New directions in breast cancer treatment

Three out of a hundred Filipinas will develop breast cancer in their lifetime. Many are diagnosed in the late stage. It is the second leading cause of mortality in the country.

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Traditionally, treatment is via surgery (radical mastectomy), hormone therapy, and chemotherapy. But there are newer modalities of treatment now. One is neo-adjuvant therapy, where the patient receives chemotherapy before surgery to remove the tumor (breast-conserving surgery) or the entire breast (radical mastectomy). It is especially useful for shrinking large, bulky tumors, so that the surgery is less complicated. Oftentimes, on pathological examination, there is complete (pathologic complete response) or near-total absence (residual disease) of tumor cells in the mastectomy specimen and the axillary lymph nodes, where breast cancer usually metastasizes first. The five-year survival rate for this treatment modality is an astounding 96 percent for those without inflammatory disease. For patients with inflammatory breast cancer, it is still an impressive 67 percent.