Breast cancer

Breast cancer is the most common cancer in women. The disease can be formed in the inner shell breast ducts (ductal carcinoma), as well as mammary lobules cells producing milk (lobular breast carcinoma).

Breast cancer (especially of the non-invasive form) lends itself well to treatment in the early stages. Therefore, if detected early should contact our specialists for correct diagnosis and proper treatment.

Less common type of the disease is an invasive lobular breast cancer that develops in the cells of the lobules that produce milk, and Paget’s disease of the breast.

Breast cancer survival rate in Israel

According to the Israeli Ministry of Health information.

The relative survival to 5 years expresses the survival of those diagnosed with a particular disease in relation to the survival of the population group corresponding to them in sex and age, at the same time period.

The relative 5-year invasive breast cancer survival rate among Jewish and other women and Arab women diagnosed in 2008-2013 was 84% and 89%, respectively. Among Jewish and other women and Arab women diagnosed in 2002-2007, the relative five-year survival rate was 82% and 86% respectively.

Among Jewish and other women and Arab women diagnosed between 1996 and 2001, the relative five-year survival rate was 73% and 84%, respectively. In both population groups, a moderate improvement in survival was observed among women aged 20 – 49 and 50 – 74 at diagnosis.

Since Israeli medicine, and in particular the cancer treatment Israel, is one of the advanced fields in the world, here you can get a cancer second opinion from one of the best oncologists in Israel and undergo treatment in one of the leading Israel Cancer Centers, where all the advanced diagnostic methods are presented, including a Pet Scan for cancer, MRI, as well as advanced treatment technologies, including personalized cancer treatment and immunotherapy in Israel.

Types of BC:

• Non-invasive ductal carcinoma in situ (DCIS);
• Invasive ductal carcinoma (IDC);
• Triple Negative Breast Cancer (TNBC)

If you or any of your relatives were diagnosed with such disease, please contact us. We accept patients for the treatment of all disease stages, any kind of tumor location and malignancies in the body.

We will promptly coordinate doctor consultation and medical treatment in Israel.

You will be advised and treated by a doctor who focus on treatment of your disease, who is a head of specialized department of one of the best hospitals in Israel.

We will provide examination program focused on your problem, according to which, you will clearly understand before coming to Israel, on what day and at what time you scheduled for a consultation and procedures.

One of the Leading breast cancer doctors in Israel

Head of Onco-Gynecology Unit and Breast Cancer Unit.
Lis Hospital for Maternity and Women, Oncology Department, Sourasky Medical Center (Ichilov).
Doctor Consultation Online

In addition to an Israeli doctor breast cancer second opinion you can also get:

– Breast Cancer Second Opinion Pathology to confirm or clarify the diagnosis. An experienced Israeli pathologist will review the samples under a microscope in an Israeli laboratory and issue a biopsy slides second opinion report.

– Breast Imaging Second Opinion or second opinion MRI / PET / CT. Our experienced radiologist will interpret the disc and write a report. So you will have an Israeli radiologist second opinion as well.

A second opinion will help the doctor make the right decision about your treatment.

Breast Cancer Screening in Israel

• Blood test (including tumor marker Ca 15-3).
• Mammography and breast ultrasound.
• Biopsy tumor tissue and study it for cancer cells. Needle aspiration FNA – fine needle is inserted into the tumor in the breast, and from there a small sample of tissue is removed. The entire procedure is performed under ultrasound. Likewise performed biopsy of nearby lymph nodes (axilla).
• PET Scan – body scan for detecting metastatic invasive disease.
• Oncotype DX test are used to determine the risk of distant metastases in patients with locally invasive breast cancer, which is with stage 1 – stage 3 breast cancer, estrogen positive / or progesterone positive and HER2 negative breast cancer. Molecular tests provides the oncologist with information that allows to cancel chemotherapy in addition to hormone therapy.

The pathology examination of the removed tumor gives information for the right medical treatment. An experienced Israeli pathologist will examine the sample under a microscope for determining details as follows:

• type of tumor – whether it is an invasive breast cancer or non invasive breast cancer. The invasive type is a tumor that spread into surrounding breast tissues. This type can be Invasive ductal carcinoma or IDC or Invasive lobular carcinoma or ILC. Invasive ductal carcinoma is divided into: Cribriform carcinoma, Metaplastic carcinoma, Medullary carcinoma, Mucinous carcinoma, Papillary carcinoma, Tubular carcinoma.
• size of the tumor 
• Nottingham grade
• tumor necrosis
• tumor margins
• lymphovascular invasion
• lymph node status
• hormone receptor status.
  • triple positive breast cancer – estrogen, progesterone and Her2 positive breast cancer
  • or estrogen, progesterone positive and Her 2 negative breast cancer
  • or triple negative breast cancer (TNBC) – estrogen, progesterone and Her2 negative breast cancer

  rate of cell growth – Ki-67 breast cancer levels

• BRCA breast cancer – BRCA gene mutation status
• stage – stage helps in planning the treatment and is the part of the data set to assess the risk of future recurrence of the disease.

Stages of Breast cancer

Stage 0 breast cancer – The tumor is not invasive and is limited by a thin membrane called local carcinoma (in situ), for example non-invasive type (DCIS – Ductal Carcinoma In Situ). This tumor does not metastasize and does not involve lymph nodes.

Stage 1 breast cancer – A cancerous growth of up to 2 cm in diameter that extends beyond the tubular boundaries, invaded the breast tissue, but did not spread to lymph nodes or out of the breast. A tumor at this stage is also called an infiltrating or invasive tumor.

