First Alert: Breast Cancer Treatment Moves Forward

October is Breast Cancer Awareness Month, when the disease and our loved ones who have struggled against it (or still are) is top of mind. But fighting the disease is a year-round battle. And so is preventing it in the future.

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Breast cancer is among the most commonly diagnosed cancers in women—one in eight will be diagnosed in her lifetime, according to the Susan G. Komen Foundation (a dramatic increase from the “one in nine” of a few years ago). Still, a lot has changed in terms of what we now know compared to years ago. For one thing, it also impacts men—The American Cancer Society states that about 460 men will die from breast cancer this year.

Something else we also now know: most breast cancers are treatable if caught early. Early detection is key and it starts by knowing what’s normal and what’s not when it comes to breast health in terms of size, shape and density. Although everyone’s breasts are different, there are certain signs to be cognizant of before heading to the doctor’s office. The Breast Cancer Research Foundation recommends the Worldwide Breast Cancer’s #KnowYourLemons campaign, which lists 12 signs anyone can check for: changes in thickness, indentation, dimpling, skin erosion, redness/heat, unexpected fluid or discharge, bumps, growing veins, a new shape/size, orange peel skin and lumps.

These can help catch the disease early, but the majority of breast cancer in the United States is still diagnosed by mammography, said Dr. Nieca Goldberg, medical director of NYU Langone’s Joan H. Tisch Center for Women’s Health. Since 2015, more than 95 percent of mammograms have been done digitally. This allows for greater contrast, computer analysis and a lower radiation dose. But it has its drawbacks. Digital images are associated with an increased rate of false-positives, especially in women younger than 50, Dr. Goldberg said.

An advanced type of 3-D mammogram called Tomosynthesis is now being introduced—particularly in cases with denser breasts. Tomosynthesis creates a three-dimensional image of the breast, unlike traditional mammograms, which take one picture in just two directions. The test looks to overcome some of the limitations of the traditional mammogram, such as breast compression during the test and restricted views of the breast from multiple angles. “Tomosynthesis, in addition to mammography, modestly increases rates of cancer detection and decreases recall rates for false-positive mammography readings,” Dr. Goldberg said.

According to the American Cancer Society, standard treatments and cutting-edge medical research have resulted in a steadily declining mortality rate since 1990. Researchers are currently investigating other innovative screening techniques and new avenues for treatment. This includes procedures like immunotherapy, which harnesses the power of a patient’s immune system to fight cancer, and precision medicine, which tailors a patient’s treatment to the genetic makeup of the specific tumor they are fighting.

Promising new targeted treatments that kill damaged cancer cells are becoming more readily available, said Steven M. Sugarman, M.D., chief medical oncologist at Memorial Sloan Kettering Cancer Center in Commack. Medication such as Olaparib prevents the cancer from dividing and multiplying. This FDA-approved treatment has been shown to be superior to chemotherapy for patients who carry the BRCA1 and BRCA2 genes—the genes most commonly linked to breast cancer risk. “This is not chemotherapy and the side effects are well tolerated,” Sugarman explained.

The advancements in research draw an optimistic bottom line, Dr. Goldberg said. “Treatment has improved and women are living longer.” But we’re far from being in the clear.