NEW YORK, Jun 08 (Reuters Health) - A panel of some of the world's
best-known authorities on breast cancer has expressed optimism about the future
of breast cancer detection and treatment during an educational session.
"I think the future actually looks very bright," said Dr. Larry Norton of
Memorial Sloan-Kettering Cancer Center, New York, at a presentation here on
Wednesday. He cited breast cancer vaccines and expression profiling--using blood
tests or cell samples to discover a person's likelihood of developing breast
cancer, as well as that cancer's unique characteristics--as especially hopeful
developments.
In particular, techniques to detect breast cancer at extremely early stages
could be as effective as the Pap smear has been in preventing cervical cancer
deaths, according to Dr. Susan Love, the medical director of the Santa Barbara
Breast Cancer Institute in California.
"What we call early detection is not very early," Love said. "Cancer cells
grow 8 to 10 years before you can see them on a mammogram or feel them."
One promising early detection idea now in clinical trials is ductal lavage,
in which the milk ducts are washed so that the cells lining them can be examined
to see if they look precancerous. Because breast cancer is believed to originate
in the milk ducts, Dr. George Papanicolaou, for whom the Pap smear is named,
proposed this idea in the 1950s, Love said.
On the subject of treatment advances, Dr. Umberto Veronesi--the Italian
Health Minister widely recognized as the originator of breast-conserving
"lumpectomy" surgery--described a new approach to radiation therapy used by his
group in Milan.
Instead of requiring patients to receive daily radiation therapy for weeks
after removal of a cancerous breast lump, they deliver the radiation while the
patient is still on the operating table and before closing the incision, to
spare the skin. The amount of radiation delivered in this single dose (22 Gray)
is equivalent to the 55 Gray normally administered after surgery in many small
doses, Veronesi said.
"We reviewed 2000 cases and discovered that 92% of recurrences are in the
same area where the tumor was originally located," Veronesi explained. "We think
the present habit to irradiate the whole breast is not needed, so we concentrate
the radiation to where the tumor is located." After one year, the group has
observed no radiation side effects in the approximately 100 patients treated
this way so far, he added.
The educational session, sponsored by the American-Italian Cancer
Foundation, the Susan G. Komen Breast Cancer Foundation and the New York Times,
was open to the public. Of the several hundred attendees, a show of hands
suggested that half or more identified themselves as breast cancer survivors.
