Leading breast cancer expert Dr. Sheldon M. Feldman, chief of Breast Surgery and Breast Surgical Oncology at Montefiore Einstein, emphasizes the critical importance of personalized medicine in modern breast cancer management, highlighting how individualized approaches are revolutionizing patient care.
Understanding Breast Cancer Diversity
Breast cancer presents as a complex spectrum of diseases rather than a single condition, with variations in both staging and biological subtypes significantly impacting treatment decisions. These distinctions play a crucial role in determining prognosis and developing effective treatment strategies.
"Breast cancer is not a single disease," emphasizes Dr. Feldman. "The stages range from early to advanced, and each stage requires different treatment approaches."
Tailoring Treatment to Individual Profiles
Treatment planning has evolved to incorporate multiple factors, including:
- Cancer stage and subtype
- Patient age
- Reproductive history
- Concurrent health conditions
For younger patients with early-stage breast cancer, breast conservation surgery has emerged as a preferred option. This approach typically combines lumpectomy—a minimally invasive procedure that preserves most breast tissue—with adjuvant radiation therapy to minimize recurrence risk.
Age-Specific Treatment Modifications
Recent research has led to important age-based treatment modifications. Dr. Feldman notes that for women over 65-70 years, radiation therapy following lumpectomy may be unnecessary, as studies show minimal benefit in this age group. This finding has opened the door to non-radiation treatment options for eligible older patients.
Molecular Markers and Targeted Therapies
Treatment complexity varies significantly across tumor types, with molecular markers playing a decisive role in therapy selection. Hormone receptor status—including estrogen and progesterone receptors—determines the effectiveness of hormone-blocking therapies.
Approximately 25% of breast cancers exhibit HER2 overexpression, a genetic mutation historically associated with poor outcomes. However, Dr. Feldman highlights that targeted therapies, particularly monoclonal antibodies against HER2, have dramatically improved the prognosis for these patients.
"The diversity in cancer subtypes and stages underscores the necessity for personalized treatment plans that consider both cancer biology and individual patient factors," Dr. Feldman concludes, emphasizing the continuing evolution of precision medicine in breast cancer care.
