An interview with Beth Baughman DuPree, MD, FACS, ABIHM
Because the biology of each patient’s tumor can be understood with genomic testing, the job description for doctors who treat breast cancer is now a little longer than it used to be. And that’s a good thing – for doctors and their patients, says Beth DuPree, M.D., a board-certified general surgeon who specializes in diseases of the breast.
Genomic testing has made it possible for Dr. DuPree and other breast cancer specialists to offer better, more individualized care, because of the sophisticated analysis the tests provide of each patient’s illness.
Before genomic testing, most patients got the same aggressive – and often destructive – chemotherapy treatment. That’s because physicians never knew if they were facing the worst-case scenario: a tumor “determined” to recur and kill.
We interviewed Dr. DuPree to tell us more about how this technology has changed her practice. Dr. DuPree is Medical Director of The Holy Redeemer Breast Health Program, in Southampton, Penn. and Adjunct Assistant professor of Surgery at The University of Pennsylvania.
A new study shows that the MammaPrint and BluePrint tests can accurately identify the four molecular subtypes of breast cancer, according to the journal Breast Cancer Research and Treatment. The different subtypes have received substantial public attention recently, with a major paper in the journal Nature and an article in the New York Times.
The study of 437 patients showed that MammaPrint and BluePrint, which are part of the Symphony panel of genomic breast cancer tests, correctly identified whether breast cancer patients had the Luminal A subtype of cancer, Luminal B subtype, basal-like cancer or Her2-enriched cancer. This is valuable information, because different subtypes respond better to different types of treatment, including preoperative chemotherapy.
For more information on molecular subtypes and treatment choices, see www.knowyourbreastcancer.com.
The recent news about actress Angelina Jolie getting a double mastectomy because of a genetic test result has sparked the public’s interest in advanced breast cancer assessment. But it may also have caused some confusion about the difference between genetic and genomic tests.
The first way the tests are different is that genetic tests take place BEFORE DIAGNOSIS and genomic tests are given AFTER DIAGNOSIS.
Women take genetic tests to assess the risk they have of getting breast cancer. In Jolie’s case, some of her closest female relatives had suffered breast or ovarian cancers. She used genetic testing to see if she had a defective BRCA gene that dramatically increases the risk for those diseases. The test was positive, meaning she had an 87% chance of developing breast cancer. She chose mastectomies to help prevent the disease.
Genomic tests analyze the genes in the tumor AFTER cancer has developed. They provide information about how aggressive the cancer is and which drugs will help keep the tumor from growing or spreading. For instance, the Symphony test panel will tell women if they can safely avoid chemotherapy and be treated in less toxic ways – for instance, with hormonal therapy alone — that will be just as effective for their genetic makeup. To learn more about the difference between genetic and genomic testing, click here.
If you should get breast cancer while your children are still young, how do you talk to them about it? What do you tell them about what you – and they – will experience as you go through the various phases of treatment?
Now there’s a book to help you with those conversations. Metu and Lee Learn about Breast Cancer, by board-certified breast surgeon Shenin Sachedina, M.D., explains surgery, chemotherapy, radiation therapy, and other relevant topics in language that children can understand.
Using characters such as Chemo Commando and Radiation Rod, the book was written to ease children’s fears by giving them accurate information that educates and empowers them. Thank you, Dr. Sachedina, for meeting this important need!
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