The content below appears in H4TG's A Guide to Caring for Yourself inside A Calendar to Live By 2022.
NEWEST BREAST CANCER TREATMENTS AND TECHNOLOGY
Content provided by Riverside Health System
Treatments for breast cancer are constantly evolving and today’s ideas and research become tomorrow’s standards of care. If you or someone you love is diagnosed with breast cancer, you’ll find helpful information below on some of the newest treatments currently available to patients as well as what may be on the horizon for treatment improvements in the near future.
MEDICINES & CHEMO
Treatments for breast cancer are based on the cancer’s stage and subtype, each of which respond differently to various treatments. Hormone receptor (HR) positive breast cancers, which grow in response to estrogen (ER) and/or progesterone (PR), are the most common; about 2 of 3 breast cancers have at least one of these receptors. The current standards of care for these types of tumors generally include hormone therapy, also called endocrine therapy, which is targeted drug treatment given either before or after surgery. According to Dr. Flavia Kostov, hematologist-oncologist with Riverside Health System, medicines currently used to treat these types of cancer include tamoxifen, or aromatase inhibitors like letrozole (Femara), anastrozole (Arimidex), and exemestane (Aromasin). “Endocrine therapy typically lasts five years. But now there is more knowledge about these treatments, and the standard of care can expand to 10 years.”
Advances in the understanding of genetic mutations that drive breast cancer have led to better, more targeted treatments. Recent research has led to the development of drugs that can treat patients with specific mutations – for instance, new medicines called PARP inhibitors have been developed to specifically treat BRCA-mutated cancers. Genomic testing gives physicians information about a patient’s specific breast cancer gene mutations and can also provide information on genetic traits that may increase cancer risk.
Genetics and genomics sound similar, but they don’t mean the same thing. Genetic testing can help determine a person’s risk of getting cancer; genomic testing can help determine the best way to treat an existing cancer.
New breast cancer treatments are on the horizon for those with metastatic (stage IV) disease as well as those with earlier stage cancers. Clinical trials for CDK4/6 inhibitors which are currently used to treat metastatic breast cancer for hormone receptor-positive, HER2-negative cancers are now underway for patients with an earlier stage of cancer, and these show promise, according to Dr. Kostov. Trials are also underway with immunotherapies that target TNBC (triple negative breast cancer) as well as ER+ disease and could soon offer new treatment options for patients.
SURGERY & RADIATION
For many patients, surgery is part of breast cancer treatment. Recent advances in breast cancer surgery include a focus on preventing lymphedema, a condition where excess lymph fluid collects in the tissue instead of draining through the lymphatic system. The result can be swelling, discomfort, and numbness. Breast cancer patients are at risk for developing lymphedema once the lymph nodes are removed during surgery, so new techniques aim to minimize this risk, according to Dr. Kostov. “We are trying to do fewer axillary lymph node dissections whenever possible. Lymphedema can lead to other health problems for patients.” She encourages patients who have had lymph nodes removed to talk to a lymphatic therapist before lymphedema develops.
One relatively new but well-established treatment now available in radiation therapy is internal beam radiation, known as brachytherapy, which uses a radiation source that is placed inside the body rather than outside the body, as is the case in standard radiation treatment. Brachytherapy reduces the duration of treatment time when compared to conventional radiotherapy.
One cutting-edge breast screening technology that is becoming more commonly used to detect breast cancer is 3D mammography. A 3D mammogram is an imaging test that creates a three-dimensional picture of the breast and makes certain features easier to see. A breast MRI with contrast dye is another useful tool for tumors that are hard to see or for women with very dense breast tissue, Dr. Kostov notes. With this type of test, an injected dye helps create clearer images that outline abnormalities more easily. MRI can locate small breast lesions sometimes missed by mammography.
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