With over 200 BCRF researchers in attendance at the Annual Symposium and Awards Luncheon, guests were given the opportunity to pose questions to leading experts in breast cancer research. Below are highlights from the interactive discussion:
Does aspirin prevent breast cancer?
According to Dr. Walter Willett, aspirin does not offer the same prevention benefits for breast cancer as it can for colorectal cancer and cardiovascular disease. He described aspirin as a potent drug with serious side effects, including hemorrhagic stroke and intestinal bleeding. He cautioned the use of aspirin for breast cancer prevention, except under the supervision of a doctor who can carefully balance the risks vs. benefit.
What is proton radiation?
Dr. Bruce Haffty explained the difference between proton radiation and the standard photon radiation used in breast cancer treatment. The potential benefit, he explained, is that proton radiation may reduce the amount of radiation to the heart or lung during radiation therapy to the breast and lymph nodes. The benefit of proton radiation has not been determined, but Dr. Haffty is involved in a large clinical trial that is comparing the benefit of proton radiation in reducing long-term damage to the heart and lungs compared to traditional radiation therapy. He stressed that traditional radiation is safe for the majority of patients and that there is very little radiation dose to the heart and lungs with this therapy.
What is being done to improve hormonal therapies?
Dr. Larry Norton explained that while hormonal therapies are very effective against breast cancers that depend on estrogen, tumor cells have ways to resist the killing effects of the therapy. Some of these involve other pathways that may be targeted with drugs in combination with hormonal therapy. Examples include the new class of drugs called CDK 4/6 inhibitors. Palbociclib (Ibrance®), ribociclib (Kisqali®) and abemaciclib (Verzinio®) are examples of CDK 4/6 drugs approved to treat metastatic breast cancers that have become resistant to hormonal therapy. Studies are ongoing to test these drugs in patients with early stage breast cancer. Drugs that target other hormone resistance pathways are also under clinical development.
Why do we need basic research?
Dr. Robert Weinberg used success of the CDK 4/6 inhibitors to explain how curiosity-driven basic laboratory research can lead to discoveries that benefit patients. “In studies that started in single-cell yeast years ago,” he said, “scientist learned the basics of cell growth and cell division. It is only recently that curiosity led to studying this in breast cancer cells and the developed of drugs that are now benefitting patients with metastatic breast cancer.” Dr. Norton further stressed that most important discoveries occur out of curiosity rather than in pursuit to solve a specific problem. When laboratory scientists are exposed to clinical investigators, they are able to connect the dots between their discovery and how it can benefit patients. BCRF plays a critical role in this process by allowing scientists to pursue their ideas unrestricted by directional guidelines and bringing clinical and basic scientists together in a collaborative setting.
What do I need to know if I have dense breasts?
We do know that dense breasts can obscure detection of breast cancer. Dr. Wendie Berg specializes in breast density and believes that tomosynthesis (3-D mammography) should be used for standard screening in all women with dense breasts. For women with extremely dense breasts, tomosynthesis alone is not good enough and needs to be combined with breast ultrasound or MRI for breast cancer screening. Dr. Berg recommended DenseBreast-info.org as a resource for women who want to know more about breast density and screening for breast cancer.
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