The earliest stages of breast cancer are usually discovered during a mammogram. Right now, the standard treatment when tumors are found is surgery, followed by radiation therapy and then hormone treatment. Some women who have a high risk of getting breast cancer even opt to have mastectomies - the surgical removal of one or both breasts - just to reduce their risk.
At Johns Hopkins Cancer Center in Baltimore, one oncologist has been studying a less radical approach.
"Since most cancers originate within the breasts and the cells that line the milk ducts within the breasts, can we possibly eliminate those dangerous cells, and by doing so, eliminate breast cancer?" asks Dr. Vared Sterns.
The idea is simple. Give a small concentration of a chemotherapy drug directly through the patient's nipple and into the milk ducts where cancer cells or even pre-cancerous cells are forming. The entire procedure takes about 30 minutes. In clinical trials, researchers found this technique was more effective and less toxic than the conventional practice of administering chemotherapy through the vein.
"What we found was that the concentration of the drug within the breast was very, very high, while the concentration of the drug within the blood system was very low," said Sterns.
With conventional chemotherapy, the opposite was true: Drugs administered through the vein concentrated in the blood system and but were less concentrated where they were most needed - in the breast. The clinical trials have been so promising that this type of treatment might eventually become the standard for patients with very early stages of breast cancer or those who are at risk of developing it.
"It is my hope that the treatment can be delivered in just your usual mammogram suite. This has been done in our study quite easily on an outpatient basis. It doesn't take very long. It's not painful," said Sterns.
She likens this procedure to a colonoscopy. If there's a polyp, the doctor removes it before it can become cancerous.
Dr. Sterns said researchers need to find out how much of the drug is needed and how often it should be administered to rid the breast of cancer. She estimates that work will take another 10 years. Then, if this procedure is as promising as it seems, it may become standard treatment for patients with early stage breast cancer.
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