Breast cancer

There are many different types of breast cancer, as well as irregularities that aren’t breast cancer but might develop into cancer (such as ductal carcinoma in situ; DCIS):

• Invasive carcinoma NST
• Invasive lobular carcinoma
• Lobular carcinoma in situ (LCIS)
• Hormone-sensitive breast cancer
• HER2-positive breast cancer
• Triple-negative breast cancer

You can find more information about these types of breast cancer at kanker.nl

There is one more rare tumor type: the Phyllodes tumor of the breast. Less than one percent of all people diagnosed with breast tumors have this tumor type. Some of these tumors are benign (not cancerous), others are  malignant (cancerous). The malignant type is very uncommon. It usually does not affect the lymph nodes in the armpits and the cancer only spreads in less than 5 percent of all cases.

In collaboration with the Phyllodes Foundation and our breast cancer surgeon dr. Frederieke van Duijnhoven, we have developed a website dedicated to this tumour type: Phyllodes tumoren. 

The causes of breast cancer are often not clear, although there are several personal factors that can affect someone’s chances of developing this type of cancer:

• People who start menstruating relatively early, and reach menopause relatively late
• People who don’t have children, or have their first pregnancy after the age of 35
• Long-term use of heavy hormonal birth control pills at an early age and/or long term hormone replacement therapy to alleviate menopausal symptoms
• An unhealthy lifestyle; not enough exercise, too much alcohol, smoking, or an unhealthy weight.

Please consider consulting a doctor if you experience the following physical changes:

• a lump or dimple in the breast
• a sunken nipple
• eczema around the nipple
• bloody nipple discharge

Please contact your practicing physician at your current hospital or your general practitioner. He or she can submit your request digitally here, together with any further medical information and test results. Any visual materials can be submitted by mail on a CD-ROM. It might take some time before all materials have arrived, but once your submission is complete, our medical team will review your request and our Planning department will contact you to schedule an appointment.

It never hurts to request a second opinion. We can help you the most before the start of your treatment. Once our specialists have offered you their advice about your treatment plan, you are free to decide where you want to receive your treatment. If you are already receiving your treatment, we usually recommend that you continue at the hospital you started at, unless you are eligible to participate in a trial.

Our Netherlands Cancer Institute specialists offer advice to various other hospitals in the Netherlands. They discuss patient cases and share their knowledge. Sometimes they recommend a transfer so the patient can be included in a suitable trial. Our advice to medical specialists might be different from our advice to the patients themselves. When consulting with other medical teams, we look at the possibilities of the hospital itself. The recommendations may also be different when our specialists can meet the patient at the Netherlands Cancer Institute.

If your general practitioner suspects breast cancer based on your screening results or a lump in the breast, you will rarely have to wait more than 24 hours before your visit. Once we have received your referral from your general practitioner we will schedule your appointment for the following day. You will usually receive your results within 2 hours on that same day. If you are diagnosed with breast cancer but need to undergo further testing, we will schedule your appointments within the same week.

A mammogram will be scheduled for you if we are not sure whether chemotherapy will be necessary. Sometimes chemotherapy is essential, and sometimes it won’t be needed. If that is the case, there is no need for a mammogram. Not all health insurance providers cover the price of these breast x-rays. Please make sure to ask your health insurance provider whether yours will be covered.

Inherited mutations play a role in a small percentage of cancer diagnoses – about 5%. If you suspect such an inherited component, please contact the Hereditary Tumor Clinic at the Netherlands Cancer Institute. We can find out whether you are at heightened risk by collecting details about your family, tracing your family tree, or DNA testing. Depending on the results of these tests, we can offer advice on periodic check-ups or preventative measures. Our specialists at the NKI Breast Cancer Centre can refer you to this clinic. All costs regarding hereditary testing are covered by your general health insurance policy. A part of the costs will be taken from your own risk.

On average, we have 40 running trials concerning breast cancer. Every study is aimed at a different target audience. Your practicing physician can discuss your options with you. 

Due to capacity, our plastic surgeons can only help our current patients. Most patients will receive immediate reconstructive surgery.

For breast prostheses, visit www.semh.info and select ‘zoek erkend bedrijf’. Enter your zip/postal code, the range in which you wish to search, and select MMC under ‘Regeling’. You will see a list of all stores near you that are specialized in prostheses. You might qualify for a refund if you purchase your prostheses at a store connected to SEMH. Please contact your health insurance provider for more information.