Today the chance of a woman being diagnosed with invasive breast cancer is 1 in 8. The chance of it killing her is 1 in 35. And it remains the second leading cause of cancer death for American women behind lung cancer.

But missing in those statistics from the American Cancer Society is a message of progress and hope for October, which is National Breast Cancer Awareness Month. Millions of lives have been saved through advances in early detection, surgical procedures and research into prevention and new ways to attack the cells.

Successes with drugs such as Tamoxifen and Herceptin have led to discoveries of an overwhelming selection of targeted therapies, which interfere with the pathways that help cancer cells divide and spread.

Now researchers are racing to compute mountains of information to find the best approach for treating specific patients.

A leading breast cancer scientist, V. Craig Jordan, who has been called the “father of Tamoxifen,” is finding new promise in the natural hormone estrogen. His research has uncovered its use as a killer of cancer cells rather than an agent that fans their flames.

“I’m excited beyond belief,” said Jordan, scientific director and vice chairman of the department of oncology at the Lombardi Comprehensive Cancer Center at Georgetown University Medical Center. “After having contributed all of my career to helping women treat or prevent their cancers, I have new insight into being able to kill breast cancer cells with a natural hormone — estrogen.”

The challenge now, he said, is how to go from 3 in 10 responses to low-dose estrogen to 100 percent responses.

An indication of how far researchers have to go is how long it has taken to get to this point. Mortality rates started to head down only 20 years ago after consistently climbing. Developing a map for understanding humans’ genetic makeup, the Human Genome Project, took until 2003 to complete.

But science has come far enough that finding a lump no longer has to shorten a life or even doom its quality.

“Eighty percent or more [of those diagnosed with breast cancer] are going to survive long term and will end up dying of something else,” said Dr. Debasish Tripathy, co-leader of the Women’s Cancer Program at the Norris Comprehensive Cancer Center, University of Southern California. “They’re essentially cured of breast cancer even though there’s a chance the cancer might come back. The biggest part of that has been earlier detection.”

While recognizing the part that mammography has played in early detection, Tripathy is hopeful that new methods, such as MRI (magnetic resonance imaging), will have even more reliable results and reduce false positives that lead to unnecessary biopsies. Because of the expense, he said, MRI is now used mostly for high-risk patients.

“Mammography leaves a lot to be desired,” Tripathy said. “We are desperately looking for better tools.”

As to hopes for a cure, both experts say progress will come in small steps.

“Cancer is too complicated for us to find one drug or one treatment that’s going to cure it,” Tripathy said. “I don’t see a cure in our lifetime for those in which the cancer has spread. What we will see in our lifetime more likely will be more diagnostic tests, more therapies that can extend life or — if [the cancer is] caught early — prevent recurrence to a greater degree. … Advances will come one step at a time.”
Chicago Tribune