There is no diversity, from a biological point of view, between male and female cancer. This is what Doctor Marco Bernini, surgical oncologist for the Universitary Hospital Careggi of Firenze is telling us today. The surgeon has been part of the hospital Breast Unit since 2012 and is only dedicated to breast cancer. The Breast Unit of Firenze, fourth in Italy after the Units in Milano, was established before the European legislation of 2013, becoming soon an italian excellence.
Breast cancers are increasing, but their mortality rate is reducing. The surgeon states that this growth isn’t due to a larger screening, but to the average age of the patients that has lowered. Moreover, breast cancer represents the first female neoplasia for incidence. However, an early diagnosis allows the location of cancers at their early stages, which makes them easily curable and treatable. It is possible thanks to the several prevention campaigns but also to the availability of more efficient therapies, pharmacologically speaking.
This neoplasia doesn’t hit women only: also men are involved. A tumor pathology can develop even if the mammary gland is small and atrophic. It is estimated that among 100 diagnosed cases in the Careggi Hospital Breast Unit, 0,7-0,8% concern men. A lack of knowledge towards this topic among men, often causes a late diagnosis. There is in fact a false belief that they aren’t concerned about it. If the survival rate is lower for men it isn’t because the male tumor is more aggressive, but it is due to the lack of information about the topic and the consequent late diagnosis.
The only differences between mammary glands in men and women concern the late diagnosis and the surgical intervention. Conservative surgery for men is in fact not conceived, because the remaining mammal gland is always removed.
Breast Cancer is always a bolt from the blue in a woman’s life but the emotional impact is even heightened during pregnancy.
Both diagnosis and therapy are changing. Ultrasound, for example, has no side effects and histological tests can give a diagnostic guarantee. Also a resonance can be done during pregnancy because the electromagnetic waves have no harmful effects.
In cases of breast cancer during pregnancy, complex choices and crossroads are ahead, especially during the first trimester. A small cancer at its first stage and diagnosed in the first trimester, can be surgically removed while postponing therapy to a following stage. However this happens rarely.
From the second trimester on, it is possible to begin chemotherapy following proper protocols. Once the third trimester is reached, the labor can be anticipated, combining a C-section with breast cancer removal.
Women can have children and breastfeed once healed. There are chances to get pregnant after surgery and medical treatments. Moreover, in Tuscany, ovocytes cryopreservation is guaranteed to all women under 42 years old who have cancer. Not every woman risks infertility after treatments, but this procedure represents an opportunity to safeguard her future possibility to chose maternity.
Doctors must offer this option to allow every woman such an important chance for her life.