Dr. Susan O'Connor
PHOTO COURTESY OF EASTERN MAINE MEDICAL CENTER
Dr. Susan O'Connor
Instead, "we'll be fixing things at the cellular level," said Dr. Susan O'Connor of Eastern Maine Medical Center Breast Surgical Specialists and medical director of the EMMC Breast and Osteoporosis Center.
"But I think in 10 to 15 years we'll be fixing the problem, not treating the side effects.
It seems way out there, but it's not."
Even in 2015, the amount of surgery required for breast cancer is much less than was once common.
"For a lot of women, we're doing less and less surgery," O'Connor
"Fifteen years ago, if you were going to do a lumpectomy, you needed to remove a lot of tissue around it."
A few years ago, that changed to just removing a couple millimeters of tissue around the tumor, the doctor said.
That's changed again to just removing the tumor, taking care to not cut across it.
"The pace of change has become more and more rapid," O'Connor
"So much I do now wasn't even known 21 years ago."
"I would say probably one of the biggest things that's changed is our ability to better assess people's risks for breast cancer," she
"There are certain people who are at an elevated risk for breast cancer."
Who is considered high risk?
If your mother had premenopausal breast cancer, if there have been multiple generations of breast cancer in a family or "bilateral breast cancers," meaning a family member had cancer in both breasts, which is rare, that person is considered to have an increased risk for breast cancer.
In addition, the breast cancer gene, which is called BRCA1, is a very strong predictor of ovarian cancer risk, O'Connor
Many women with mothers who get breast cancer later in life, at 70 years of age for example, think they're at higher risk for breast cancer, but they're really not, O'Connor
"For most women, it's an age-related disease process."
That said, the medical community is getting better at tracking genetic patterns in families, O'Connor
"We've identified just a huge series of lesser known mutations where there's an increased risk of breast cancer," she
"This technology to identify gene mutations is just exploding.
We've identified mutations we just don't know what to do with too."
Another hallmark of breast cancer treatment has been personalization.
"When I first came out of training there were limited options," O'Connor
"We're actually giving less chemotherapy now than we were 10 years ago because we're able to identify who will benefit from it," O'Connor
The survival rate for breast cancer is 96 percent, O'Connor
"It is the rare person that dies of breast cancer today," she
More advances in technology include reconstruction options for women after mastectomies.
said there are better implants that feel like real breasts and options, in certain cases, to transfer tissue - say from one part of the body to the chest.
"Certain people and it really depends on breast size and how droopy they are, there's a chance of keeping the nipples," O'Connor
"You don't undertake mastectomy lightly," O'Connor
"The sensation is pretty much gone.
It should only happen after significant discussion and counseling."
As an oncologist, O'Connor recommends yearly mammograms for every woman starting at age 40 and a yearly exam by a physician.
Breasts change over time and mammograms provide a record, letting providers see if there have been dramatic changes since the prior year.
"I would rather take out something that's quarter of an inch in size than 2 inches in size," O'Connor