In 1757, surgeon Henri Le Dran advocated for the surgical removal of tumors to keep them from spreading.
In 1976, the American Cancer Society officially recommended the use of mammograms to screen for breast cancer.
In 2019, researchers confirmed that many women with early-stage estrogen receptor (ER)-positive breast cancer — which affects nearly 60,000 women each year — can avoid chemotherapy with a new testing system that determines the most effective care for specific types of tumors.
Every day, researchers make advancements in the prevention, diagnosis, and treatment of breast cancer. Each of these advancements help save lives and bring us one step closer to a world free of breast cancer.
Less than 30 years ago, breast cancer offered limited treatment options — and prevention seemed impossible. Now, thanks to early detection and advanced treatment options, countless lives have been saved from the disease.
Here's a look at how breast cancer treatment has changed over the past 30 years.
From Surgery to Drugs: The Many Advancements in Breast Cancer Treatment
Just 30 years ago, the most common surgical option to treat breast cancer was a mastectomy, which is surgery to remove the entire breast.
Catherine Porter, DO,
Chair of the Breast Health Program at Chester County Hospital
"Now, women have options that don't have such a drastic impact on their body, such as lumpectomy (a breast-conserving surgery where just the cancerous portion is removed, rather than the entire breast) followed by radiation. This less invasive option allows women to keep their breasts, which are often an important aspect of a woman's identity," says Catherine Porter, DO, Chair of the Breast Health Program at Chester County Hospital.
Today, treatment also goes far beyond surgery. Roughly 30 years ago, scientists began studying hormonal treatments, which became a game-changer for breast cancer treatment. This allowed researchers to divide breast cancer into subtypes, helping healthcare providers to utilize the appropriate treatment according to the type of breast cancer.
Hormone Receptor (HR) Positive Breast Cancer
HR-positive breast cancer — which makes up nearly 70 to 80% of breast cancers — grows in response to estrogen and progesterone hormones. As a result, hormone therapies are used to effectively treat this type of breast cancer.
Currently, researchers are studying the use of targeted therapy — which attacks cancer cells with less harm to normal cells — for HR-positive breast cancer that is advanced or metastatic (has spread to other parts of the body). These drugs, some of which are already approved, can prolong the time until chemotherapy is needed and even extend survival.
Human Epidermal Growth Factor Receptor 2 (HER2) Positive
HER2-positive breast cancer has high amounts of the HER2 protein, and it can be treated with therapies that target this protein. Currently, there are many drugs approved to treat this type of cancer effectively.
Once HER2-positive breast cancer has spread to the rest of the body, it is more likely to spread to the brain than other kinds of breast cancer. In 2020, a drug was approved that, when used with other drugs already approved for HER2-positive breast cancer, may prolong survival without the disease spreading to other parts of the body, including to the brain.
Triple-Negative Breast Cancer (TNBC)
The hardest type to treat, TNBC lacks both hormone receptors and high amounts of HER2. As a result, therapies aimed at these targets are not helpful and the typical treatment is chemotherapy.
Some new drug therapies — including one recently in April 2020 — have been approved and have shown promise to treat triple-negative breast cancer effectively.
"Over the years, the primary forms of breast cancer treatment have developed to consist of surgery, radiation, chemotherapy, hormone therapy, and targeted therapy. Scientists have made progress not only in new approaches to these treatments but also regarding how a combination of treatments can benefit breast cancer patients and save lives," says Dr. Porter.
Beyond Treatment: Prevention and Diagnosis of Breast Cancer
Effective breast cancer treatment is critical — but so is early diagnosis and preventing it altogether.
Thanks to advanced imaging tests and programs that promote awareness for important screenings, such as the Breast Cancer Surveillance Consortium launched in 1994, healthcare providers are able to diagnose breast cancer in its early stages. As a result, the cancer is easier to treat.
Also, researchers are currently studying the significant health disparities that exist within breast cancer. For instance, Black women are more likely to be diagnosed with aggressive breast cancer than white women — and they are also more likely to die from the disease.
One possible reason is due to differences in access to screening and treatment options. To combat this disparity, studies are examining medical, social, environmental, and other factors that may impact survival.
Breast cancer prevention also relies on your individual choices, and researchers continue to identify lifestyle factors that affect your risk of developing breast cancer. For instance, eating healthy and exercising regularly can reduce your risk.
Ridding the world of breast cancer completely will take time, but every year, experts make important strides toward doing so. If these past 30 years are any indication of future success in breast cancer treatment, the possibilities of the next 30 years are endless.
Do you have questions about breast cancer prevention, diagnosis, or treatment? Call 610-738-2300 to find a healthcare provider at Chester County Hospital.
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