Effective breast cancer treatment requires coordinated multidisciplinary care, from screening to therapy

Breast cancer is the most common cancer among women. While it is curable, high mortality rates remain due to late-stage diagnosis and limited access to treatment. At the “Breast Cancer – From Screening to Treatment” symposium held by FV Hospital on March 15, 2025, in Ho Chi Minh City, oncology experts highlighted the importance of a comprehensive, multimodal approach that integrates screening, diagnosis, and therapy for effective treatment.

The symposium was chaired by Assoc. Prof, Cung Thi Tuyet Anh, MD, PhD, a leading oncology expert in Vietnam, with the participation of 550 doctors.

Assoc. Prof, Cung Thi Tuyet Anh, MD, PhD, served as chairperson of the symposium

Personalised Breast Cancer Diagnosis

According to GLOBOCAN 2022, Vietnam recorded 24,563 cases of breast cancer, accounting for 13.6% of all cancer cases in the country. Dr Phung Ngoc Thu, Specialist Level I, an expert in diagnostic imaging at Obstetrics & Gynaecology – Breast Care Clinic of FV Hospital, highlighted that late-stage breast cancer treatment in Vietnam is costly, and the mortality rate reaches 8.3%. This underscores the critical importance of early screening and diagnosis in improving patient outcomes.

550 doctors attended the “Breast Cancer – From Screening to Treatment” symposium.

To diagnose breast cancer, patients must first undergo a clinical examination, followed by screening and diagnostic imaging by a specialist. Various imaging techniques are available, including X-ray, MRI, second-look ultrasound, and vacuum-assisted biopsy. Recently, artificial intelligence (AI) has also been integrated into diagnostic imaging.

Dr Phung Ngoc Thu, Specialist Level I

However, Dr Thu emphasised that no single diagnostic method is perfect. Breast cancer screening does not follow a one-size-fits-all approach but should be personalised, requiring doctors to effectively combine available diagnostic tools. She also emphasised the crucial role of clinical examination, considering it the first step toward comprehensive diagnosis and standard-of-care treatment.

“Women should have their first breast examination at age 25 to assess risk factors. Mammography is recommended for women at age 40, but those with risk factors may need their first mammogram at age 30,” Dr Thu advised.

Advanced Techniques in Breast Cancer Surgery

Specialist Level II, Tran Viet The Phuong, MD, PhD, Deputy Head of the Breast Surgery Department, Ho Chi Minh City Oncology Hospital, stated that despite the many treatment options available today, surgery remains a crucial approach in breast cancer treatment.

Specialist Level II, Tran Viet The Phuong, MD, PhD

There are three main surgical approaches for breast cancer: total mastectomy, breast-conserving surgery (BCS), and mastectomy with reconstruction. While breast-conserving surgery is a less invasive technique and is applied in 60–70% of breast cancer cases in Western countries, its use in Vietnam remains limited. Many Vietnamese patients fear that partial breast removal may not be sufficient, leading them to opt for more extensive surgeries.

Axillary lymph node metastasis is the most critical prognostic factor in breast cancer. In the past, complete lymph node dissection was commonly performed, but it often led to complications such as arm lymphedema, sensory nerve damage, shoulder joint mobility issues, and axillary vascular injury. Today, doctors use the sentinel lymph node biopsy (SLNB) technique, which identifies the first lymph node in the lymphatic drainage pathway of cancer cells. If cancer cells are detected in this node, axillary dissection is performed. Otherwise, radiotherapy may be used as an alternative to full lymph node removal, reducing side effects.

The goal of breast cancer surgery is to achieve optimal treatment outcomes while minimising harm to the patient. Therefore, multidisciplinary collaboration with medical oncologists and radiation oncologists is often necessary to develop the most effective treatment strategy.

Dr Kahouadji Mohammed Nassim

Dr Kahouadji Mohammed Nassim, a pathologist at the Laboratory & Blood Bank Department, FV Hospital, presented reports on the effectiveness of neoadjuvant chemotherapy – also known as pre-surgical chemotherapy or primary chemotherapy – in breast cancer treatment. The approach aims to shrink the tumour size in early-stage breast cancer, facilitating breast conservation, reducing the need for extensive axillary surgery, improving survival rates, and helping preserve organ function.

