Breast cancer is one of the most commonly diagnosed cancers in women. One in nine women will develop breast cancer in their lifetime.
And the most common way the patient presents to us is that they will have a routine screening mammography performed, and there’s an abnormality that is noticed on the mammogram. So the mammogram that is performed is part of a routine screening mammogram that most women will have, and that’s part of the mammogram screening strategy, according to your country or regulatory agencies.
Loading the player...Breast Cancer Diagnosis and Treatment Strategies Dr. Sunil Verma, MD, MSEd, FRCPC, Oncologist, discusses breast cancer symptoms, screening and diagnosis..
Loading the player...Advanced Breast Cancer Treatment and Prognosis Dr. Sunil Verma, MD, MSEd, FRCPC, Oncologist, discusses advanced breast cancer symptoms, diagnosis and treatment options.
Loading the player...Breast Cancer Reconstruction Nancy Van Laeken MD, FRCSC, discusses breast cancer reconstruction.
Loading the player...Breast MRI - Core Biopsy, Breast Cancer Ian Gardiner, MD, FRCP(C), discusses Breast MRI - Core Biopsy, Breast Cancer
Breast cancer is one of the most commonly diagnosed cancers in women. One in nine women will develop breast cancer in their lifetime. And the most common way the patient presents to us is that they will have a routine screening mammography performed, and there’s an abnormality that is noticed on the mammogram. So the mammogram that is performed is part of a routine screening mammogram that most women will have, and that’s part of the mammogram screening strategy, according to your country or regulatory agencies.
When the mammogram is performed, it usually detects an abnormality. And when that abnormality is noted by the radiologist, they will recommend either a biopsy or further tests. And once the biopsy is done, that is what confirms the diagnosis of breast cancer.
So once an abnormality is diagnosed, they usually refer you to a surgeon. And the surgeon of course – along with the radiologist – will determine the need for a biopsy. And usually the way to confirm that somebody does have breast cancer is the biopsy of that particular abnormality that is noticed on the imaging finding, or sometimes from a physical exam.
Once the diagnosis of breast cancer is made, the surgeon along with the patient will make the decision as to what the best course of action is. Is it something that can be resected, and if is resected, should this be a mastectomy, which is removal of the breast, or lumpectomy, which is removal of the lump, associated with where the tumour resides?
Along with that, there’s usually determination of the lymph nodes through a test which is called sentinel lymph node biopsy, where a dye is injected and the lymph node is picked out, that picks up the dye to see if there’s any cancer cells within that lymph node.
So, once the surgery is performed, then the patient is referred to a cancer centre, and at the level of cancer centre we have a team of oncologists, including medical oncologists and radiation oncologists that usually determine what is the next course of action – what we call adjuvant treatment after the surgery.
And that course of action could include radiation treatment, could include chemotherapy, could include drug treatment, including pills or what we call targeted therapy or targeted treatment. And basically that decision is based on what has been obtained at the time of surgery, to determine what is the risk of this cancer coming back, and how can we reduce that risk while maintaining a good side effect profile, so we’re not affecting the patient’s quality of life too much.
And if you do have to, we have to make sure that the benefit far outweighs the side effects that we are going to give with some of our treatment.
So the discussion is quite personalized based on our determination of the risk, how much we can lower it giving treatment after the surgery, and what is the side effect profile. And it’s really dependent on multiple factors, including patient preference, which is paramount.
And really our main goal is to prevent the cancer from coming back, because if you can prevent the cancer from coming back, in most cases the patient is cured of this breast cancer. So we really encourage our patients to consider and educate themselves about the different treatment options, and discuss with their specialist as to what is the right treatment for their disease.
Many of our patients with breast cancer are cured of their disease. However, still about 20 percent of them will relapse, and the breast cancer will spread in what we call advanced breast cancer – metastatic breast cancer. And about 5 to 10 percent of our patients, when they present, already have metastatic breast cancer – advanced breast cancer – to begin with.
So at the present time, advanced breast cancer is not curable. When the breast cancer is metastasized, we can’t cure it, but we can control it. And by controlling it, what our main goals are, are to improve a patient’s quality of life, extend their survival, and decrease their symptoms.
So we want our patients to live as normal a life as possible for as long as possible. And we have made some tremendous achievements in advanced breast cancer where many of our patients are living longer and are living a better life, but we still have a long ways to go.
And I would really recommend our patients who have advanced breast cancer to discuss with their oncologist – discuss with their specialist – to say, “What can they do to maintain their quality of life?”
What can they do to extend their survival and how they can be involved with research, because many of our patients who do have advanced breast cancer we encourage them to participate in research and clinical trials that may benefit them, but may also benefit many generations of women who will be affected by this disease in the future.
So, we really encourage our patients to consider and educate themselves about the different treatment options, and discuss with their specialist as to what is the right treatment for their disease. Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also important for overall health.
Local Practitioners: Oncologist