As Breast Cancer Care Evolves, Patient-Clinician Communication Is Essential

With an influx of advances in the breast cancer space, it is essential that patients and their caregivers stay up to date on the latest treatments, said Dr. Igor Makhlin, assistant professor of medicine at Penn Medicine.


“Speaking from somebody who’s had multiple family members go through cancer diagnoses, it’s a life-changing event. It’s extremely distressing,” Makhlin said. “Patients can often feel like they are losing control. Having clear communication with their oncology team, being up to date on advancements and really understanding the nature of their disease and the treatment options is empowering and helps patients regain a sense of control over the process. This can lead to better outcomes.”

Makhlin touched upon some of the updates that are happening in a variety of breast cancer subtypes, like updates in how clinicians are using oncotype score and specific patient characteristics to determine treatments for patients with early-stage breast cancer. Additionally, immunotherapy has been shown to reduce relapse risk in patients with early-stage triple-negative breast cancer (TNBC), while prolonging life in those with metastatic TNBC.

“We’ve also been seeing advancements in terms of how we design clinical trials and incorporating patient-reported outcomes, which has been great,” Makhlin said. “It’s been helping us understand not only how effective drugs are in terms of improving outcomes, but also how tolerable they are for patients and how they’re affecting quality of life, which is a much more patient-centered approach.”

Breast cancer advancements won’t stop there.

One area of focus, Makhlin said, is to prevent breast cancer from relapsing into metastatic disease, which is then incurable.

“We at Penn are leading several trials looking into this and looking into identifying patients who are especially high-risk, and (we’re) intervening after patients have received their standard of care treatment (with) additional investigational agents to help prevent the occurrence of metastatic disease,” he said.

Makhlin also said that he hopes to see the ongoing expansion of targeted treatments that are more specialized to each individual and also have fewer side effects. “It’s not a general chemotherapy approach anymore. It’s really targeting what is the critical feature of the patient’s breast cancer that is sensitive and dependent… things that we can target.”

Finally, Makhlin also explained that the use of immunotherapy in breast cancer will also, hopefully, continue to expand by the development of new drugs that can better activate the immune system to fight cancer in a safe way.

“It’s a really exciting time for breast cancer research and treatment,” Makhlin said. “I feel like we’re just at the tip of the iceberg for where we’re headed, which is more targeted therapy, less toxic therapy and hopefully much better outcomes in the near future.”

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