Julie Gralow, MD, blogs about the advances we’ve experienced in treating and managing one subtype of metastatic breast cancer, and calls for more support in research and care for people affected by the disease worldwide.
Substantial advances have occurred in the field of breast cancer during the 20 years I’ve been caring for people diagnosed with metastatic disease. I had a chance to reflect on this last month, when I saw a woman newly diagnosed with breast cancer whose sister had also been a patient of mine. The sister died of metastatic breast cancer in 1995 at the age of 35. There were few effective treatments at that time, and despite access to state-of-the art care and enrollment in a clinical trial, her survival following recurrence was short.
My current patient accompanied her sister to many of those last clinic visits. Memories of those visits were prominent in her mind when she was diagnosed with breast cancer in 2014, at the age of 47, and became a patient herself. Both sisters were diagnosed with HER2-positive breast cancer, but there were no approved HER2-targeted therapies in 1995. In 2014, there are four approved therapies and others in development. What used to be an aggressive type of breast cancer with a poor prognosis has now become much more treatable and survivable. This woman’s outlook is tremendously hopeful.
Thanks to the Human Genome Project, we no longer think of breast cancer as a single entity, or its treatment as “one-size-fits-all.” Our increasing understanding of cancer genomics has revealed multiple subsets of breast cancer with different behavior patterns and different responses to therapy. Dozens of new agents have been approved for the treatment of metastatic breast cancer in the past two decades, offering meaningful improvements in the likelihood of response and length of survival. Continue reading