Cancer is a broad term for a group of diseases characterized by the growth of abnormal cells that invade healthy cells in the body. In breast cancer, it begins in the breast cells as a group of cancer cells that can then invade surrounding tissues or spread to other areas of the body (metastasis). According to the World Health Organization, breast cancer is the most common cancer among women worldwide, and accounts for nearly a quarter of new cancer cases among women. It is diagnosed most frequently in 140 of 184 countries, and is particularly increasing in developing countries where the majority of cases are diagnosed. Cases are in the late stages. It is the disease that kills hundreds of thousands of women every year and is a leading cause of premature death among them. According to The Cancer Atlas.

Early detection, in order to improve breast cancer outcomes and survival, remains the cornerstone of breast cancer control, and mammography saves lives through early detection, according to the American Radiological Society (RSNA).

Breast cancer in numbers

October was designated for Breast Cancer Awareness Month in 1985. On this occasion, the Saudi Society of Oncology, in cooperation with Pfizer Saudi Medical Company Ltd., held a press conference on the platform of the Forum of Experts, last Monday, October 18, 2021, in which the latest developments in breast cancer were highlighted. Diagnostic and therapeutic and the role of artificial intelligence in early palm.

Talk to the “Your Health Attaché” Prof. Dr. Mutaib Al-Fahidi - President of the Saudi Society of Oncology, Breast Cancer Consultant at King Abdulaziz Medical City for the National Guard in Jeddah, President of the Annual International Breast Cancer Conference, Chairman of the Conference - He explained that breast cancer is the most diagnosed type and the most deadly type of cancer for women in the world. It is responsible for 25 percent (1.7 million) cancer cases and 15 percent (521,900) cancer deaths annually. The global standard incidence of breast cancer is 43 cases per 100,000 people. Breast cancer recorded slightly higher prevalence rates in the least affected areas (883,000) cases, compared to the more developed areas, which recorded (794,000) cases. As for cancer in the world, there are 19 million and 300 thousand cases of cancer, of which two million and 300 thousand cases of breast tumors account for 11.7 per cent, of which 24 per cent are breast cancer cases. There are 4.4 million cancer deaths among women, of which breast cancer represents 15.5 per cent. According to GLOBOCAN, a global cancer statistics website.

Locally, the statistics of the Saudi Cancer Registry issued in 2020, indicate that there were 2508 cases of breast cancer in both sexes (2,463 cases among women, 45 cases among men) recorded in 2017, which represents 18 percent of other types of cancer in total. This means that 30 Saudi women out of every 100,000 are diagnosed with breast cancer, compared to 92 out of every 100,000 American, British or Irish women. Despite the low percentage we have, the problem of breast cancer in the Kingdom lies in the fact that early cases (stage I and II) represent approximately 40% of the total cases and that locally advanced cancer, including lymph nodes (stage III) also represents 40% and metastatic cancer (stage IV). ) represents 15.5 percent, while the remainder (3.8 percent) is of unknown type.

Risk factors and causes

> Risk factors, including

Gender, the prevalence of breast cancer among women (one hundred) times that of men.

Age. The risk of infection increases with age.

Genetic factors. Genetic mutations account for about 12 percent of breast cancer cases, and the most common mutations are Braca 1, Braca 2 (Braca 1, 2).

Family history. The risk is higher if a first-degree relative is affected.

Personal history. The risk of recurring cancer increases to three or four times with a previous diagnosis.

Hormonal level. Risks rise with early menstruation, late menopause, and use of oral contraceptives. Risks decrease with premenopausal oophorectomy, pregnancy before the age of 30, and breastfeeding.

Lifestyle. The risk increases with obesity, postmenopausal women, drinking alcohol, smoking, and exposure to ionizing radiation, while the risks decrease with exercise and maintaining a normal weight.

> Causes of breast cancer. Professor Miteb Al-Fahidi says that no one knows yet what is the reason for the identification or how to prevent infection, but we know very well that the discovery of breast cancer while it is still confined to the breast makes the survival rate up to 98 percent.

tags. We advise every woman to

To know the risks of developing breast cancer through infected cases in her family, and to inform her doctor about that.

Remember that risk factors do not cause breast cancer, but rather increase the chances of developing it.

The presence of many risk factors means that there are more chances of contracting the disease than those that have fewer risk factors.

Some risk factors can be controlled.

All that can be done is to conduct the necessary tests, consult a specialist doctor about the appropriate ones, make sure to perform a mammogram every year starting from the age of forty if the risks are moderate, and conduct a clinical examination of the breast at least every three years starting from the age of twenty and every year after the age of forty.

Hereditary breast cancer

Prof. Dr. Ezz El-Din Ibrahim, a consultant oncologist and head of the Oncology Center at the International Medical Center in Jeddah, says that some studies have proven that the examinations that are carried out for patients with breast cancer who meet certain specific conditions, the genetic factor is discovered in 10% of them, and if we expand the system and justifications for specifications Genetic testing may increase this number. Also, most hereditary breast tumors are due to a genetic factor, and recently it was found that there are some genetic inheritances of a nature related to the severity of breast tumors, and their percentage was much lower than the breast tumors arising from PRACAA 1 or PRACAA 2.

