Breast cancer is the number-one cancer in women in terms of incidence’there are 22,400 new cases a year’but advances in detection and treatment are lowering mortality rates. ‘Much of breast cancer is manageable,’ says Morag Park, scientific director of the Institute of Cancer Research in Montreal. ‘We are beginning to look at it as a chronic disease. The advances are quite staggering.’
There are many subtypes of the cancer, each with medical advances. About 60 percent are estrogen-receptor positive, meaning the cancer thrives on estrogen. Tamoxifen is a known therapy and, in a newer discovery, an aromatase inhibitor drug called exemestane (Aromasin) has been found to reduce recurrence by about 30 percent when taken halfway through treatment instead of tamoxifen. HER-2-positive breast cancer, which accounts for about one in five cases, involves a gene mutation that causes cancer cells to make excess HER-2 protein.
In 1998, Herceptin was approved for use in the late stages of these cancers, and in 2006 it was approved in early-stage disease. Researchers are working on ways to be more exact about who will benefit from it.
‘This is the beginning of personalized medicine [when it comes to breast cancer],’ says Park.
New treatments are also coming for the five percent of breast cancer cases and 10 percent of ovarian cancer cases that are hereditary, caused by mutations in the BRCA1 and/or BRCA2 genes. The most exciting of these, according to Huntsman, are the PARP-1 inhibitors, a targeted therapy that has the capacity to destroy tumours without harming normal cells.
A 2007 study conducted at Harvard University found that the relative risk of developing breast cancer after menopause was 400 percent higher in women who have dense breast tissue. The study also found that women with high levels of estrogen and testosterone had a 200 percent increased risk of developing breast cancer relative to those with lower levels. Women who started menstruating late, have more pregnancies and breastfeed for longer periods have a lower risk.
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