Theresa Lee, MD
Breast cancer treatments have improved over the years, giving women hope, restoring health, and providing choices for care. Having earned accreditation from the prestigious National Accreditation Program for Breast Centers (NAPBC), UPMC is leading the way in advanced treatments and helping each woman determine the best approach to beating her cancer.
Currently, the overall five-year survival rate for breast cancer that is confined to the breast is more than 90%. For women with breast cancer that has spread to the local lymph nodes, the five-year relative survival rate is 86%. There are four stages of breast cancer. Non-invasive (stage 0) and early stage invasive (stages I and II) have a better prognosis than those diagnosed with later stage cancers (stage III and IV).
In the past, treatments for breast cancer usually included a combination of surgery and systemic therapy, such as an anti-hormonal pill, coupled with radiation therapy and chemotherapy in some cases, depending upon the type and stage of cancer.
“Today, there are advances in treatments of all stages of breast cancer,” according to Theresa Lee, MD, oncologist, UPMC Hillman Cancer Center in Central Pa. “Patients now have options beyond traditional invasive surgery, medication, chemotherapy, and radiation.”
Innovative surgical procedures such as Hidden Scar™ and micropigmentation, now yield better cosmetic outcomes without compromising cancer control or cure. Restoring the breast to a natural look, with minimal scarring or deviations, is important to women. UPMC in Central Pa. is one of just two Centers of Excellence for Hidden Scar™ surgery in the state.
Breast cancer care has become more individualized. Molecular profiles of tumors allow us to minimize the number of patients who require chemotherapy and help guide which targeted therapies may work for a breast cancer. We are also making advances in side effect management. For example, scalp cooling uses cold technology to keep the scalp cold during chemotherapy administration, which minimizes hair loss from chemotherapy.
Most advances in the diagnosis, treatment, and prevention of cancer have occurred because of clinical trials. UPMC offers hundreds of trials to treat a wide range of cancers, which are incredibly valuable to both researchers and patients. Breast cancer research specifically has led to new types of medical therapies, including, for example, immunotherapy and targeted therapies.
“We participated in some of the clinical trials that helped to define the role of immunotherapy in breast cancer, and I have several patients who are participating in a trial to help us know how long women should take their antiestrogen pills. This is truly cutting-edge care,” Lee says.
Endocrine therapy slows or stops the growth of breast cancers that are sensitive to hormones. Hormones play an important role in the body, however the female hormones estrogen and progesterone can also promote certain breast cancer growth. These are known as hormone-sensitive or hormone dependent breast cancers.
Unlike chemotherapy, which can damage healthy cells along with the cancerous ones, immunotherapy encourages the patient’s own immune system to kill cancer cells. This type of therapy is targeted, working to stop or slow the cancer’s growth and perform like the natural antibodies in your immune system.
While side effects vary with the medicines used, Dr. Lee emphasizes that supportive care helps minimize side effects such as nausea, diarrhea, and neuropathy. Temporary hair loss and fatigue are still common but resolve after the completion of treatment. And scalp cooling technology can decrease the chance a woman loses her hair with some types of chemotherapy.
In radiation therapy, mild skin toxicity (like sunburn), along with fatigue are common. Fortunately, new radiation technologies are allowing for fewer side effects and sometimes a shorter course of therapy.
“At UPMC, we have an extensive provider network and wonderful team of doctors, nurses, and support staff who are knowledgeable and compassionate. We work collaboratively to make breast cancer treatment very tolerable, and the care is so compassionate,” says Dr. Lee.
However, before that first dose of medication or initial operation, we must focus on early detection. UPMC has programs in place to help women at high risk identify those risk factors, while encouraging screening mammograms. Dr. Lee believes knowledge is power and self-awareness is critical in avoiding illness or disease.
“Get your routine screening mammograms, and if you notice a change in your breast, don’t delay getting it checked out. With continuing advances, treating cancer now often means beating cancer, or living much longer with it.”
For more information about all UPMC services specific to breast health, visit www.UPMC.com/CentralPaBreastHealth.
This column is sponsored by UPMC.
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