Türkçe
ASSOCIATE PROFESSOR SABAHATTİN DESTEK | GENERAL SURGERY SPECIALIST
1.Can you assess the increase in the incidence of breast cancer?
Breast cancer is the most common type of cancer in women and the leading cause of death. In developed countries, women who are not in the risk group have a 12% chance of developing breast cancer. Although this rate is lower in our country and other developing countries, it is increasing. Women with breast cancer risk factors are 3-4 times more likely to develop breast cancer than normal people. Many models such as Gail and Claus have been developed to identify women in the high risk group. These include the presence of breast cancer in the family, age at first menstruation, age at first pregnancy, age at menopause, body mass index, risky breast biopsy results such as atypical ductal hyperplasia and genetic factors such as BRCA1/2.
2. Does the prevalence of breast cancer vary according to age groups? Is it seen at young ages?
In developed countries, it is predicted that one out of every 8 women will develop breast cancer during her lifetime, but as diagnostic and treatment opportunities increase, deaths from breast cancer decrease. In contrast, in low- and middle-income countries, the increase in breast cancer incidence is accompanied by an increase in mortality rates. In a multicenter study conducted by the Federation of Breast Diseases Associations of Turkey on 20,000 women in Turkey, the average age of breast cancer incidence was 51, the proportion of patients younger than 40 was 16.6%, the proportion of premenopausal patients was 37.2%, and the proportion of patients who had not had a pregnancy was 13.6%. According to the calculations made, the likelihood of the disease increases at a young age in those who do not pay attention to healthy living such as avoiding obesity, regular exercise, balanced nutrition, not drinking alcohol, not using hormone replacement therapy for a long time.
3. What is the age to start screening with mammography? At what intervals should screening continue?
Self-examination from the age of 20, clinical examination after the age of 20 and mammography every two years after the age of 40 are recommended as screening methods for breast cancer. Scientific studies show that mammography reduces deaths from breast cancer by 20% to 40%, which is why mammography is used as a screening method for breast cancer all over the world. Screening mammography should be performed at two-year intervals in asymptomatic women aged 40 years and older. “Women in high-risk groups (such as genetic carriage, family history, dense breast structure) should continue screening at an earlier age, at recommended intervals and with recommended methods. For example, women with first-degree relatives with breast cancer should start screening 10 years earlier than the age at which their relatives were diagnosed. Asymptomatic women who have breast implants for prophylactic or cosmetic purposes should also be included in the screening program.” Breast screening should start at the age of 25 in patients who are carriers of the BRCA1 gene mutation.
4. In which cases is breast tomography used?
Breast tomosynthesis (often called 3D mammography) is a type of X-ray examination of the breast. It is a relatively new technology and research on how to fully utilize it is still ongoing. Digital breast tomography provides a more detailed image of the breast and makes it easier for the radiologist to differentiate between dense breast tissue and cancer. Especially in women with dense breast tissue, digital breast tomosynthesis may be a good option for detecting breast cancer. In studies, digital breast tomosynthesis detected cancer at a higher rate than digital mammography in breast cancer screening. Breast biopsy recommendations were more accurate with breast tomosynthesis. Breast tomosynthesis helped detect aggressive breast cancers earlier than digital mammography. Breast tomosynthesis can also be used to improve images in dense breast tissue and to obtain clearer images of a suspicious abnormality seen on a screening mammogram and/or breast ultrasound. Digital breast tomosynthesis is usually preferred in private clinics for patients who High-risk patients such as women with a family history of breast cancer, women with signs and symptoms such as a lump or nipple discharge, women with dense breast tissue (common in women under 50).
5. Is breast tomosynthesis a commonly used diagnostic device?
Tomosynthesis is widely used in specialized diagnostic clinics where patients are often investigated for breast symptoms or high risk of breast cancer. Recent US-based studies have shown that breast tomosynthesis shows a lower recommendation for further investigations and higher cancer detection compared with digital mammography in interval breast screening visits. On the other hand, no difference in interval or advanced cancer rates or sensitivity was observed between breast tomosynthesis and mammography. In terms of cost and effectiveness, screening digital mammography remains the first line of investigation in the absence of any symptoms in one or both breasts. In conclusion, studies have shown that breast tomosynthesis can improve the detection of breast cancer and reduce false positive results, especially in women with dense breast tissue and can be recommended to this patient group by radiologists.
6. What is the role of artificial intelligence in cancer diagnosis? What are its advantages?
Artificial intelligence has improved imaging processes in a wide range of cancers, including skin, lung, prostate, breast, cervical, colorectal and gastric cancer, with benefits such as early diagnosis, ease of surgical revision and drug development. AI algorithms enable better detection of breast cancer on mammography and help predict the long-term risk of invasive breast cancer.
7. When artificial intelligence is used in the diagnosis and treatment of cancer, can the tumor be fought? What kind of future awaits us in this respect? How close is this future?
Using machine learning algorithms to evaluate large amounts of data for precise and effective diagnosis, artificial intelligence has become a useful tool for cancer diagnosis. In medicine, AI is used in two categories: virtual and physical. Applications such as electronic health record systems and neural network-based treatment decision guidance are done with virtual AI. Elderly care, smart prostheses for people with disabilities and robots that assist in surgery are done with physical AI. AI algorithms help in diagnosis and treatment selection by analyzing multiple patient data, including medical imaging, genomic data and electronic health records. For example, AI is increasingly contributing to early and accurate diagnosis in digitized medical fields such as radiology, especially in cancer detection. AI has the potential to significantly improve cancer survival rates by enabling earlier detection, more accurate diagnosis and more personalized treatment planning.
8. Is it possible to personalize cancer treatment using artificial intelligence?
AI algorithms can be used to identify specific disease subtypes based on genomic data, medical imaging and other patient data, enabling more targeted treatment. Personalized medicine with AI-assisted diagnosis analyzes large amounts of patient data, including genomic data, medical imaging and electronic health records, to develop personalized targeted treatment plans. AI can enable personalized medicine by identifying disease subtypes.