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Experts and epidemiological data remind us that breast cancer can also occur after the age of 69 and before the age of 50, which are the age limits that determine access to the cantonal mammography screening program in Ticino.

New recommendation for early breast cancer detection: mammography screening already starting at 45 years. Earlier diagnosis reduces mortality, improves survival chances and lowers long term healthcare costs.

Interview with Dr. med. Damir De Monaco at Spazio Medicina

An Evening Dedicated to Solidarity This year’s gala offered an impressive interplay of musical highlights, the moving moderation of Sven Epiney, and an exquisite gourmet dinner prepared by the Dolder Grand’s kitchen team. As a long‑standing specialist partner of Pink Ribbon Switzerland, Affidea brustCare is repeatedly deeply impressed by what Nicole Zindel and her team achieve for those affected through their tireless commitment, as well as by the broad solidarity that becomes palpable every year. The special highlight of the evening: CHF 100,000 were donated to the International Breast Cancer Study Group (IBCSG) – a valuable contribution to research for young breast cancer patients. A remarkable example of how dedication, art, and culinary excellence can come together to create something good. Donation Project The Pink Ribbon Christmas Gala supports the groundbreaking POSITIVE study of the International Breast Cancer Study Group (IBCSG) – a research project offering new perspectives to young women with hormone‑receptor‑positive breast cancer. Many affected women face a difficult decision: anti‑hormone therapy or the desire to have children? The POSITIVE study investigates whether it is medically justifiable to temporarily interrupt this life‑saving therapy to allow for pregnancy. The first results give reason for hope: more than 440 healthy babies have already been born – without any increased risk of recurrence observed so far. To reliably assess the long‑term effects of this strategy, monitoring will continue until 2029. This important research project relies on financial support, and we are proud and grateful to contribute through the Pink Ribbon Christmas Gala.

To mark the launch of the Breast Health Podcast, PD Dr. Constanze Elfgen shares her vision, experience, and commitment to improving information and awareness around breast cancer. What motivated you to start this podcast on breast health? Until now, there has been no podcast in Switzerland that covers breast health in such a comprehensive way. We don’t only talk about breast cancer treatment, but also about early detection, benign changes, hormones, and many other topics. Our goal is to provide clear and reliable information while creating a reassuring and encouraging atmosphere. Who is this podcast aimed at? At anyone who is interested. Unfortunately, breast cancer is very common and affects a large number of women as well as their families. We also want to raise awareness about prevention and measures to maintain breast health. The podcast can also be helpful for healthcare professionals who are not specialised in senology. Which topics will be covered? The series begins with key topics: early detection, mammography, understanding a breast cancer diagnosis, and patient stories. In the upcoming episodes, we will also discuss breast surgery, integrative medicine, hormones, and many other aspects related to breast health. Who are your guests? We will invite patients, physicians from various specialties, researchers, and other experts. The idea is to offer a diverse and comprehensive perspective that is medical, scientific, and human at the same time. What kind of feedback do you expect from your listeners? I hope the podcast will be well received. We want to provide answers based on clinical experience and the latest scientific findings. Personal stories should also show listeners that they are not alone in their journey. As a specialist in senology, how do you perceive the evolution of breast cancer treatment? A lot has changed over the past twenty years. Today, the needs of patients are better taken into account, and therapeutic approaches are more tailored to each individual. We also have new medications and more targeted treatments. In addition, there are more female physicians in this field, and the understanding of the patient’s perspective has evolved. Which misconceptions would you like to address with this podcast? There are still many myths and false beliefs about breast cancer, especially regarding early detection through mammography or the supposed causes of the disease. We want to help correct these misconceptions by sharing reliable, scientifically grounded information. How do you integrate the human and emotional dimension into your daily practice? This is a central aspect. I am grateful for this wonderful profession, because we often manage to detect breast cancer at an early stage and therefore cure it. Seeing patients healthy again years after treatment is incredibly fulfilling. Of course, there are difficult moments too, but the human and personal support means a great deal to me. What does Pink October mean to you as a doctor and as a woman? It is an important month that puts breast health in the spotlight and reminds us how essential it is to talk about it. For a long time, breast diseases were a taboo. Today, awareness and visibility have helped women cope better with the illness. Which measures do you consider most effective for raising awareness about prevention? The key is information shared through different channels. Pink October is an excellent opportunity to spread these messages and reach a wide audience. What is the most important message you want to convey this year? The earlier breast cancer is diagnosed, the higher the chances of recovery. My wish is that all women have access to early detection. Can you share an experience that has particularly shaped you during your career? I once cared for a young patient, barely thirty years old, who had developed an aggressive form of breast cancer. She had to undergo intensive treatments and several surgeries. I accompanied her for many months. Despite the difficulties, she never lost her optimism. A few years later, after completing her treatment, she became pregnant. When she visited me with her baby in her arms, radiant with happiness, I was deeply moved. How has breast cancer treatment evolved in recent years? Thanks to early detection, we diagnose the disease more often at an early stage, which means fewer aggressive treatments such as radical surgery or chemotherapy are needed. We also have more targeted therapies today, such as antibody treatments, which allow for even more personalised care. More and more young women are affected. How do you explain this? We do not yet have all the answers. Scientists believe that lifestyle changes may play a role. Increased awareness has also likely contributed to more frequent diagnoses in younger patients. ⭐⭐⭐⭐⭐ Follow the podcast on Apple Podcasts and Spotify, and leave a 5‑star rating to help increase its visibility and reach even more listeners. PD Dr. Constanze Elfgen – Biography Dr. Constanze Elfgen is a specialist in gynaecology and obstetrics with recognised expertise in senology. After completing her medical studies at Philipps University Marburg (2004), she worked in several hospitals in Germany and Switzerland, including the University Hospital Zurich. In 2015, she joined the Breast Center Zurich as a specialist, and in 2019 she became Head of the Breast Surgery Department. She is a member of the medical advisory board as well as the centre’s board of directors. She holds certification as a breast surgeon from the German Cancer Society and the Senology Diploma of the Swiss Society of Senology. She is active in research and teaching, has published numerous works on breast cancer, and led the MIBB working group.

