By Sankari Sivasailam, M.D.
Board Certified, Hematology and Oncology

The picture of breast cancer in 2009 is one of hope, progress and dedication to achievement. Although incidence rates continue to rise by 0.3% each year, the death rate from breast cancer has declined at an annual rate of 2.3%. This decline in breast cancer mortality is related to both the advances in early detection as well as improvements in breast cancer treatment.

According to the American Cancer Society, there are approximately 2.5 million women alive today with a history of breast cancer. The majority of these women are cancer-free, while others still have evidence of cancer and may be undergoing treatment. Breast cancer continues to be the most common cancer in women and is the leading cause of death for women between the ages of 20 and 59 years. In 2009, the American Cancer Society reported that 192,370 women were diagnosed with invasive breast cancer in the U.S. In Maryland, 3,660 cases of invasive breast cancer were diagnosed in 2009. At Upper Chesapeake Health, there were 125 new cases of breast cancer diagnosed.

Survival rates for breast cancer have steadily improved over the last 20 years. This improvement can be linked to the advances in our understanding of the disease and the outcome of clinical trials which evaluates the effectiveness of new treatments and procedures.

There are several known factors that may play a role in the development of the disease. These risk factors include:

• Female gender
• Increasing patient age
• Family history of breast cancer at a young age
• Early menarche/late menopause
• Older age of first live birth
• Prolonged hormone replacement therapy
• Benign proliferative breast disease
• Genetic mutations of the BRAC1/2 genes

Breast cancer treatment may include surgery and radiation therapy for disease that localized in the breast as well as chemotherapy, hormone therapy or biologic therapy when the cancer cells have traveled to other parts of the body. Women who undergo surgery may elect to have breast reconstruction either at the time of the initial surgery or delay reconstruction until the completion of all therapies. The selection on of the treatment modality and sequence of therapy is based on an assessment conducted through a multi-disciplinary consultation on process with radiologists, pathologists, surgeons, radiation oncologists and medical oncologists. The outcome of the discussion is a comprehensive plan of care that is tailored to the individual’s overall health, stage of disease as well as the patient’s preference.

Non-medical components such as the emotional, social and physical side effects from cancer diagnosis and treatment must also be taken into account when treating cancer. Supportive services for patients with breast cancer are provided by the UCH Cancer LifeNet Program and include coordination of care by nurse navigators, and emotional and psychological support from oncology social workers. Cancer LifeNet offers two support groups for women with breast cancer. The first group is a general support group for all patients and the second group is for women with metastatic breast cancer. Patients also have access to programs developed by the American Cancer Society such as “Look Good Feel Better,” and “Road to Recovery.”