Where are we in breast cancer research?

One of my goals for this year's SABCS was to get a sense of where we are from those who have been coming to this meeting for a number of years.The result was somewhat predictable in that the physicians see more progress than the advocate/survivors – except perhaps for those survivors who have benefited from one or more of the findings in the treatment area over the past 10 years.Overall, the physicians see progress in diagnostics and treatment - two areas summed up by Debu Tripathy, MD, professor of medicine and co-leader of the Women's Cancer Program at the University of Southern California Norris Comprehensive Cancer Center, and John Pippen, MD, a medical oncologist at Baylor Sammons Cancer Center in Dallas.Tripathy, who is also editor-in-chief of CURE, has not missed a meeting since 1989 when he began attending as a fellow."Many things have happened that have made an impact," he says. "There has been progress, definitely more than in the preceding 20 years. In the last few years, we have two drugs for prevention that have been approved and better imaging techniques - neither perfect but progress. We have shown that preventive surgery helps women with the BRCA1 and 2 mutations. We have approved new treatments in the adjuvant setting that improved outcomes: taxanes, dose-dense therapy and Herceptin for HER2-positive cancers. These have lowered the risk of recurrence to only 10 to 15 percent - half of what it used to be. 0ur biggest challenge is still metastatic cancer." John Pippen, who has been attending for 15 years, points to molecular information as the greatest breakthrough."The last two or three years, I have come away feeling much more positive. The era of molecular medicine means being able to look at a tumor ahead of time to maximize the effectiveness of treatment. This minimizes toxicity and cost."On the other side, Susan Love, MD, was pessimistic about the meeting, wishing more of the research looked at the causes of the disease and how to stop it."We are stuck in trying to make the treatments the best we can instead of finding the cause and stopping it," she says.Love's sentiment was voiced by many of the advocates, who are asking for information about prevention for the next generation when their daughters may face the risk of developing breast cancer.But as Dr. Tripathy points out, it's at SABCS where all the disciplines come together to learn from each other in hopes of going home with new ideas about ways to end this disease.