By Dr. Olivia Hightower
We are making advancements every year in breast cancer treatment. Patients are being cured at a higher rate, and even those whose cancer is detected at later stages are living longer, as chemotherapy options are improving.
Breast cancer is the most common cancer in American women, excluding skin cancers. About one in eight U.S. women will develop invasive breast cancer over the course of her lifetime — constituting approximately 12 percent of women. Early detection of breast cancer is key to improved survival rates. Annual mammograms and self-exams are important components of finding the disease early. Mammograms will detect the vast majority of early breast cancers. 3D mammograms have become more readily available, and they are more sensitive with fewer false positives. If a mammogram is negative but a woman finds a lump on self-exam, she should see her doctor and pursue further workup with breast ultrasound and biopsy.
Breast cancer treatments are improving every year. Five-year survival rates are very high for stage 1 breast cancers at greater than 99 percent. Regional disease involving the lymph nodes have an 86 percent survival rate at five years with appropriate treatment. Treatments include surgery with lumpectomy or mastectomy, chemotherapy, radiation and endocrine therapy with hormone-blocking pills. Patients will need to discuss with their doctor which of the above treatments are needed.
Genetic testing of hormonally driven breast cancer cells helps determine the recurrence risk for each woman and the benefit that chemotherapy will provide, allowing us to make better decisions about adjuvant treatment and to educate the patient on the risks and benefits. Chemotherapy options also are improving and becoming more targeted. For example, if a patient has a protein that is overexpressed called HER2, there are more targeted options for chemotherapy, in combination with traditional chemotherapy, that allow for better response rates and recurrence prevention.
Risk factors for breast cancer include being female, increasing age, family history of breast or ovarian cancer, postmenopausal hormone replacement, increased age of having first child or not having children and increased age of transition to menopause. Patients can reduce their risk of developing breast cancer by maintaining a healthy body weight, limiting alcohol and avoiding hormone exposure. Women with strong family history should be genetically tested for mutations that increase their risk, as 5-10 percent of breast cancers are hereditary. If patients have these mutations, genetic counseling is undertaken, and preventative surgeries can be considered.
Patients in the high-risk group also can take hormone-blocking treatments such as Tamoxifen that decrease their risk of developing breast cancer. Thorough preventative care with annual breast exams, mammograms and monthly self-exams, lives can be saved. Women with no family history should start at age 40 with mammograms and continue yearly. Women with family history should start 10 years earlier than the youngest relative was diagnosed or age 35, whichever is earlier.
We are making advancements every year in breast cancer treatment. Patients are being cured at a higher rate, and even those whose cancer is detected at later stages are living longer, as chemotherapy options are improving.
Advances in fighting breast cancer are frequent, as clinical trials are continuing to produce breakthroughs in chemotherapy options every year. I am excited about the continued progress that is being made and the lives that are being saved.
Dr. Olivia Hightower is a medical oncologist at Gulfport Memorial Hospital. Reach her at (228) 575-1234.