Breast cancer: New findings and treatment options
October is designated as a time to promote breast cancer awareness and share information about breast cancer issues. And no matter what time of year it is, it’s always a good time to learn more about breast cancer.
What you can do
Breast cancer is the second most common type of cancer in American women (the first is skin cancer). It also ranks second as the cause of cancer deaths (lung cancer is No. 1).
According to the National Cancer Institute at the National Institutes of Health, cancer prevention is action that is taken to help lower a person’s chances of getting cancer. This, in turn, will hopefully lower the number of deaths from cancer.
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Some risk factors for developing cancer, like smoking, can be avoided while others, like genetics, cannot. We know there are healthy living guidelines to follow that may help reduce the risk of breast cancer -- things like limiting alcohol consumption; controlling your weight (a key factor in breast cancer prevention, according to the Mayo Clinic); being physically active; and discontinuing hormone therapy.
There are easy things you can do to help detect breast cancer, and early detection may help with treatment. Consider the following:
- Conduct monthly self-exams. (Check out this guide from the National Breast Cancer Foundation on how to conduct a breast self-exam.)
- Contact your doctor if you notice changes in your breasts, like a lump or skin change.
- Talk to your doctor about the best time to begin mammograms and other screening procedures.
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City of Hope is an independent biomedical research, treatment and education institution, one of 40 National Cancer Institute-designated Comprehensive Cancer Centers nationwide and a founding member of the National Comprehensive Cancer Network.
The following information about genetic testing for cancer was prepared by Dr. Jeffrey Weitzel, director of the department of clinical cancer genetics at City of Hope.
About genetic risk assessment
Genetic testing for cancer risk is used to determine if a genetic change, called a mutation, is present in genes that predispose an individual to developing cancer at an earlier age than would be expected. Having a predisposition for developing cancer does not mean you will definitely develop cancer, but does increase your risk. Knowing this may help you and your doctor to make health care decisions to prevent or reduce your chances for cancer.
Testing can identify who is at high risk for particular cancers and who is not. If an individual learns she has a cancer-causing mutation, she can make health care decisions that may prevent or lower her chances for cancer, or help detect cancer at an early stage. A person who does not have the mutation that is responsible for cancer in their family would not need extra health care exams and tests, and may be relieved to learn that they, and their children, are not at increased cancer risk because of this mutation.
Hereditary factors that might put you at risk
Cancer is a common disease. It is expected that families will have one or more relatives with some form of cancer. There are clues that can suggest hereditary cancer in a family. These clues include:
- Cancer at an early age
- More than one generation with cancers
- The same type of cancer in at least two closely related relatives
- Multiple primaries (more than one type of cancer in the same person)
- Bilateral disease (cancer occurring in both sides of a paired organ, e.g., cancer in both breasts)
- Multifocal disease (many primary tumors arising in the same organ)
- Rare cancers clustered on the same side of the family
- Breast and ovarian cancer on the same side of the family
- Breast cancer that occurs in a male
- Colon and uterine cancer in the same side of the family
The genes involved with cancer can come from either side of the family. Therefore, a cancer gene trait may be passed to a daughter through her father who did not have cancer. Accurately interpreting family history information is an essential aspect of genetic counseling.
Limitations of genetic testing
Because testing techniques vary, it is important your genetic counseling team explain the method of testing being used to look for a mutation and the chances that method may find a mutation. Different methods have different levels of sensitivity; therefore, even with the best technology, in some cases testing may not be able to find an existing cancer-causing mutation for you or your family.
For more information, read about the study led by Dr. Weitzel on how genetic testing can benefit breast cancer patients.
New findings and breast cancer treatment options
Findings from a 21-year study of about 1,000 women in California conducted by Kaiser Permanente and published in the September 2012 issue of Cancer Epidemiology, Biomarkers & Prevention, recently revealed that the least aggressive and most common type of breast cancer still carries a risk of death, even 10 years after diagnosis. This information could be helpful for doctors to determine how to treat this type of cancer.
“The findings of this study indicate that it is important to consider breast cancer molecular subtypes in determining the optimal treatment for women with breast cancer,” says study lead author Reina Haque, PhD, MPH, from Kaiser Permanente Southern California’s department of research and evaluation. “Women with luminal A tumors -- the least aggressive but most common cancerous breast tumor -- could benefit from extended treatment to improve their chances for long-term survival.”
There are four molecular subtypes of breast cancer:
- Luminal A: Typically tends to have the best prognosis and fairly high survival rates.
- Luminal B: Typically occurs in younger women and has a poor prognosis.
- Basal-like subtype: Typically occurs in younger women, as well as African American women, and has a poor prognosis.
- HER2-enriched subtype: Typically has a fairly poor prognosis and prone to early and frequent recurrence and metastases (i.e., the disease spreads to other areas of the body).
As the most common subtype, luminal A is responsible for 42 to 59 percent of all breast cancer cases.
“These and earlier findings strongly support molecular subtypes as important independent predictors of breast cancer mortality,” said Haque. “It is important for women with breast cancer, even those diagnosed with the least aggressive form of the disease, to be an advocate for their own health and speak to their doctors about treatment options.”
For resources on breast cancer information and how to access services, visit National Breast Cancer Awareness Month.
Talk to your health care provider about specific concerns you have or for help making decisions that are best for you and your health.