South Florida Hospital News
Wednesday August 15, 2018

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October 2017 - Volume 14 - Issue 4




Breast Cancer – Always Different, Always Something New

Dr. Nuria Lawson is a breast surgeon who focuses her practice on breast cancer, and you can hear the passion in her voice as she talks about her work. One of the reasons is because of the diversity that can be found in the field.

She said, for example, that when a patient has a finding and is referred to her for follow‑up work, "We determine whether the patient needs a biopsy or further studies, and then take it from there. There is a wide variation of cancers, and I always say, I can have 10 different patients and I will give all of those patients a different game plan of how to attend to their cancer. It's always different."
However, Dr. Lawson said that along with the differences, "There is always something new coming out. This is why you really need somebody who is dedicated to breast cancer to provide the most advanced care."
She credits the amount of money spent on research as one of the reasons for the new findings, saying that breast cancer is where all the money is being poured, it's where everybody wants to be doing research. But because it is a very common disease, it deserves to have that money funneled in its direction.
According to Dr. Lawson, some of the findings from the research have shown, "We are able to do less extensive procedures for a patient and get either the same results or better results than in the past." In recent decades, just about every woman who had breast cancer was given a mastectomy, but that is not necessary now in a vast majority of patients. "As long as we do a lumpectomy, remove the cancer with a margin of healthy tissue that shows we removed everything, and give them a little bit of radiation, the results are the same as if we had done a mastectomy. The recurrence rate of the breast cancer is statistically the same. So we can confidently tell a woman, you don't need to lose your breast."
Another advancement can be found in the genes. Dr. Lawson explained that just as people have genes in their bodies that determine whether they have blue eyes or brown, or whether they will be short or tall, the cancers within the cancer cell have genes that tell whether the cancer is going to be aggressive or not. "We can test the cancers for those genes, and according to what genes the cancers have, we are now developing medications that shut down those genes. This is what we mean by targeted therapy. Instead of shooting at the cancer with a shotgun full of pellets of chemotherapy, you give them the exact little magic bullet that works for that cancer."
This targeting has also had an effect on other forms of cancer. Dr. Lawson said that because of the advances that have been made, "We have now extrapolated the treatment from breast cancer to other types of cancer. Breast cancer is at the cutting edge, and all the other cancers are playing catch-up in terms of discoveries. That's how innovative things are."
Additionally, Dr. Lawson mentioned another development: "This is for patients who are newly diagnosed; we can now treat them with new medication that will give them a much longer chance of survival, and even disease-free survival, even if they become metastatic." She said the future is already pointing to turning breast cancer into a chronic disease. "We may not cure it, but we will be treating the patient chronically; like with diabetes or hypertension – you're always going to be treated for it."
For these reasons, the first thing she tells patients is, "Forget about the stories everybody else has told you about what they went through. You have a unique cancer, and we need to target our treatment to you."
However, despite advancements, Dr. Lawson warns that women cannot sit back and get comfortable. "They can't say, 'Oh I had a mammogram five years ago and things are going well, I'll just sort of coast.' No, no, no. The most common, serious, type of cancer in women is breast cancer, but it's the number two cause of cancer death. [Number one is lung cancer.] The reason it's not the number one cause is because we're able to save more and more women; we do so much research, we do a lot of screening, and we're trying to catch it at an earlier, curable stage."

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