5 ways breast cancer treatment has changed

As a nurse navigator at MD Anderson in The Woodlands, I get to connect with breast cancer patients just as they’re contacting MD Anderson for the first time to schedule an appointment.

My job is to make sure I have a good understanding of the events leading up to their diagnosis and that we’re scheduling them to see the most appropriate physicians first. I also spend time educating patients about their diagnoses and what they can expect during treatment.

Every person’s diagnosis is unique

A patient with a new cancer diagnosis can have a lot of fears and questions related to treatment. And with breast cancer being the most commonly diagnosed cancer among women, many of us have a close friend or family member who’s already been treated for this disease. So, when the word “cancer” is mentioned, all of our past experiences color how we think and feel about the disease today.

That’s why I typically stress two things during my initial phone call with patients. The first is that every person’s diagnosis is unique. It’s almost impossible to compare one patient and their treatment course to another, even if they appear to have the exact same diagnosis.

The second (and perhaps most important) is that we have come such a long way in the 18 years I’ve been a nurse. Researchers continue to make advances every day, so you won’t necessarily be offered the same treatment your friend or family member had 20 years — or even six months — ago.

The biggest changes I’ve seen

Just a few of the advances that have significantly changed how we approach breast cancer today include:

• Genetic testing: When we see a new patient, one of the first things we do is obtain a family history to determine the possible need for genetic testing. And we’re not just looking for one or two specific gene mutations either. Patients who meet certain criteria are tested for entire “panels” of gene mutations, and the results can impact their treatment recommendations and how they’re monitored.
• Surgical advances: When most people think about breast cancer, one of the first treatments that typically crosses their mind is surgery. At MD Anderson, we are very fortunate that our breast surgeons have completed an additional year of training specifically in the surgical treatment of breast cancer. Because of that specialized training — and the fact that their practice focuses exclusively on performing breast surgery — they are extremely knowledgeable and proficient in that area. Our surgeons are now able to target the tumor to be removed with great accuracy, as well as any lymph nodes involved. Our surgeons also conduct and participate in clinical trials aimed at limiting the amount of tissue removed at the time of surgery and minimizing the complications, while still treating the cancer effectively.
• Advances in reconstruction: Plastic surgeons have expanded upon the use of tissue from other areas of the body to reconstruct the breast, including not just the abdomen, but also the thigh and buttock. They have also improved their ability to hide tissue loss from surgery by utilizing fat grafting (injecting a patient’s own fat cells to fill in gaps) and tissue rearrangement (moving tissue around after cancer is removed to reduce visible defects). I always encourage patients to at least have a consultation with a reconstructive surgeon to hear what options might be available.
• Reducing or eliminating radiation therapy: Historically, breast cancer patients needing radiation therapy would receive treatment daily for six weeks. Now, we’re tailoring the length of treatment for the individual cancer with treatment ranging between 2 and 6 weeks. For some low-risk cancers, patients can avoid radiation entirely.
• Better side effect management: Historically, nausea and vomiting were extremely common side effects for patients receiving chemotherapy. Now, we have several very effective medications that can manage those side effects. So, we encourage our patients to make us aware of any side effects they might be experiencing so we can address them or the treatment they are receiving.

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