What We Know About Breast Cancer Today (that We Didn’t Know Ten Years Ago)

Randy Holcombe, M.D., and Marie Wood, M.D.

We sat down with Randy Holcombe, M.D., the new director of the University of Vermont Cancer Center and Marie Wood, M.D., professor of medicine and director of the Familial Cancer Program at the University of Vermont Medical Center, to learn about the impact science has had on the screening, risk, prevention and treatment of breast cancer. 

Here is a summary of the greatest gains over the past decade:

SCREENING: 

Randy Holcombe (RH): Particularly for younger women with dense breasts, we have better ways of screening (e.g. 3D imaging, MRI, ultrasound) 

Marie Wood (MW): which help us find things earlier and at a more treatable stage.  

RISK: 

RH: We also know more about the link between obesity and exercise and the risk between developing breast cancer. And, for patients who do get cancer, we learned that diet and exercise can lead to better or worse outcomes. Our Steps to Wellness program aims to make coaching and exercise more accessible to cancer patients throughout the network. 

MW: We also know more about the genetics of cancer and can identify those at hereditary risk who would be candidates for more intensive screening and prevention options. I oversee the Familial Cancer Program at the UVM Medical Center which we developed to support patients with potentially hereditary risk for cancer. 

PREVENTION: 

MW: In addition to screening, we know more about prevention, especially for patients with significant risk. We now have options for people to prevent cancer with medications such as tamoxifen or aromatase inhibitors.

TREATMENT: 

RH: Speaking of medications, from 1949-1988 only eight new breast cancer drugs had been approved, but the number of drugs approved for breast cancer from 2009-2018 was 10. These newer therapies are targeted therapies because they are specific to the individual’s type of cancer based on the genetic mutations and proteins that are expressed and tend to have less toxicity than traditional chemotherapy.

MW: For example, we have many more options for patients with breast cancer that express the HER2 protein and cancers that are ER positive, and there’s a new targeted therapy for people with a mutation in one of the BRCA genes. 

WHERE DO WE GO FROM HERE?

RH: We have just scratched the surface on understanding how immunotherapy may be beneficial for patients with breast cancer. I anticipate our clinical trials and research will explore more in this area over the next 10 years.   

For more information about women’s health and cancer, attend the free, virtual, and accredited 24th annual Women’s Health and Cancer Conference on Friday, October 1: go.uvm.edu/whcc

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