Come spiega la guida realizzata da Onda, la possibilità di valutare il rischio eredo-familiare di insorgenza di tumori permetterà di offrire alle pazienti strategie di prevenzione, diagnosi e terapia. Nel 2013 partorà anche un nuovo progetto di screening alla mammella basato sulla densità mammaria.
Possibilità per le donne di valutare il rischio eredo-familiare di sorgenza di tumori della mammella e dell’ovaio offrendo, alle pazienti a rischio, strategie di prevenzione, diagnosi e terapia. È questa la nuova frontiera che, partendo da questi due tumori, coinvolgerà in un prossimo futuro – e a 360 gradi – la prevenzione oncologica.
Di questo si è parlato ieri sera a Milano, alla Sala Gonfalone della Regione Lombardia, nel corso della conferenza “I tumori eredo-familiari della mammella e dell’ovaio”.
Un incontro in cui sono stati annunciati i lavori preliminari per la stesura di linee guida regionali condotte dal Servizio di Epidemiologia della ASL 1 di Milano in collaborazione con la Divisione di Prevenzione e Genetica Oncologica dell’Istituto Europeo di Oncologia e O.N.Da, l’Osservatorio Nazionale sulla salute della Donna. Durante l’incontro sono stati discussi anche gli aspetti più cruciali relativi alla definizione di strategie operative e sinergie per la miglior governance dei tumori eredo-familiari femminili.
“Con questo nuovo progetto finanziato dalla Regione Lombardia e ora in dirittura d’arrivo – ha spiegato Bernardo Bonanni, direttore della divisione di prevenzione e genetica oncologica dello Ieo – abbiamo redatto delle linee guida sui tumori ereditari di seno e ovaie, in cui ci si occupa della valutazione del rischio, della sorveglianza clinico-strumentale, delle misure di prevenzione e di nuovi aspetti e figure professionali. Una volta concluse, le proporremo alla Regione perché vengano adottate in tutti gli ospedali Lombardi. Tra le indicazioni che sono emerse – ha proseguito Bonanni – vi è quella per cui, alle donne con i geni mutati Brca-1 e Brca-2, dunque con un alto rischio di tumore maggiore, si raccomanda l’utilizzo della risonanza magnetica, limitando invece l’esposizione ai raggi X. Inoltre, per quanto riguarda i farmaci, risulta che alcuni possono avere efficacia preventiva. Per quanto riguarda il tumore all’ovaio, per esempio, si è notata una riduzione del rischio con l’utilizzo di contraccettivi orali”.
“I tumori alla mammella e all’ovaio, che riconoscono una base di predisposizione ereditaria rappresentino la percentuale minore di tutte le forme tumorali – ha aggiunto Francesca Merzagora, presidente dell’Osservatorio Onda – sono patologie che meritano un’attenzione particolare per il pesante impatto clinico, psicologico e sociale, dal momento che molto spesso colpiscono donne giovani, dunque nella fase della vita fertile e produttiva. Per questo le iniziative promosse dall’Osservatorio nell’ambito di questo progetto realizzato in collaborazione con la Regione Lombardia, quali la pubblicazione e divulgazione di una breve monografia dedicata e l’organizzazione di una conferenza sul tema, rispondono proprio all’esigenza di informare le donne in modo semplice, chiaro e diretto sulle possibilità offerte da questa nuova frontiera dell’Oncologia”.
“Il nostro opuscolo – ha aggiunto Maria Antonietta Nosenzo, membro del consiglio direttivo di Onda – ha proprio l’obiettivo di far conoscere alle donne il ruolo dell’oncogenetica e le opportunità concrete offerte dalla consulenza specialistica, in particolare nella valutazione del rischio oncogenetico, nella definizione di programmi personalizzati di sorveglianza clinico-strumentale per i soggetti ad alto rischio e nell’adozione di misure farmacologiche o chirurgiche di riduzione del rischio”.
“Anche per quanto riguarda gli screening – ha spiegato Luigi Biasanti, consulente epidemiologico dell’ASL di Milano e referente scientifico del progetto – dopo aver coperto la fascia d’età 50-69 anni, è venuto il momento di verificarne altre precedenti. Tuttavia, per le donne più giovani, tra 45 e 49 anni, va chiarito quale sia lo strumento migliore. Non essendo ancora in menopausa infatti, la mammella di queste donne risulta ancora troppo densa e la mammografia spesso poco leggibile dal medico”.
Per capire meglio qual è quindi lo strumento di prevenzione migliore, nel 2013 partirà una sperimentazione triennale in 6-7 Regioni su 40mila donne, finanziata con i fondi della ricerca corrente del Servizio sanitario nazionale, nella quale le donne saranno divise in due gruppi: ad uno sarà applicata la mammografia con periodicità annuale, mentre all’altro si proporrà una periodicità annuale o biennale in base della loro densità mammaria.
Fonte: “Quotidianosanità.it” – 08 novembre 2012
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