Advance with MUSC Health

Breast Cancer Awareness: 2023 Sees Improved Survival Rates and Advanced Treatment Options

Advance With MUSC Health
September 25, 2023
Care team member speaking with a smiling patient

An estimated 297,790 new cases of invasive breast cancer will be diagnosed in 2023, according to the American Cancer Society. About 55,720 new cases of ductal carcinoma in situ (DCIS) will be diagnosed, and around 43,700 women will die from breast cancer. 

The encouraging news is that the breast cancer survival rate has improved over the last 30 years, says an MUSC Health breast cancer surgeon. Dr. Andrea Abbott, medical director of the Comprehensive Breast Program at the NCI-designated MUSC Hollings Cancer Center, cites multiple reasons for the lower mortality rate, from advances in screening technology and tailored treatments to increased knowledge of ways to modify one’s risk for breast cancer.

“Improvements in imaging quality, more precise screening such as 3D mammography, expanded access to health care, as well as increased education about the importance of early detection are all factors that have contributed to the improved survival rate,” says Dr. Abbott, who also is medical director of Quality Assurance and Program Improvement for the MUSC Hollings Cancer Center Network and an associate professor of surgery.

Taking Control of Breast Cancer Risk

People are taking ownership of their health and changing behaviors that heighten their risk for breast cancer. Increased alcohol consumption, being overweight or obese, particularly after menopause, and lack of physical activity can increase the risk for developing breast cancer. Other factors such as the use of hormone replacement therapy and family history of breast and ovarian cancer are important to discuss with your physician.

“Weight gain late in adulthood is associated with an increased risk for breast cancer,” she says. “Hormone replacement therapy (HRT) is appropriate for bone and heart health in women who have their ovaries removed at an early age, but it is important to consider an individual’s risk for breast cancer and continually balance the risks and benefits of HRT with a planned stop date in mind.”

Bioidentical hormone therapy, a natural estrogen alternative that is derived from a plant, has the same risk profile as estrogen and should not be considered a safer alternative to HRT, she says. It is important to note if you are currently taking HRT, do not abruptly stop this medication. Tapering the dose can help minimize symptoms and ease the transition and should be done with the help of your healthcare providers who prescribe that medication.

Breast Cancer High-Risk Factors and Prevention Strategies

On the other hand, certain factors are beyond control. Being female, aging, or having dense breast tissue, genetic mutations or strong family history can increase one’s risk. That’s why it’s so important to know if your risk is high so you can get into a screening program early, Dr. Abbott says.

She advises women to sit down with a parent when they’re between the ages of 25 and 30 and review their family history.

“Find out who had breast or ovarian cancer and at what age. If early, that should trigger an alert that you may have an increased risk for breast cancer. Then meet with a specialist or your primary care physician to calculate your risk. If you have a greater than 20% lifetime risk, you’ll qualify for high-risk screening that could begin as early as age 30, or 10 years younger than the relative who had breast cancer.”

Early Detection Matters: Screening Protocols and Significance

High-risk women with a genetic mutation may require mammograms or MRI starting at age 25; women at average risk should begin having mammograms at age 40. Dr. Abbott also recommends clinical breast exams.

“It’s very important to have a breast exam at the time of your annual mammogram (or twice a year if you are high-risk). Between those exams, women should perform their own breast exams. A proportion of patients come to me without significant symptoms because cancer was detected at an early stage on a screening mammogram, and a fair number come because they felt something.”

If detected early, breast cancer is very survivable, Dr. Abbot says. “The overall five-year survival rate for patients whose cancer has not spread beyond the breast is 99%. The earlier breast cancer is detected, the less treatment a patient will need.”

Breast Cancer Survivability and Treatment Options

Dr. Abbott says Hollings offers advanced treatments, including customized treatments with fewer side effects and new surgical techniques, to improve patient outcomes.

“The treatment of breast cancer can involve surgery, radiation, chemotherapy and endocrine therapy. At Hollings, we can tailor the treatment and better predict which therapies will benefit patients and which therapy may not be necessary,” she says.

“There is a constant balance to be aggressive enough without being overly aggressive when there would be no benefit to the patient. We know that not everyone responds to chemotherapy the same way, and we have tests that allow us to determine if a patient needs chemotherapy. Not everyone does. Our radiation oncologists can be precise when we use radiation therapy, so a patient does not receive more radiation than is needed.”

Advanced Breast Cancer Treatment and Comprehensive Care

Specialists at Hollings also are using immunotherapy, a new class of drugs that activates the body’s own immune system to fight cancer cells, and monoclonal antibody therapy, which targets the specific cancer cells in patients diagnosed with HER 2 cancers.

If a patient does require a mastectomy, she’ll have access to the latest surgical techniques for breast reconstruction and to minimize the risk of lymphedema and its associated discomfort. Hollings surgeons utilize cutting-edge techniques in breast reconstruction, including nipple-sparing mastectomy and reconstruction with nerve preservation. Patients also can have a procedure that allows lymph fluid to drain even after lymph nodes have been removed.

Dr. Abbott says patients who choose the NCI-designated MUSC Hollings Cancer Center will be cared for by a multidisciplinary team of nationally recognized oncologists, plastic surgeons, navigators, counselors and therapists to manage their care.

“A lot of exciting developments are happening on many fronts.”