Breast cancer is perhaps one of the most visible cancers today, thanks in large part to the highly successful pink ribbon campaign of the 1990s, but it wasn’t always this way.
While breast cancer was first described more than 3,500 years ago in Ancient Egyptian records, since then, a combination of taboo and embarrassment mean it often went undiagnosed and untreated.
In all those years, though, there were few treatments available before the 18th century. In 1757, French physician Henri Le Dran introduced the surgical removal of tumours and infected lymph nodes as a treatment option. This approach morphed into radical mastectomy, where not only the breast was removed, but also an extensive amount of surrounding tissue. Though improvements in anesthesia, hygiene, and blood transfusions improved surgical outcomes, this approach remained the best option for breast cancer well into the 20th century.
Yet, in the past 20 years, everything’s changed. And as we look ahead, there’s hope on the horizon for breast cancer prevention and treatment.
But first, let’s take a closer look at breast cancer.
Breast cancer is a form of cancer that occurs in the epithelial cells that line the ducts or lobules — the glandular tissue responsible for producing and carrying milk — in the breast. If left undetected and untreated, breast cancer can spread — or metastasize — into surrounding tissue, then lymph nodes, and eventually to other organs in the body.
Like any cancer, breast cancer occurs when the DNA in those cells mutates or changes. About 13% of people with breasts will develop breast cancer in their lifetime. In 80% of all cases, there are no known risk factors.
Between 5–10% percent of breast cancer cases are connected to harmful hereditary genetic variants, passed down through family members. These variants can increase the chances of someone getting cancer.
Other risk factors include: increased age, dense breasts, alcohol use, reproductive history, and family history.
Some breast cancers — about 75% total — are sensitive to the hormones estrogen and progesterone and need these hormones to grow. These breast cancers are called hormone receptor-positive.
Surgical removal of breast cancer and surrounding tissue remains a common treatment. However, it is often combined with other treatments, and advancements in surgical approaches mean surgery is less invasive with better outcomes.
Other treatments include:
Thanks to our uniquely collaborative environment and thoroughly modern Rose Ages Breast Health Centre, The Ottawa Hospital is a leader in the field of breast health.
Our researchers are looking at everything from prevention to diagnosis to treatment. Here are just a few of the exciting new developments that are helping patients today — or will be helping them tomorrow.
Tomosynthesis
Dr. Jean Seely is leading a multi-centre trial at The Ottawa Hospital called the Tomosynthesis Mammographic Imaging Screening Trial —or TMIST — to look at the effectiveness of using a 3D imaging technique during mammograms instead of the traditional 2D imaging. So far, it appears this technique can better identify tumours while minimizing abnormal recalls — those where it doesn’t wind up being cancer.
REthinking Clinical Trials
Radioactive seeds
In terms of treatments, The Ottawa Hospital is constantly innovating, and an excellent example of this is the radioactive seeds now being used to help surgeons locate tumours during surgery. Before this innovation, an uncomfortable wire would be inserted into the patient’s breast in advance of the surgery. Now, using a seed the size of a grain of rice that emits tiny amount of radiation, patients are more comfortable and the surgery is safer and more accurate. The Ottawa Hospital was only the third site in Canada to implement radioactive seeds for breast cancer.
Faster breast MRIs
The Ottawa Hospital was also the first site in all of Ontario to implement a new approach to breast MRIs that reduced the time from 45 minutes to 12 minutes. It’s shown improvements in patient satisfaction, outcomes, and improved capacity.
