«Breast cancer is curable in most cases»

Published on February 05, 2024

Breast cancer is the most common cancer in women, affecting around 6,500 women every year. Thanks to early detection and individually adapted treatment methods, the cure rate is 80 percent. In addition to lifestyle, the risk factors also include those that women cannot control themselves: Hormones, age and genes.

Breast cancer can affect any woman. All that is needed is a cell change in the mammary gland tissue. Originally healthy cells grow uncontrollably, spread and eventually form a lump or tumor in the breast.

Not every tumor is malignant

Benign tumors are not cancer. Benign tumors include fibroadenomas, for example, which can develop as a result of hormonal fluctuations. One of the characteristics of malignant tumors is their rapid growth. They penetrate neighboring tissue, destroy it and can form metastases in the body. Malignant tumors are referred to as breast cancer or breast carcinoma. A distinction must be made between invasive and non-invasive breast cancer. In invasive breast cancer, cancer cells have already spread into the neighboring tissue. In non-invasive breast cancer, the tumor is still localized and is considered a preliminary or early form of the disease.

Certified breast center with interdisciplinary treatment options

Diagnostics and treatment are carried out at the USZ in the certified Breast Center, which in turn is part of the Comprehensive Cancer Center Zurich. «The aim of our interdisciplinary Tumor Board is to put together a treatment method that is tailored to each individual patient and is as gentle as possible» says Isabell Witzel, Director of the Department of Gynaecology at the USZ. Today, breast cancer can often be cured if detected early. «Four out of five breast cancer patients are cured. It is an advantage that we can offer comprehensive, state-of-the-art care under one roof at the USZ.»

Breast CT does not require compression

Early detection continues to be an important factor in the diagnosis of breast cancer. While the canton of Zurich still lacks a comprehensive screening program for the early detection of breast cancer, the USZ is making rapid progress with its own developments in diagnostics. The USZ was the first institute in the world to develop a spiral computed tomography device for the female breast. «The so-called breast CT creates mammograms without the previously necessary and often painful compression of the breast», says Isabell Witzel. This diagnostic tool complements the equally modern, automated ultrasound. «The more precise the imaging and diagnostics, the better we can put together the treatment plan.»

The range of therapy methods is broad. From breast-conserving surgery to chemotherapy, anti-hormone treatment, drug-based cell growth inhibition, immunotherapy and radiotherapy, many forms of treatment contribute to the high cure rate.

Lifestyle as a risk

Lack of exercise, especially after the menopause, but also a high-fat diet, obesity, diabetes, smoking and excessive alcohol consumption are now considered confirmed risk factors for breast cancer. Isabell Witzel: «We have found that in up to a third of breast cancer cases that occur in women after menopause, lifestyle has contributed significantly to the disease.»

Genetic material can play a role

Genetic testing is particularly important if there are multiple cases of breast cancer in the family. The Breast Center at the USZ offers specialized genetic counseling. Women with a genetic mutation of two so-called tumor genes BRCA-1 and BRCA-2 are at a high risk of developing breast cancer at a young age, with a frequency of 50 to 80 percent. In addition, BRCA genes also increase the risk of other forms of tumor disease.

Women also have no influence on their ageing process. The risk of breast cancer and the incidence rate increase significantly with age. The average age for breast cancer now is 64. The hormone balance changes significantly during the menopause. It is not uncommon for women to undergo hormone replacement therapy to help them overcome the symptoms of menopause. However, the medical profession now agrees that long-term hormone replacement can also increase the risk of breast cancer.

Hormones stimulate the growth of tumors

In the most common types of breast cancer, the tumor cells have hormone docking sites for the female hormones oestrogen and progesterone. The hormones stimulate the growth of tumor cells via these receptors. Breast cancer grows in a hormone-dependent manner.

In these cases, anti-hormone therapy is intended to block the formation and effect of estrogens and thus prevent the growth of hormone-sensitive tumor cells. It is used in conjunction with other treatment methods, but only after chemotherapy has been completed. Depending on the active ingredient, patients receive the anti-hormones daily as tablets or monthly as injections. The active ingredients are distributed throughout the body. They also act on tumor cells that may still be present after surgery and/or radiotherapy but are not visible during examinations. Most patients require anti-hormone therapy over a longer period of time.

Further research at the USZ

The increased chances of recovery are largely due to intensive breast cancer research. In addition to ongoing studies on the new, automated ultrasound, one study at the USZ is focusing on the identification of biomarkers (tumor cells) in the blood in advanced breast cancer. Therapy studies are also in the starting blocks. «The focus here is on customized procedures and operations that are as gentle as possible», explains Isabell Witzel. «Our maxim is: we operate as little as possible, but as much as necessary.»

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Responsible specialist

Isabell Witzel, Prof. Dr. med.

Director of Department, Department of Gynecology

Tel. +41 44 255 52 00
Specialties: Breast cancer treatment, Gynecological oncology, Familial breast and ovarian cancer