There is no question that breast cancer is a major public health issue. Diagnosed in about one out of every eight women, breast cancer is the most common cancer among women and the second most common cancer overall (not including non-melanoma skin cancers). While significant advances have been made in breast cancer treatments and survivorship, relaxed vigilance is never an option with this disease. The best possible outcomes are achieved when the cancer is detected and effective treatment is begun early in the disease process.
In terms of early detection, one of women’s greatest allies is routine breast cancer screening with mammogram. “Early detection makes all the difference. I usually tell my patients to schedule their annual mammogram during the week of their birthday, to think of it as a gift to themselves,” says radiation oncologist Mersiha Hadziahmetovic, MD, of The Toledo Clinic Cancer Centers. She further notes that there are different guidelines for when to start getting mammograms, so it is important for women to discuss with their doctor the timing and frequency that is appropriate based on their individual history and risk factors (e.g., average versus increased risk for developing breast cancer).
Dr. Hadziahmetovic points out that 3D digital mammograms with tomosynthesis, available at The Toledo Clinic Cancer Centers, is the most advanced form of the screening technology, offering a high degree of sensitivity, or ability to detect disease.
It is also critical for women to be aware of their risk factors for developing breast cancer. “The two biggest factors are being born female and getting older, but there are several others as well. Among them are having a family history of breast, ovarian, or prostate cancer; having a personal history of breast cancer or other breast diseases; having dense breast tissue; having children after age 30; getting your first period before age 12 or starting menopause after age 55; and having certain hereditary genetic mutations such as the BRCA1 or BRCA2 gene,” explains Dr. Hadziahmetovic.
In addition, Dr. Hadziahmetovic encourages women to be familiar with what their breasts feel like normally. Be on the lookout for “red flags” such as a lump or knot in the breast or under the arm; swelling, warmth, or patchy redness in the breast, especially around the nipple; dimpling or tethering of breast tissue; abnormal discharge from the nipple, especially if one-sided; itching or soreness around the nipple; or pain in the breast. “Women should be familiar with what their breasts normally feel like and monitor for any of these changes,” she says. If any of these occur, women should promptly notify their physician.
Many significant treatment advances have been made thanks to robust research. We now know that breast cancer has several different subtypes. Determining a cancer’s subtype makes it possible to hone in on treatments that exploit its unique vulnerabilities, thus resulting in more effective, better targeted therapies.
Being a radiation oncologist, Dr. Hadziahmetovic is especially excited about recent technological advances in radiation therapy. “For example, we can now offer heart-sparing radiation treatments, including radiation during breath-hold or radiation in the prone position. In addition, we also now offer shorter, but just as effective, courses of radiation, as these have been proven non-inferior to the longer course. In other words, patients receive a slightly higher dose of radiation per day, but over fewer days. Also, with modern technology and advanced radiation treatment planning software, we’re better able to optimize radiation beam shaping, achieve a more uniform dose in the breast, and minimize stray radiation dose to the underlying heart and lung,” she says.
The rate of high-quality research data pouring in often leads to some changes in how breast cancer is treated. For example, women with HER2/neu-amplified breast cancer can now get chemotherapy before or after surgery, whereas in the past it was always administered after. This is just one of many examples in which differentiating breast cancer by subtype and targeting treatments accordingly is making a significant difference in outcomes. Of course, none of these advances would have been possible without clinical research. “We owe all these advances and all our new-and-improved standards of treatment to women who chose to participate in breast cancer clinical trials,” Dr. Hadziahmetovic states.
The nature of breast cancer survivorship has also changed markedly thanks to advances in treatment and technology. “More and more women are living long-term with their breast cancer in remission and their care team doing surveillance so they can step in immediately in case of recurrence. So now we want our patients not just to be survivors, but ‘survivor-thrivers.’ To help them achieve that goal, we teach them how to improve their overall health and reduce the risk of the disease coming back. Some of the things patients can do to play an active role in their care and well-being include maintaining a healthy body weight, exercising regularly, and restricting alcohol intake. Essentially, we’re empowering women to be active participants in their own care to further reduce the risk of their breast cancer recurring or developing other health issues as they get older.”
The Toledo Clinic Cancer Centers, located at 4126 N. Holland Sylvania Road, Suite 105, also provides imaging, laboratory, chemotherapy and IV services. The cancer center consists of 8 medical and 2 radiation oncologists along with 8 nurse practitioners and 4 research nurses. The cancer center also has satellite centers in Maumee, Napoleon, Bowling Green, Wauseon, and Monroe.
The Toledo Clinic Cancer Centers has earned Patient-Centered Specialty Practice level 3 recognition and Oncology Medical Home recognition from the National Committee for Quality Assurance. Oncology homes align systems and resources with coordinated care focused on cancer patients and their needs. This reduces fragmentation, supports shared decision making, and improves the patient experience. They are the first oncology practice in the state of Michigan and the second oncology practice in the state of Ohio to receive this recognition.
For more information, please call The Toledo Clinic Cancer
Centers at 419-479-5605.