in Spanish, but the rest of the interview will be in English. We wanted
00:59to know a little bit first about the International Society, SIS. Tell us a little bit about the SIS.
01:06All right. So, first of all, I'm from Pittsburgh, University of Pittsburgh. I'm a professor of
01:11surgery and a general secretary of the Cenology International Society. This society is one of
01:18the biggest societies established in 1974. And in all continents, a lot of countries are our members
01:26and expanding recently more and more. This is the organization trying to not only get together,
01:33not only the meetings, but we also have the other things such as the fellowship program,
01:39such as we have the programs for the accreditation of the centers. We are trying to educate not only the
01:46physicians, also the nurses and then other healthcare professionals for the breast cancer. As you know,
01:53breast cancer is the most common cancer all over the world in women. So it's the time maybe for to be
02:01more active on all of the continents, not only focusing one area to make sure that everybody's
02:07getting the at least standardized therapy and diagnosis. And we are very happy being in Puerto Rico
02:13is a great, I should say, the country and the city, even if it's a United States territory. I think it's
02:21the Puerto Rico has its own culture. I have been in this city and all over the Puerto Rico more than six
02:30times. I love it. Great hospitality, great environment. But additionally, this meeting is a great opportunity for the
02:38Puerto Rican physicians who are dealing with the breast cancer, in general, breast diseases to learn and to
02:45communicate with the expertise all over the world, and also share their experiences with us. It's important
02:52to learn from the local as well, and their diagnostic approach and treatment.
02:57Yeah, I think this is very important in the sense that a meeting of this caliber, a truly international
03:07meeting with speakers of the greatest knowledge in the field, have convened here in Puerto Rico to share
03:17their knowledge with us. And as you say, perhaps take a little bit from us too, because every different
03:23country have their own difficulties in diagnosis, management, treatment. The beauty of an international
03:35society like ours is that we get to know what is going on in each of these countries that have different
03:44different cultures, they have different economic means. And what we learn about ideal treatment in the
03:55United States, Puerto Rico, and other advanced countries in Europe may not be available in a number of
04:01countries. And we have to tailor that approach to see what we have to do with those in those countries.
04:12As it pertains to Puerto Rico, the Sociedad Puerto Riqueña de Cenología was founded in 2013. We have been a
04:21member of the international societies in 2014. And we are honored to have been selected to host this
04:31international meeting. Breast cancer in Puerto Rico, as well as in the United States, as Atila just mentioned,
04:39is the most common cancer in women. So we have a lot of work to do. Early detection is definitely
04:50the most important tool we have for this disease. If we detect breast cancer early, we have an excellent
05:00opportunity to cure our patients, don't we?
05:04Corey, I agree with you. Even if we look at the last 10-20 years, there's a lot of development in
05:12medicine, including the pharmacy, pharmaceutical companies. We have a lot of different therapeutic
05:20tools. But if you diagnose the patient in early stage, you may not need that much
05:25therapies, maybe like in the DCIS, which we call stage zero disease. Most of the times,
05:32you don't need anything else. You just maybe need some small diagnosed, some,
05:39you may need just some like the systemic therapy, we may need just like a short term radiation therapy,
05:46that's it. So there's a hundred percent cure. But if the patient comes like the stage three advanced
05:51or stage four disease, there's a time that you have to do a lot of things, you may change the survival.
