Information on breast cancer

It should first be noted that management of breast cancer is steadily improving: treatments are becoming more advanced, patients receive better support (before, during and after the illness, psychological support, social support, pain management, etc.) and the cure rate is very high. More than 86% of patients are still alive 5 years from diagnosis. However, one problem remains: treatment observance, especially if care is provided in an outpatient setting.

Breast cancer in a few words

Breast cancer is a tumour that develops from cells forming the mammary gland (see diagram below). Malignant cells multiply in an uncontrolled manner forming various types of tumour which are treated in different ways.

Breast cancer
source: e-cancer.fr

95% of breast cancer cases are adenocarcinomas developing either from duct cells (ductal cancer) or, in rarer instances, from lobule cells (lobular cancer).

If the cancerous cells are confined to the ducts or lobules, the cancer is described as 'non-invasive' or 'in situ'.

If the mammary tissue and/or adjacent tissue - or even other parts of the body - are contaminated, the breast cancer is described as 'invasive' or an 'invasive carcinoma'.

Other rarer types of breast cancer exist:

Genomics (the study of genomes) has enabled tumours to be characterised so the type of cancer affecting patients can be determined (luminal A or B cancer, HER2-positive cancer, basal-like cancer, triple-negative cancer) and the most appropriate treatments can be offered.

Treatments may entail exclusive or combined use of:

  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Hormone therapy
  • Targeted therapies

Treatments may be administered in different ways:

  • Intravenous administration: performed in hospital or at home by trained specialist staff with knowledge of the drugs used.
  • Oral administration: may be initiated in hospital and continued in an outpatients setting. This often entails patients taking multiple tablets and requires strict observance in terms of when and how many tablets are taken. Requirements in terms of eating or not eating before and after taking tablets must also be monitored. This is known as treatment observance. Pill dispensers allowing patients to take their breast cancer treatment properly are a very effective tool, especially when patients require fragmented doses due to side effects.

Screening in France

As part of the 'cancer plan' launched by the French government, an organised breast cancer screening plan is offered to all women aged 50 to 74, a period in their lives when they are most at risk of developing breast cancer.

From the age of 50, women are given a mammogram every two years. This consists of two X-rays per breast and two readings by specialist radiologists.

If an abnormality is detected (which occurs in less than 7% of cases) the radiologist can offer additional examinations.

It is essential to undergo a mammogram every two years to ensure early detection of even the smallest tumours.

It is easy to take part in screening: you receive a letter asking you to undergo a screening mammogram. You choose a practitioner from the enclosed list of radiologists in your area who are approved for the national prevention plan. Then it's just a matter of making an appointment.

It is free to take part in screening: clinical examinations and mammograms are fully funded by your sickness insurance fund without you having to pay upfront.

Taking part in screening gives you a major advantage: if you are monitored regularly, breast cancer will be detected sufficiently early increasing your chances of being cured and enabling you to take a less arduous treatment.

Take control of your health with breast cancer screening!

Breast cancer in figures

1 in 8 women will suffer from breast cancer at some point in their lives.

Every year, 49,000 women in France discover they have contracted breast cancer.

If detected early, 9 out of 10 cases of breast cancer can be cured.

Less than 1% of all cases of breast cancer affect men.

The annual death rate is estimated at 11,900.

Average age of diagnosed patients in 2012: 63.

More than 8 out of 10 women affected by breast cancer are aged 50 and above.

The number of breast cancer cases increased by 138% between 1980 and 2005 for several reasons:

  • Increased life expectancy
  • Increased screening enabling cancer to be detected in the early stages
  • Increased environmental and behavioural risk factors according to some experts

Above the age of 40, statistics show that the risk of contracting breast cancer increases one-and-a-half times every ten years.

Risk factors

Several factors moderately increasing the risk of breast cancer are highlighted by the French National Authority for Health (HAS):

  • Family history
  • Obesity, especially post-menopause
  • Hormonal contraception
  • Hormone Replacement Therapy (HRT) for the menopause
  • Late pregnancies or a lack of full-term pregnancies
  • Alcohol consumption
  • Type 2 diabetes
  • Consumption of fatty meat

Progress on research

Every year, cancer research takes a step forwards. One of the largest European cancer research centres,the Institut Curie, has highlighted several very promising developments:

  • Precision medicine is based on tumours' molecular characteristics. Four biomarkers (specific characteristics of a tumour) are used for breast cancer. By systematically identifying these biomarkers, patients can be offered a treatment tailored specifically to their tumour type, if such a treatment exists.
  • Targeted therapies specifically block tumour cells unlike chemotherapy which attacks all the body's fast dividing cells, irrespective of whether they are healthy or cancerous.
  • New diagnostic methods are being developed based largely on advances in imaging techniques.
  • Detection of circulating tumour cells. Cancerous cells that 'detach' from the tumour and circulate in the body are detected by a simple blood test. This examination should improve monitoring of disease progression in the metastatic phase and enable treatment to be adapted accordingly. This method is faster and less invasive than biopsies.

The Institut Curie is also looking at circulating tumour DNA.

Sources: e-cancer.fr, cancerdusein.org, ameli-sante.frcurie.fr