Dr. Alexandrina Percheva is one of the best imaging specialists in the field of mammology in our country. It is no coincidence that he is the winner of the Cancer Patients Association award. According to her, technology is already so advanced, that even a tumor of size can be detected 7 mm and this gives an extremely good prognosis for the final outcome of the treatment. For that to happen, however, women must be responsible for preventive examinations. Here is what else Dr. Percheva told OFFNews, who was one of the presenters at the 21st National Meeting of Health Experts and Journalists, organized by a foundation “BRIDGE”.
Dr. Percheva, which patients predominate among you – the late diagnosed or those with a wrong diagnosis?
Cases of late diagnosis prevail and this is a problem. Late diagnosis means breast cancer over 2 cm. When a tumor is over 2 cm is allowed, that he has already built his own, new circulation, which enables it to send tumor cells long distances via blood and lymph. A tumor 3 cm may have already metastasized to the liver, in lung, in the bones, in brain.
It is one thing for an oncologist to treat a local disease, it is another to treat a widespread disease. Therefore, the goal of all campaigns, of appeals to people is to strive for early diagnosis. Early diagnosis can be made by following the rules. There is a globally accepted standard – every month self-examination in the shower, in the bed, in front of the mirror. On 6 to 12 once a month – a visit to a qualified imaging specialist. We, radiologists, with the apparatuses we can peer into the bodies.
You presented the new possibilities for diagnostics of modern devices, but some time ago your colleague shared, that in our country we work massively with mammograms, which do not detect the small tumors. Isn't it better to separate several centers, to which women should be referred for accurate diagnosis?
Of course, it is not necessary for every village to have a palanquin “aliens” appliances. We can estimate how many women live in Bulgaria, how many of them and what age they are and to review them purposefully. That's exactly how I imagine it. Several well-equipped centers, in certain places in the country. People should be well informed and know where to go, to review.
Do you relate to the national anti-cancer plan? Are the means provided for prevention in it sufficient??
I haven't read it, i know, that it is under discussion.
I ask you, because I am impressed by the comments, that prevention will again be damaged at the expense of hospital treatment and expensive therapies, although the funds provided are not small.
I think the idea is not to go to therapy, and to early diagnosis. To all men after 50 r. for example, they should be given a tumor marker for prostate cancer prevention. A low-dose scan should be performed on smokers, because of lung cancer.
Are there states, in which the tumor can escape even on a 3D ultrasound?
There is, about 20 % of breast cancer cases, we cannot diagnose them and find them after the fact. The machine has some resolution, it is not a microscope, you can't see cells. We are effective in tumors larger than 7 mm. Below such dimensions we allow, that maybe the image is cancer, or that it will, and that is why we very often do biopsies in such places.
In this respect, devices help us a lot, because they can show us in a targeted manner where the needle should go in and bring in cellular material. This cellular material then goes to a pathologist. So yes, breast cancer can be missed and because we know that, we tell women to get tested periodically with hope, that if something was not noticed before, will be established later.
What can trigger this disease - are pregnancy or menopause factors?
Age is a factor. 80% from women, which have triggered breast cancer, are over the age of 40 r. The first conclusion is, that breast cancer is an age-related disease. Not that there aren't women either 30 r. with this disease, but it's not everyday. We have such patients – young women, who have nothing and suddenly unlock the disease. But everyday life is women in their 50s. It seems to be the highest concentration there. Therefore, the appeal is primarily to the women of 35-40 g., in order to learn to go regularly for a preventive examination and to find a good specialist in a timely manner.
Women with family burdens, during what period do you observe them?
The women, who have a family history or other tumor disease, or take hormone replacement therapy on any occasion, we examine with a mammogram once a year, and not once every two years, as we do in screening.
How many family members actually get breast cancer??
nMust see the stats, but not necessarily if the mother has breast cancer, her daughter to unlock it too. In addition, geneticists are already coming to the rescue, after all, we are in 21 century. A drop of blood can be taken and analyzed, to see what mutation might be expected. We live in a very turbulent time, interesting time for medicine, which gives us many possibilities for diagnosis and treatment of oncological diseases.
Dr. Alexandrina Percheva completed her medical education at the Medical University - Sofia. He successively worked as an internist in the regional hospital in the city of Slivnitsa and the Center for Cardiac Rehabilitation in Bankya. For several years he worked and specialized in imaging diagnostics in the X-ray Department of the District Hospital – Sofia, where he acquired a specialty in diagnostic imaging. From 2002 r. to 2007 r. works at Oncodispenser, Sofia, where he became the head of the department and gained experience in the diagnosis and follow-up of oncological diseases. From 2008 r. works at Polymed Medical Center, later he started working at MC "Euromedic", with a digital mammogram. From 2015 r. is a specialist mammologist at the Imaging Clinic at UMBAL Achibadem City Clinic, Youth. She was a teacher at the Medical College "Y. Filaretova". Participates in the programs - ESDIR, HALLEY Project. He is the winner of the award from the Association of patients with oncological diseases for diagnostics in the field of mammology. He is a member of the Bulgarian and European Society of Radiology and the Bulgarian Society of Oncology.