Vo Kim Dien, MD, MSc

At the symposium, Vo Kim Dien, MD, MSc, Deputy Head of Hy Vong Cancer Care Centre at FV Hospital, highlighted the importance of neoadjuvant systemic therapy. This approach combines chemotherapy, hormonal therapy, or targeted therapy before surgery to shrink the tumour, improve the chances of breast conservation, and enhance the overall treatment response.

In the past, many breast cancer surgeries were unsuccessful due to distant metastasis. Today, neoadjuvant systemic therapy helps control metastasis, increasing the likelihood of a successful surgery. “Currently, if the tumour is greater than 2 cm and there are affected lymph nodes, neoadjuvant systemic therapy is essential,” Dr Dien emphasized.

Short Course Radiotherapy and Brachytherapy: Faster Treatment, Reduced Side Effects, and Protection for Healthy Tissue

Radiotherapy is a crucial technique in breast cancer treatment. Dr Basma M’Barek, Head of Hy Vong Cancer Care Centre at FV Hospital, shared that FV has implemented short course radiotherapy with boosted doses in each session, effectively reducing the treatment duration from six weeks to three weeks.

This method offers several advantages, including shortened treatment time, lower treatment costs, and optimized use of medical resources. “The key is advanced technology and methods to protect healthy tissue. For precise radiotherapy, FV uses CT simulation, which helps doctors, and the team calculate the dose distribution and identify the exact location to target cancer cells without damaging healthy tissue,” Dr Basma emphasized.

For patients with left-sided breast cancer, FV uses a deep-breathing hold technique to minimise radiation exposure to the heart. During treatment patients are instructed to take a deep breath and hold it while the radiation is delivered. This technique allows the lungs to expand, separating the heart from the chest wall.

“Over the past five years, shortened radiotherapy has been applied to 426 patients. The results show that there have been almost no complications commonly seen with traditional radiotherapy, such as damage to the heart, lungs, or arm lymphedema,” Dr Basma added.

Elekta Infinity Digital Radiotherapy Machine at Hy Vong Cancer Care Centre.

Since 2022, FV has also implemented brachytherapy, also known as internal radiation therapy, for cervical cancer treatment, with statistics demonstrating its high effectiveness and safety for patients. “Brachytherapy targets the tumour directly to destroy cancer cells effectively. A device is placed inside the patient’s body, delivering radioactive material directly to the tumour area. As a result, the radiation does not pass through healthy organs, minimizing side effects. Additionally, this method allows a high dose of radiation to be concentrated on the tumour, shortening the treatment time,” Dr Basma explained.

Dr Basma M’Barek

In the near future, FV plans to extend the use of brachytherapy for breast cancer treatment. Currently, FV is the only private hospital to invest in and perform this advanced technique. The goal is to provide patients with treatment at a single location, ensuring seamless and safe management of the entire patient care process.

Effective Breast Cancer Treatment Requires Multidisciplinary Collaboration

Breast cancer treatment is inherently multimodal, requiring collaboration across multiple specialties, from diagnosis and staging assessment to developing the most effective treatment plan, which may involve a combination of treatment methods. According to Dr Basma, at FV Hospital, patients undergo all diagnostic screenings in a comprehensive, one-stop service at the same location. With the advantage of being a multidisciplinary hospital, FV organizes multidisciplinary consultations with various support tools to ensure seamless information sharing across different departments.

The speakers answer questions from the attendees of the symposium.

Speaking at the symposium, Vu Truong Son, MD, MSc, Medical Director at FV Hospital, stated: “Thanks to significant investment in equipment and a multidisciplinary team of specialists, including oncologists, radiologists, obstetricians and gynaecologists, and especially experts in chemotherapy and breast surgery, FV Hospital provides a comprehensive, multi-dimensional approach that offers maximum and long-term benefits for patients.”