Breast cancer treatments improve 

Published 8:21 pm Tuesday, November 11, 2014

By Dr. Anita Johnson

As a surgical oncologist focused on treating breast cancer, I see daily how devastating a breast cancer diagnosis can be. But I also see daily how new and often cutting-edge treatments give women the hope and courage they need to help manage or overcome the physical, mental and emotional challenges of breast cancer, and in many cases, beat the disease altogether.

One in eight women will develop breast cancer in her lifetime. While the leading risk factors are well known — age, family history, mutations in certain genes — the most important risk factor for breast cancer is simply being a woman.

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The fact that any woman can develop breast cancer is one reason annual mammograms and clinical breast exams are so important; regular screening helps detect cancer early. As with every type of cancer, when breast cancer is discovered early, there are more treatment options available, survival rates are longer and the cure rate is higher.

In the U.S., trends in breast cancer are encouraging. Data from the National Cancer Institute show consistent declines in both new cases and deaths from breast cancer since 1990. Further, the U.S. Centers for Disease Control and Prevention reports that from 2001 to 2010 the incidence of breast cancer among U.S. women did not increase, while mortality decreased 2 percent annually.

Breast cancer mortality is decreasing faster than incidence, meaning that women with breast cancer are living longer. That trend is borne out by NCI data. Only 75 percent of women with breast cancer survived more than five years in 1975; in 2011 more than 90 percent did.

New technologies and improvements in existing treatments are very likely contributing to higher survival rates and improved quality of life for women with breast cancer.

For example, a new technology called the MarginProbe System helps surgeons determine if cancer cells are present in the margins of tissue that has been removed. The technology helps reduce the rate of second surgeries following lumpectomy.

Genomic testing is an innovative diagnostic tool that allows tumors to be examined at the genetic level. By identifying mutations that occur in a cancer cell’s genome, doctors can better understand what caused the tumor and tailor treatment based on these findings.

Genomic testing might suggest a drug normally used for another type of cancer could be an appropriate treatment for breast cancer based on the genetic properties of the tumor.

Intraoperative radiation therapy is one of many new technologies that deliver radiation more precisely, helping minimize damage to healthy tissue and treatment times. With IORT, radiation is delivered directly to the tumor site after a surgeon has removed the tumor. A 30-minute dose of IORT can often replace weeks of traditional radiation.

There have also been numerous advances in chemotherapy treatments for breast cancer. Targeted therapy blocks specific molecules involved in tumor growth by directing drugs or other specially created compounds to attack cancer cells. Chemoembolization delivers medication through a catheter directly into a tumor using image guidance. The chemotherapy drugs are mixed with microspheres, which block blood flow to the tumor.

With so many options available to treat breast cancer today, treatments can almost be tailored to the individual in collaboration with her family, personal physician and oncologist.

Women who are at an increased risk of breast cancer should talk to their doctors about how often to receive mammograms and what other screenings, such as genetic testing, might be beneficial.

Although breast cancer continues to claim too many lives — more than 40,000 this year — advanced treatment options are having a significant impact on survivability and quality of life.

Anita Johnson, MD, FACS, is medical director of breast surgical oncology at Cancer Treatment Centers of America at Southeastern Regional Medical Center in Newnan, Ga.