The announcement from Julia Louis-Dreyfus that she has been diagnosed with breast cancer came with both a revelation and a warning. Her tweet revealing her diagnosis also contained some important reminders: that breast cancer is the most common type of cancer among women in the U.S., affecting 1 in 8 over their lifetime, and that while the disease does not discriminate, screening and treatment strategies, especially in the U.S., often do.
A cancer diagnosis is one of the most personal
experiences a woman can go through. Yet the
strategies that doctors have used for detecting
and treating the disease are only just beginning
to be optimized for individual women. It wasn’t
until 2009, for example, that recommendations
for breast-cancer screening with mammograms
were changed from ones that broadly called for
most women over 40 to get tested every year. Now
most expert groups agree that women should start
getting mammograms at age 45 or 50, repeating the
process about every other year. The exact schedule
should be determined after women and their
doctors consider risk factors like family history
and smoking habits. It became clear that screening
advice needed to become more personalized after
data failed to show that the previous guidelines
led to fewer breast-cancer deaths or even helped
women live longer with the disease. Broader
screening, it turned out, often contributed to a high
rate of false-positive readings, which prompted
many women to get unnecessary testing and
biopsies that came with serious complications. It
simply doesn’t make sense to apply the same advice
to all women about when and how often they
should get mammograms, when the risk for breast
cancer varies depending on who the woman is.
Treatments and cancer care are also becoming
more bespoke, reflecting what doctors are learning
about who benefits, and who doesn’t, from certain
therapies. Women now have more information
about their disease—down to the very DNA of
their tumors—than ever before, so they can make
more informed decisions about how aggressively
they want to be treated. Scientists also have an
evolving understanding of how women can better
endure treatment with fewer side effects—and they
have plenty of options to do so, from getting more
sleep to practicing yoga or eating healthfully. As
breast-cancer care gets more personal, women are
becoming empowered to make better decisions,
and research is even revealing what they should
know about the potential biases of the doctors who
treat them. A breast-cancer diagnosis is still a lifechanging
journey. But now women have more of the
custom tools they need to effectively navigate it.
Read more > An Individual Approach to Breast Cancer
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