Stage 2 breast cancer

Stage 2a – one of the following can take place:

• There is no breast tumor, but there is a cancerous growth of 2 mm or more in 3 lymph nodes in the armpit or near the sternum.
• Tumor size 2 cm or less west 3-1 lymph nodes in the armpit.
• Or a tumor 2 to 5 cm in diameter that did not spread to the lymph nodes.

Stage 2b – one of the following can take place:

• Tumor 2 to 5 cm in diameter west of lymph nodes in the armpit or near the sternum.
• Tumor over 5 cm in diameter, which does not involve lymph nodes.

Stage 3 breast cancer – Divided into two sub-steps:

Stage 3a – one of the following can take place:

• Invasive tumor up to 5 cm in diameter, west of lymph nodes fixed in the armpit, or attached to each other.
• An ingrown tumor over 5 cm in diameter, west of the lymph nodes in the armpit on the same side, which can be moved.

Stage 3b – one of the following can take place:

• A tumor, of any diameter, that has spread to the tissues surrounding the breast (chest wall or skin), including the ribs and chest muscles.
• Inflammatory breast cancer – a rare type, classified as a stage 3 cancerous growth.

Stage 3C – the presence of a tumor of any diameter that has spread to at least 10 lymph nodes in the armpit; or at least to one lymph node in the armpit and one below the sternum; or spread to at least one lymph node below or above the clavicle.

Stage 4 breast cancer – there are cancerous growths in the breast that have metastasized to other organs in the body, such as the bones, lungs, liver or brain. It is advanced or metastatic disease.

One of the Leading breast cancer doctors in Israel

Dr. Noa Efrat Ben Baruch – Expert in advanced breast cancer treatment and HER2 mutations. Former Director of the Oncology Institute at Kaplan Medical Center in Rehovot

Breast cancer management in Israel 

Surgery

There are several types of surgery:

Lumpectomy and Quadrantectomy – surgeries to remove the entire malignant tumor, sometimes one of the segments of the breast, but with the preservation of most breast cancers.

Mastectomy – surgery to remove the entire breast (sometimes also removed nearby lymph nodes), followed by reconstructive surgery in order to restore the breast. Surgery with preservation of the breast and subsequent radiation therapy have shown good results in the treatment of breast cancer at an early stage.
Surgery method depends on the size of the tumor location and extent of the process.
 

Radiation therapy

Radiotherapy – removal of cancer cells with high energy X-rays or electron beams.
Treatment takes from 5 days to several weeks.
Before the procedure, CT simulation modeling process should be performed for mapping of spot beams for irradiation. Computer software program determines exposure for each women individually.
When storing the breast after the surgery, radiation therapy supplied to the rest of the breast tissue.
In the case of removing the entire tumor radiation therapy is done to the chest wall.
Radiation therapy can also be directed to the lymph nodes at the armpits and their surroundings to kill cancer cells that may be present in the lymph nodes.

Chemotherapy 

Chemotherapy involves the use of anti-cancer (cytotoxic) drugs to remove cancer cells. Chemotherapy is usually used after surgery to destroy any cancer cells that could not be removed during the operation. This is called adjuvant chemotherapy. In some cases chemotherapy can be administered prior to surgery to reduce tumor size. This is called neo-adjuvant chemotherapy. 
Chemotherapy is also used in cases of advanced breast cancer and recurrence. In this case, the disease can not be cured by chemotherapy, but it can reduce the size of the tumor, relieve symptoms and extend the life of a person substantially improving its quality.

Hormone therapy

Endocrine therapy for breast cancer aims to reduce the level of hormones in a woman’s body.
Type hormone therapy depends on the stage and grade of the disease, endocrine tumors, age, menopause woman whether passed or not, but also on whether it was already held any treatment.
Hormone therapy may be used as the sole method of treatment of the disease, if the general condition of the woman avoids surgery, chemotherapy or radiation therapy.
If the tumor is non-hormones depended, hormone therapy will not have any effect.
 

Biological treatment

Biological drugs or Targeted Therapy drugs are drugs that work against genomic changes in cancer cells that give them a survival advantage. In situations where these changes further activate the mechanisms of cell division and thus the cancer cells divide and thrive, the biological drugs or targeted drugs succeed in a targeted way to delay the development of the tumor and even shrink it. In contrast to chemotherapy drugs, which act on every cell that divides, targeted biological drugs mainly act on the cancer cell, and therefore damage healthy cells to a lesser extent, and are usually characterized by less.
 

Immunotherapy for Breast Cancer

Relatively new approach in breast cancer treatment. Immunotherapy treatments are based on the activation of the body’s immune system to act against the cancer tumor. The activation of the immune system is made possible thanks to the removal of the inhibition induced by the tumor cells on the cells of the immune system. The immunotherapy can be given as a single treatment or in different combinations: a combination of immunotherapy treatments, combinations of immunotherapy and chemotherapy as well as combinations of immunotherapy treatment and goal-directed treatments.
Immunotherapy drug Pembrolizumab was approved for the treatment of a variety of cancer tumors in an advanced/metastatic stage, including metastatic breast cancer by the US Food and Drug Administration, the FDA in May 2017.

⇒ Immunotherapy for breast cancer
 

Innovative breast cancer treatment

⇒ Personalized (precision) treatment of breast cancer – new method that allows to choose individual protocol for each patient in order to avoid ineffective treatment

⇒ Molecular genomic analysis for precision BC treatment