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The European School of Oncology (ESO) held a two-day conference on breast cancer on September 30 and October 1 at the Hotel Monroe, Beirut. Dr. Naji El-Saghir of the AUB Medical Center (AUBMC) and Dr. Cornelius J. Van De Velde of the Leiden University Medical Center co-chaired the event. Dr. Umberto Veronesi of the European Institute of Oncology, Milan, and the former Minister of Health of Italy, was the guest speaker. In his opening remarks, Dr. El-Saghir thanked the ESO president, Dr. Alberto Costa, for holding the conference in Beirut, despite the unfortunate bombing incidents that have been destabilizing Lebanon during the past year, and said he hoped ESO would continue to hold conferences in Beirut on a regular basis. Dr. El-Saghir also thanked all the doctors, who came from Italy, Switzerland, Scotland, Holland, Egypt, Lebanon, and other countries around the world, for their attendance and participation. Innovative Surgical Techniques Dr. Veronesi, who is renowned for his skills and research in partial breast surgery and whose name is coming up for candidacy for the Nobel Prize, was the first conference speaker. He talked about the developments in partial breast surgery and of his innovative work on the first gland that becomes infected by cancerous cells—the sentinel gland. He also described his new laser invention to cure breast cancer from one session only, instead of submitting the patient to six weeks of treatment, on condition that the session be held right after surgery. Dr. Van De Velde then took the floor to speak of surgery on young women and the measures that should be taken to decrease the possibility of the cancer resurfacing after partial surgery. He said that women under the age of forty should be given the option of either partial breast surgery or reconstruction after complete breast removal. He referred to some cases of cancer where chemotherapy is a must before surgery, and he proposed several new surgical tactics. New Chemotherapy Cures Dr. Harvey Bonnefoi of the University Hospital of Geneva discussed cases of breast cancer in which there is no formation of nodes under the armpit. He explained how DNA analysis can determine whether a woman can be cured only by the use of chemotherapy or only by surgery, radiation, and a few hormones. He also talked about the classical and new medications—such as Taxan and Trastozomap-used in chemotherapy. Dr. El-Saghir added his observations on possible chemotherapy cures in the case of breast cancer spreading to the lymph nodes under the armpit and referred to new research on preventing the resurfacing of cancer. Low-Fat Diet Dr. El-Saghir referred to the new American WINS study that has proven that a low-fat diet decreases the possibility of breast cancer resurfacing by 20 percent over a span of five years, and said that doctors today should advise women to follow a diet high in vegetables and fruits and low in fat to help in preventing recurrence of the disease. Hormonal Cures Dr. David Cameron from Western General Hospital of Edinburgh spoke of the use of new hormonal cures and referred to the efficiency of Tamoxifin with the removal of the ovaries, as well as to new research on the use of medications that completely stop the secretion of the estrogen hormone in women above the age of fifty. Breast Cancer and the Pregnant Woman Dr. Cameron also discussed a cure for breast cancer when diagnosed during pregnancy and on what the doctor should look for in treating such cases. He cautioned that the infant should be kept out of harm's way in instances of radiation or chemotherapy, or even surgery and anesthesia. He spoke of the possibility of abortion should the diagnosis be made in the first trimester, but said that if the diagnosis is made in the second or third trimester and the mother chooses to keep her child, there are new therapeutic methods that can be carried out when the fetus is more fully developed. If chemotherapy is carried out during pregnancy, however, the child must be constantly checked against future complications resulting from the chemotherapy. Radiation Therapy for Breast Cancer Dr. Fadi Geara of AUBMC spoke of the latest developments in radiation therapy and of its benefits when coupled with partial breast surgery. He emphasized the new techniques that reduce the risks of breast cancer resurfacing, and referred to the new radiation therapy machines and programs that help aim the radiation at a specific area of the breast or gland, therefore keeping other parts of the body from being damaged by radiation leakage. Breast Cancer in the Arab World Dr. Salwa Boulos from the Ospedale Italiano Umberto I, Cairo, gave a seminar on breast cancer in the Arab countries, based on a study of early detection and mammography that included a survey of 5,000 women. She said awareness is spreading in the Arab countries, that organizations are explaining to women how they can detect breast cancer during the early stages and easily get a cure. Dr. El-Saghir also gave a presentation on breast cancer in the Arab countries, with specific reference to Lebanon, where breast cancer has increased in the past forty years from 20 cases for every 100,000 women annually to 46 cases for every 100,000, while in Europe and the United States the ratio is 70 to 90 cases for every 100,000. He encouraged the use of mammography to detect cancer in its early stages, especially in women above the age of forty. Seminars on Specific Breast Cancer Cases Three seminars were held during the conference, in which specific breast cancer cases occurring in Lebanon were discussed. The European physicians were impressed by the experiences of the doctors participating in the seminars, and they commended Dr. El-Saghir's recommendation to create a Tumor Board in every hospital that deals with breast cancer, so that the surgeon, the oncologist, the chemotherapist, the radiation therapy doctor, the pathologist, the nurse, and other specialists can confer for discussions on the best treatment for the patient.
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