– By Anita Johnson, MD, FACS, Special to The Newnan Times-Herald
As a surgical oncologist focused on treating breast cancer, I see daily how devastating a breast cancer diagnosis can be, but the sad fact is, the most important risk factor for breast cancer is simply being a woman.
Trends in breast cancer show consistent declines in both new cases and deaths from breast cancer. The U.S. Centers for Disease Control and Prevention (CDC) reports that from 2003 to 2012 (the most recent time period for which CDC statistics are available) the incidence of breast cancer among U.S. women did not increase, while mortality decreased approximately two percent annually.
Increased awareness, earlier screenings, new technologies and improvements in existing treatments are very likely contributing to higher survival rates and improved quality of life. For example:
• MarginProbe is an advanced technology that helps surgeons determine if cancer cells are present in the margins of excised tissue. It provides real time, detailed information to help surgeons decide if additional tissue should be removed. MarginProbe increases the probability of a correct margin assessment before tissue is excised and sent to a pathologist for examination. A major benefit is that it may reduce the likelihood of the need for a second procedure.
• Genomic testing is another innovative diagnostic tool. It helps identify DNA alterations that may cause cancer growth. When physicians can better understand what is fueling that growth, they can tailor cancer treatment therapies that target specific changes in the tumor’s genomic profile and slow or stop the cancer in its tracks.
• Intraoperative radiation therapy (IORT) is a technology that delivers radiation to a very precise area of the breast, after a tumor has been removed, versus standard radiation therapy which targets the entire breast. IORT, may help minimize damage to healthy tissue, involves a single, smaller dose of radiation at the time of surgery and often requires no further radiation treatments.
• Chemoembolization delivers medication through a catheter directly into a tumor using image guidance. Chemotherapy drugs are mixed with particles, called microspheres, which may block blood flow to the tumor and inhibit growth.
These and other treatments can be tailored to the individual based on factors such as genetic profile, type of tumor and whether the cancer has spread.
The American Cancer Society (ACS) predicts there will be more than 249,000 new cases of breast cancer in the United States this year alone, and even with a declining mortality rate, far too many victims succumb to its effects. The aforementioned advanced treatment options are having a significant impact on survivability and quality of life, but even with that more positive outlook, the ACS still projects almost 41,000 will die as a result of breast cancer in 2016.
The specter of breast cancer can be frightening, but it is important to remember that most women will not develop the disease at any point in their lifetimes. For those that are stricken, hopefully we can keep that trend line for deaths heading downward to a point where someday we are looking at a rate that is near zero.
In the meantime, women who are at increased risk should know their family histories, as genetics offer significant insight into the risks of developing breast cancer. Patients should talk to their doctors about how often to undergo mammograms, genetic testing and other screening alternatives.
When faced with a breast cancer diagnosis, it is important for every woman to have a team that specializes in treating breast cancer. It should be a collaborative group of physicians and clinicians who will take time to understand the uniqueness of each case – and the specific needs of the individual patient – and work together to develop an integrative treatment plan that increases the likelihood of a positive outcome.
(Anita Johnson, MD, FACS, is a breast surgical oncologist at Cancer Treatment Centers of America at Southeastern Regional Medical Center in Newnan, Ga.)