As I think of this special day, I think of my grandmother who died of breast cancer  after a radical mastectomy when she was in her fifties  and of my mother, who underwent a mastectomy for a precancer when I was in college.

Today, we have lots of tools: surgery, radiation therapy, chemotherapy, and hormone therapy as well as newer, targeted therapies, like Herceptin, which is used to treat tumors that are HER2-positive. Most importantly, we’ve learned that not all tumors respond to the same therapies, and that we need to match the treatment to the cancer. For example, some women’s tumors respond to hormones but not to chemotherapy while others do better with chemotherapy.

Until recently, we had no good way to know which tumors were which. As a result, virtually all women with tumors over 2 cm or who had positive lymph nodes received chemotherapy. Those with hormone-sensitive tumors (ER+ and/or PR+) also received hormone therapy. Now, though, we have tests that can help determine which tumors need which treatments. Mammaprint is available mostly in Europe while Oncotype DX,  is done more in the United States.  It is used on tumors that are ER+, and the test is conducted on the slides that made the cancer diagnosis. By  measuring molecular patterns in the tumor, it can distinguish between two different kinds of ER+ breast cancer: one that does fine with hormones alone and doesn’t benefit from chemotherapy and another that benefits from chemotherapy. Early studies suggest that it also works in women with positive nodes, although the definitive research is still ongoing.

This test is not done automatically, and not all insurance covers it. But YOU can ask your doctor to have it done. One of my older friends was diagnosed with breast cancer and also had significant heart disease. She did not want to have chemotherapy, which can cause heart problems, but her oncologist was insisting on it. I told her about the test, and she turned out to have a tumor that did not respond to chemotherapy but did respond to hormone therapy. She is still doing well, and she is so grateful that she took the time to become informed. It’s important that every woman with ER+ breast cancer know that a test that can help her as she makes her way through the maze of breast cancer treatments and decisions is now available.  You can learn more about the test in this video, and we encourage you to pass the information on to friends and family members.

Matching treatments to tumors is a tremendous step forward in our ability to treat breast cancer. But as you know, for me, the end goal is not finding a cure but figuring out what causes breast cancer and how to prevent it once and for all.

That’s why this Mother’s Day, I’m honoring my grandmother, mother, and all the other women I know who have had breast cancer, by re-dedicating myself to my mission to end this disease—now. As part of that effort, I’m continuing to recruit every woman I meet for our Army of Women.  I’m also in training for the upcoming 4th Annual Love Walk/Run, which will be taking place in Pacific Palisades on Sunday, May 22. You don’t need to be a runner or a walker to come out and show your support for the Love Walk/Run. You just need to be someone who, like me, wants to go beyond a cure and end this disease.

I hope you take time to celebrate all the amazing mothers in your life on Mother’s Day this Sunday. And if you live near L.A., I hope you’ll come out and join us for the Walk/Run on Sunday, May 22. Because when you think about, there are really never enough days to honor our mothers and grandmothers.

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6 Responses to A Special Mother’s Day Message

  1. Dawn Ramari says:

    Concise, understandable synopsis of options… well written as always, Dr. Love. Here’s to having no reason for a walk or run for the cure and then having found the cause to prevent it from stealing away those we love.

    I know what it feels like to lose my grandmother to breast cancer in her 50s, and to watch my mom’s pain as she watched he die with the horrific effects of chemo back then.

    Grateful for doctors like you!

  2. Nan says:

    When the Oncotype DC was done on my tumor the only result I received was a rating on a scale of 1-100 showing whether I would benefit from chemo (yes – maybe – no) Has it improved? I was not impressed with the test nor the way of conveying results. I had micro mets in one sentinal node, with a small tumnor, ER PR +, HER-2 , so I was borderline anyway. I did not find the Oncotype DX helpful at all since the one score just put me in the “maybe” category. If it hasn’t changed, I would be careful of claiming it does more than it acatually does. I already had the ER, PR, HER2 ratings done anyway and I believe the Oncotype DX put those and 19(?) other readings in a formula/algorithm (proprietary) and gave you one score. Not only did I not find the score helpful, the intellectual property on the other (proteins? genes? genetic expressions – what do you call them?)was owned by them and not available to me. What if science came along and found another expression key to determining treatment? I found the whole experience unhelpful. (In spite of the fact that I had 2 long conversations with genomic health.) Pleae let me know what you think about my thoughts. I’d be so curious. Thanks for all you do. Nan

  3. Anne says:

    Like Nan, above, I also had the Oncogene study and was in the intermediate range. Since at least 1/3 of people are in this range, there are definite limitations with the test, and it is quite expensive unless insurance covers it. In my own case, I had completed the first 4 cycles of the dose-dense chemo, and had medical complications/problematic side-effects. Although I was in the intermediate range, the fact that I wasn’t in the high-risk range gave my oncologist and myself the courage to forgo the last four cycles of the chemo. That was six years ago, and I have not yet had a recurrence of my stage II B cancer. So I guess I am pleased to have had the test, even with the limited information that was obtained. For patients who are in the low-risk or high-risk ranges there are definite advantages.

  4. Michelle says:

    Thank you for this message at Mother’s Day. My supportive, terrific, and wonderful aunt died of breast cancer. I think of her often — and especially around the summertime.

    Thank you for all the great work that you do and I also want to help spread the word about The Army of Women.

  5. Pink Kitchen says:

    Thanks for this hopeful message. It’s a real-life, in-your-face reminder to cancer that we survivors are not just generic statistics. rather, we are unique and beautiful individuals.

  6. Anne smith says:

    I think the fact that a patient has to research on her own to find this information is disgusting. Anyone with cancer is scared and filled with fear. Filled with fear that we think our doctors are not giving us test and information we need for our survival. Excuse me but it’s the doctor’s job, that’s why we are paying an excessive amount of money for doctor visits. I would not be bragging about the inadequate job of my colleagues. Perhaps you are in a position to make this better for all breast cancer patients.

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