Empower yourself in the fight against breast cancer
Not so long ago, people used to whisper the words "breast cancer" or not talk about it all. Today, the disease is out in the open. And although some statistics about a rise in breast cancer might be alarming, women should feel positive about the great number of strides that have been made.
Phillip Aronow, MD, chairman of the department of surgery at Virtua West Jersey Hospitals, believes the subject of why so many new cases of breast cancer are occurring is complicated.
New diagnostic developments on the horizon
A less invasive approach to diagnosis
A promising treatment for more advanced disease
The Study of Tamoxifen and Raloxifene: commonly known as STAR
Detection is often in your own hands
Be in the know
New diagnostic developments on the horizon
"Today, we have very reliable methods of detection — many more breast cancers are identified and caught early on, when they are small, contained and highly treatable. Another reason is that women are living longer. Years ago, many women did not live into their 60s and 70s when the majority of breast cancers occur. Because we're living longer, we're seeing more cases. Lifestyle changes, such as women having children later, also have increased the risk of developing the disease. The best news is the progress we continue to make in combating it."
"One important new diagnostic development for high-risk, pre-menopausal women is MRI — magnetic resonance imaging," explains Maurice Cairoli, MD, medical oncologist, at Fox Chase Cancer Center at Virtua Memorial Hospital Burlington County. "Younger women have denser breast tissue. MRI is able to detect subtle changes in the breast tissue that mammography may not be sensitive enough to pick up. This is especially useful for women at risk. It's important to add that mammography is still the cornerstone of diagnosis for most women at standard risk for the disease."
A less invasive approach to diagnosis
It's called sentinel lymph node biopsy and it allows doctors to tell with great accuracy and much less surgery if breast cancer has spread beyond the breasts into the nodes. With this technique, the surgeon only has to biopsy the lymph nodes guarding the lymph node basin, so less extensive surgery is needed. Right now, the technique is being evaluated in a study conducted by a team of 14 surgeons at Virtua Hospital Voorhees, headed by surgeon Charles Butler, MD. "This is the biggest advance in the surgical treatment of breast cancer in the last 20 years," says Dr. Butler. "It has a significant impact in post-surgical side effects such as swelling, limitation of arm motion and disfigurement. We've performed approximately 180 procedures over the past two years. And although it is not yet the standard of care, there are high hopes that in the near future, this new less-invasive technique can be offered to all women with breast cancer."
A promising treatment for more advanced disease
For women with a certain types of metastatic breast cancer, a new treatment called monoclonal antibody therapy is being explored. A drug called herceptin triggers a biologic mechanism which kills cancer cells more selectively than chemotherapy. It's a real benefit to the patient since chemotherapy not only kills cancer cells, but a certain number of normal cells. Before a woman can receive herceptin, she must first be tested to determine that the HER2 gene is genetically altered. If it is, she is a likely candidate for herceptin in conjunction with standard chemotherapy. Early results show that a combination of herceptin and chemotherapy produce higher response rates than chemotherapy alone.
The Study of Tamoxifen and Raloxifene: commonly known as STAR
Risk for developing breast cancer increases with age. An individual's risk depends on a combination of lifestyle and personal traits known as risk factors. Fox Chase Cancer Center at Virtua Memorial Hospital Burlington County now offers high risk, post menopausal women the opportunity to enroll in a national breast cancer prevention trial known as STAR, the study of tamoxifen and raloxifene. Tamoxifene is an FDA-approved drug that helps prevent breast cancer in women who are at higher risk for the disease. STAR will examine whether raloxifene is as effective as tamoxifene in preventing breast cancer, without some of the side effects associated with tamoxifene. Women who are interested receive a free personal risk assessment.
Detection is often in your own hands
Often, the ability to detect breast cancer early is through self-examination. From age 20 to 39, women should perform a breast self-examination each month and have a clinical breast exam annually. For women age 40 and older, screening guidelines include a monthly breast self-examination, a yearly clinical breast exam and an annual mammogram. If a woman has a mother, sister or daughter who has had breast cancer, guidelines suggest more frequent surveillance. Another fact: 80% of women with breast cancer do not have a family history of it, so it's critical to follow the recommended guidelines.
Be in the know
Early detection is still the critical factor in treating breast cancer. While it is always best to discuss risk factors and a course of action with a doctor or medical professional, here are some factors that put a woman at higher risk:
- A first-degree relative who has had breast cancer.
- Early onset of one's period.
- Late onset of menopause.
- Having no children or a first child after age 35.
It is important to note that there is a high risk of developing breast cancer in the other breast once cancer has been diagnosed in the breast.