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Professor Arnie Hill, breast cancer surgeon and head of the medical school at the Royal College of Surgeons in Ireland, jokes that many women with breast cancer could almost have a degree in breast cancer after their treatment, such is the amount of knowledge acquired throughout the experience.
Professor Arnold Hill.
Knowing the type of breast cancer you have is just the beginning of a journey to understand the different anticancer drugs, the suitability or not of chemotherapy and the types of surgery, as ongoing research changes the focus of cancer from mom.
One of the most exciting developments in recent years is the OncoType DX test. This genetic test in tumor tissue clarifies whether chemotherapy is necessary or not. “The oncotype test reduces the amount of chemotherapy given for breast cancer by 50 percent,” explains Professor Hill.
This is a game changer in breast cancer treatment as previously, despite doctors’ opinion that many women did not need chemotherapy, most women opted for it with a 3-5% chance of that would improve their survival rates. . “The Oncotype test shows what type of breast cancer a woman has. And now we know that chemotherapy is beneficial for early breast cancers (such as HER2-negative, ER-positive and node-negative breast cancers, see definitions below) which account for about 45 percent of diagnosed breast cancers. ” explains Professor Hill.
Cara McAdam says she researched all the articles and clinical trials when she was diagnosed with HER2 positive breast cancer. “I’m a biology teacher and I remember thinking that it would be very interesting if it wasn’t happening to me.”
Cara McAdam.
She was dreading chemotherapy, having read about the serious side effects of adriamycin cyclophosphamide (AC) chemotherapy, so she was relieved to learn that she would only be given a newer chemotherapy drug, Taxol (paclitaxel).
“I had a grade three tumor, so I needed chemotherapy, but I benefited from the trials that showed that the recurrence rates were the same with or without AC chemotherapy, which meant I didn’t have to have AC chemotherapy.”
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Naoise Coogan (46), who works in corporate communications for Glanbia, is very grateful for the Oncotype DX test. “It made a huge difference in my diagnosis. I found a lump under my arm five years ago and had a triple evaluation (clinical evaluation, mammogram, and ultrasound) in two weeks. A biopsy of my cancer [ductal carcinoma] it was sent to San Francisco for analysis and the Oncotest DX result came back with a low reading, which means it would not be beneficial to have chemotherapy, “explains Coogan.
Women in Ireland now have more opportunities to undergo reconstructive surgery than they would have had ten years ago.
She says she had two young children at the time and she didn’t want to look sick. “I went to the hospital as a day case for a lumpectomy and to have my lymph nodes removed and then started 7 weeks of radiation six weeks later,” Coogan explains. Five years cancer-free, Coogan will continue to take hormonal drugs, tamoxifen for another five years.
Another advancement in breast cancer in the last 10 years is the ability to treat some HER2-positive breast cancers with medication alone. “There is a panel of drugs that have been shown to be effective for this 20 percent subset of breast cancers. We are now at the stage where 50 percent of these patients will respond to medications alone, making them the first group of breast cancer patients to avoid surgery, ”explains Professor Hill. These patients will continue to receive chemotherapy treatments along with their medication for four to five months.
Women in Ireland who nevertheless need a mastectomy to remove malignant tumors from their breasts now have more opportunities to undergo reconstructive surgery than they would have had ten years ago. “We now have six plastic surgeons at Beaumont Hospital compared to one plastic surgeon when I started here in 2005,” says Professor Hill. Standard reconstructive surgery now involves removing fatty tissue from a woman’s lower abdomen (abdomen) to rebuild the breast. It is a four-hour, four-day operation in the hospital. About one in three women who have had breast cancer surgery opts for reconstructive surgery.
Triple negative breast cancer, which is breast cancer that does not have estrogen, progesterone, or HER2 receptors, is one of the most aggressive and most difficult forms of breast cancer to treat. Researchers at Queen’s University Belfast (QUB) are currently studying new treatments for this subset of breast cancer patients.
“This is a type of breast cancer for which we have no immediate answers and that is why Breast Cancer Ireland is funding research at QUB. We need to look at different pathways in the cell and introduce new drugs to block these pathways, ”explains Professor Hill.
Through its research and education programs, Breast Cancer Ireland wants to help transform breast cancer from what can be a deadly disease to one that can be controlled and cured during treatment. A new Breast Cancer Ireland research center on the Beaumont Hospital grounds will be completed in 2021.
As part of the annual fundraiser, the Great Pink Run (5km or 10km) takes place each year, with 10,000 participants in 2020 between three locations: Dublin’s Phoenix Park, Kilkenny Castle Park and Chicago’s Diversey Harbor. This year will be the tenth staging of the event, but of course it will have to be very different. Still, the virtual staging, on October 17 and 18, is expected to continue to have good support (see greatpinkrun.ie to register).
Explainer: different types of breast cancer
Breast cancer is described as invasive or non-invasive. Invasive breast cancer means that the cancer cells have moved beyond the lining of the milk ducts and invaded the surrounding breast tissue. Invasive breast cancer subtypes are invasive ductal carcinoma, the most common type of breast cancer, which invades the surrounding breast tissue, and the rarer invasive lobular breast cancer, which is more likely to spread throughout the breast. . The main non-invasive breast cancer is ductal carcinoma. Metastatic breast cancer is breast cancer that has spread (metastasized) beyond the breast. About 5 percent of breast cancers are caused by faulty genes, the most common of which are the BRCA1 and BRCA2 genes.
Breast cancer specialists also define the different types of breast cancer based on the parts of the cell that the cancer responds to.
– HER2 positive breast cancer is breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2). This protein promotes the growth of cancer cells. In about one in five breast cancers, cancer cells have extra copies of the gene that makes the HER2 protein. HER2 negative breast cancer is a breast cancer that is negative for the HER2 protein.
– ER positive breast cancer is a breast cancer that has receptors for the female hormone, estrogen (estrogen). ER negative breast cancer is breast cancer that does not have estrogen receptors.
– PR-positive breast cancer is a breast cancer that has receptors for the female hormone, progesterone. PR-negative breast cancer is a breast cancer that does not have progesterone receptors.
– Node-positive breast cancer is breast cancer that has spread to the lymph nodes in the armpits. When the lymph nodes are free of cancer, this is called node-negative breast cancer.
– Triple positive breast cancer is a breast cancer that has receptors for estrogen, progesterone, and HER2. Triple negative breast cancer is breast cancer that does not have receptors for estrogen, progesterone, or HER2.
