Breast cancer

Understand breast cancer

Breast cancer is a tumour which develops from the cells that form the mammary gland. It is known as a heterogeneous disease, because there are several types of tumour. Each tumour calls for a specific treatment.

• It is called a carcinoma in situ if the cancerous cells are confined to the level of the breast channels or lobules.
• If the cancerous cells have crossed the so-called "basal" membrane of the channels or lobules and invaded the neighbouring tissues, it is an infiltrating carcinoma. The cancerous cells may propagate either in the lymph nodes under the armpit, or through the veins.
• Progress in research has now made it possible to distinguish three major types of tumour: Luminal A or B type cancer, HER2 type cancer and basal-like cancer. Determining the type of tumour makes it possible to now offer more appropriate treatments.
• Two genes contributing to susceptibility to breast cancer have been identified, called BRCA1 and BRCA2. 60,000 women are thought to carry one of these two genetic mutations. They may be transmitted by either of the parents and significantly increase the risk of one day developing breast or ovarian cancer. Women identified as carriers of one of these mutations are offered suitable monitoring.

The treatment of breast cancer depends on the extent of the cancer at the time of diagnosis. It usually includes removal of the tumour (or of the breast, if the cancer has spread) and the nearby lymph nodes. Today, the sentinel lymph-node technique (removing the lymph node closest to the breast) makes it possible to determine during surgery whether or not it is necessary to remove the entire lymph-node chain. Surgery is often complemented by chemotherapy and radiation therapy.

Thanks to the progress made in treatments as well as in screening carried out for women aged 50 to 74 years, the five-year survival rate after diagnosis is around 90%.

Breast Patient Care at Institut Curie

Institut Curie is a key center for the treatment of breast cancer. Leading experts treat patients according to the most appropriate protocols. Innovation is at the heart of breast cancer treatment.

>>  Institut Curie offers a seamless care framework, that centralizes all the information you need, avoiding multiple trips to the hospital before treatment begins. When the medical record permits, patients are operated on in the morning and can go home in the evening of the same day.

>> “Alternative” techniques are proving successful. For example, several surgical procedures, including mastectomies (total removal of the breast), have been carried out under hypnosis. This technique allows patients to avoid the complications and fatigue linked to a general anesthetic.

>> Institut Curie is also the leader in terms of post-breast-cancer reconstruction, which must first be handled as a psychological issue. Physical reconstruction is not routinely chosen. Part of the mission of Institut Curie’s actors involves helping patients along their path toward healing. This led to the 2014 production of a documentary, Healing Our Perceptions, which follows patients as they make their various choices.

>> Institut Curie offers a broad range of supportive-care services, including the post-cancer phase, once treatment is complete. The Programme Activ’, in partnership with the charity Siel Bleu and AGR2 La Mondiale, offers appropriate exercise and nutrition workshops to help reduce the risk of recurrence.

Research on Breast Cancer

Institut Curie is currently participating in more than 20 clinical trials for breast cancer on a variety of topics.

• Precision medicine For some types of cancer, the characteristic biomarkers of the tumor are known. By systematically identifying them, the patient can be offered the treatment, if one exists, that corresponds precisely to the nature of her tumor. For breast cancer, four biomarkers (HER2, ER, PR, Ki67) are already routinely looked for. Other biomarkers should be validated via clinical trials.
• Targeted therapies These present many advantages: unlike chemotherapy, which attacks all the rapidly dividing cells in the organism, whether healthy or cancerous, targeted therapies block tumor cells more specifically.
• The development of new diagnostic methods is also at the heart of our concerns. Imaging techniques are being perfected
• The detection of circulating tumor cells (cancerous cells which “detach” from the tumor and circulate within the organism before installing themselves on another organ in order to develop) can be accomplished via a simple blood test. This should allow for better monitoring of the disease’s evolution in its metastatic phase so that the treatment can be adapted. This method is faster and less invasive than biopsies.