Cancer is a leading cause of mortality in the Western world, and in recent years it has become the number one cause of death in Israel. Over the years, there has been a moderate upward trend in cancer morbidity, but a moderate decline in mortality in some types of cancer, which apparently stems from early diagnosis, the implementation of cancer screening tests in the medical system, as well as advances in treatment methods and the increase in the development and approval of new drugs.
Early Identification of Risk Factors for Breast Cancer It may delay and even prevent the development of the disease, and therefore it has the power to save lives. Risk factors for developing cancer include a family history of cancer, inherited genetic predisposition to mutations in genes such as BRCA1/2, known exposure to carcinogens or radiation, excessive exposure to the sun, smoking, and more. The mere presence of these risk factors in the background of a particular patient will not necessarily lead to the development of cancer, but it does increase the risk of developing it. Awareness of risk factors can lead to relevant screening tests that increase the chances of detecting cancer, if it develops, at an early stage, in which in many cases a complete cure is possible.
Age is the most common risk factor for cancer, so starting at the age of 50, it is recommended that the entire population undergo screening tests for the early detection of common cancerous tumors such as breast cancer, colorectal cancer, and lung cancer (among smokers).
Breast Cancer Screening Test
Breast cancer is the most common tumor in women. In Israel, more than 5,000 new breast cancer patients are diagnosed each year, and about 70% of breast cancer cases are diagnosed at an early stage – and in these cases, good chances of recovery are expected.
Periodic Breast Cancer Screening Tests These include a breast surgeon's examination, mammography imaging, ultrasound or MRI, as recommended and a breast self-examination. It should be noted that the self-examination technique by itself has not been proven to be an effective screening method for early detection of breast cancer. The purpose of these tests is to identify new lumps in the breast, changes in the appearance or structure of the breast or nipple, and to enlarge lymph nodes in the armpit and in the breast area where cancer cells sometimes reach from the tumor in the breast itself.
The recommended frequency for mammography examination according to the Ministry of Health's guidelines is once every two years for women defined as at normal risk from the age of 50 to 74 years, and once a year from the age of 40 for women who are at high risk defined as
Having a first-degree relative who has been diagnosed with breast cancer, benign breast disease (e.g., cysts), after discovering only suspicious findings in a past biopsy, and other reasons at the discretion of the attending physician. Sometimes, a breast MRI scan will be offered to women in high-risk groups, such as women who have been diagnosed with a carrier of a pathogenic genetic change in one of the BRCA1 or BRCA2 genes.
What happens after a breast cancer diagnosis?
After a suspicious lump is identified in the breast following the screening test detailed above, or when the patient feels it herself and seeks clarification, a sample is taken from the suspicious lump using a needle (biopsy). The sampled tissue undergoes a pathological examination under a microscope in order to distinguish between a cancerous process or a benign finding. In addition, biomarkers are examined in order to characterize the type of breast cancer, and for this purpose, the tumor tissue is stained with what is typical of breast cancer: the receptors for the sex hormones estrogen and progesterone, and the HER2 receptor. Information classifies breast cancer into subtypes: Most cases will be classified as breast cancer that expresses more hormone receptors and is negative for oncogen expression HER2, another group for the type that expresses more HER2. This information is essential for further treatment planning.
The goal of treating breast cancer that is detected at an early stage is cure, and therefore the treatment includes, in addition to tumor removal, radiation treatments, which are local treatments, as well as systemic complementary therapy in order to reduce the chance of distant recurrence of the disease. These treatments may include hormone therapy, chemotherapy and/or biological therapy.
As mentioned, breast cancer is actually a group of diseases and therefore it should not be treated in a "one-size-fits-all" format. Various genomic tests for breast cancer subtypes diagnosed at an early stage provide unique biological information aimed at assisting in therapeutic decisions regarding the degree of benefit of various complementary therapies.
• OncotypeDX Breast Recurrence Score – has been used for about 20 years in Israel and the United States and is intended for those diagnosed with breast cancer at an early stage, when the tumor expresses receptors for estrogen and/or progesterone and does not express the receptor for HER2. The purpose of the test is to assess the risk of recurrence of the disease and the expected benefit of adding chemotherapy to hormone therapy. In fact, this test is included in all professional guidelines around the world for deciding on adjunctive chemotherapy for patients diagnosed with this type of breast cancer.
• The HER2DX test is intended for those diagnosed with breast cancer at an early stage – when the tumor overexpresses the HER2 receptor and its purpose is to identify the patient's level of risk of recurrence of the disease and predict the degree of response of the tumor to various treatments.
In cases where breast cancer is discovered at an advanced stage of the disease or after the progression of an existing disease, genomic tests that characterize the tumor's genomic profile identify changes that can indicate the suitability of new treatment options that would not have been available without this information, such as immunotherapy.
Examples of such tests are:
• Tempus xT test – based on an analysis of tumor tissue and includes sequencing of 648 genes in tumor tissue as well as in non-cancerous cells (from blood or saliva samples). The test is an aid in choosing the most appropriate treatment on the one hand, and helps to avoid inappropriate treatments on the other.
• The Guardant360 test is a "liquid biopsy" test – it detects genomic changes relevant to cancer in free DNA segments. The test includes an analysis of 74 genes and its purpose is to enable personalized treatment adjustment even in cases where there is no tissue suitable for analysis or the existing tissue no longer represents the current disease.
Oncotest offers help in performing genomic tests privately with professional guidance, assistance in checking eligibility with insurance companies and of course in full cooperation with the treating physician – these tests can be the difference between making the right decision about treatment or even omitting treatment that is not necessary. It is always important to examine all the factors that can help in choosing the treatment and to consult with the treating doctor about the progress of such a process. You can contact us by phone at the following number: 072-271-3444 Or visit our website at: https://oncotest.co.il/ .