Nearly 192,000 women in the United States are diagnosed with breast cancer each year – the most common cancer found in women. As physicians learn more about this disease and translate groundbreaking research into new diagnostic tools and better treatment options, the number of women surviving breast cancer is increasing dramatically.
Early Detection Means Better Outcomes
Many women never experience any pain or symptoms before being diagnosed with breast cancer. That’s why routine mammograms are so important. Today’s digital mammography is able to detect breast cancer before lumps can be felt or symptoms appear. Early detection not only helps provide a woman with more treatment options, it also increases the probability of good outcomes.
Innovative Medical Treatment
Chemotherapy is still a mainstay in treating breast cancer. Based on the findings in clinical trials over many years, doctors can now more effectively use chemotherapy drugs to treat a woman’s cancer while reducing side effects. New technologies are helping clinicians to determine which cancers may need, and benefit from, chemotherapy.
“Targeted cancer therapies are treatments that block the growth and spread of cancer by interfering with the specific molecules involved in tumor growth and progression,” says Robert A. Somer, MD, Medical Oncologist and Associate Director of the Janet Knowles Breast Cancer Center. “Physicians and researchers are working toward finding a way to individualize all cancer treatments based on the unique set of molecular targets produced by each patient’s cancer.” Research is evaluating the incorporation of some of these new therapies into the management of both early and advanced breast cancer.
Hormonal therapy is often recommended alone or following chemotherapy to women whose cancer is estrogen receptor- or progesterone receptor-positive. Estrogen and progesterone feed the cancer, making the cancerous cells grow and spread faster. In early-stage or metastasized cancers, hormonal therapy blocks this hormonal pathway, depriving the tumor cells of the substances they need to grow. A variety of hormonal agents are available, including tamoxifen, Aromatase Inhibitors and other newer compounds. The choice of agents often depends on the woman’s menopausal status, as well as balancing the risks and benefits in the presence of other medical conditions.
Advances in Surgery
About two thirds of all women with breast cancer are diagnosed with early-stage disease. “Studies show that chances of survival are equally good whether a woman has a mastectomy (full removal of the breast) or a lumpectomy (removal of just the tumor with some surrounding tissue) followed by radiation,” says Kristin L. Brill, MD, Breast Surgeon and Director of the Janet Knowles Breast Cancer Center at Cooper. “New tissue-sparing surgical techniques provide women choosing breast reconstruction with more options.”
Sentinel Node Mapping is another important step forward in breast cancer surgery. This term refers to finding the first (or sentinel) lymph node in the underarm into which breast cancer cells could travel. “If the sentinel node is cancer-free, chances are that other, nearby lymph nodes are also unaffected and can be left in place,” explains Dr. Brill. “In the past, surgeons routinely cut out many lymph nodes to find out whether the cancer had spread. If the nodes are clean and can remain untouched, the chances of a woman developing lymphedema, a painful swelling of the arm, decrease dramatically.”
Innovative Radiation Therapies
Radiation therapy involves using precise amounts of high-energy radiation to kill cancer cells. The radiation stops the reproduction of cancer cells while attempting to minimize damage to healthy tissues. Radiation treatments are done either alone or in combination with surgery, chemotherapy and/or hormone therapy. One of the newest types of radiation treatment for early stage breast cancer is Mammosite treatment, where only part of the breast receives radiation.
Mammosite is a targeted radiation therapy treatment where a small, soft balloon is attached to a thin tube (catheter) and placed inside the lumpectomy cavity through a small incision in the breast. “During therapy, the portion of the catheter that remains outside of the breast is connected to a computer-controlled High Dose Rate (HDR) machine that inserts a radiation “seed” to deliver the therapy to the area where cancer is most likely to recur,” explains Tamara A. LaCouture, MD, Chief of the Department of Radiation Oncology at Cooper. “Once therapy is complete, the ‘seed’ is automatically removed and the catheter unplugged. Therefore, a patient is not radioactive and has no risk to her family. At the completion of treatment, the entire balloon device is removed in the office, without any need for surgery.”
Mammosite offers patients several advantages, including:
- Shorter treatment period (five days) than traditional radiation therapy
- Fewer or more mild side effects
- Therapy is delivered on an outpatient basis
Cancer and Genetics
“Only five percent to 10 percent of breast cancers involve inherited mutations that are passed from generation to generation,” says Dana Clark, MS, Certified Genetic Counselor. Scientists have identified a number of genes, that when changed, can increase the likelihood of breast and other cancers and affect more than one generation of a family. The most common genes are breast cancer 1 (BRCA1) and breast cancer 2 (BRCA2) and clinical testing is available to patients and their family members who qualify. Mutations in these genes also increase the risk of ovarian and other cancers.
Anyone with a strong family history of breast cancer – or other cancers – should consider speaking to a genetic counselor that will review the family’s health history and discuss the benefits, risks and limitations of genetic testing.