A new audio series, hosted by PD Dr. Constanze Elfgen, Head of Breast Surgery, designed to inform, raise awareness, and support patients as well as the wider public.

First successful autologous flap breast reconstruction performed by the medical team of Affidea Brust-Zentrum Ticino at the Clinica Sant’Anna in Lugano A major milestone in the care of breast cancer patients in Ticino Affidea Brust-Zentrum Ticino , under the direction of Dr Barbara Pompei , specialist in plastic and reconstructive surgery, in collaboration with the Plastic Surgery Group led by Prof Jian Farhadi and the Clinica Sant’Anna, proudly announces a significant step forward in regional healthcare. For the very first time, an autologous flap breast reconstruction – an innovative technique using the patient’s own tissue – has been successfully carried out at the Clinica Sant’Anna in Lugano. This complex microsurgical procedure represents a particularly natural and long-lasting method of reconstruction, offering women who have undergone breast cancer treatment restored bodily integrity and an improved quality of life. Due to its high level of technical difficulty, it requires exceptional surgical expertise. “We are proud to be able to offer this specialised procedure for the first time in a private clinic in the Canton of Ticino,” says Dr Barbara Pompei, head of plastic and reconstructive surgery at Affidea Brust-Zentrum Ticino. “This marks an important step in the medical care of women in our region and a major advance towards more comprehensive, personalised and humane breast cancer therapy.” With this new microsurgical option, Affidea Brust-Zentrum Ticino is further expanding its already wide-ranging services in diagnosis, treatment and follow-up, strengthening its role as a leading centre of excellence for integrative breast medicine in Ticino. Carrying out this operation locally allows patients to benefit from shorter travel distances, support in their native language and access to highly specialised surgery in a familiar environment. About Affidea Brust-Zentrum Ticino Affidea Brust-Zentrum Ticino offers interdisciplinary care, high medical standards, and a complete, holistic and specialised treatment pathway in breast medicine. This includes breast cancer prevention, diagnostic imaging, outpatient consultations, and drug-based cancer therapies. All stages of treatment can be delivered by a single medical team, forming the foundation of this integrated and comprehensive care pathway. The highly specialised medical team successfully began its activities in 2024, comprising breast surgeon Dr Damir De Monaco, plastic surgeon Dr Barbara Pompei, oncologist Dr Alexandre Christinat, radiologist Dr Valerio Vitale, and breast surgeon Prof Virgilio Sacchini. The centre continues to expand its services and grow its teams to ensure patients receive the very best care close to home.

