Breast Cancer: What We Know Today
Nearly everyone knows someone who has had breast cancer. Fortunately, we’ve made significant headway in treating the disease; scientific research and innovation have increased the five-year survival rate to close to 90 percent – up from 75 percent in 1980. Here, experts at the University of Vermont Cancer Center highlight five areas of promise that may someday make breast cancer a preventable and curable disease.
Technology has allowed physicians to capture much clearer images of women’s breast tissue, particularly those who have what is referred to as “dense” breasts. Breast density refers to the amount of fibrous or glandular tissue vs. fatty tissue in a woman’s breast. About half of women over age 40 have dense breasts, which puts them at increased risk for breast cancer. Fortunately, MRIs, 3D Imaging and ultrasound are all now routinely used for screening, and the technology improves every year. “These types of technologies help us find things earlier and at a more treatable stage,” says Marie Wood, MD, Director of the Familial Cancer Program at the University of Vermont Medical Center.
A 2016 study by the National Cancer Institute found that physically active women had a 12 to 21 percent lower risk of breast cancer than those who were least physically active. “Eating a minimally processed, plant-based diet, limiting alcohol, maintaining a healthy weight and regular exercise can reduce your risk for breast cancer recurrence,” says Kim Dittus, MD, Ph.D., a medical oncologist and Director of the Steps to Wellness Program at UVM Medical Center. While years ago, patients with breast cancer were not advised to be physically active – indeed they were often told to not lift anything – now women with cancer routinely participate in exercise groups that focus on fitness, strength and community.
Lifestyle modifications play such a significant role in reducing cancer risk, the University of Vermont Medical Center introduced the Steps to Wellness Program to provide a medically-informed rehabilitation and group-exercise program that serves the unique needs of cancer survivors. The 12-week program helps participants achieve renewed levels of strength and wellbeing, and provides practical tools to create lifelong health benefits.
Ten to 15 percent of breast cancer is hereditary. By assessing an individual’s risk – taking in a combination of family history and genetic screening – doctors are able to identify those with a hereditary risk who might be good candidates for further screening and, potentially, prevention options. Dr. Wood, who oversees the genetic testing program at UVM Medical Center, explains “there are now medications, such as tamoxifen or aromatase inhibitors, that can help prevent tumors from forming.” Think you may be at higher risk? Learn more about advanced screening options.
Over the course of nearly 40 years, from 1949 to 1988, just eight new breast cancer drugs had been approved. But research and treatments have accelerated substantially. During the nine years from 2009 to 2018, more than 10 drugs were approved for breast cancer treatment and prevention. Even better, according to Randall Holcombe, MD, Director of the UVM Cancer Center, is the fact that “newer therapies are specific to the individual’s type of cancer and tend to have less toxicity than traditional chemotherapy.” These customized treatments, tailored to the tumor, lead to better outcomes for the patient.
Currently, one in eight women in the United States will be diagnosed with breast cancer in their lifetime. It’s a daunting statistic, but research, treatments and prevention methods push forward. “We have just scratched the surface on understanding how immunotherapy may be beneficial for patients with triple negative breast cancer,” forecasts Dr. Holcombe. When a patient has cancer, their immune system is suppressed, but by removing the blocks in the immune system, patients may be better equipped to fight the cancer cells with their own immunity.
For patients with hormone receptor positive breast cancer, we’re also seeing exciting improvements with a number of targeted therapies,” explains Peter Kaufman, MD, breast oncologist and Professor of Medicine at UVM’s Larner College of Medicine. “The UVM Cancer Center has several clinical trials evaluating exciting new targeted therapies as well as hormonal medications, which are potent anti-estrogens, that appear very promising.” For more information about breast cancer clinical trials, please visit: https://www.med.uvm.edu/uvmcancercenter/clinicaltrialsgroup/clinical-trials or contact the UVM Cancer Center’s clinical research supervisor, Karen Wilson at karen.m.wilson [at] med.uvm.edu.