Breakthrough drugs and new, advanced treatments give breast cancer patients and their families hope for a longer and better life. Here’s a look at some recent advancements:
Gene mutations
It’s an exciting time in breast cancer research, especially with what’s happening with genetic research and testing, said Dr. Marleen Meyers, assistant professor in the Division of Medical Oncology at the NYU Perlmutter Cancer Center.
The PALB2 gene is something doctors have known about for years, but recently they’ve uncovered that it holds a newfound importance. The new research shows that women with mutations in the PALB2 gene have on average a 1 in 3 chance of developing breast cancer by age 70, making it potentially one of the most relevant genes associated with breast cancer after BRCA1 and 2. “It’s not new, but it’s important,” Meyers said.
“Women who were tested 10 years ago, but came up negative for BRAC1 and BRCA2, should go back and get tested again for the PALB2. It’s especially important if you have a strong family history of breast cancer,” she said.
Pre-surgery drug
Also exciting is the first drug approved to shrink breast tumors cancer before surgery, said Dr. Chau Dang, chief of medical oncology at MSK West Harrison, an outpatient treatment center of Memorial Sloan Kettering Cancer Center, which will open in October.
Oncologists sometimes use chemotherapy to treat breast cancer before surgery, but this is a drug. Pertuzumab was approved last year to treat metastatic HER-2 positive breast cancer along with a combination of other drugs, and is now approved to treat patients with early stage breast cancers that respond to the HER-2 protein, said Dang. The medical oncologist specializes in the treatment of women with breast cancer, and her research focuses on developing more-effective and less-toxic treatment strategies.
Screening
New screening technologies like tomosynthesis are also benefitting breast cancer patients. In this digital process, rather than one photo, a series of small, photographic “slices” at different depths and thicknesses is taken, which saves both time and reduces radiation exposure. While mammography and MRI have their downsides (false positives and unneeded biopsies), tomosynthesis or digital breast imaging is more precise and can pick up smaller, hidden tumors, Meyers said.
A new three-dimensional breast imaging device, General Electric’s SenoClaire, was approved by the FDA in September. Developed in collaboration with Massachusetts General Hospital, SenoClaire uses a step-and-shoot procedure and a low-dose short X-ray sweep to create a 3-D image with no increase in radiation from a standard 2-D mammography.
Hormone, radiation therapy
Another recent change in treatment is the duration of the therapy for women with hormone-receptor positive breast cancer — the most common form of breast cancer, Dang said. “While five years used to be the standard, now a decade of follow-up care is being shown to lead to a longer survival rate and lower risk of breast cancer recurrence,” Dang said.
The American Society of Clinical Oncology now recommends 10 years of tamoxifen for both pre- and perimenopausal women. Post-menopausal women who have completed a five-year regiment of tamoxifen have the option of five more years of AI (aromatase inhibitor) treatment.
“Hormonal therapy is effective and women have options. The choice of drugs depends on their tolerance, but for most people longer therapy is better,” Dang said.
Radiation therapy is also “shorter and more safe now,” said Dang. “The classic regiment was five or six weeks, now it’s three weeks or even one week,” she said “And it’s given on the stomach to protect the heart and lungs.”