Breast cancer is common: According to the National Cancer Institute, 13 percent of US women will acquire breast cancer. If you know more than eight women, you undoubtedly know someone who has had or will have breast cancer.
If you’re trying to understand your breast cancer risk or if you or a loved one has been diagnosed, you probably have questions for a doctor.
Virginia Kaklamani, MD, chief of the Breast Cancer Program at UT Health San Antonio MD Anderson Cancer Center, gave her suggestions for your list. Before writing questions, Dr. Kaklamani advises considering family history, lifestyle risk factors, and treatment choices.
Dr. Kaklamani regularly hears that breast cancer treatment usually entails chemotherapy and is hazardous. In response, she reminds people how far treatment options—and the skills to assess which therapy may work best for each individual—have progressed in the previous 20 years.
An example: Last year, a landmark study published in The New England Journal of Medicine showed that thanks to a genomic test called the Oncotype DX Breast Recurrence Score® test, even more patients with a common type of early-stage breast cancer may not need chemotherapy. That means more patient-specific treatment plans and less chance of overprescribing chemo to those who may not benefit.
Age, family history, alcohol, obesity, and race increase breast cancer risk. Dr. Kaklamani says white women are more likely to have breast cancer, while Black women are 40 percent more likely to die from it, according to the Centers for Disease Control and Prevention (CDC).
Dr. Kaklamani says studies suggest that Black women are more likely to be diagnosed with late-stage illness. “Instead of stage one or two breast cancer, they may have stage two, three, or four. It’s unclear. Most research shows that it’s tied to socioeconomic circumstances and the kind of breast cancer women receive (more triple negative, which is more aggressive and found later).”
Ask your doctor about race and breast cancer to better advocate for yourself and understand your risk factors.
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Dr. Kaklamani advises breast cancer patients to consult their doctors about their treatment choices, beginning with the tests available to customize their therapy.
Genomic testing like the Oncotype DX® test examines tumor genes for over- or under-activity. Dr. Kaklamani says the Oncotype DX Breast Recurrence Score® tells patients and doctors how aggressive their cancer is and the risk of it returning, and if chemotherapy may be beneficial or safely omitted.
“The wonderful thing about the [Oncotype® test] result is that it’s particular to the lady we’re testing,” she explains. “When I speak to someone about breast cancer, none of the hundreds of women in our clinical studies are in my office. Each test reflects that woman’s breast cancer.”
Asking your doctor about genetic testing may help guarantee you receive a personalized cancer treatment plan. After all, you wouldn’t take someone else’s prescription drug, would you?
Dr. Kaklamani believes you should always monitor your breast health even if the American Cancer Society stopped advocating self-exams in 2015.
She adds “breast self-awareness” is necessary by the guidelines. “It’s crucial to know what your breasts look like and to consult your doctor if anything changes.”
Dr. Kaklmani states that one research found that nurses who were appropriately educated in self-breast checks could identify their breast cancer. She recommends asking your gynecologist or primary care doctor for guidance.
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