FALLS CHURCH, Va. --
Thanks to improvements in detection and treatment, “more and more breast cancer patients are becoming breast cancer survivors,” said Army Col. Craig Shriver, director of the John P. Murtha Cancer Center at Walter Reed National Military Medical Center in Bethesda, Maryland. “We’re making strong progress in decreasing death from breast cancer.”
Citing a study that was published this month in the American Cancer Society’s “CA: A Cancer Journal for Clinicians,” Shriver said breast cancer deaths declined 40 percent from 1989 to 2015. “That’s dramatic,” said Shriver, who’s also an oncology surgeon and a surgery professor at the Uniformed Services University of the Health Sciences in Bethesda.
Shriver credits the Cancer Genome Atlas for other promising developments. Begun in 2008, the atlas was a collaboration among the nation’s top scientists and practitioners to collect and analyze genetic mutations that are responsible for various cancers. Understanding the genetic materials in cancer cells and their order – called genome sequencing – leads to treatments that can be adapted to each patient, and, perhaps one day, to prevention.
The Murtha Cancer Center partnered with the National Institutes of Health’s National Cancer Institute on breast cancer genome sequencing for the atlas. Breast cancer is the most common cancer among women, according to the Centers for Disease Control and Prevention. It’s the No. 1 cause of cancer deaths among Hispanic women, and the second most common cause of cancer deaths among white, black, Asian, and Native women.
According to the CDC’s most recent statistics, almost 237,000 women in the United States were diagnosed with breast cancer in 2014.
Shriver said the study showed the number of women diagnosed with breast cancer during the 15-year period didn’t change much. “But our screening programs are better, so we’re able to detect the cancers at an earlier stage, when they’re treatable.”
Also, oncologists have fine-tuned traditional treatment approaches. Genetic testing of breast cancer tumors allows oncologists to treat with chemotherapy only those patients who are most likely to respond to it. Those who aren’t can be given other treatments, or put into clinical trials.
“In the past, we’d spend a year or two giving chemotherapy, only to find out the cancer came back anyway,” Shriver said. “Now, we’re not wasting that time.”
Shriver said less-invasive breast cancer surgeries are also on the horizon. For example, in a traditional lumpectomy – also known as a breast-conserving therapy – surgeons remove the tumor and some surrounding normal tissue. Researchers are conducting clinical trials to determine if instead of surgical removal, the tumor can be destroyed while it’s still in the breast with directed laser technology.
“We’re moving more and more toward a day, maybe five years from now, when women with breast cancer will be treated almost exclusively without surgery,” Shriver said. “That would be a great advance.”
Meantime, he stresses early detection. So does Air Force Lt. Col. Michelle Nash, a branch chief in the Air Force Research Laboratory at Wright Patterson Air Force Base in Ohio. Nash had a double mastectomy after being diagnosed with breast cancer earlier this year at the age of 40. The cancer was discovered after Nash had a routine mammogram, her first.
“The whole thing was so shocking and unexpected,” she said. “I had no family history. I breastfed all four of my children, and that’s a protective factor. I didn’t have any lumps or any symptoms that would cause me to think, ‘I should go get that checked out.’ So I’ve become an even firmer believer of preventive medicine and getting screenings done, and not delaying them.”
All women over the age of 20 should do a self-exam monthly and get a clinical breast exam annually, Shriver said. For mammograms, women ages 40 to 44 who are at average risk for breast cancer can choose an annual mammogram after consulting with their health care provider. For women 45 to 55 years old, an annual mammogram is recommended. Women 55 and older can get mammograms annually or every two years, based on provider recommendation.
“We can treat breast cancer patients with fewer side effects and with better, targeted therapies,” Shriver said, “and survival rates are better. But early detection is still the best thing.”