Breast Cancer

It is a fact that every 8th woman in the Czech Republic suffers with breast cancer.

Breast cancer is a malignancy in the tissues of the breast. Normally cells reproduce themselves by dividing in an orderly fashion, so that growth and repair of body tissues can take place. Cancer is the disease that interrupts this normal cell function, so cell and tissue growth cannot be controlled.

Breast cancer is the most frequent cause of death in women up to 60 years of age living in Europe.

Little is known about the causes of breast cancer. Around 10% cases are connected with genetic predisposition, the rest arise due to changes in cells that take place as a result of aging. With this cancer , more than with any other, the earlier the disease is discovered, the higher the chance of cure.

We at the Canadian Medical Centre are delighted that from March 2010 we have a dedicated Senology service, managed by the top Czech specialist Dr. Karel Raus.

Senology is a branch of medicine that handles the complex care of breast diseases. It looks at both the appropriate diagnosis and treatment of the disease. The aim of senology is to firstly consider the risks connected with a woman´s family and personal history and secondly to choose a correct examination method that could lead to an early uncovering of a malignant tumour in the breast and its subsequent treatment.

Canadian Medical Care is delighted that we can now offer a dedicated senological consultation. In this consultation you will:

· better understand, the issues relating to breast diseases.

· consider your individual risk , regarding your personal and family history.

· get clear information on the advantages and disadvantages of using female sex hormones in respect to breast disease.

· Receive a briefing in the purpose and technique of regular self-examination.

This will be followed by a clinical examination of the breasts and of the lymphatic nodes by palpation. Examination by palpation can lead to the uncovering of breast lesions, which would stay concealed when using other screening methods.

Should you have medical notes and findings from previous examinations, these will be considered and explained by the doctor. After this appointment and based on the actual clinical condition, further medical investigations may be recommended.

If you have not undergone any previous examinations, the doctor will identify the most suitable for you. In the first instance these usually comprise of;

a mammogram
In the Czech Republic a mammogram is recommended for all women above 40 years of age, (For patients with OZP insurance a screening mammogram every two years will be refunded to women over 40, for VZP the age is 45).

Two x-rays of each breast will be taken. To do this your breast will be pressed firmly between two pieces of plastic. Some women find this uncomfortable, or even painful, but the x-ray takes less than a minute.
Mammograms use very low doses of radiation which pose a minimal risk to your health.

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ultrasound
An ultrasound scan is a simple test which uses sound waves to build up a picture of your breast. It is very sensitive and can tell the difference between a solid lump and a cyst, for example. The test is painless

Aspiration
Sometimes the doctor will then want to take a small sample of cells from a lump, if found. This is often called a fine needle aspiration (FNA).,

Other diagnostic tests might include MRI or CT. Your doctor will choose the most appropriate examination for you, taking into account your age and condition.

A biopsy
Sometimes it isn’t possible to be sure if a change in the breast is benign or cancerous without doing a biopsy. A biopsy is when a sample of breast tissue is removed and examined under a microscope.

One type of biopsy – a trucut biopsy – may be done in the outpatient clinic using a local anaesthetic. A core of tissue is removed and sent to the laboratory. You will feel pressure and some discomfort when this biopsy is taken.

We recommend all women should make an appointment to visit a senological office whenever the following symptoms occur:

1. Pain or discomfort in the breast

2. Feeling lumps in the breast or in the underarms.

3. Secretion from the nipple (especially if only from one breast).

4. Eczema or itching of the nipple or a change of colour or appearance in the nipple.

5. A reddening of the breast skin
Tissue and/or pain of the lymph nodes in the underarms, around the breast or collarbone.

Women are also recommended to attend the Senology office for the following reasons;

2. As a part of annual gynaecological examination

3. Where there is a family member with breast cancer, especially if a first line relative (mother, sister).
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4. A strong family history of any other cancer , for example ovarian cancer, cancer of the large intestine, prostate cancer.

5. Where there is a known genetic predisposition of breast cancer in the family.

6. In case of an unclear or suspicious medical finding during breast examination (Mammography, ultrasound, MRI, etc.).

Before using medicines containing female sex hormones or their derivatives. (This also applies to women, about to undergo hormone treatment as part of assisted reproduction).