A woman’s risk of developing breast cancer increases with age, with about one in eight women in the United States — or 12 percent — developing invasive breast cancer during her lifetime, according to the American Cancer Society.
But the good news is that more women are surviving the disease, thanks to screening tests, such as mammograms, that help detect cancer early, as well as ongoing developments in causes, prevention and treatment.
“The majority of people who are diagnosed with breast cancer will be cured,” says Dr. Clifford Hudis, president of the American Society of Clinical Oncology and chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center. “As scary as the diagnosis is, that’s a fact.”
Screening
Despite an increased survival rate, the U.S. Centers for Disease Control and Prevention say that less than 73 percent of women get their recommended mammograms. (Be aware that just 5 to 10 percent of breast cancers occur in women with a direct family history, with the majority of cases found in women with no known genetic predisposition.)
The U.S. Preventive Services Task Force recommends a mammogram every two years for women aged 50 to 74; women who are younger may also benefit from mammograms, according to the task force, which suggests talking to your doctor to find out if a mammogram is right for you. “Mammograms remain the gold standard,” says Hudis.
Prevention
Researchers are discovering that weight control and exercise can lead to lower risk of breast cancer — a recent study in the Journal of Clinical Oncology reveals that obese women have four times the risk of developing inflammatory breast cancer, a rare form of the disease that comprises 1 to 6 percent of all breast cancers.
Tamoxifen, a breast cancer drug, and Bazedoxifene, an osteoporosis medication, has been shown to lower the risk of some forms of breast cancer and was recently approved by the FDA for that use, Hudis says.
A study has found that women with early-stage breast cancer who had low levels of vitamin D were more likely to have their cancer recur in a distant part of the body, according to the American Cancer Society. While more research is needed to confirm this finding, and it is not yet clear if taking vitamin D supplements would be helpful, the ACS suggests talking to your doctor about testing your vitamin D level to see if it is in the healthy range.
Dr. Katherine Crew at NewYork-Presbyterian/Columbia is currently exploring how high doses of vitamin D might help prevent breast cancer. In the past she has similarly explored green tea, and plans to do the same with omega-3s.
Treatment
Memorial Sloan-Kettering has begun offering women a new procedure to more precisely pinpoint and remove small breast cancers that can be detected on a mammogram but not felt in the breast. Called radioactive seed localization (RSL), the procedure reduces the time it takes for doctors to precisely locate and remove the cancer, and its efficacy and safety were reported on in this month’s issue of the journal Health Physics.
Following surgery, other treatments may be needed. “We know that while most people are cured by surgery, too many are not,” says Hudis. “[Additional treatments] improve the odds.”
For women who need radiation after breast-conserving surgery, newer methods are being studied to shorten the length of treatment. Studies are underway to see if they work as well as standard treatments in keeping breast cancer from coming back, according to the ACS.
New chemotherapy
According to the American Cancer Society, researchers are looking for newer, better drugs to combat hard-to-treat advanced breast cancer. A drug class called PARP inhibitors has been developed that targets cancers caused by BRCA mutations, and has shown promise in clinical trials treating breast, ovarian, and prostate cancers that had spread and were resistant to other treatments. Further studies are being done to see if this can also help patients without BRCA mutations.
Targeted therapies
According to the American Cancer Society, about 1 of 5 breast cancers have too much of the growth-promoting protein HER2. These cancers tend to be more aggressive than other types. There are now a number of drugs approved to target excess HER2 protein, such as trastuzumab (Herceptin®) and lapatinib (Tykerb®), and studies are being done to see how best to use these in treating early breast cancer. Researchers are also looking at using a vaccine to target the HER2 protein.
For cancers to grow, blood vessels must be made to feed the cancer cells. New drugs, known as anti-angiogenesis drugs, may be useful by keeping new blood vessels from forming. Some studies have found that breast cancers with many new, small blood vessels are likely to spread more quickly.