Once treatment ends, many breast cancer patients may struggle with fears about their cancer returning. Expert Dr. Daniel Silbiger explains how the healthcare team, a strong support system, ongoing follow-up care, and advances in monitoring can help patients manage these concerns. Dr. Silbiger also emphasizes that newer treatments are helping reduce the risk of recurrence and improve long-term outcomes.
Dr. Daniel Silbiger is a hematologist/oncologist at the Cleveland Clinic. Learn more about Dr. Silbiger.
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Transcript
Laura Beth Ezzell:
Elise asked, “I’ve been through treatment, and I’m worried about recurrence. How can I put my mind at ease, and are there ways to prevent a recurrence?”
Dr. Daniel Silbiger:
I think this is the importance of getting a really strong breast-dedicated team for a patient, having comfort in that surgeon, radiation doctor, medical oncologist. Because you need that confidence and trust in your team from the beginning to give you the best treatment to get the lowest, lowest, lowest chances of recurrence. I think that’s one of the foundations that I really feel is critical to the success for patients because that leads to the answer to this question is, we know that recurrence is the number one concern that patients have.
By using these newest and best options for patients, we are trying to lower that recurrence to as small a number as possible. I am never hiding from my patients I can never bring down that number to 0 percent. And that’s not to share with your audience to keep the anxiety high, but many of these newer facets of treatment, extending, for instance, in hormone-positive breast cancer, extending estrogen-blocking therapy longer, adding these medicines like Kisqali or Verzenio, changing some of these chemo strategies really have proven to lower the recurrences to as low as we have ever seen in these state. Triple-negative breast cancer, we’ve seen the best outcomes that we’ve ever seen. But the reality is that regardless, it’s having that team for you to reassure.
And if new issues come up, then we prepare accordingly. We order imaging to make sure that things are okay, to make sure we’re not seeing recurrences. We use the latest and greatest tools to monitor for that. I know one of the tools that people are talking about is circulating tumor DNA, it’s called ctDNA and whether to use these tests. They’re not ready, in my opinion, for prime time, but some folks are seeing these available commercially and wanting to order them. It’s a blood test to see if there’s any cancer cells remaining in the blood stream. The challenge is, we don’t know what to do yet with that information.
But I wanted to share that with your audience because there’s a lot out there right now, there are a lot of platforms out there. We do have ongoing studies available, and certainly on a trial it’s reasonable to look for those things. But that is something that I know that folks are looking at. But we just don’t know yet how to handle a positive result or, quite frankly, how to reassure with a negative result on those tests too.