STOP cancer: how to effectively reduce breast cancer mortality?

On May 13, a meeting of the Parliamentary Group for Cancer Prevention - RAK STOP was held at the Polish Parliament, dedicated to one of the most serious health challenges in Poland: how to effectively reduce breast cancer mortality and encourage women to undergo preventive examinations. Among experts and patients, much space was devoted to the need for personalized treatment, the role of multi-gene testing and the emotional dimension of the disease, which is still too rarely discussed.

During the meeting, the results of the report "Patients' Perspective on Breast Cancer Treatment in Poland," prepared by the Healthcare Institute in cooperation with patient organizations, were presented. Experts also discussed solutions available and recommended worldwide that can improve the quality of treatment, reduce the overuse of chemotherapy and address the emotional needs of women with breast cancer.

"I'm committed to making the RAK STOP Team a space where we realistically work to improve the system - not only at the level of treatment, but above all at the level of prevention. We want women in Poland not to be afraid of examinations and to have the feeling that a diagnosis is not a sentence, but the beginning of an effective and dignified treatment." - emphasized MP Katarzyna Piekarska, the initiator of the meeting, who has been involved in women's health advocacy for years.

Breast cancer is not just a physical disease

As recalled by Professor Mateusz Jankowski, secretary of the Polish Society for Personalized Medicine and co-author of the report "Patients' Perspective on Breast Cancer Treatment in Poland," breast cancer remains the most frequently diagnosed malignancy in women. Although the mortality rate from it in Poland remains at the EU average, the percentage of cases detected at an early stage is still 10 percentage points lower than in other European countries.

- "Breast cancer has not only a physical dimension, but also an emotional one. Women who experience treatment often point to fear of diagnosis, hair loss, fatigue or exclusion from work and family life as some of the most difficult aspects of the disease. As many as 90% of patients treated with chemotherapy experience side effects, and more than 70% say outright that the treatment has negatively affected their daily functioning," Prof. Jankowski stressed.
Modern molecular diagnostics make it possible to tailor treatment to the biology of the tumor - helping to avoid chemotherapy when it is not beneficial, or to include it where it can prevent relapse. A study of nearly 1,300 patients found that lack of access to modern diagnostic tools, such as multigene testing, adds to the uncertainty and stress surrounding treatment.

Personalization of therapy - less toxic treatment, greater patient confidence

In her presentation, Prof. Renata Duchnowska, head of the Department of Oncology at the Military Medical Institute, discussed in detail what multigene testing is and why it should become the standard for qualifying for complementary luminal treatment of HER2-negative early breast cancer.

These diagnostic tools analyze the biological features of the tumor, allowing doctors to assess whether the patient will actually benefit from chemotherapy, or whether hormone therapy alone will suffice. As Prof. Duchnowska stressed, multigene tests are not the same as testing for BRCA gene mutations - they are not used to assess hereditary risk, but help precisely tailor treatment to the individual case.

"These are diagnostic tools that avoid unnecessary toxicity of therapy and rationally manage the resources of the health care system. We are talking about technology present in ASCO, ESMO or NCCN guidelines, which is reimbursed in many countries. In Poland, the tests are commercially available, there is still no reimbursement." - Prof. Duchnowska said.
She added that thanks to studies conducted at reference centers in Poland, it is known that up to one in four women could avoid chemotherapy if they had access to the multigene test.

Prophylactic mastectomy - an important tool for high-risk women

Prof. Zoran Stojcev, MD, a surgical oncologist at Warsaw's Czerniakowski Hospital, noted the importance of prophylactic mastectomy in women with a high risk of breast cancer - such as those with a confirmed BRCA1/2 gene mutation or a family history of cancer.

The procedure is reimbursed by the National Health Fund, but, as the expert pointed out, the number of centers and specialized surgeons remains limited, which translates into longer queues and more difficult access for patients.

"On the one hand, we have sparing surgery in diagnosed cancers, and on the other, we have growing awareness among women at risk. Prophylactic mastectomy with simultaneous breast reconstruction is often the only way to significantly reduce the risk of the disease. And it is also of great importance for the psyche of the patient - it gives a sense of security and restores control over the situation," noted Prof. Z. Stojcev, head of the Department of General Surgery and Oncology at the Czerniakowski Hospital in Warsaw.

He also stressed that the effectiveness and aesthetics of the treatments are steadily improving, and that proper qualification and psycho-oncological care are crucial to the success of the therapy.

Patients' voice: multi-gene testing is a chance for a better life

Anna Kupiecka spoke on behalf of the patient organization OnkoCafe - Together Better. She pointed out that despite improving treatment results and technological advances, mortality rates in Poland remain alarming.

- "Prevention is still an orphaned area of the system. We have access to drugs, to excellent doctors, but there is no institution that makes prevention a priority in a coordinated and responsible way. Multigene testing is concrete - a tool that allows the patient and doctor to make an informed decision about treatment. From the patients' perspective, it is also a reduction in anxiety and a greater sense of security," Anna Kupiecka stressed.

Experts and patients agree - breast cancer is not only a medical challenge, but also a social and emotional one. Early detection, equity in access to effective diagnosis and the ability to reduce toxic treatment where it is not necessary are key. Modern tools are available - it's time for decisions that will realistically improve the quality of breast cancer diagnosis and treatment in Poland.

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