Ángeles Cruz Martínez
La Jornada Newspaper
Thursday, October 17, 2024, p. 13
Microscopic lesions that cannot be palpated, suspicious of being breast cancer, are identified in mammograms. At that time, the radiologist can extract them to later confirm the diagnosis and, if appropriate, conservative surgery is performed. That is, with that minimum level of damage, women eradicate the disease and do not lose their breasts. That is the objective of early detection of the tumor that still remains the main cause of illness and death in the adult female population due to malignant tumors, stated specialists from the Mexican Social Security Institute (IMSS).
The timely identification of the neoplasia is possible due to the scientific development and medical technology that began to arrive in Mexico at the end of the 90s with digital mammography equipment and devices for performing stereotaxy biopsies, as well as others that are useful to avoid complications and loss of quality of life in patients with early-stage tumors (stages 1 or 2), undergoing surgery and in whom, in addition to resection of the tumor, it is necessary to verify that it has not spread to the lymph nodes. from the armpit.
October 19 is the International Day against Breast Cancer, of which 31 thousand cases are diagnosed in Mexico a year and is the cause of more than 8 thousand deaths, according to 2022 data from the Global Cancer Observatory (Globocan) of the World Health Organization.
Avoid breast removal
In an interview, Samuel Rivera, head of the IMSS Adult Oncology Care Division, explained the procedure for lymphatic mapping and sentinel lymph node biopsy. It consists of identifying, using a dye that is introduced through the areola at the time of surgery, if there are cancer cells in the nodes.
If the area not painted
there is no need to remove anything more than the tumor mass or just a first line of lymph nodes and that’s it. In the past, he said, when technological tools were not available, extensive surgeries were performed.
Because it is often the case that the tumor that has spread to the lymphatic system is small and cannot be felt on palpation, doctors had to reduce the risk of spread. The problem is that these extensive operations involve the removal of several nodes and at least 30 percent of patients present complications; from longer surgery recovery time and pain to disabling arm swelling (lymphedema). The latter deteriorates the quality of life and mood of those affected.
The mapping carried out by surgeons in the highly specialized medical units (UMAE) of Social Security is being extended to second-level hospitals because the institute has the human resources and supplies to make it possible, Rivera explained. In recent days, together with José Luis López Obispo, coordinator of Medical Programs of the Coordination of Oncological Care, the specialist organized a course aimed at oncological surgeons on this technique.
Available technology
He assured that 60 percent of women with tumors in early stages can benefit from this procedure, and added that of the total cases of breast cancer that are diagnosed in Social Security, 60 percent are in stages 1 or 2.
López Obispo commented that there has been progress in early detection through mammograms that must be taken for women between 40 and 65 years of age and that in the IMSS it is available in some family medical units, in general and specialty hospitals.
Regarding the microscopic lesions that are like pinpoints that are identified in 20 to 25 percent of IMSS beneficiaries, he explained that, normally, women develop calcifications in the breasts that look like white spots. Some are suspicious, as they may be inside a tumor. They are identified in the image obtained by a computer and a three-dimensional scanning device and attract attention due to their shape or because they are grouped in a concentric shape.
With the support of the mammogram and the stereotaxy biopsy device (special needle), the sample is extracted for review in the pathology area. If the diagnosis of malignancy is confirmed, completely conservative surgery proceeds. We aspire to that level of detection and treatment in the country, the specialist stressed.
Stereotaxy biopsy is also available at the Salud Digna laboratory at its headquarters in Coyoacán, Mexico City.
