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    Q&A: The Latest on Breast Cancer

    researcher

    The San Antonio Breast Cancer Symposium is an annual meeting of doctors, researchers, health care professionals and others that offers the latest information on breast cancer research.  WebMD recently talked to Hollye Jacobs, RN, MS, MSW, to share some meeting highlights from her perspective. Jacobs is the best-selling author of The Silver Lining, A Supportive and Insightful Guide to Breast Cancer, which is drawn from her personal experience with breast cancer and her clinical experience as a nurse and social worker.

    Q: What is the most interesting or significant finding out of the conference?

    A: In the SOFT trial, researchers looked at the benefits of adding ovarian suppression to two drugs typically given to women who have hormone-receptor-positive breast cancer: Tamoxifen and Aromasin.

    As you may already know, for someone with hormone-receptor-positive breast cancer, estrogen can stimulate the growth of breast tumor cells. Ovarian suppression uses drugs or surgery to stop the ovaries from making estrogen, thus preventing a tumor from getting the estrogen that it needs to grow.

    Each year, there are reams of fascinating research findings that are presented at the SABCS, so it’s difficult to choose the most significant one. But I’d say that the most interesting results came out of the SOFT (Suppression of Ovarian Function Trial) trial.

    They found that in premenopausal women diagnosed with early-stage, hormone-receptor-positive breast cancer, the women who got the drug Tamoxifen and ovarian suppression did better than taking Tamoxifen alone.

    Further – and this is the biggie – the medication Aromasin combined with ovarian suppression reduced recurrence risk better than Tamoxifen and ovarian suppression. The group that benefitted the most was women under the age of 35.

    These outcomes are potentially practice-changing. The bottom line is this: in premenopausal women who have had surgery for hormone-responsive breast cancer, to reduce the risk of the cancer coming back, instead of taking Tamoxifen for 5-10 years, oncologists may begin recommending ovarian suppression (either in the form of medication or surgery) combined with Aromasin.

    Q: What are some other trends in breast cancer treatment?

    A: Even though breast cancer is commonly referred to as a single disease, the reality is that there are many of different types of breast cancer. Yes, they all start in the breast, but after that? Well, tumor cells have their own agendas.

    Triple-negative breast cancer is a particularly aggressive type that is typically difficult to treat, although it can often be treated successfully if caught early. An interesting study revealed that people with triple-negative breast cancer may benefit from taking a combination of the drug carboplatin and standard chemotherapy prior to surgery. Often people are given chemotherapy before surgery to help shrink tumors so that they can be surgically removed.

    For women with metastatic breast cancer, the FERGI Phase II study provided an interesting (and hopeful!) finding. Researchers found that adding something called a PI3K inhibitor to treatment may delay the cancer’s progression. It works by blocking a pathway often associated with cancer growth. This study was especially effective in women with both estrogen and progesterone receptor positive cancer.

    Q: What is the latest on detection?

    A: While the debate continues about the efficacy of early detection and whether or not it saves lives, this study reiterates the need to talk with your doctor about proper screening and what steps you can take to reduce your risk of developing breast cancer.

    At the conference, researchers revealed data showing that using ultrasounds in women with dense breasts potentially increased the ability to diagnose cancers that might not have been seen on screening mammograms alone.

    A relatively unknown but incredibly important fact about breast cancer is that women with dense breasts are four times more likely to develop breast cancer. They also are much less likely to have their breast cancer detected with a mammogram. This is a big deal. And, it’s estimated that 40-50% of women have dense breasts.

    Q: Is there anything new on prevention?

    A: An interesting study found that breastfeeding does reduce the risk of breast cancer. Further, results showed that even if women breastfed for only a short time, that they still received the benefit.

    And, on the food front, one study that surprised me was the Women’s Intervention Nutrition Study (WINS). This study began in 1994, and looked at the effect of a low-fat diet on breast cancer risk reduction and risk of recurrence. The findings showed that eating a low fat diet for five years did not improve survival in the overall population of women. But those with hormone receptor negative breast cancer did see a 54% improvement in overall survival. In other words, women who had estrogen and progesterone negative tumors who were on a low fat diet for five years lived an average of 1.9 years longer than women who did not make changes to their diet.

    The bottom line: doctors and researchers agree that anyone who has had breast cancer needs to focus on maintaining a healthy weight to reduce the risk of the cancer returning.

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