There has been increased attention focused on breast cancer recently, thanks in part to a few high-profile celebrities who have shared their personal battles with this life-threatening disease. But despite the growing awareness, there are still huge strides to be made, according to Otis Brawley, MD, FACP, Chief Medical Officer of the American Cancer Society (ACS). He points out that 40,000 women will die from breast cancer in 2014, reinforcing the need for more resources to be allocated to better educate women about the importance of getting an early diagnosis, as well as to help develop new and improved strategies to treat invasive forms of breast cancer.

New Developments in Breast Cancer Research

The good news is that in the last year, the medical field has made some small but significant strides toward these all-important goals, Brawley says, both in shaping stronger messages and also in developing new protocols. Here are six lessons that recent breast cancer research has revealed—and you should know about:

  1. Not all mammograms are equal. "We recommend mammograms every year, staring at the age of 40," Brawley says. But what truly hasn’t been stressed enough is that the quality of the mammogram matters, Brawley points out. That’s why ACS now emphasizes that the best place to get a mammogram is a designated breast center, where the technicians do dozens of mammograms a day, rather than at general imaging facility where the personnel isn’t specifically trained in breast imaging.
  2. Consistency matters. "It’s also important to have the mammogram done at the same center every year," Brawley explains. This will allow the radiologist to compare the latest mammogram imaging results with those of the previous years, and identify any changes, Brawley says. This is especially crucial for women in their 40s, whose breasts are still very dense, making it hard to see any suspicious areas. If you do switch centers and don’t have your records transferred to the new facility, the radiologist can easily miss a change that could be worrisome.
  3. Treatment only works if you take it. It sounds like common sense, but Brawley points out that many women actually don’t take their recommended breast cancer treatments for a variety of reasons. For instance, as many as 25 percent of women with cancer who could benefit from taking an estrogen-blocking drug to prevent the tumor from growing forego this step, either because they don’t want to take the medicine or because their doctor has not prescribed it in the first place.

    In other cases, women who have been prescribed radiation stop after the first few visits—sometimes this is because they can’t feel it working, so they assume they don’t need it, or in other cases, because the treatment center is inconvenient. Then there’s chemotherapy, which can cause side effects that are difficult for many women to tolerate. In addition, some doctors are afraid to prescribe a strong enough chemo dose for their heavier patients, so the women are undertreated. All of these scenarios can be dangerous.
  4. Women should be their own advocates. If you rely completely on your doctors to guide your treatment decisions, you could be making a dangerous mistake. While your doctor can be an importance resource, keep in mind that he or she may not be up on the latest options and considerations. This makes it important to do your own homework and understand the diagnosis and treatment options that exist. Ask lots of questions so you’ll know exactly what is being done and why. Also don’t be afraid to get a second opinion to see if there are other treatments that might be viable for you.
  5. Better diagnostic approaches are on the horizon. Many doctors today don’t fully understand the epidemiology (the incidence, distribution, and control) of breast cancer. Therefore, they also don’t fully understand the limitations of mammograms, particularly in younger women where many abnormalities won’t be easy to spot (again, due to density in their breasts). But the good news is that the diagnostic options and tools are growing, which can help close up the gap. Some breast centers now have 3-D mammograms available, and many breast centers are trying to define high-risk women who would benefit from routine breast MRIs (magnetic resonance imaging) scans, too.
  6. Not all cancers need to be treated. How the different forms of breast cancer are being defined is slowly changing, as is the way they are treated. Brawley points out that researchers are starting to realize that some breast cancers will never progress at all or become dangerous or life-threatening. The latest tests make it possible to identify these types of cancers. While modern medicine is not yet at a point where they will just ignore such mild forms of cancer, they certainly don’t treat it aggressively either. In the future, Brawley says that such benign forms of cancer won’t even need any type of intervention.

Learn More

For more information about the latest research, findings, and best practices for breast cancer, you can visit the ACS website at cancer.org.

Otis Brawley, MD, FACP, Chief Medical Officer of the American Cancer Society (ACS), reviewed this article.


Sources

"Breast Cancer." American Cancer Society. Last revised 01/31/2014. Accessed website on Sept. 23, 2014. 

Brawley, Otis, MD, FACP, Chief Medical Officer of the American Cancer Society (ACS). Phone interview, Sept. 19, 2014.