The doctor spoke about modern ways of fighting breast cancer

Breast cancer remains the most common malignant tumor among women, and the prognosis of treatment directly depends on early detection. Dmitry Bulanov, Director of the Department of Pathomorphology and Clinical Cytology at the LabQuest Laboratory, Candidate of Medical Sciences, told Izvestia on October 15.

He noted that the disease can be asymptomatic in the early stages, so regular screening is a key tool for prevention and timely diagnosis.

"There are signals that cannot be ignored: the appearance of a lump in the breast or armpit area, local thickening or a change in the structure of the skin like an "orange peel", redness or peeling of the areola, nipple retraction, discharge (especially bloody), a change in the shape and size of one breast or persistent local pain," Bulanov said.

The absence of pain, he said, does not exclude the presence of a problem, so any changes require specialist advice.

About 5-10% of breast cancer cases are associated with inherited pathogenic gene variants. The most well-known are BRCA1 and BRCA2, but PALB2, TP53, PTEN, CDH1, CHEK2, ATM and others are also of clinical importance. Carrying such variants significantly increases the lifetime risk of developing breast and ovarian cancer. With the BRCA1 mutation, the risk of ovarian cancer reaches 39-58%, BRCA2 — 13-29%, and the risk of breast cancer significantly exceeds the average population level.

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As a hybrid protein, it simultaneously suppresses the growth of a neoplasm and reduces the number of vessels around it.

"Genetic counseling and testing are recommended for women with breast cancer up to 45 years old, with a triple negative variant up to 60 years old, with bilateral lesions, familial cases of breast cancer, ovarian, pancreatic or prostate cancer, as well as with a known family variant or Ashkenazi origin," said the candidate of medical Sciences.

The results of genetic testing are classified according to ACMG standards: pathogenic and probably pathogenic variants require clinical solutions, variants with uncertain significance should not change tactics, but can be reclassified over time.

Identifying high-risk options allows you to build an individual prevention strategy: prescribe earlier and more frequent screening, discuss chemoprophylaxis, or consider risk-reducing surgery. Bilateral preventive mastectomy can reduce the risk of breast cancer by 85-95%, and preventive salpingo-oophorectomy in BRCA carriers reduces the risk of ovarian cancer and additionally breast cancer, especially if performed before menopause.

The screening strategy is based on an assessment of individual risk. Since the age of 25, it is recommended to conduct a formal assessment once, taking into account family history, reproductive history and breast tissue density. For women of average risk aged 30-39 years, regular self-examination and medical treatment when symptoms appear are sufficient. If there is a high risk, annual MRI and mammography are recommended, starting from the age of 25-30. From 40 to 74 years of age, women at average risk are shown mammography every two years, and it can be started earlier according to clinical indications.

"In cancer prevention, the so—called "prevention molecules" are becoming increasingly important - drugs that reduce the risk of cancer in high-risk women. These include selective estrogen receptor modulators and aromatase inhibitors," the specialist added.

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Studies have shown their ability to reduce the risk of ER-positive breast cancer by 50% or more, but such drugs are prescribed only after a thorough assessment of the benefit-risk ratio.

A rapidly developing field is polygenic risk-based models that take into account a set of small genetic variants and allow for more accurate prediction of individual risk. In 2025, the first international recommendations on their use were published, and although their integration into clinical practice is uneven, the potential of this technology is enormous.

It is important to remember that there are no "breast cancer blood tests" for screening. Cancer markers are not used to detect the disease in healthy women. Diagnosis and prevention are based on a comprehensive assessment of clinical, genetic, and laboratory data, regular screening, and careful attention to one's own health. Early diagnosis and knowledge of your risk make it possible to build an individual protection strategy, while regular examinations become not a cause for alarm, but a tool for controlling your health.

In September, oncologist Alexander Seryakov named the most common cancers in men and women. According to him, breast cancer is the most common disease in women in the world. Almost one in eight experiences this disease during their lifetime. And men have prostate cancer.

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