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Carmen Dannecker – the radiologist at Affidea brustCare – Breast Center Zurich, talks about cancer prevention and an extended form of mammography. In addition to conventional mammography for the detection of breast cancer, contrast-enhanced mammography has recently also been introduced. How does this new method work? The so-called CE-MAM (contrast-enhanced mammography / KM-MG) is an extension of mammography that provides significantly improved visibility of tumors. From a size of around three millimeters, breast cancer is supplied locally by newly formed small blood vessels. These vessels differ from others in the body because they are more permeable. The contrast agent administered through a vein leaks into these areas and “lights up” on the image at the location of the tumor. This not only makes breast cancer visible, but also shows the size of the tumor and any additional tumors. When is contrast-enhanced mammography used? In addition to determining tumor size more precisely in breast cancer, CE-MAM can be used for further clarification of unclear findings in mammography and ultrasound. In such cases, the absence of “enhancement” can rule out a malignant tumor in almost all cases and thus helps to avoid unnecessary biopsies. For certain tumors, chemotherapy is administered before surgery in order to shrink the tumor. To assess how the tumor responds to therapy, CE-MAM can also be used. What are the advantages of contrast-enhanced mammography? Because it works on a similar principle to magnetic resonance imaging (MRI), CE-MAM offers a comparable alternative for women who suffer from claustrophobia. During an MRI, patients must lie still for about twenty minutes in a prone position inside the “tube,” while loud noises occur. For many people, this is highly stressful and sometimes only possible with sedatives. CE-MAM is also an excellent alternative for women with pacemakers. What is the actual procedure for contrast-enhanced mammography? Many women appreciate that they are not left alone: a radiology specialist is always present in the room close to the patient. While seated, contrast agent is administered through a vein. It is the same contrast agent used in computed tomography (CT). Two minutes later, the mammography is performed. Shortly after administration, temporary sensations such as warmth, a metallic taste, or an urge to urinate may occur. Working at the Breast Center Zurich since 2022: Carmen Dannecker, specialist in radiology with a focus on breast imaging What happens afterwards? The patient remains under observation for about thirty minutes due to possible – but very rare – allergic reactions to the contrast agent. Afterwards, she can be discharged. She should drink plenty of fluids throughout the day, as the contrast agent is eliminated through the kidneys. There are no restrictions afterwards. What about radiation exposure? Radiation exposure is slightly higher than with conventional mammography. For comparison: the natural annual radiation exposure in Switzerland is 1 millisievert (mSv). Mammography is about 0.4 mSv, while contrast-enhanced mammography (KM-MG) is around 40% higher. Are there studies on the effectiveness of KM-MG? In recent years, the number of publications on study results worldwide has increased significantly, and numerous studies are currently underway or planned. Until now, MRI was the only method to examine the breast using contrast agent, which is why KM-MG results are measured against MRI. Studies are promising and show comparable results to MRI. How long does a patient have to wait for the results? The images are assessed immediately after the examination by a radiologist and discussed directly with the patient. Waiting times are minimal. This way, the patient receives clarity faster than with other methods. In which cases should a woman undergo breast cancer screening? Mammography is currently the standard examination for early detection of breast cancer. Since one in eight women will face breast cancer during her lifetime, we recommend mammography every two years starting between the ages of 45 and 50. If there are breast cancer cases among close relatives, screening is usually recommended more frequently, after consultation with the gynecologist, family doctor, or following advice from a specialized breast center. Is breast cancer screening free of charge? Early detection programs, also known as screening programs, are organized at cantonal level. They send an invitation for a mammogram every two years to all women aged 50 and over living in the respective canton. Unfortunately, this is not the case in all cantons. Only in cantons with such a prevention program does basic health insurance cover preventive mammography. Who pays in cantons without a screening program? In cantons without early detection programs, basic insurance covers the cost of mammography only if a physician wants to clarify a medical finding. However, many supplementary insurance plans offer mammography for early detection. And if breast cancer is suspected? In that case, it is no longer about prevention. If a woman has symptoms or complaints, or if something is detected during a screening examination, all follow-up examinations – including KM-MG – are billed through health insurance. Contrast-enhanced mammography offers many advantages. Why is Switzerland behind compared to other European countries? In countries with widespread screening programs, such as the Netherlands, there is a high demand for fast, high-quality diagnostic options to further clarify suspicious mammography findings. The use of contrast agent is very helpful and previously was only possible with MRI. That is why these countries in particular have been actively looking for solutions that are quickly available, cost-effective, and equally reliable. Does that mean Switzerland wants to fully utilize MRI equipment first to justify the investment before using more cost-effective examinations? No, I wouldn’t say that. The same MRI scanner can be used not only for breast imaging but for virtually any part of the body. For breast imaging, MRI will remain the first choice for women with genetic mutations, for example. What role will artificial intelligence play in breast cancer detection? Artificial intelligence is currently being tested in breast imaging in several countries, including Switzerland. It is already being used in Sweden to assess screening mammograms. The potential for its use in KM-MG is also very large, and several studies are currently underway worldwide. How do you see the future of breast cancer treatment? Thanks to increasingly precise diagnostics, early detection, and ever-improving treatment approaches tailored to each individual patient, a breast cancer diagnosis is no longer a death sentence for most patients today. Surgical techniques allow breast-conserving operations in most cases, and oncology treatments target tumors more precisely and reduce the risk of recurrence. For patients, this means good survival chances while maintaining quality of life. Interview by Silvia Aeschbach, Sonntagszeitung

BRA Day

Breast Health in Focus: Inform, Detect, Treat