It is clear that today, in the diagnosis of breast cancer, the patient's complaints, self-control, physician examination, radiological examinations and biopsy are of indisputable importance. However, research is developing that some molecular parameters may also be important in diagnosis and treatment. While patients are generally made aware with frequently repeated information, unnecessary fear can also be created.
Confidentiality, which should be carefully protected in patient-physician relationships, is violated by some information shared on the internet, and by giving general information, the possibility of special situations and patient-specific treatment responses is ignored.
br /> In my opinion, we are living in a period where this general information is repeated frequently and creates fear instead of raising awareness on the internet and in the media. In the fight against a disease, patient information and consent should be done one-on-one with the patient, and the principle of "there is no disease, there is a patient" should always be kept in mind. The fight against cancer has an individual and intimate character with deep psychological and psychiatric dimensions. While often "desensitizing" the patient to accept his illness, it should be kept in mind that the patient may be put into a chronic patient psychosis and fear may be created. For this reason, in my opinion, the fact that the individual's tumor characteristics and some molecular parameters in breast cancer are "non-generalizable" should form the basis of awareness-raising. In this article, I would like to briefly touch upon the "molecular parameters", which have become increasingly important lately and whose importance is indisputable in the development of personalized treatment.
Molecular parameters
When it comes to molecular features, deciding on the need for genetic counseling, early diagnosis, the detection of a diagnosed cancer. Necessary examinations come to mind in order to have a prediction about the behavior or to detect the presence of recurrence or distant organ spread. Studies on these issues primarily focus on Her-2-neu, but research continues.
The behavior of a tumor is significantly determined by the relationship between the host, that is, the patient's immune system, and the tumor. The immune system mounts a response to contain the host's tumor or prevent it from spreading. The stronger this response, the more tumor r is well limited.
Some substances secreted from these cells, as well as the support tissue and inflammatory tissue cells around the tumor, are effective in this limitation. These determine the relationship between tumor tissue and patient tissue, in other words, the severity of the war. According to our current knowledge, it would be beneficial for our patients diagnosed with breast cancer to be informed in an appropriate language by both the surgeon and the medical oncologist about tumor characteristics, not only tumor size and axillary spread, but also ER/PR/Her2 Neu positivity. > Recently Ki-67 has also been added to this list. Although these parameters, which are most practically studied by the method called "immunohistochemistry", can sometimes delay the reporting of biopsy results, they are very important in planning the treatment of the patient and making predictions about the future of the disease. Because now the new classification of breast tumors is made according to these "immunohistochemical" results. Especially according to the new classifications, if there is any doubt about Her 2 neu positivity, it may be necessary to perform more detailed examinations with the FISH technique. In conclusion, although it seems difficult for our patients to keep in mind, estrogen receptor (ER), progesterone receptor (PR) It is appropriate that microscopic pathological examinations such as , Her2 Neu, Ki67 are examined carefully by the attending physician at the very beginning of the surgery and the patient is given a prediction about the future of the disease in an appropriate language. While making this prediction, the doctor's approach towards the patient is to avoid creating fear and panic. But there should also be a careful attitude and discourse that will not cause negligence.
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