05:59But again, if you do the screening, you can see the calcification, you just start the diagnosis as
06:05early as possible, like any diseases. If you diagnose earlier, there's a lot of opportunity
06:10to cure the patient. The screening is, I heard that, you told me, in the Puerto Rico also,
06:18there's a screening program, which is great. But SIS, some of the countries, unfortunately,
06:23they do not still have any screening programs. So those patients are coming to their physicians in
06:30the very late stage. And unfortunately, some of those countries, they may not have the enough
06:35radiation oncology units. So the tool, the best tool to prevent yourself from the future advanced
06:49cancer is the screening. Definitely. And Atila, I know you are particularly interested in surgery for
06:59advanced breast cancer in some patients. I do remember one of the presentations in ASCO a few
07:09years ago about a study in which you were the PI. Could you tell us a little bit about
07:17when is surgery indicated in patients that have advanced disease? Correct. So the idea came to us
07:25when there is a stage four disease, which means that there is a spread already in some organs,
07:31the idea came to us that if we can remove the breast cancer, can we help those patients to treat
07:38better, even if they have a metastasis? We call these patients de novo stage four breast cancer,
07:44which means that there is already spread to the organs, even if we diagnose the primary tumor
07:50at the same time. So it's like, it depends which country, but it's around six to 10% of women come
07:57to us already as a stage four breast cancer. In the previous decades, we were thinking that they are
08:05done. There's no surgical or radiation therapy benefit for them. So they are going to take only
08:11the systemic therapy, chemotherapy. It may help, it may not help. But we are eating the out of box
08:18differently. So the idea came to us that if we can remove the primary tumor and can it be possible
08:26to fight against the cancer in the metastatic side? I always give this example. So if you think
08:34about you are a general, the commander of the army, there are only one place to fight with the enemy
08:42or you have more than one. So which one is better for a general or which one is better for the commander?
08:48So fight against the one enemy, not more than one. That's the idea, the same thing. So if you remove
08:54the primary tumor, breast cancer, there may be opportunity in some patients that you can,
08:59your medical therapy, your systemic therapy, your chemotherapy, radiation therapy may work better.
09:05So we did the study and show, again, the study was like we started in 2007, but now we have 10 years
09:13follow-up. What we see that if you do the multidisciplinary approach, including surgery,
09:20radiation therapy, and systemic therapy, then 20% of our group of patients in the surgery group,
09:27they are still alive after 10 years. When you compare the control group, no surgery group,
09:32only 4% alive. So yeah, in the five year, actually, when you look at the at five year,
09:39medium five year survival, it is like 58% of the woman who got the primary surgery is still alive
09:46at the five years. So there is a group of patients who are they. So those patients are like the bone
09:52metastasis only, like we call oligometastasis, which means the limited metastasis. So those patients
09:59may have the chance to live longer if you consider multidisciplinary approach. It's not only us,
10:05actually. When you look at the prostate melanoma, when you look at the lung cancer, are all the same,
10:12like kidney cancer, the colorectal cancers. They are all the same approach when they have the ability
10:19to consider the multidisciplinary approach. They live longer, they got better quality of life as well,
10:25because when you remove the breast, there is a 40%. So think about there's a patient with this stage 4,
10:31you don't do the breast surgery, 40%. 40% of patients come back to the surgery for ulcer,
10:40bleeding, infection. So if you remove the tumor, this is like less than 5% may come back to you for
10:48some local problems. For what we call salvage vasectomy.
10:52Exactly. Exactly. So if you are thinking the survival benefit, there is a group of patients
10:58may live longer. But if you think about the local regional control of the breast, which may cause a
11:03problem, so you remove them. So patient quality is much better when you look at who has bleeding or
11:10infection. Correct? Yes. So we have two benefits, but this is not for everybody, of course.
11:17Of course. Well, you know, it's so good to be able to hear experts in each of our different fields in
11:28this conference, Dr. Soran, here with me. And we are so lucky to have this type of meeting here in Puerto
11:39Rico. So I'd like to thank Dr. Soran and all of our international and local speakers that have
11:48contributed to having this meeting here in Puerto Rico. So we are also very thankful a lot for Medicina
11:57y Salud Pública to spread the word and keep informing our medical community, our general community about the
12:10importance of this disease, importance of prevention. And I always mention, every time I have an opportunity,
12:22the mammography saves lives. Las mammografías salvan vidas. So that's something that we have to always
12:31keep in mind. Thank you, Matilda. And it has been a pleasure having you and saludos to all of our
12:40viewing audience. Thank you very much for having us to hear and muchas gracias.
12:45El dolor que causa la endometriosis no es un show, es un dolor extremo durante la menstruación y
12:52durante el sexo. Endometriosis, tómala en serio a ella y a la enfermedad. Habla con tu médico y visita
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