Scientist testing samples in medical lab

Advances in Breast Cancer Prevention and Treatment

Loyola Medicine oncologist Shelly Lo, MDBy Shelly Lo, MD, Hematology and Oncology
Director of Loyola Medicine's Cancer Risk Assessment and Prevention Program

I'd like to share with you several recent medical advances in the prevention and treatment of breast cancer. First, let's look at risk factors and prevention.

Breast Cancer Risk Factors

You may be at increased risk for breast cancer based on your personal and family history. Some risk factors you cannot control, such as age, gender, family history and genetics, while some are lifestyle-related.

Breastfeeding, exercise and maintaining a healthy body weight can help decrease your risk of developing breast cancer.

Most patients with breast cancer do not have a family history of breast cancer, however women who have a close blood relative with the disease may be at higher risk of developing breast cancer.

Only 5 to 10 percent of breast cancers diagnosed are hereditary, meaning that a genetic defect is passed down from a parent to a child. The most common genes associated with hereditary breast cancers are due to a change in the BRCA1 or BRCA2 genes.

At Loyola Medicine, a licensed genetic counselor is available to meet with patients who have a family history of breast cancer or who are newly diagnosed with breast cancer.

Genetic testing may be useful in planning cancer surgery and treatment. Genetic test results may also be helpful to your family members.

Recent Advances in Prevention

Certain medications have all shown favorable results in large breast cancer prevention studies. These medications include:

  • Tamoxifen
  • Raloxifene
  • Anastrozole
  • Exemestane

In some of these studies, the prevention drugs are taken every day for five years. The benefits of breast cancer prevention may persist beyond the five years of treatment. Most women tolerate these prevention medications well. Recently, a study showed that low-dose tamoxifen can be just as beneficial in preventing breast cancer as the traditional tamoxifen dose with fewer side effects.

Women older than 60 years, those with a family history of breast cancer, or those who had a biopsy that showed atypical breast cells may be able to take prevention medications. We recommend that you speak with your doctor to see if taking a medicine to prevent breast cancer makes sense for you.

Breast Cancer Treatment

Cancer is a complex disease, and there are many different types, or “subtypes,” of breast cancer. Here are new drugs approved in 2019 by the U.S. Federal Drug Administration (FDA).

For advanced triple negative subtype (estrogen receptor negative, progesterone receptor negative, HER2 negative):

  • Atezolizumab (an immunotherapy) in combination with nab-paclitaxel for patients with advanced disease.

For advanced stage ER positive subtype, with tumors with a PIK3CA mutation:

  • Alpelisib

The Importance of Clinical Research

The important developments in fighting breast cancer are the result of patients taking part in research and clinical trials. Loyola is an academic medical center where patients have access to important clinical trials, new drugs and novel approaches to breast cancer prevention and treatment.

Offering these trials serves as an example of our commitment to advancing the field in the fight against cancer. Loyola physicians are deeply involved in breast cancer research and have made important advances in cancer-fighting drugs.

The Importance of Supportive Oncology

Loyola’s cancer care team provides support services, from diagnosis through survivorship. Through the backing of the Coleman Foundation, the Cardinal Bernardin Cancer Center identifies what kinds of support cancer patients need and helps find ways to provide it. Licensed dietitians, art therapists, clinical psychologists and chaplains provide an additional layer of support for patients.

We also offer licensed cosmetologists to provide assistance with any hair and makeup needs. Patients undergoing certain chemotherapy regimens can also minimize hair loss with the Paxman Scalp Cooling system.

Our Multidisciplinary Breast Cancer Clinic

At Loyola Medicine, new patients diagnosed with breast cancer attend our weekly multidisciplinary breast cancer clinic. During this appointment, they meet their breast surgeon, medical oncologist and radiation oncologist in one visit. We review patients’ mammograms with our radiologist and the patients’ pathology with our breast pathologist.

Patients have access to our specialized breast care nurses, research nurses for clinical trials, psychology support staff, social workers, genetic counselors and art therapists.

Shelly Lo, MD, practices medical oncology and is the director of the cancer risk assessment and prevention program at Loyola MedicineHer clinical interests include breast cancer, chemoprevention of breast cancer and supportive oncology care.

Dr. Lo earned her medical degree from SUNY Upstate Medical University College of Medicine and completed her residency at Albany Medical Center Hospital in internal medicine and pediatrics. She completed fellowships at Mount Sinai Medical Center and the University of Pittsburgh Medical Center in hematology and oncology.