This week, Bobbi Conner talks with Dr. Andrea Abbott about right-sizing, or tailoring breast cancer treatment to the individual patient. Dr. Abbott is a surgical oncologist and Section Chief of the Comprehensive Breast Program at MUSC Hollings Cancer Center.
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Breast cancer treatments can now be tailored more precisely to each individual patient, so that women receive the most effective care with the fewest side effects. Doctor Andrea Abbott is here to provide the details. Doctor Abbott is a surgical oncologist and Section Chief of the Comprehensive Breast Program at MUSC Hollings Cancer Center. Doctor Abbott, tell us about this concept of right-sizing breast cancer treatment to each individual and why this approach is beneficial.
Dr. Abbott: So much of our recent research has really focused on how can we avoid overtreating a patient. Right-sizing is really dialing back the treatment to make sure we are effectively treating the cancer without creating unnecessary toxicity for a patient.
Conner: What kind of patient specific information is needed to develop this sort of right- sizing approach to breast cancer treatment?
Dr. Abbott: So, for breast cancer in particular, we know that there are certain genes within the cancer itself that would make it more likely to come back or more likely to spread to other parts of the body. And if a patient's tumor expresses those genes, we want to be more aggressive with the cancer treatment. So, at each different treatment algorithm, we really want to look at the patient and that tumor and see how much surgery is needed, how much systemic treatment is needed, how much radiation is needed. And can we cut down in all three of those domains or one out of two?
Conner: When the oncology team evaluates whether an individual patient needs chemo and how much chemo, what goes into that type of decision?
Dr. Abbott: It used to be that every patient that had a large tumor or had a positive lymph node received chemotherapy, and we learned that a lot of women suffered the side effects of chemotherapy unnecessarily. And now there is a test called Oncotype DX that looks at the genetics of the tumor and helps the medical oncologist decide if chemotherapy would actually benefit the patient. You receive a score for that patient's specific tumor to know what's the recurrence risk? What's the benefit of chemotherapy? What's the benefit of taking a hormone blocking pill or endocrine therapy, and then using exact data for that exact tumor and that exact patient. You can have shared decision making about should you pursue chemotherapy or not.
Conner: Part of this right-sizing treatment approach actually incorporates the latest breast cancer research as well. Tell us about that.
Dr. Abbott: Just this past week, our breast team met and we reviewed two journal articles that came out that really looked at what is the value of doing the sentinel lymph node biopsy, and is that necessary for all patients? And using this research, we were able to decide that there is a group of patients that don't benefit from this surgical approach, and therefore we no longer need to do it routinely. So, we are constantly looking at research, keeping up to date with what's happening within the field so that we're not overtreating patients and we're only doing what's necessary.
Conner: When it comes to the patient being involved in all of these types of treatment decisions, what could they be asking their oncologist?
Dr. Abbott: I think the important thing for both the physician and the patient to consider is, will the treatment improve your survival, or will it decrease the risk of cancer coming back? And if the answer is yes, then that treatment is the right size for you.
Conner: Doctor Abbott, thanks for talking with us about right-sizing breast cancer treatment.
Dr. Abbott: Thank you so much for the opportunity.
Conner: From the radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.
