New Weapons in the Fight Against Breast Cancer

Dr. Isabella Martire

from "Your Health Magazine," July 2010

           One out of 8 women over a lifetime will be diagnosed with breast cancer. Even though the incidence of this disease has gone up over the last two decades, the mortality has actually gone down and this is thanks to prevention, screening, early detection, and new, improved therapeutic modalities.

           Chemotherapy is no longer the only modality used to fight this disease. We currently have new treatments that include monoclonal antibodies like herceptin, tirosine kinase inhibitors like tykerb, antiangiogenic agents like avastin and many new agents on the horizon like the PARP inhibitors. With molecular fingerprinting of tumors by oncotype DX and mammaprint the treatment for patients is being more individualized and only patients who will benefit from chemotherapy will be treated with it. In the near future, the genetic makeup of breast cancer will determine the drug choice for the patient.

           Only a decade ago, we only had tamoxifen as hormonal therapy for estrogen receptor positive breast cancer while we currently have a total of six agents including arimidex, femara, faslodex, examestane, raloxifene and new agents are currently being tested.

           While the majority of breast cancers are sporadic, 10-15% are genetically predisposed and we are now very familiar with the BRCA, and BRCA-2 genetic abnormalities that can be easily detected in the blood. Commercial kits are now available to all physicians who are interested in genetic counseling. The purpose of genetic counseling for women considered high risk is to offer improved screening methods like breast MRI, instead of simple mammograms, and implement preventive measures.

           My mother was diagnosed with breast cancer when I was in medical school and my sister was diagnosed with breast cancer 15 years ago and I can guarantee that enormous strides have been made in treating this disease. I am hopeful that additional diagnostic and therapeutic modalities will be available in the near future.