Inside Breast Cancer Care: Interview with Dr. Petia Kiene

1. From your perspective at the Breast Centre, what does the breast cancer care pathway look like for a patient today?

P.K.: The first step is detection and diagnosis. Since there are many types of breast cancer, identifying the specific type is crucial to determine the necessary treatment. This decision is made by a multidisciplinary team (MDT). Treatment is followed by rehabilitation and support. While the majority of women will recover fully, long-term monitoring remains essential.

2. What would you most like women to understand about breast cancer detection and seeking medical advice when they notice a change?

P.K.: A shift in mindset is needed, moving from simply performing a routine "self-exam" to practicing "breast self-awareness." Women should watch for subtle changes—such as skin dimpling, nipple alterations, or bloody discharge—rather than searching solely for a lump. While most changes are benign, prompt evaluation is vital for early detection, which significantly improves outcomes if cancer is present.

3. How has breast surgery evolved in recent years, particularly in terms of combining effective cancer treatment with quality of life and the individual needs of patients?

P.K.: Through shared decision-making, the patient's personal lifestyle, body image priorities, and emotional comfort now actively shape the final surgical plan. While a mastectomy is sometimes necessary, a standard lumpectomy is possible in most cases. The standard of care is oncoplastic breast-conserving surgery, which combines cancer removal with plastic surgery techniques during the same operation. If a radical mastectomy is required, the patient has the option to undergo the procedure with or without immediate reconstruction.

4. Breast cancer care brings together specialists from different disciplines. How does this multidisciplinary approach help tailor treatment to patients?

P.K.: The multidisciplinary team (MDT) approach combines experts from multiple medical fields to jointly review a patient's diagnostic results and design a single, personalized treatment strategy. The core team consists of a pathologist, radiologists, breast surgeons, medical and radiation oncologists and support specialists.

A shift in mindset is needed, moving from simply performing a routine "self-exam" to practicing "breast self-awareness.

5. Where are digital technologies already making a difference in breast cancer diagnosis, treatment planning or follow up, and where do you see the greatest potential for further development?

P.K.: AI takes the first reliable steps in screening and initial assessment, but these do not offer absolute certainty. It functions as a learning platform that will continue to improve its detection capabilities over the coming years. Treatment decisions can initially be AI-created and drafted based on official guidelines and current publications; however, a physician’s review remains mandatory. Additionally, numerous supporting programs and digital life coaches are available 24/7.

6. What gives you the most hope when you think about the future of breast cancer care?

P.K.: First, intercepting cancer before it truly forms. While numerous tests exist to detect tumor cells in a blood sample, the definitive standard has yet to be established. Advanced genomic tests now determine individual treatment pathways. This marks the systematic dismantling of the 'one-size-fits-all' approach, driven by the convergence of tumor biology and technology.