Here are the most exciting advancements we’ve seen in recent years in the field of breast cancer treatment.
A breast cancer diagnosis in 2022 can have extremely different implications than the same diagnosis had 40 years earlier. In fact, from 1989 through 2017, breast cancer mortality rates have dropped by a whopping 40 percent, thanks to the rapid growth and innovation in the fields of treatment and early detection. But that doesn’t necessarily make a diagnosis any less scary. And beyond that, it can be hard to know what, exactly, has improved in terms of treatment, and therefore what to ask of your doctor to make sure you know of the best options available.
To get to the bottom of what’s going on in the field of breast cancer treatment and advancement, KCM spoke with Erika Hamilton, MD, director of breast cancer and gynecologic cancer research at the Sarah Cannon Research Institute at Tennessee Oncology. Dr. Hamilton discussed what excites her most regarding advancements in breast cancer treatment, advice for patients looking to inform themselves, and what makes her most hopeful about the future.
KCM: What changes have you seen in breast cancer treatment in recent years?
Dr. Hamilton: First, more women with hormonally driven breast cancer are being spared chemotherapy and instead are only needing estrogen-blocking pills. We also have new genomic tests that look at the genes in an individual woman’s breast cancer that can tell us how likely it is to come back.
Here’s another exciting development: Women with a lower genomic risk do not need chemotherapy anymore, particularly if they are post-menopausal. It’s been a massive win to be able to better identify which women will have great outcomes with fewer side effect-causing treatments like chemotherapy.
There are also a number of new therapies we can use to fight cancer. Two big wins have been immunotherapy for triple-negative breast cancer (cancer that doesn’t express the estrogen receptor, progesterone receptor, or a third aggressive protein called HER-2) and a new class of drugs called antibody-drug conjugates (ADCs). Immunotherapy harnesses the body’s own infection-fighting cells and trains them to recognize and fight cancer cells.
We also now have antibody-drug conjugates approved for all three types of breast cancer. What’s especially exciting about this class is that not only does it often work better than chemotherapy, but it can also be much better tolerated.
How can patients stay aware of what’s happening in the field of treatment?
First, ask your doctor about clinical trials and research. Even if your doctor doesn’t participate in research, they should be able to put you in contact with someone who does or could tell you if there was a good clinical trial option for you.
Clinical trials are not just for people “who don’t have options left.” At Sarah Cannon, we believe clinical trials should be your first option — not your last. There are ongoing clinical trials that are studying increased imaging for people who don’t even have cancer, for endocrine therapy for patients who are likely cured of their cancers and on maintenance therapy, for first-line cancer, and of course for cancer that it is incurable and progressed through multiple lines of therapy.
What type of innovation in breast cancer treatment can we expect to see on the horizon?
I think we will continue to see big strides in a number of areas, but especially in terms of personalized medicine. Personalized medicine is a fancy term that really means treating you and your cancer in a personalized fashion that isn’t one size fits all. This can take into account things as simple as age and goals of care, and as complex as hundred-gene genomic panels that tell us what makes an individual cancer grow.
The amount of treatments personalized to a specific mutation or abnormality in the cancer grows every year and translates to one 55-year-old woman with breast cancer likely being treated very differently than another 55-year-old woman with breast cancer beside her. That’s what we strive for — giving treatments in a tailored approach that will optimize the chance of success or cure for the individual person sitting in front of us.
