Editorials

The fight goes on to defeat breast cancer

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There is hardly a more dreaded word in the English lexicon than “cancer.” And with good reason. While hearing the word is no longer the death sentence it once was, cancer remains a formidable opponent. Breast cancer is particularly deadly for women.

According to the American Cancer Society:

▪  About 252,710 new cases of invasive breast cancer will be diagnosed in women in 2017.

▪  About 63,410 new cases of carcinoma in situ (a group of abnormal cells that are found only in the place where they first formed in the body), will be diagnosed. CIS is non-invasive and is the earliest form of breast cancer.

▪  About 40,610 women will die from breast cancer.

According to the Centers for Disease Control and Prevention, “Other than skin cancer, breast cancer is the most common cancer among American women.”

Dr. Paul Dale, surgical oncologist at Navicent Health, said the diagnosis of breast cancer is much improved over the past 10 to 15 years when a mammogram gave doctors just two views of the breast. Now, due to digital tools such as tomosynthesis, (basically 3-D mammography resulting in multiple images of the entire breast), doctors have the ability to view the entire breast rather than just a portion — and the pictures are much more precise and detailed..

Better and earlier diagnosis produces better outcomes. For example, the five-year relative survival rate when the cancer is detected at stage 0 or stage I is close to 100 percent. However, that percentage drops to 22 percent if the cancer is stage 4 at detection. The CDC states that 90 percent of women diagnosed with breast cancer are alive five years after being diagnosed.

According to Dr. Dale, using advanced techniques, once breast cancer has been detected and dealt with using surgery or other techniques, the recurrence rates have dropped from 60 percent to 8 percent for a variety of reasons. And after 100 years of radical mastectomies, removal of the entire breast is no longer the only option women have.

Treatments have certainly evolved. Where patients used to have to undergo radiation daily for six weeks following surgery, for some patients that’s been cut to five days. And some patients have interoperative radiation (radiation applied at the time of surgery) and still others have Brachytherapy, or radioactive beads placed directly in the breast tissue impacted by the cancer.

October is Breast Cancer Awareness Month and, as always, one of the objectives is to promote early detection. While women are still encouraged to do self examination, mammography remains the best tool for early detection. Women should have a mammogram, starting at age 40 and every two years after.

According to the CDC, “Most breast cancers are found in women who are 50 years old or older. Still about 11 percent of new cases of breast cancer are found in younger women but as Dr. Dale points out, women under the age of 40 should not think about expensive genetic tests ($2,000) to detect breast cancer genes (BRCA1 and BRCA2) unless they have had close relatives diagnosed when they were younger than 45 with breast or ovarian cancer and various other exceptions.

“The fact is,” Dr. Dale explained, “Most women don’t have a genetic deposition. Seventy percent of women (who develop breast cancer) have no risk factors.”

Dr. Dale said Navicent Health has a genetic counselor on staff that can help women navigate through their options if they think they fall into a category that indicates genetic testing might be necessary.

There are a number of hopeful signs on the horizon. Clinical trials are being conducted in hospitals all over the world. Though the battle against breast cancer is far from over, Dr. Dale says, “Every time we make a step, we move in a positive direction.”

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