Talking breast cancer with University of Minnesota
Breast cancer is the most common cancer among Minnesota women, according to the Minnesota Department of Health. For Breast Cancer Awareness Month in October, Dr. Stuart Bloom with the University of Minnesota Medical School, Masonic Cancer Center, and M Health Fairview discusses screening guidelines, risk factors, and how research is shaping care.
Q: What is breast cancer?
Dr. Bloom: Often, people hear the word “cancer” and become understandably distressed. They know it means something serious and sometimes life-threatening. To understand cancer, it’s important to recognize that organs are made up of cells that perform the function of that organ. For example, salivary cells make saliva, heart cells help the heart pump blood and breast cells make milk for a growing human. When the DNA of a normal cell mutates, it becomes a cancer cell. When this happens to a breast cell, the cancer cell no longer does its usual job. Instead, it makes copies of itself without end. If left untreated, the cancer can develop the ability to spread outside the breast — metastasize — to other sites in the body, where it can cause real trouble.
Q: What are the current guidelines for breast cancer screening?
Dr. Bloom: The current recommendation for screening from the United States Preventive Services Taskforce is that women should get mammograms every other year beginning at the age of 40 and should continue through the age of 75. This is true for women with normal risk. People who have a heightened risk, such as a family history or an inherited predisposition like the BRCA gene, may be candidates for a heightened screening program, such as alternating mammograms with MRIs, depending on the level of risk.
Q: If someone is diagnosed with breast cancer, what should they know about the diagnosis?
Dr. Bloom: The good news is that the vast majority of breast cancers are curable. This is because they are found so early, and the cancer cells have not had a chance to spread outside the breast. They are cured with local measures, such as surgery and radiation. Even if these cancer cells do microscopically spread, our adjuvant systemic therapies, such as endocrine therapy and chemotherapy, are usually effective enough to get rid of them.
Many factors influence what type of treatment we recommend for those with breast cancer. There are many different subtypes of breast cancer, each with a different biology. We personalize the treatment to the specific kind of breast cancer biology a patient has.
Q: What are some of the risk factors for breast cancer? Is there anything I can do to prevent it?
Dr. Bloom: While people always ask about the risk factors for breast cancer, it’s important to know that the vast majority of breast cancers occur sporadically. That means there is no known risk factor to account for their diagnosis. In terms of risk factors, we divide them into those that are fixed (can’t be changed) and those that are related to lifestyle changes (that can be modified). Fixed risk factors include being a woman, getting older, having a family history or inherited predisposition to breast cancer and having prior radiation exposure from a previous cancer treatment.
Modifiable risk factors include being postmenopausal on hormone therapy, obesity and living a sedentary lifestyle. Alcohol use has recently been implicated as increasing the risk of breast cancer, and the risk increases with the amount consumed.
Q: How does your research at the University of Minnesota impact clinical care?
Dr. Bloom: I try to get to know each patient personally, so they know I think of them as a fellow human being and not just a disease. I try to get as many patients living with breast cancer as possible on clinical trials. This allows them access to cutting-edge treatment while at the same time allowing us to acquire information that will be helpful to future patients with cancer. And these days, I am spending more time focusing on geriatric oncology. Many older women with breast cancer can do well with even fewer treatments than younger women.
Stuart Bloom, MD, MSc, is an associate professor of medicine at the University of Minnesota Medical School specializing in breast and prostate cancers. He is also a member of the Masonic Cancer Center and a physician at M Health Fairview.
This article was originally published by Alex Smith, Media Relations Manager, at the University of Minnesota Medical School. View the original post on their website.