Awareness and Molecular Details in the Diagnosis and Treatment of Breast Cancer
It is clear that the patient's complaint, self-control, physician examination, radiological examinations and biopsy have an indisputable importance in the diagnosis of breast cancer today. However, research is developing that some molecular parameters may also be important in diagnosis and treatment. While patients are usually made aware of frequently repeated information, an unnecessary fear can also be created.
Confidentiality, which should be carefully protected in patient-physician relations, is violated by some information shared on the internet, general information is given and it is ignored that there may be special situations and patient-specific treatment responses.
In my opinion, there is a period in which this general information is repeated frequently, creating fear instead of raising awareness in the internet and media. In the fight against a disease, patient information and consent should be done one-on-one with the patient, "there is no disease, there is a patient". principle should always be kept in mind.
The fight against cancer has an individual and private character with deep psychological and psychiatric dimensions. “desensitize” While doing this, it should be kept in mind that he can be put into chronic patient psychosis and create fear.
For this reason, all the characteristics of the individual and some molecular parameters cannot be "generalized" in breast cancer. In my opinion, it should form the basis of awareness raising. In this article, I would like to briefly mention the "molecular parameters" that have gained importance recently and whose importance is indisputable in the development of personalized treatment.
Molecular parameters
In this limitation, some substances secreted from these cells are effective as well as the support tissue and inflammatory tissue cells around the tumor. These determine the relationship between tumor tissue and patient tissue, in other words, the severity of the war. According to our current knowledge, our patients diagnosed with breast cancer are only magnified in all their characteristics. It would be beneficial for both the surgeon and the medical oncologist to be informed in an appropriate language about ER/PR/Her2 Neu positivity, not just underarm and underarm spreads.
Recently, the Ki-67 has also been added to this list. Sometimes, "immunohistochemistry" is the most practical way to report biopsy results. Although these parameters, which are tried with the method called, can delay, it is very important for planning the treatment of this patient and for predicting the future of the disease. Because now the new classification of breast tumors is based on this "immunohistochemical". are made according to the results. Öespecially according to the new classifications, if there is any doubt about the positivity of both neu, it may be necessary to perform more detailed examinations with the FISH technique.
The result is; Although it seems difficult to keep in mind by our patients, the strogen receptor (ER), progesterone receptor Microscopic pathological examinations such as (PR), Her2 Neu, Ki67 must be carefully examined by the attending physician at the very beginning of the surgery, and it is appropriate to give the patient a suggestion about the future of the disease in an appropriate language in this direction.
This 'hanging' While doing this, the approach of the physician to the patient should be a careful attitude and speech to avoid creating fear and panic, but not to cause neglect as well.