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Personalizing Breast Cancer Care

By: Asma Latif, MD, Hematologist and Medical Oncologist at Sturdy Hematology & Oncology Associates

We all know someone whose life has been affected by breast cancer, whether as a patient or as a loved one of someone diagnosed with the disease. The diagnosis can be overwhelming. Feelings of anxiety about what steps to take next are natural.

Breast cancer is recognized as the most common female cancer, however, it is important to remember the disease affects men as well. Upon initial diagnosis of early stage breast cancer, meaning a cancer that has not spread beyond the breast and nearby lymph nodes, many people may expect to receive a combination of surgery, radiation, chemotherapy, and pill therapy. However, not all patients need all of these treatments. Experience has taught us that each individual is unique, and so too is his or her disease. Gone are the days of “cookie cutter” treatments. Personalized medicine, also referred to as precision medicine, allows physicians to tailor treatments for an individual patient based on a variety of factors in order to offer the most effective therapy for that person. Scientists and physicians have made great strides in personalizing breast cancer therapy to match an individual’s specific disease, and modern treatment plans are evolving to offer the therapies that are most appropriate while avoiding unnecessary risks.

Most patients diagnosed with breast cancer will undergo surgery and possibly radiation treatment in order to remove the cancer cells from the breast. These cancer cells are carefully examined to understand what makes them grow and multiply. In many breast cancers, physicians are able to identify a reliance on estrogen, a hormone naturally present in everyone’s body. This characteristic is referred to as estrogen-receptor (ER) positive breast cancer. The ability to identify this provides oncologists with a wealth of information. Hormone-modulating pills, referred to as endocrine treatments, are generally recommended for these patients in order to prevent the spread of the cancer. The specific medication prescribed often depends on whether a woman has gone through menopause.

Similarly, some breast cancers are found to have elevated levels of a particular gene or protein referred to as human epidermal growth factor receptor 2 (HER2). This gene plays a role in the rapid growth of some breast cancers. By understanding the HER2 status of the tumor, oncologists can offer the appropriate patients very specialized drug treatments that work to block the action of the HER2 protein, thus helping to stop the spread of the cancer.

Patients often have anxiety about undergoing chemotherapy as part of their cancer treatment. With a personalized approach to breast cancer care, oncologists are now able to request a genetic test on certain breast cancer tumors. This test can provide insight into distinguishing which patients may benefit from chemotherapy after surgery in order to prevent the spread of the cancer. Perhaps even more importantly, it can identify those patients who would not benefit from chemotherapy after surgery, allowing them to avoid unnecessary side effects from treatment.

For patients who have more advanced breast cancers, those that have spread beyond the breast and local lymph nodes, continuing a personalized approach to treatment is vital. Innovative genome-sequencing tests may allow oncologists to identify whether a patient’s breast cancer contains any meaningful mutations that could cause the tumor to be vulnerable to particular medications, many of which are currently being tested in clinical trials. Additionally, personal genetic testing to identify the presence of a BRCA1 or BRCA2 mutation, which can increase the risk for breast or ovarian cancers, can guide specific treatment choices as well.

Facing a cancer diagnosis is never easy. However, knowing that you have comprehensive treatment options available right here at your community hospital can provide reassurance. As advances in medicine continue, we are able to personalize your care and provide you with the right treatment tailored specifically for you. For more information about the comprehensive cancer care offered at Sturdy Memorial Hospital, call our Oncology Department at 508-236-7010 or click here.