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A look at the latest on breast cancer detection, treatment and research

By Irene Maher

Orange pumpkins and black cats may feature prominently starting tomorrow, but don't forget to think pink, too. October is National Breast Cancer Awareness Month, a time to draw attention to annual screening, the need for research funding and programs that support patients, their caregivers and families.

The Times spoke with Dr. Brian Czerniecki, chairman of the department of breast oncology at Moffitt Cancer Center, for an update on breast cancer detection, treatment and research. Here are some highlights from that conversation.

Are women still wondering about the value of getting mammograms?

Some are, especially older women. Some, in their 70s, 80s, are told by their family doctors that they don't need mammograms anymore. While tumors do slow as you age, (not screening) can still lead to a tumor being picked up much later than it might be otherwise. A safe rule is, if you're not going to screen yearly, do it every other year, unless there is some other limiting health condition, such as Alzheimer's. But with no other life-threatening health issues, I say get screening into your 70s, 80s and beyond. That way we can often pick up tumors and remove them just with surgery and no radiation.

What should young women, those in their 20s, know about breast health?

Do self breast exams and don't ignore any lumps. Screening mammograms are not as effective at that age, so pay attention to your breasts, do self-exams and don't assume a lump is benign. Breast cancer can happen in 18- to 30-year-olds and it tends to be a little more aggressive in younger people. Most lumps will be benign, but get it checked out.

There's still disagreement among medical groups over when to screen for breast cancer. What should we do?

It's mostly about risk and benefit. You have to determine what's right for you. Now, with three-dimensional mammograms, screening has gotten better, so it's in your best interest to get screened. Talk to your doctor, discuss your risk factors, find out what your insurance will cover — most will cover every other year.

You've been working on a breast cancer vaccine for 15 years. What's the latest?

We're involved in trials using a vaccine in early breast cancer patients. The vaccine is made from the patient's own immune cells and is designed to boost their immune response. We gave the vaccine to patients once a week for six weeks before surgery and in 30 percent of patients, the tumor disappeared before surgery and they remained cancer free for five years. We've done two trials now and the results suggest the vaccine may be preventive in one subtype of breast cancer. Our goal is to prevent a recurrence of the cancer.

Any final thoughts for women?

Continue screening as recommended by your physician, and if you're at higher than normal risk, get screened as early as possible. Treatments are becoming much more effective. There's a lot going on in breast cancer to help cure women.

Contact Irene Maher at [email protected]