Optimised treatment improving breast cancer outcomes

Could a ‘less is more’ approach change breast cancer treatment in Australia? New clinical trials reveal promising results for patients.

It is a common myth that more treatment is always better when it comes to breast cancer.

New treatment research is investigating if a “less is more” approach could yield the same or better outcomes for some patients living with breast cancer.

What is optimised treatment for breast cancer?

Optimised treatment offers a more precise, personalised and comprehensive approach to breast cancer treatment compared to regular treatment.

By focusing on the individual patient’s unique cancer profile and overall wellbeing, optimised treatment aims to improve outcomes, reduce side effects and enhance the quality of life for breast cancer patients.

Medical oncologist and Breast Cancer Trials medical advisor Dr Nick Zdenkowski says optimised treatment is about getting patients with breast cancer the right amount of treatment.

“You want to give patients as much treatment as is necessary to give them the absolute best outcomes, but no more treatment than they need,” Dr Zdenkowski says.

The clinical trials being conducted at Breast Cancer Trials are working to find out which patients and cancer types may respond to less treatment.

How does this approach differ from previous treatment options?

Breast cancer treatment has previously taken a one-size-fits-all approach, with treatments chosen based on broader categories such as cancer stage and type, without detailed molecular profiling.

Dr Zdenkowski says optimised treatment, on the other hand, focuses on personalisation, precision and a multidisciplinary approach.

“It is tailored to the individual patient’s specific cancer characteristics, genetic profile and personal health, and uses genetic and molecular testing to identify specific mutations and markers, guiding the choice of therapies that are most likely to be effective for that particular patient,” he explains.

Dr Zdenkowski says the idea that more is better is a long-standing concept that doesn’t always work for everyone.

“It comes from the distant past when the diagnosis of breast cancer had a poorer prognosis for many people compared with today, (and) people would want to do absolutely everything that they could to prevent the cancer from returning, with less concern for the short- and long-term side effects,” he explains.

“We just wanted to give those patients the greatest likelihood of the cancer being cured.

“We now know more about some types of breast cancer, we have these different tests available, we have better pathology, and we have seen a substantial improvement in the outcomes that breast cancer patients achieve.”

What does optimised treatment look like for patients?

Optimised treatment for breast cancer differs from regular treatment in several key ways.

Historically, Dr Zdenkowski says, women with breast cancer were treated with radical mastectomies, which involved the removal of the entire breast, the skin and underlying muscle, as well as the lymph glands.

“Radical mastectomy has been replaced by less invasive procedures that offer better outcomes, fewer complications and improved quality of life for patients,” he says.

“Modern breast surgery focusses on removing cancer effectively while preserving as much of the breast’s appearance and function as possible, including reconstruction techniques where needed to give the best cosmetic results.”

How does optimised treatment improve outcomes for patients?

By using an optimised approach to determine the best treatment options, patients will be subject to less unnecessary treatment.

“Treatment of cancer causes a range of side effects that are suboptimal and can cause patients long-term issues,” Dr Zdenkowski says.

He says improved breast cancer treatments have increased survival rates, allowing patients to focus more on their long-term quality of life.

“Treatment can leave you with long-term fatigue, chemo fog and numbness in your fingers or toes, leaving you feeling as though you cannot participate in the workforce or support your family as well as you used to,” Dr Zdenkowski explains.

“By giving selected patients less treatment but with the same prognosis, we are allowing them a better quality of life and confidence in the treatment process.”

Can this approach work for all breast cancer patients?

Optimised treatment is about administering the right amount of treatment for each individual patient.

Breast Cancer Trials is investigating which patients and cancers may benefit from less treatment.

Not all patients will be able to receive less treatment, but Dr Zdenkowski says research into optimised treatment will also help to determine which cases need to be escalated.

There are some patients who need more or different treatments to those used now to minimise the risk of recurrence.

“People who have cancers that are aggressive and treatment resistant also benefit from the research into optimisation,” he adds.

Join Breast Cancer Trials on Wednesday, 12 June from 5-6:30pm (AEST) for a free online Q&A, where leading researchers and women with a history of breast cancer will discuss a ‘less is more’ approach to treatment.

To sign up, visit: Q&A Event – Is Less More: Rethinking Breast Cancer Treatment

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Written by Mackenzie Archer.