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Sharing Hope: Advancements in Breast Cancer Treatment · Talking FACS

• 0:01
  Welcome to Talking FACS, and thank you for tuning in to Cancer Conversations
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  on Talking FACS, a podcast collaboration between the University of Kentucky
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  Markey Cancer Center and the UK Martin-Gatton College of Agriculture,
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  Food, and Environment's Cooperative Extension Service.
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  We will share with you the latest developments in cancer prevention,
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  diagnosis, treatment, and research from the experts at Markey Cancer Center,
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  Kentucky's only National Cancer Institute-designated Comprehensive Cancer Center.
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  Talking FACS is hosted by the UK Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families and communities
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  to improve quality of life.
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  Hello and welcome to Cancer Conversations on Talking FACS.
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  This partnership presentation from the Markey Cancer Center and the Martin-Gatton
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  College of Agriculture, Food, and Environment brings you the latest research
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  news to improve the quality of life for Kentuckians.
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  I am your host, Mindy McCulley, Extension Specialist for Instructional Support
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  with Family and Consumer Sciences Extension.
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  My guest today is Dr. Jessica Moss. Dr.
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  Moss is an assistant professor of internal medicine in the Division of Medical
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  Oncology with the Markey Cancer Center and the UK College of Medicine. Welcome, Dr. Moss.
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  Thank you. As we have discussed on the show previously, since science is always
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  progressing, this allows for new treatments and advances in cancer care.
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  So, Dr. Moss, can you share about some of the latest advances in breast cancer treatments?
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  There have been many advances in breast cancer treatment over the last few years,
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  and the treatment of breast cancer is changing very rapidly on a monthly to yearly basis.
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  In the last few years, some major things have come about are the incorporation
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  of immunotherapy into treatment of triple negative breast cancer,
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  and that has made a huge difference for those patients,
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  triple negative breast cancer is the most aggressive subtype of breast cancer.
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  Other treatments that have become available for breast cancer patients is that
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  we have many more targeted therapies for stage four breast cancer patients.
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  So many times patients with stage four disease think that they're facing a very bad prognosis,
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  but we have much better targeted agents now that are both less toxic than chemotherapy
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  and tailored to that patient's particular breast cancer and what particular
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  mutations are found in that breast cancer.
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  So, when you say a triple negative breast cancer diagnosis, how is that different from stage 2?
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  So, triple negative breast cancers can be stage 2. They can be stage 1, 2, 3, or 4.
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  There are many different subtypes of breast cancer.
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  So, not all breast cancer is created equal or the same.
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  When we talk about breast cancer, we always look for three different proteins
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  which can either be present or absent on breast cancer cells Those are the estrogen receptor,
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  or ER, the progesterone receptor, or PR,
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  and the HER2 receptor,
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  HER2 We always look for the presence or absence of those proteins in breast
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  cancer cells They can be either all present, sometimes we call that a triple
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  positive, or all absent.
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  We would call that a triple negative or any combination thereof.
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  Based on which ones are present or absent, that tells us things about the prognosis
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  of that cancer, whether it is more aggressive or less aggressive and more slow-growing,
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  and what kind of treatments it would respond to.
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  That is so interesting. I know that we typically think of breast cancer as a
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  female disease, but men can also get breast cancer.
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  So are these advances making a difference in getting the word out for males?
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  Yes. So men can get breast cancer, and men make up about 1% of all breast cancer
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  patients in the U.S., which is a very small percentage. but when you're talking
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  about thousands of patients, there certainly are some.
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  And here at UK, we see anywhere from 5 to 10 men per year diagnosed with breast cancer.
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  As far as our treatment for breast cancer in men, it is essentially the same
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  with a couple of notable differences.
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  Genetic counseling and genetic testing is always recommended for men who have
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  breast cancer because we have a hard chance of identifying an inherited reason for that.
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  And the management of what we call estrogen receptor positive breast cancer
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  in men is a little bit different in that we choose different types of estrogen
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  blocking pills to treat them compared to women.
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  Just makes logical sense, I think. Are we seeing breast cancer rates increasing or decreasing?
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  So we're actually seeing breast cancer rates overall increasing,
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  especially in younger women. Okay.
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  Premenopausal women in their, you know, 20s, 30s, 40s.
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  Are there certain risk factors that we see in breast cancer patients?
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  Yes. Some factors that increase the risk of breast cancer that people are not
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  particularly aware of are obesity.
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  Obesity does increase the risk of breast cancer. And if you have breast cancer,
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  being obese increases your risk of recurrence.
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  Other things that increase breast cancer risk include alcohol intake.
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  So alcohol does increase the risk of breast cancer.
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  Other things that increase the risk of breast cancer can be things like early
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  age when you start having periods and fewer pregnancies or pregnancies later
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  in life or no pregnancies at all.
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  You talked about the genetic markers that you look for for men and women also.
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  Benefit from genetic counseling? Yes. Some women do benefit from genetic counseling.
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  And that's, for example, when I was talking about triple negative breast cancers,
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  and those are the ones that don't have that estrogen receptor,
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  progesterone receptor, or HER2 protein on them.
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  And that is the most aggressive subtype of breast cancer.
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  Any patient, man or woman, who has triple negative breast cancer meets criteria
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  for genetic counseling and potentially genetic testing.
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  So triple negative breast cancer is more likely to be associated with inherited mutations,
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  such as the BRCA1 or BRCA2 gene mutations that are talked about a lot in the
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  late public, but there are also some lesser known inherited mutations,
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  for example, one called PALB2 that It can be associated with breast cancer,
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  triple negative breast cancer, and some other subtypes.
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  It's also important for young women, so under age 50, but even more so under
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  age 45, if they are diagnosed with breast cancer, to have genetic counseling and testing.
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  So, we talked about risk factors. What are some common symptoms that someone
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  might recognize if they might have breast cancer?
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  So most breast cancers are diagnosed by screening, with screening mammograms,
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  and that's ideal because that picks up on a breast cancer, which would be far
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  too tiny to be felt by exam.
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  But certainly if a woman notices any change in her breast, and that can be something
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  like feeling a mass in the breast, but also seeing changes in the skin of the
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  breast, redness, dimpling, kind of a puckered or orange peel-like.
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  Change to the skin of the breast, those are always things that should be brought
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  to a doctor's attention immediately.
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  Any swollen lymph nodes in the armpits, because this is where breast cancer
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  cells move to and the lymph node change, all of those things should be brought
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  to a doctor's attention.
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  As a woman, we are advised to do monthly self-exams. Are men advised to do that as well?
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  No, not necessarily, but certainly if a man were to notice any mass or change
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  in the skin over the breast area, they should also bring that to a doctor's attention.
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  Some things as far as misconceptions and things that I try to focus on are that,
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  you know, people, I think it's important to understand that breast cancer is
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  not really just one disease. There are multiple different subtypes of breast cancer.
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  And so the treatments for those and the prognosis for those is very radically
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  different depending on which type you have.
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  Other things is that, you know, most patients with stage 4 breast cancer live
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  for years and sometimes even decades.
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  So that people should not give up hope if they have that diagnosis because we
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  have so many more treatment options available than we did even just a few years ago.
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  I think that is encouraging, especially for those of us who have family members
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  who have had or are surviving breast cancer.
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  Dr. Moss, I really appreciate the time that you spent with me today.
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  And I know that this is information that will be beneficial to our listeners.
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  If you are just tuning in, you're listening to Cancer Conversations on Talking
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