Breast cancer, being the most common cancer among women, has seen massive advancement in its treatment over the past few years. These advances in diagnosis and testing for breast cancer have resulted in better cure rates and improved quality of life among women. Here, you will be able to understand some latest trends involved in treating a breast cancer patient. We are using all these newer techniques to help our patients in the best possible way.
Feel free to reach out to our expert Dr. Navneet Tripathi, regarding any query related to breast cancer and to explore breast cancer treatment in Lucknow. So keep reading to know more.
Current Trends in Diagnosis and Treatment of Breast Cancer
3D Mammography or Digital Breast Tomosynthesis: This newer mammography technique takes multiple images at different angles in 3 dimensions. Advantages include ability to pick up very small cancer lesions, better sensitivity in dense breasts (younger women have dense breasts) and stereotactic biopsy to target non palpable lesions detected on mammography.
PET CT/ PET MRI scan: These newer tests can scan full body from head to toe to look for any evidence of cancer in breast as well as other organs for metastasis (cancer spread). Previously it was very cumbersome to look for metastasis by performing 3 different tests. PET scan is also being used to assess response to therapy and in follow up of breast cancer patients.
Breast Conserving Surgery (BCS): Traditionally mastectomy (removal of whole breast including nipple/areola) was standard surgery for any breast cancer patient. But mastectomy leads to loss of confidence and low self esteem among women, owing to change in feminine body shape. However, in current times, women who are detected in early stage having small tumours can be offered breast conservation (preservation) surgery. During this surgery, only the tumor with a rim of normal breast tissue is removed, preserving the remaining breast. It leads to better self esteem and confidence among women after breast cancer surgery. Such surgery is available at dedicated centres and performed by expert breast cancer surgeons. Women who undergo breast conserving surgery need radiotherapy after surgery, to prevent risk of local cancer recurrence in remaining normal breast tissue.
Genetic Testing For Breast Cancer: 15-20% women diagnosed with breast cancer have a family of either breast or ovarian cancer in family. However, less than 7% patients have a known high penetrance gene mutation. BRCA 1 and BRCA 2 are the most common genes, whose mutations (abnormal genetic structure) are associated with breast cancer. Testing of these genes for breast cancer association is now available and reasonably affordable. Indications of genetic testing for breast cancer are:
-Breast cancer < 45yrs
-TNBC (Triple negative) breast cancer < 60yrs
-B/L Ca breast
-Male Ca breast
-Strong family history (breast/ovarian cancer)
Gene Expression Profiling (GEPs): These are now available high end gene testing panels which test multiple genes, to provide prognostic and predictive information. Most practical use of GEPs is to know whether chemotherapy is required in low-risk patients where cancer has not spread to axillary lymph nodes.
Oncotype Dx is the only GEP which is now available in India. However, it is still very costly, prohibiting its wider application among patients.
Other GEPs are:
Accelerated Partial Breast Irradiation (ABPI): This is an alternative to conventional whole breast radiotherapy is usually given for 3-6 weeks. ABPI incorporates short duration radiotherapy (up to 5 days) with increased dose per radiation fraction. This technique of short duration radiotherapy can be used for low-risk early breast cancer patients.
Targeted therapy and Immunotherapy: Over the last decade, various systemic therapy options have been developed to benefit breast cancer patients. These new therapies are especially useful in metastatic breast cancer where frequently oncologists run out of treatment options. Various newer options are
-Anti Her 2 targeted therapy: Trastuzumab and Pertuzumab
The advancement in technology and methods for breast cancer treatment has brought about a significant decrease in the mortality rate from this disease. Newer less extensive surgical methods and other newer drugs have played an essential role in our fight against breast cancer.