Breast Cancer: Where We Are & Where We Are Heading

From advances in research to updates in screening guidelines, Erika Hamilton, MD , MD, breaks down what people should know about breast cancer.

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Prevention

When considering breast cancer prevention, it is important that people understand the risk factors that can increase chances of developing breast cancer. These can be categorized by those that modifiable and those that are non-modifiable.

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Modifiable Risk Factors for Breast Cancer

·???????? Obesity, especially after menopause

·???????? Alcohol Consumption: People who drink alcohol have a higher risk than people who do not drink alcohol

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Non-Modifiable Risk Factors for Breast Cancer

·???????? Age: Female breast cancer is most common in women ages 65-74

·???????? Genetics: Approximately?5-10 %?of breast cancer are genetically mediated

·???????? Family History: Having a first-degree relative with breast cancer

·???????? Breast Density: As density of the breast (more fibrous tissue and less fatty tissue) increases, so does the risk. As of 2023, reporting breast density in mammogram reports is required. If a person has high breast density, they should speak with their doctor about screening that is right for them

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Although it is less common, it is important that men also recognize that they too can be diagnosed with breast cancer. Men should be mindful of signs, and speak with a doctor about any changes in the body, such as lumps in the chest. Those who are diagnosed with breast cancer are more likely to have a BRCA mutation, and testing for this genetic indicator is recommended.

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Detection

Mammograms are an important step in the detection of breast cancer, and should not be delayed. The earlier a breast cancer is detected; the less treatment will be necessary to have a good outcome.

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Sarah Cannon Research Institute (SCRI) recommends people with an average risk of developing breast cancer begin screening at age 40. However, people should speak with their physicians regularly starting as early as age 25 about their individual risk for breast cancer, as people with higher risk may benefit from genetic counseling or early screening.

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Additionally, during a mammogram, a person will complete a questionnaire that helps compute a Tyrer-Cuzick?score, which assesses their risk of developing breast cancer by considering individual factors such as family history, radiation exposure, and more. Further testing may be recommended, depending on the score.

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Unmet Needs in Breast Cancer

African American and Hispanic patients with breast cancer have statistically poorer outcomes as compared to Caucasian patients with breast cancer. It is incredibly important that the work we do continues to close the care gap and help ensure that every person who is diagnosed with breast cancer has the same chance to do well. Screening, access to healthcare, education, resources – these are all key areas where we can make a difference.

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At SCRI, our passion is clinical trials, and making sure that people with cancer have access to the cutting-edge therapies close to where they live. While there is research to support the fact that people with cancer who participate in a clinical trial do better than those who do not, there continue to be misconceptions, including when people should consider clinical trials in their cancer journey. At SCRI, we believe that clinical trials should be the first step in the fight against cancer, not the last. There are trials for all stages of breast cancer, including for those who have been cured and are in surveillance, trials for endocrine therapy, and more.

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The Future of Breast Cancer Research

There continues to be excitement in the field of personalized medicine. Because of advances in this area, cancer treatment is no longer a “one size fits all” approach. Now, treatment is tailored to a person’s unique cancer and its genetic characteristics.

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Antibody drug conjugates, or ADCs, is also an exciting new class of drugs. When chemotherapy is linked to an ADC, it is like a “smart bomb” that attacks only the cancer cells and spares the healthy, non-cancer cells. This is a more targeted approach, and one that appeals to patients facing cancer. There are currently 3 FDA-approved ADCs – T-DM1, trastuzumab deruxtecan, and sacituzumab?govitecan – and this exciting field of research will only continue to evolve.

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