- Dr. Laia Bernet points out that there has been a lot of progress in therapeutic de-escalation, so that treatment is personalized based on the extent and biology of each tumor, either with minimally invasive interventions or avoiding the toxicity of treatments with a low probability of response.
- He highlights the advances in the study of the immune system, “which allow us to better understand how the body's “defense” cells interact with the tumor to prevent or limit its growth.”
Laia Bernet, coordinator of Pathology at Breast Area of the health group Ribera, highlights the importance of research to improve the understanding of breast cancer and offer the best therapeutic option for patients. In the context of the Day against cancer, which is commemorated tomorrow, February 4, Dr. Bernet assures that "the diagnosis of breast cancer is based on the report of the pathologist, who is the one who integrates the microscopic and molecular information to determine the type of tumor that each patient has and the most appropriate treatment for each breast cancer," she explains, highlighting research in the area of Pathology.
In this way, and thanks to the multidisciplinary team that cares for patients in the Ribera Group Breast Area, the most appropriate personalized treatment is always offered for each patient, with a clear commitment to therapeutic de-escalation and, when specialists so determine, less invasive interventions and treatments with less toxicity.
Dr. Bernet points out that “there has been a lot of progress in therapeutic de-escalation, by being able to make more individualized diagnoses, which allows us to better differentiate between patients and offer more appropriate treatments for each case.” For example, she points out, “previously, axillary lymphadenectomy was performed on all patients with breast cancer, but now it is only done in very selected cases. Likewise, chemotherapy is administered only to those who really benefit from it, while other patients can receive hormone therapy or biological therapies, which are less toxic and more effective for certain types of tumors.”
Furthermore, Laia Bernet, a pioneer in Europe in the molecular diagnosis of the sentinel node, highlights the de-escalation at this level as well. While just a few years ago, the sentinel node was mandatory in all cases of infiltrating carcinoma, today it has precise indications and there are more and more cases in which any type of surgical intervention on the armpit can be avoided.
Furthermore, the incorporation of advances in molecular pathology into histological diagnosis adds to the “classical” diagnosis the evaluation of molecular biomarkers that define the “genetic signature” of each tumor, which constitutes the basis for personalizing therapy.
Among the current lines of research in the Ribera Group's Breast Department, headed by Dr. Julia Camps, Dr. Bernet highlights the study of the immune system and its relationship with different types of tumors. “This allows us to better understand the interaction between the body's lines of defense and tumor cells,” she explains. She assures that the suitability of “extirpative” treatments, which are minimally invasive, is also being investigated in collaboration with several European hospitals.
Other lines of research underway study the clinical impact of small tumor volumes in the axillary lymph nodes after oncological therapy. And in other cases, they focus on the validation of imaging biomarkers as an expression of the underlying tumor biology (joint project with the Polytechnic University of Valencia) and on the creation of artificial intelligence algorithms from breast resonance images (European multicenter project).ODELIA funded by the European Union through a HORIZON grant).
Laia Bernet stresses that investing in diagnosis is key to saving on treatments and improving patients' health.
The Breast Department of the Ribera healthcare group is made up of a multidisciplinary team of more than 100 professionals from various Spanish regions, which integrates the vision of all the specialties involved in breast pathology from the group's different centers: Radiology, Pathology, Oncoplastic Surgery, Oncology, Nuclear Medicine, Radiation Oncology, Nursing with its oncology case managers and Psychology, among others. The objective is to put the knowledge, innovation and research of everyone at the service of each case and each patient, regardless of their reference hospital.