To detect hereditary breast cancer, an examination is performed and a sample is taken from the mucous membrane lining the mouth, which is a universally agreed upon examination. The importance of genetic testing lies in the presence of recent therapeutic discoveries and drugs that deal with the genetic factor, and we expect in the near future that other more effective drugs will be available and can greatly reduce the use of chemotherapy.

Genetic testing can be done for the following groups

For women without breast cancer, but there are cases of her first-degree relatives such as the mother and sister, for example, and she has a high rate of genetic disorders. She may have a genetic disorder, the most famous of which are Praca 1 and Praca 2, which are the most famous genes that represent 5 out of 10 per cent of the genes.

For a woman with breast cancer, if the result is positive, she will also have an increased risk of ovarian and fallopian tube cancer. She had to remove the breasts as a precaution, and after marriage and completing the family with childbearing, she removed the ovaries and fallopian tubes at the age of approximately 40-45 years. And if she refuses to undergo preventive surgery, she must be sure that her risk of breast cancer is high, as well as ovarian cancer and other cancers. And she must do an MRI and mammogram every six months consecutively, that is, once the x-rays and then the mammogram, starting from an early age (thirties).

For a woman with breast cancer, as well as her mother and grandmother, both have breast cancer, and the reason is that there are modern medicines directed at such a case. We advise her to remove the other unaffected breast. We emphasize the eradication of breast tissue, not just mastectomy, and we maintain the aesthetic shape of the breast to raise its morale.

style and lifestyle

> Lifestyle. Dr. Mubarak Al-Mansour points out that lifestyle is very important. Here are some examples:

Overweight and obesity, for example, are a risk factor for developing tumors. Limit your intake of fast food because it is high in fat.

Contraceptive pills, the use of them for long periods of more than 5-7 years and without medical advice and follow-up due to personal and family history carries a risk of breast cancer, especially previous contraceptive pills whose composition differs between estrogen and progesterone.

Sugars, there is a syndrome of insulin resistance in the blood, accompanied by an increase in many diseases in humans, including cancers.

Nutritional supplements, vitamins are not harmful, but during treatment and afterwards, a healthy balanced diet must be followed with a lot of fruits and vegetables. As for the use of nutritional supplements, which contain antioxidants, which have been proven to increase the risk of breast tumors, the advice is to avoid them.

Innovative prevention methods

> A comprehensive approach to prevention. Advances in breast cancer prevention research have resulted in new and innovative opportunities to modify breast cancer risk, and the potential to reduce incidence and mortality, according to a study by researchers from the Mayo Clinic Cancer Center published in the Journal of Clinical Oncology Practice.

The study''s lead author, Dr. Sandia Bruthy, a Mayo Clinic internal medicine consultant, says it is wise for a health care provider to be aware of the benefits of individual breast cancer risk assessment, and to advise and implement strategies to reduce disease risk. She adds that for many years, breast cancer prevention research has focused primarily on the use of anti-estrogen drugs to reduce the incidence of higher-probability, hormone-sensitive breast cancers, but it is important that we re-screen and implement other risk-reduction strategies to prevent unlikely breast cancers, known as Triple negative neoplasms.

Women and health care providers should be encouraged to consider a comprehensive approach to breast cancer prevention that includes:

Lifestyle modification.

Preventive anti-estrogen medications.

Mammogram for monitoring.

Gene testing.

Finally, women at high risk of developing one of the hereditary breast cancer mutations should consider the option of preventive surgery to reduce the risk. To achieve this, clinicians must assess their patients'' individual risks and advise them on interventions, which range from making lifestyle modifications to using preventive (anti-estrogen) or equine estrogens.

These strategies may be useful in reducing hormone-sensitive breast cancer tumors with good prognosis, and may be useful in preventing hormone-insensitive tumors with poor prognosis.

> Artificial intelligence systems for early detection of breast cancer. Prof. Dr. Ezz El-Din Ibrahim says that the traditional methods for detecting breast cancer are mammograms of different types every year or two starting from the age of forty, ultrasound examination, which is complementary to the role of the mammogram and not a substitute for it, and then magnetic resonance imaging, especially in the presence of a genetic factor or family history Strong for breast tumors.

Finally, the role of artificial intelligence systems, which appeared in the past few years, came to reduce the burdens of human and technical resources. Artificial intelligence devices are given large numbers of information about previous mammogram results. Many studies have proven that this method matches, if not increases, human capabilities in diagnosis. One of the most important scientific centers in the use of artificial intelligence in medical applications is the Massachusetts Institute of Technology (MIT) not only for breast cancer but for all tumors. This institute bears the name of Sheikh Abdul Latif