Cancer is not one disease but many, and new genomic tools are showing that tumors are more diverse than anyone anticipated. For breast cancer patients, that diversity can have a profound impact on their treatment plan and how their cancer responds.
Cancer care is a partnership between patients and their physicians, and that process begins with prevention. Women can decrease their risk by making sure they get enough vitamin D. The body manufactures this essential nutrient when exposed to sunlight, but even in Southern California, not everyone is getting enough.
“Many women assume they have an adequate vitamin D level if they’re frequently in the sun, but that’s not always the case,” says Sonia Ali, MD, a medical oncologist at Scripps Clinic Torrey Pines, whose practice focuses on breast and gynecologic cancers. “Ask your primary care doctor to test your vitamin D level to make sure you’re not deficient.”
Dr. Ali also recommends regular, moderate-intensity exercise, which has been shown to reduce the risk of breast and other cancers.
Choosing when to get a mammogram is extremely personal. Women should talk to their primary care doctors, as they are best equipped to assess risk and optimize a surveillance strategy.
“There are genetic cancer syndromes,” says Marin Xavier, MD, a hematologist and oncologist at Scripps Mercy Hospital. “If you have a close relative with ovarian cancer, male breast cancer, or multiple relatives with breast cancer, you could be at increased risk of having an underlying mutation.”
For these individuals, genetic testing may be in order. If an underlying mutation is identified, there are additional screening guidelines. Dr. Xavier also encourages women to express any concerns they may have to their doctors.
“If you’re doing a self-exam and find something that’s abnormal, be sure to bring it to the attention of your physician and make sure it’s looked at,” says Dr. Xavier. “Nothing trumps knowing your body and knowing what’s new and what’s changed.”
Diagnosis and treatment
Receiving a cancer diagnosis is scary and will naturally trigger intense emotions. The first step is to gather and understand all the information before deciding on a course of action. Cancer does not grow overnight, and patients should proceed carefully.
It’s also important to remember that each breast cancer is unique, with differing profiles and mutations and diverging clinical paths.
“It’s natural for friends and family members to give well-intentioned advice based on their experience with cancer and treatment,” notes Dr. Ali. “However, patients must keep in mind that not every cancer – and more specifically, not every breast cancer – is the same.”
New genomic technologies are driving this lesson home. Breast oncologists now have diagnostic tests that can analyze individual tumors on a genetic level. The results can help guide treatment decisions.
Cancer treatments are also a concern for many patients but, again, the stories do not always match the reality.
“A lot of women will say something like: ‘Dad had cancer, I know what chemotherapy is like,’” notes Dr. Ali. “But there are many different types of chemotherapy regimens, and even people who get the same drugs often don’t have the same reactions. Don’t take someone else’s experience and assume it will be your own.”