The battle against breast cancer is being fought on many fronts. The medical community is working earnestly to improve diagnostic techniques, fine tune treatment options, and take better care of cancer survivors. While breast cancer survival rates are improving, in large part to finding cancers earlier and to improved treatments, there is still much more to be done. Nearly 200,000 new cases of breast cancer will be diagnosed this year and some 40,000 women will die from the disease.
Advancing Diagnostic Tools Cleveland Clinic in Florida is proud to be part of efforts to advance breast cancer care, which includes participation in multiple clinical trials. For example, the Cleveland Clinic Florida Breast Center is part of a study investigating blood-based diagnostic assays for human cancers, which could some day lead to simple blood tests for cancer detection. We are also participating in a trial of a test that examines breast cancer tumor tissue at a molecular level and gives information about the patients individual disease. This type of molecular diagnostics could help doctors make better recommendations during breast cancer treatment planning and as a result improve patient outcomes. Right-Sizing Treatment Options Surgical advancements in the treatment of breast cancer have been made that spare healthy breast tissue and improve cosmetic results for patients. We are applying plastic surgery techniques during lumpectomies in what is now called oncoplastic surgery. We can offer patients skin and nipple sparing mastectomies, and there are major innovations in natural tissue breast reconstruction, giving women more options than ever before. Accelerated partial breast irradiation (APBI), which is offered to patients of Cleveland Clinic, is another area where efforts have been successful in minimizing treatment impacts on healthy tissue. Surgeons temporarily place a device in the breast at the lumpectomy site that allows the delivery of radiation therapy directly to the site of the cancer, as an alternative to whole breast radiation therapy. Maturing data, published this July by the American Society of Breast Surgeons, supports the use of APBI for appropriately selected women who have had a lumpectomy in the management of their breast cancer Cleveland Clinic is also involved in ongoing clinical trials of various targeted therapies to prevent cancer reoccurrence. One study is looking at the use of Letrozole to treat breast cancer in postmenopausal women. The drug selectively prevents the body from making estrogen, which can stop the growth of certain types of cancer cells that need estrogen. Another group of drugs, called monoclonal antibodies, have been found to slow the growth of cancer cells and may also stimulate the immune system to better attack the cancer. Cleveland Clinic is involved in a multi-center trial comparing four different treatment regimens involving two of these drugs, trastuzumab and lapatinib. Beyond the Cancer At Cleveland Clinic, we have paid particular attention to cancer survivorship issues such as lymphedema. This condition is common in women with breast cancer who undergo lymph node surgery to determine their stage of disease. Strides are being made to better diagnose lymphedema so that early therapy can limit and possibly reverse its progression. An exciting new device has been developed that monitors lymphedema by utilizing the characteristics of frequency dependent current flow to quantify changes in extra-cellular fluid. Cleveland Clinic specialists have also been involved in the initial study of Axillary Reverse Mapping (ARM). This technique uses an injection of dye during a sentinel lymph node biopsy to identify which lymph nodes drain the arm before surgery, so that they can be preserved when possible. Cleveland Clinic plans to participate in a study of ARM once it becomes an approved NSABP multi-center trial. There are many exciting advancements being made in the treatment of breast cancer. And it is our goal, at the Cleveland Clinic Florida Breast Center, to bring these advancements to South Florida.