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Thanks to advances in treatment, more robust screening guidelines and awareness, and multidisciplinary teams like VCU Massey Comprehensive Cancer Center’s breast health team, more people than ever are living full lives after a breast cancer diagnosis.

This Breast Cancer Awareness Month, we spoke with Mary Helen Hackney, M.D., medical oncologist and director of community oncology at Massey, to find out what patients should know about the latest screening recommendations and breast cancer care approaches.

The importance of screening

Massey providers recommend starting regular mammograms at age 40—guidance shared by most U.S. medical organizations including the United States Preventive Services Task Force, who recently lowered their recommendation from 50 to 40. If there is a family history or other high-risk factors, some women may decide with their provider to start screening earlier.

As for when to stop, Hackney says she looks at the individual’s health and preferences to make that decision with her patients.

“If they’re 75 and in good shape and probably going to live another 10 or 20 years, I’d say keep doing that mammography. But if someone older than 75 tells me they wouldn’t pursue treatment if something was found in a mammogram, then we may look to stop screening,” she said.

Hackney also warned that while mammograms are an excellent tool at helping catch breast cancer early and lead to early interventions, they don’t catch everything—so if you find a lump, it’s important that you bring it to the attention of a physician.

A team approach to treatment

A multidisciplinary approach, especially at the beginning of your cancer journey, is key to successfully treating breast cancer and will put you in the best stead for longevity, says Hackney. Your team may include specialists in medical, surgical and radiation oncology, genetic counseling, pathology, nursing, physical and occupational therapy, psychology, social work, nutrition, navigation and more.

Your treatment will look different depending on your type of breast cancer, but many patients can expect surgery as well as systemic therapy such as chemotherapy or hormone therapy.

Hackney notes that recent advancements have led to great improvements in patient outcomes. “New drugs are making an incredible difference in not just lifespan but quality of life, particularly in our metastatic patients with HER2-positive and hormone receptor-positive breast cancer,” said Hackney.

Part of Massey’s comprehensive treatment planning is discussing fertility preservation in women of childbearing age, as there is a risk of the treatment leading to early menopause. Hackney recommends patients who hope to have children speak to their provider about egg or embryo freezing options prior to beginning any systemic therapy.

 

Women who are currently pregnant can be safely treated during pregnancy starting in the second trimester without harm to their baby. Recent research also suggests that some women with previous hormone receptor-positive breast cancer can temporarily interrupt their endocrine therapy in order to have a baby, and then restart the therapy, without increasing risk of cancer recurrence.

At Massey, clinical trials are considered part of the best “standard of care” for cancer patients. Breast cancer clinical trials currently enrolling at Massey are investigating the latest advances in treatment, including modifying the type and duration of radiation therapy for some breast cancer patients. Currently, Massey offers more than 30 clinical trials for patients with breast cancer.

Surviving well after cancer

As medical advances have led to improved cancer outcomes, the population of cancer survivors has grown exponentially. Massey experts are increasingly focused on ensuring that those patients survive well, studying common side effects of cancer treatment such as cognitive dysfunction, neuropathy and heart damage to assess patients for appropriate interventions.

There is also increasing evidence to support that regular exercise can help reduce both the risk of cancer recurrence and reduce side effects of treatment.

Massey’s unique Survivorship Program follows cancer patients through and beyond treatment to help monitor for side effects and connect patients to treatments and clinical trials that can help them live better, longer.

Written by: Annie Harris