Q: What is breast cancer?
Patel: It’s the most common type of cancer in women. It affects one in eight women, and there are about 180,000 to 200,000 cases diagnosed every year.
Q:How is it different from other forms of the disease?
A: That’s tricky, because to an oncologist, every tumor is different in its own way. Because it attacks the breast, it is something we can detect early. People typically don’t get screening CAT scans of their abdomen, so when something like pancreatic cancer is found, it’s already in a late state.
The nice thing about breast cancer is, if women get regular mammograms, we can catch it earlier. In that way, we can increase the chances of a cure.
Q:What does breast cancer do?
A: Basically, a cell becomes malignant. We don’t know 100 percent what that pathway is, but at some point, it becomes a rogue cell which then replicates, then develops and becomes a tumor, which is a big ball of malignant cells. Cancer calls tend to be overactive cells, in that they tend to make more cells and then locally invade.
Q:Is all breast cancer the same?
A: There’s different types of breast cancer. Some develop from the ducts within the breast, and some develop from what we call the lobules. There’s something call inflammatory breast cancer, which actually looks like a rash on a patient. And it can be very deadly, because it’s a very aggressive type of cancer.
You can get a sarcoma of the breast. You can get something called a phyllodes tumor. There’s multiple types of tumors that can affect the breast. The most common is invasive ductal cancer.
Q:What’s the first concern during diagnosis?
A: The immediate pathway is to the lymph nodes, which are under the arm. When a surgeon does surgery for breast cancer, they will always evaluate the lymph nodes as well. That significantly affects survival and what kind of treatment the patient gets.
Q:What are the survival chances of breast cancer today?
A: They’re improved. Of course, that range is significsantly based on what stage the patient is at: how early it’s found and whether it has affected the lymph nodes, whether it’s gone to other areas of the body.
One thing to remember is that we’re tailoring therapy. We’re finding more and more molecular targets we can give specific drugs based on the tumor’s characteristics.
Q:Is it getting easier to detect and diagnose breast cancer?
A: We are better in that the technology has improved. We do what’s called digital mammography now, so (the machines) are able to pick up smaller lesions. It has improved survival in that, the earlier the lesions are detected, the better the survival.
Special Reports
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Discussion
Q&A with Dr. Chandrika Patel
Dr. Patel is a radiation oncologist at Saint John's Cancer Center
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