Pink October: 6 questions about relapses in breast cancer

Medicine has seen impressive advances in breast cancer in recent years. If he touches again nearly 60,000 women in France each year, i.e. one in eight women, 86% of patients are alive 5 years after the diagnosis of breast cancer. There remains a major point on which research must focus: relapses, which still affect one in five patients. On the occasion ofPink Octoberthis operation to raise awareness of breast cancer which returns each year in the fall, lhe Institut Curie wanted to shine the spotlight on this aspect of the disease about which little is said.

How many recurrences are there?

Relapse is not a second cancer, but the same disease waking up. Indeed, the recurrence (or relapse) of cancer results in the reappearance of cancer cells after treatment. When they are in the breast that has been treated, operated, we speak of “local recurrence”. When they appear in other organs, we speak of “metastatic cancer”. Between 15 and 20% of breast cancer patients experience a relapse 10 years after the first diagnosis. “It’s about 0.5% to 1% of patients each year, or a few thousand in France”, specifies Paul Cottu, deputy head of the medical oncology department at Institut Curie.

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Which cancers are most at risk of relapse?

Cancer says “triple negative” (when the tumors react neither to female hormones nor to the protein called HER2, making treatment more complicated) is the one for which the risk of recurrence is the greatest. “When there is a relapse, this does not mean that the initial treatment was badly chosen, but insufficient”, underlines Alain Puisieux, director of the Institut Curie research center. In terms of timing, regardless of the type of cancer, the risk of recurrence peaks 2 years after treatment.

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Does “recurrence” mean “incurable”?

“A relapse can always be treated, but it is rarely cured, regrets Paul Cottu, medical oncologist at Curie. But who says metastasis does not say death in the afternoon!” Some patients sometimes live for decades with cancerous cells. “When we tell you that you have breast cancer, we have in mind that we put ourselves on hold for a few months, when we are told of a recurrence, we know that we will have treatments for the rest of your life. , summarizes Laure Guéroult-Accolas, patient and founder of Patients in Networkssocial networks in support of patients. We may not die of our cancer, but with it. There really is progress to be made on this subject.

It is not the research director of the Institut Curie who would contradict her. “Ten years ago, we did not have a treatment as effective as today in terms of healing, whereas now we take care of them much more effectively. We are doing research to do better tomorrow.”

What are the improvements on the diagnostic side?

Until researchers better understand this phenomenon, the diagnosis becomes more reliable and more precise. “The central question is whether cancer cells are already disseminated at the time of diagnosis, insists Alain Puisieux. But we do not have the tools that would make it possible to assure the patient that there is no scattered cells.”

For this, artificial intelligence can be of great help. Thus, the Institut Curie is the first center for the fight against cancer in France to use a new robot, bringing hope. To tell a patient that she is suffering from cancer and especially from what type of cancer, we start with a biopsy: we take a piece of tumor. After having cut it into very thin strips, put it in formalin, stained, the doctors will digitize this slide. “The image we had under the microscope is transformed into a digital image and thanks to artificial intelligence (AI), we will have a more precise prognosis”, explains Anne Vincent-Salomon, pathologist at the Institut Curie. The robot will digitize 450 slides in about ten hours.

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Pink October: 6 questions about relapses in breast cancer

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