Written By:  Peter Dahlberg, MD, PhD

For providers treating breast cancer patients, the first question might not be, “What’s new in breast cancer treatment?” but rather, “How do we keep up with it all?” One of the best ways to address this challenge is by assembling a multidisciplinary team—radiologists, oncologists, surgeons, radiation specialists, primary care providers, occupational therapists, genetic counselors, nurses, and researchers. Together, they regularly meet to discuss and refine each new patient’s treatment plan, drawing on advances in each related field. This collaborative approach is the goal of modern cancer care.

Let’s explore some of the latest advances in breast cancer treatment. In its earliest days, treatment methods were fairly straightforward. A biopsy would confirm the diagnosis, followed by surgery to remove all breast tissue, underlying muscle, and lymph nodes from the affected side. Imaging was not sophisticated enough to determine if the cancer had spread, leading to invasive surgeries. While some patients were cured, the procedures were often painful and disfiguring.

Today, treatment has evolved dramatically. Surgery, radiation, and chemotherapy are far more refined, effective, and less taxing on patients. Surgical goals now focus on removing the tumor with negative margins and sampling the lymph node that drains the tumor area. Further treatments are guided by the likelihood of cancer recurrence, and chemotherapy now often targets the specific cellular changes that cause normal breast cells to behave like cancer cells.

Surgical Treatment

In 2011, a landmark study concluded that women undergoing lumpectomies who had one or two positive lymph nodes could avoid further surgery to remove all their lymph nodes, sparing them the debilitating arm swelling that often-followed complete lymph node removal. However, some breast cancers still require mastectomies as the primary treatment. This year, another significant study found similar results for mastectomy patients, continuing the trend toward less invasive surgeries with excellent outcomes.

Radiation therapy’s role for these patients is still being evaluated, but the overall trend remains one of minimizing invasiveness while maintaining positive results. Newer surgical advances include the use of robotic technology to perform mastectomies with smaller incisions and advanced 3D nipple reconstruction techniques—thanks to skilled tattoo artists—that do not require additional surgery.

Medical Treatment

Artificial intelligence has garnered headlines for several years, but its influence is now permeating medical treatments as well. Immune therapy for cancer is having a similar revolutionary impact. Several strategies have been developed to enhance the ability of our white blood cells to seek out and destroy cancer cells. One prominent example is the use of immune checkpoint inhibitors in triple-negative breast cancer—a type that does not respond to estrogen or progesterone and typically has a poor prognosis.

While the immune system begins to eliminate these cancer cells, the cells fight back by producing checkpoint inhibitors that suppress the immune response. Oncologists can now administer medications that block these inhibitors, restoring the immune system’s ability to attack cancer cells. Patients with early or late-stage triple-negative breast cancer benefit from this treatment, whether it’s given before or after surgery. It’s another valuable addition to the arsenal of therapies tailored to target individual cancer cell processes.

Radiation Therapy

The principle of “less is more” also applies to radiation therapy for breast cancer. Radiation oncologists have developed more efficient methods of delivering treatment that precisely targets cancer while sparing healthy surrounding tissue. Some patients now receive as few as three or four treatments, compared to the traditional six-week protocol.

Thanks to ongoing research, patients diagnosed with breast cancer are living longer with fewer cancer-related disabilities and treatment side effects. The steady progress made in this field demonstrates the profound impact of continuous research on a widespread disease.

For more information about the Breast Care Clinic at Western Wisconsin Health, please call 715-684-1111. Western Wisconsin Health: Building a Healthier Tomorrow, Together.

References

• N Engl J Med. 2024 Apr 4; 390:1163.
• J Clin Oncol. 2021;39(36):4073-4126.