Breast Cancer: Same Diagnosis, Different Treatments

KUALA LUMPUR, Oct 21 (Bernama) -- Nearly half of breast cancer cases in Malaysia are detected at Stages 3 and 4, raising concerns among patients about treatment options, the need for surgery and their chances of survival.

Sunway Medical Centre, Sunway City (SMC) clinical oncologist Dr Nisha Shariff said advances in understanding cancer biology and diagnostic testing had enabled doctors to tailor treatment to the specific cancer subtype and individual patient profile.

She said breast cancer comprises several subtypes that respond differently to treatment, depending on the tumour’s biological characteristics.

“Some breast cancers are hormone-driven, while others produce excessive amounts of HER2 protein, which promotes cancer cell growth. Others lack both markers and are known as triple-negative breast cancer,” she said in a statement.

Explaining personalised treatment, Dr Nisha said two patients in their 50s with tumours of the same size and positive hormone receptor status could require different treatment plans depending on the biological characteristics of their cancers.

For example, a patient with hormone receptor-positive, HER2-negative breast cancer might undergo a combination of surgery, radiotherapy and endocrine therapy, depending on the disease stage and other clinical factors.

By contrast, a patient with HER2-positive breast cancer might require a combination of chemotherapy and HER2-targeted therapy, depending on clinical suitability.

“Cases that appear similar on paper can respond differently to treatment. By understanding what drives cancer growth, we can determine the most appropriate treatment. We do not treat all breast cancers the same way, but tailor treatment to the cancer subtype and the patient’s circumstances,” Dr Nisha said.

She added that age, existing medical conditions, menopausal status and patient preferences were also considered when determining treatment plans.

Dr Nisha explained that the term “aggressive” refers to the rate at which cancer cells grow and divide, but does not necessarily indicate a poor prognosis.

Dr Nisha said triple-negative and HER2-positive breast cancers, for instance, can grow rapidly, but effective treatment options are available for both subtypes.

“In the past, HER2-positive breast cancer was often associated with a poorer prognosis. However, advances in targeted therapies have significantly improved treatment effectiveness and patient outcomes,” she said.

Genomic testing can also help doctors determine whether certain patients would benefit from chemotherapy, potentially reducing overtreatment, while advances in surgery and radiotherapy may help improve patients’ quality of life.

Dr Nisha said treatment approaches increasingly focused on selecting the most appropriate therapies while preserving patients’ quality of life after treatment.

Despite advances in treatment technology, she expressed concern that many women continued to delay mammogram screenings because of fears of pain, embarrassment or receiving bad news.

“Do not let fear prevent you from taking an important step towards protecting your health. Anxiety often stems from a lack of understanding. With the right knowledge, we can make decisions with greater confidence,” she said, while encouraging women who felt anxious about screening to seek support from family members or friends when attending appointments.

-- BERNAMA