mammography

Breast cancer affected around 2.3 million women worldwide in 2020, taking an estimated 685,000 lives globally. According to the World Health Organization, at of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past five years, making it the world’s most prevalent cancer. Women worldwide lose more disability-adjusted life years (DALYs) to breast cancer than any other type of cancer.

Fortunately, human ingenuity has a way of tackling its most pressing problems. The prevalence of breast cancer makes it a prime target for technological innovation.

In fact, technology is well on its way towards finding ways to improve the options for breast cancer patients, from screening to treatment. Advancements in imaging, for instance, are creating new opportunities for improvements in both screening and early detection.

The United States National Cancer Institute is funding a large-scale randomized breast screening trial, the Tomosynthesis Mammographic Imaging Screening Trial (TMIST), to compare the number of advanced cancers detected in women screened for five years with 3-D mammography with the number detected in women screened with 2-D mammography.

3-D mammography, also called breast tomosynthesis, takes images from different angles around the breast and builds them into a 3-D-like image.

“As cancer treatment is becoming more individualized, researchers are looking at ways to personalize breast cancer screening. They are studying screening methods that are appropriate for each woman’s level of risk and limit the possibility of overdiagnosis,” the NCI wrote on its website.

The organization cited a study done by the Women Informed to Screen Depending on Measures of Risk (WISDOM) to determine if risk-based screening — or, screening at intervals that are based on each woman’s risk as determined by her genetic makeup, family history, and other risk factors — is as safe, effective, and accepted as standard annual screening mammography.

“The mainstays of breast cancer treatment are surgery, radiation, chemotherapy, hormone therapy, and targeted therapy. But scientists continue to study novel treatments and drugs, along with new combinations of existing treatments,” the NCI said.

“It is now known that breast cancer can be divided into subtypes based on whether they contain estrogen and/or progesterone receptors (that is, are hormone receptor, or HR, positive) and whether they have high levels of HER2 protein (HER2 positive).”

As more information gets discovered about the different subtypes of breast cancer and their differences in behavior, medical researchers can use this information to devise new treatment options for women.

The NCI-sponsored TAILORx clinical trial, for example, is based on a study, which included patients with ER-positive, lymph node-negative breast cancer, that found that certain tests regarding the expression of certain genes can predict which women can safely avoid chemotherapy.

Breakthroughs are also being made in the area of bridging medical disparity. Black women are more likely to be diagnosed with aggressive subtypes of breast cancer, according to the NCI, and they are more likely to die of their disease than White women. To gain an understanding of these disparities, NCI is funding a multi-institution project, the Breast Cancer Genetic Study in African-Ancestry Populations.  The genes of Black women with and without breast cancer will be compared to each other, as well as to those of White women who have breast cancer.

The Detroit Research on Cancer Survivors study will look at the major factors affecting cancer progression, recurrence, mortality, and quality of life among African-American survivors of four different cancers, including breast. Detroit ROCS will examine medical, emotional, social, environmental, and other factors that may affect cancer survival.

The significance of the rate in which medical advancements are being made cannot be overstated. As the medical world gains more knowledge on the intricacies of breast cancer, the greater chances will be for millions of women affected by this insidious disease to have better lives. — Bjorn Biel M. Beltran

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