Breast Cancer Awareness Month: Evolution in Breast Oncology

In recognition of October as Breast Cancer Awareness Month, Sarah Premji, MD, assistant director of Breast Cancer Research at Sarah Cannon Research Institute (SCRI), discusses recent advancements in the treatment landscape of breast cancer.

The field of breast oncology has undergone a profound transformation over the past few years, moving toward an era of unprecedented personalization in patient care. This evolution has been marked by substantial shifts in the treatment landscape, leading to a constantly expanding array of therapeutic options. This is a source of great excitement, not only for healthcare providers but, most importantly, for the patients who stand to benefit from these advancements.

A significant part of this progress stems from the development of targeted agents. These newer therapies are designed to specifically interfere with the molecular pathways that drive cancer growth and survival. Clinical data has demonstrated that the incorporation of these agents often leads to a marked improvement in median progression-free survival for patients. The increasing success of these targeted approaches highlights a broader, crucial understanding within the field: that tumor biology is paramount in determining both disease behavior and treatment strategy.

Breast cancer is now widely recognized not as a single disease but as a collection of distinct subtypes, each with its own unique biological characteristics and clinical trajectory. These biological differences—which include factors like receptor status (estrogen, progesterone, and HER2) and genetic mutations—dictate how the cancer will behave and how it will respond to specific treatments.

The research community is continually generating a wealth of new, exciting data on a diverse range of medications. These novel drugs are contributing in a profoundly meaningful way to extending patients' lifespans. As these therapeutic options multiply, the critical question for clinicians now becomes one of strategic implementation: How can these therapies be used most effectively for each individual patient? Moreover, there is a large pipeline of additional agents currently under development, promising even more choices in the near future.

The core philosophical shift centers on giving these powerful drugs in a "smart way." The goal is no longer simply to prolong life at any cost, but to integrate life extension with the crucial maintenance of quality of life. The contemporary approach to breast oncology recognizes that the duration of a patient's life must be balanced with its richness and comfort. Determining the optimal sequence, combination, and duration of systemic therapies—from chemotherapy and hormonal agents to immunotherapy and targeted drugs—is essential to achieving this balance, ensuring patients receive the maximum benefit with the minimum burden of side effects. This dual focus on survival and well-being is now considered a critical element of comprehensive breast cancer care.

Read the full interview with Dr Premji.