As little as five years ago, women diagnosed with breast cancer had far fewer options than are available today. Carol Scott-Conner, MD, surgeon at University of Iowa Hospitals and Clinics, talks about the advances in breast cancer treatment and the Wednesday Health for Your Life Time seminar:
Who is most likely to develop breast cancer?
Any woman can develop breast cancer. Women with family histories of breast cancer—that is women whose mothers have had breast cancer, perhaps whose grandmothers even on the father’s side who have had breast cancer—are at increased risk, but very often we see the disease in women without a family history. We’ve now got better tools for quantitating an individual risk for a woman, so if we know that a woman has a strong family history and is at increased risk, we can individualize the monitoring and treatment plan for that woman.
How has the detection and treatment of breast cancer improved over recent years?
We still rely on two things:
- Physical exam, either by the woman or her health care provider, to find a lump or notice some abnormality
- Screening mammography has gotten better and more sensitive, to the point we can see very early pre-cancerous changes and treat them before they turn into breast cancer
Then there’s a host of new imaging modalities, including MRI scans and better ultrasounds that are used under special circumstances.
The treatment of breast cancer has changed dramatically. In my professional lifetime, when I finished my training, the only operation we did for breast cancer was the modified radical mastectomy. We took the whole breast and we also removed all of the lymph nodes.
Then we realized that we could cure women just as well in selected circumstances, if we just took out the breast cancer itself and saved the breast—lumpectomy—radiated the breast, and did something for the lymph nodes.
Now we’ve got a host of options. We don’t do a full axillary dissection and subject a woman to the increased risk of lymphedema and so on—we can just sample selected nodes. If a woman comes in with a large tumor, we can give her chemotherapy up front to shrink it, so that it becomes smaller and more easily treatable by surgery.
We tailor the treatment to each woman. In recognition of this, our breast center director Sonia Sugg, MD, http://www.healthcare.uiowa.edu/surgery/sonia-sugg.html created a multidisciplinary oncology group for breast cancer. Now when women come in to see us, they can get a consultation from not only myself or one of my partners as a surgeon, but also from medical and radiation oncology, and see the whole spectrum of options.
How has early detection affected the treatment of breast cancer?
We think early detection saves lives. We have been able to prove that some of the decrease in mortality rates associated with breast cancer is related to earlier detection. We’re catching cancer sooner, before it has a chance to spread. It also increases the options a woman has so that she may not have to undergo a mastectomy—if she chooses—she can have a lumpectomy because the tumor is smaller. We think that finding cancer early is our best hope at present.
On Wednesday night, you will be speaking at a free seminar on breast cancer. Can you tell us more about that?
I’ll be there talking about individualized treatment—targeted therapy or tailored therapy as we call it—and Maheen Rajput, MD, from radiology will be there talking about advances in mammography, ultrasound, MRI scans, and things that are on the horizon for detection.
When and where is this event going to be taking place?
The seminar is going to be at the Holiday Inn Conference Center, Coralville. It’s a Health for Your Lifetime seminar and it’s going to be from 6:30 to 8 p.m.
I understand the seminar is free, but should people register? How?
We’d like them to call us and let us know they plan to come so that we can accommodate the number of people who want to be there. The number to call is 319-356-1049 or 877-MEDIOWA.
For those attending the seminar on Wednesday night, what should they expect to learn or gather information about?
We’re going to be talking about how we:
- Individualize treatment;
- Individualize the detection plan to a woman’s individual risk;
- How we assess risk;
- Modify, perhaps, a woman’s strategy of wellness behaviors; and,
- Individualize the treatment for cancer
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