Breast cancer is the most common type of cancer in women today and it is seen at younger ages day by day. Pointing out that the age of breast cancer is lower in our country compared to developed countries, Yeditepe University Koşuyolu Hospital General Surgery Specialist Prof. Dr. Neşet Köksal warned that breast cancer seen at a young age may progress faster than in advanced age and the probability of recurrence may be higher.
Although breast cancer, which is seen in approximately one out of every 8 women at any time in her life, is thought to be a disease of advanced age, its incidence in women under the age of 40 is increasing in our country. For this reason, Yeditepe University Koşuyolu Hospital General Surgery Specialist Prof. Dr. Neşet Köksal, pointing out that every young woman should start her own self-examination starting at the age of 20, said, “Especially those with a family history and women with suspected tumors should have a mammogram, even if they are younger than 40 years old.”
Prof. Dr. Neşet Köksal underlined that 25 percent of breast cancer develops in the pre-menopausal period, in other words, during the years of fertility, and said, “Breast cancer treatment at a young age affects women's reproductive health. Not the breast cancer itself, but the methods and medications used can have negative effects on ovarian functions.”
Saying “The fact that breast cancer is seen at younger ages and the age of marriage and having children increases raises questions in the minds of breast cancer patients about whether their reproductive health and fertility will continue”, Prof. Dr. Neşet Köksal gave the following information: “In particular, some chemotherapy medications called "alkylating agents" can cause acute ovarian failure or early menopause in women. In men, these medications can cause temporary or permanent azoospermia, that is, the absence of live sperm.
During or after chemotherapy, women often do not menstruate and early menopause symptoms are seen as ovarian functions decrease. Within two years after treatment ends, most women begin to menstruate again. However, the onset of menstruation should not lead to false evaluations in terms of fertility potential. There is no absolute link between menstruation and fertility. The fact that the patient does not have regular menstruation does not mean that there will be no fertility, and conversely, menstruation does not guarantee fertility. Some breast cancers are tumors that are sensitive to female hormones such as estrogen and progesterone. In patients with this type of breast cancer, some medications are used to reduce the effect of these hormones, at least for a certain period. These medications, which are used under the name of hormonal therapy, may also have negative effects on reproductive health.”
Prof. Dr. Neşet Köksal said that especially in cases where the entire breast is removed, the woman can be affected psychologically, and thus her sexual life can be negatively affected and pointed out that for this reason, they try to apply surgical methods that protect the breast as much as possible. He said, “When it is obligatory to remove the entire breast, a new breast is formed with different methods and thus the negative psychological effects that may occur due to organ loss are tried to be eliminated.”
Saying “Increasing survival is the main goal in breast cancer treatment, but it is also important to improve the quality of life of patients”, Yeditepe University Hospital General Surgery Specialist Prof. Dr. Neşet Köksal continued his words as follows: “For this reason, reproductive health needs of young patients with breast cancer should be taken into account and related branches should work together with a multidisciplinary approach. With a better understanding of the biological structure of breast cancer, there are many developments in medications every day. While targeted medications have been successfully used in breast cancer, the effectiveness of chemotherapy has increased, and its side effects, including reproductive health, have decreased. During chemotherapy, some medications that suppress the ovaries are given to patients in the reproductive period, so that they are less affected by chemotherapy. In addition to all these, studies and searches continue to obtain eggs or sperm, to protect and develop their vitality and functions.”
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Alo Yeditepe