30 LONGISLANDPRESS.COM • OCTOBER 2020
OCTOBER IS BREAST CANCER AWARENESS MONTH
Genetic screening plays a major factor in
treatment, Dr. Hodyl adds. For example,
BRCA1 and BRCA2 genes are known to
increase one’s risk for cancer, according
to the National Cancer Institute.
“We have learned over time
that some women need less, not more,”
says Jane Carleton, M.D., associate
chief of clinical affairs at the Northwell
Health Cancer Institute at Monter
Cancer Center, Lake Success. Years ago,
mastectomies were common protocol.
“We found that not all women need a
complete axillary lymph node dissection;
we could remove just a sentinel
lymph node.”
If a lymph node tests negative, removing
more lymph nodes may be
unnecessary. This is a critical “discovery,”
as a considerable number of
patients have subsequently developed
lymphedema (swelling of the arms and
legs) following a complete lymph node
dissection; with a sentinel lymph node
removal, the percent of women who
develop lymphedema is substantially
reduced, Dr. Carleton says.
As more drugs like Herceptin are being
developed, the cure rate of early stage
HER2-positive breast cancer dramatically
improves, says Dr. Carleton.
“It also means that if a woman has metastatic
HER2 breast cancer, she might live
10 to 15 years longer because of using targeted
agents like Herceptin and the many
other drugs that have been developed,”
she adds.
“The biggest improvement in prognosis
has been found in tumors that are
receptive to chemotherapy prior to
surgery, otherwise known as neoadjuvant
chemotherapy; we have
been able to downstage a lot of these
cancers and improve prognosis,” says
Anastasia Bakoulis, DO, a breast and
oncologic surgeon at Stony Brook University
Cancer Center. “There have also
been several advancements in that a
lot of chemotherapy agents are now
available to patients who may not have
responded as well to a neoadjuvant
therapy, too.”
Utilizing immunotherapy for breast cancer
is also becoming more encouraging,
says Dr. Bakoulis.
“We are trying to figure out how we can
manipulate our own immune system to
kill off this cancer and there have been
some promising pathways,” she says.
Repeat lumpectomy is a treatment option
— versus the previous standard of care
in which a patient who was diagnosed
with cancer and underwent lumpectomy
with radiation would require breast
removal if the cancer reoccurred, says
Dr. Bakoulis.
“Emerging data is saying maybe can get
away with another lumpectomy and
another round of radiation,” she says.
Although studies are still in their infancy,
Dr. Bakoulis says, “We are not seeing
adverse effects from another round of
radiation.”
With vast improvement in reconstructive
surgery, patients are much more
comfortable, notes Dr. Hodyl. One of
the newer techniques involves placing
implants on top of the muscle versus
underneath.
“We are leaving the anatomy as it is naturally,”
she says. The implants are safer,
too, she adds.
Advanced screening such as 3D mammography,
awareness, and adopting
a healthy lifestyle may influence the
outcome of a breast cancer diagnosis,
experts say. Eating healthy, avoiding
processed foods, maintaining a healthy
weight, exercising, avoiding smoking
and drinking, and managing stress can
not only decrease your risk of getting
cancer but also improve your chance of
being cured if you’re diagnosed with the
disease.
“We are moving towards personalized care,”
says Dr. Christine Hodyl.
PRESS HEALTH
continued from page 29
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