WEBVTT

NOTE duration: "00:04:53.120"


NOTE Confidence: 0.9923816

00:00:10.960 --> 00:00:12.320
There are many different treatments

NOTE Confidence: 0.9923816

00:00:12.320 --> 00:00:13.599
for breast cancer because breast

NOTE Confidence: 0.9923816

00:00:13.599 --> 00:00:15.285
cancer isn't one disease.

NOTE Confidence: 0.99840546

00:00:16.785 --> 00:00:17.845
When you have

NOTE Confidence: 0.989481

00:00:18.145 --> 00:00:20.145
many different subtypes of breast

NOTE Confidence: 0.989481

00:00:20.145 --> 00:00:21.904
cancer, they're not necessarily all

NOTE Confidence: 0.989481

00:00:21.904 --> 00:00:23.345
gonna respond to the same

NOTE Confidence: 0.989481

00:00:23.345 --> 00:00:23.845
treatment.

NOTE Confidence: 0.98342824

00:00:24.945 --> 00:00:26.085
And as

NOTE Confidence: 0.997507

00:00:26.465 --> 00:00:26.965
clinicians,

NOTE Confidence: 0.99953705

00:00:27.550 --> 00:00:29.170
our job is to

NOTE Confidence: 0.9916771

00:00:29.630 --> 00:00:31.230
work with people and try

NOTE Confidence: 0.9916771

00:00:31.230 --> 00:00:33.229
to help them arrive at

NOTE Confidence: 0.9916771

00:00:33.229 --> 00:00:35.390
the right treatment plan for

NOTE Confidence: 0.9916771

00:00:35.390 --> 00:00:37.329
the cancer and for them.

NOTE Confidence: 0.94791955

00:00:39.550 --> 00:00:41.229
We look at several different

NOTE Confidence: 0.94791955

00:00:41.229 --> 00:00:41.729
characteristics,

NOTE Confidence: 0.98503757

00:00:42.665 --> 00:00:45.565
including the expression of hormone

NOTE Confidence: 0.98503757

00:00:45.864 --> 00:00:46.364
receptors,

NOTE Confidence: 0.99360704

00:00:46.745 --> 00:00:48.905
things like estrogen receptor or

NOTE Confidence: 0.99360704

00:00:48.905 --> 00:00:50.125
progesterone receptors.

NOTE Confidence: 0.9962014

00:00:50.745 --> 00:00:52.265
There are breast cancers that

NOTE Confidence: 0.9962014

00:00:52.265 --> 00:00:54.045
are sensitive to female reproductive

NOTE Confidence: 0.9962014

00:00:54.265 --> 00:00:55.965
hormones. We call them estrogen

NOTE Confidence: 0.9962014

00:00:56.230 --> 00:00:57.610
receptor positive cancers.

NOTE Confidence: 0.9735058

00:00:58.150 --> 00:00:59.590
They're cancers that are not

NOTE Confidence: 0.9735058

00:00:59.590 --> 00:01:01.610
sensitive to those hormonal influences.

NOTE Confidence: 0.99095756

00:01:02.710 --> 00:01:05.130
When we treat any cancer,

NOTE Confidence: 0.9957015

00:01:05.430 --> 00:01:07.050
we really have two goals.

NOTE Confidence: 0.96483505

00:01:07.510 --> 00:01:08.630
We need to get local

NOTE Confidence: 0.96483505

00:01:08.630 --> 00:01:10.395
control where the cancer is,

NOTE Confidence: 0.96483505

00:01:10.555 --> 00:01:11.435
and we need to make

NOTE Confidence: 0.96483505

00:01:11.435 --> 00:01:13.115
sure there's systemic control so

NOTE Confidence: 0.96483505

00:01:13.115 --> 00:01:14.475
the cancer doesn't go elsewhere

NOTE Confidence: 0.96483505

00:01:14.475 --> 00:01:15.215
in the body.

NOTE Confidence: 0.90832645

00:01:16.395 --> 00:01:17.774
We wanna make sure

NOTE Confidence: 0.99946564

00:01:18.395 --> 00:01:18.895
that

NOTE Confidence: 0.960672

00:01:19.194 --> 00:01:20.015
that patient

NOTE Confidence: 0.9932633

00:01:20.875 --> 00:01:22.715
is treated and can go

NOTE Confidence: 0.9932633

00:01:22.715 --> 00:01:24.155
on and lead a normal

NOTE Confidence: 0.9932633

00:01:24.155 --> 00:01:24.655
life

NOTE Confidence: 0.9897358

00:01:25.049 --> 00:01:26.970
without problems from cancer and

NOTE Confidence: 0.9897358

00:01:26.970 --> 00:01:27.470
without

NOTE Confidence: 0.9935094

00:01:27.850 --> 00:01:29.450
challenges from side effects of

NOTE Confidence: 0.9935094

00:01:29.450 --> 00:01:30.670
the treatment we've given.

NOTE Confidence: 0.99818945

00:01:37.064 --> 00:01:38.284
Surgery and radiation

NOTE Confidence: 0.9979342

00:01:38.744 --> 00:01:39.564
are primarily

NOTE Confidence: 0.99980146

00:01:39.865 --> 00:01:40.365
given

NOTE Confidence: 0.9948035

00:01:40.905 --> 00:01:42.424
to control the cancer that

NOTE Confidence: 0.9948035

00:01:42.424 --> 00:01:44.024
is in the breast and

NOTE Confidence: 0.9948035

00:01:44.024 --> 00:01:45.784
to prevent any recurrence of

NOTE Confidence: 0.9948035

00:01:45.784 --> 00:01:46.524
the cancer.

NOTE Confidence: 0.98987156

00:01:47.145 --> 00:01:48.604
As we plan an operation,

NOTE Confidence: 0.98987156

00:01:48.744 --> 00:01:50.664
it's really specific for individual

NOTE Confidence: 0.98987156

00:01:50.664 --> 00:01:51.790
patients. We can do a

NOTE Confidence: 0.98987156

00:01:51.790 --> 00:01:53.710
mastectomy and remove the entire

NOTE Confidence: 0.98987156

00:01:53.710 --> 00:01:54.990
breast, or we can do

NOTE Confidence: 0.98987156

00:01:54.990 --> 00:01:55.810
breast conservation,

NOTE Confidence: 0.9789117

00:01:56.110 --> 00:01:57.310
which is removing the area

NOTE Confidence: 0.9789117

00:01:57.310 --> 00:01:58.430
where the cancer is with

NOTE Confidence: 0.9789117

00:01:58.430 --> 00:02:00.190
a clear margin followed by

NOTE Confidence: 0.9789117

00:02:00.190 --> 00:02:01.250
radiation therapy.

NOTE Confidence: 0.99511385

00:02:02.190 --> 00:02:03.869
And when we treat breast

NOTE Confidence: 0.99511385

00:02:03.869 --> 00:02:04.369
cancer,

NOTE Confidence: 0.9848042

00:02:04.670 --> 00:02:06.030
not only do we have

NOTE Confidence: 0.9848042

00:02:06.030 --> 00:02:07.815
to use local therapies, which

NOTE Confidence: 0.9848042

00:02:07.815 --> 00:02:09.115
are surgery and radiation,

NOTE Confidence: 0.99473906

00:02:09.415 --> 00:02:11.275
we also use medical therapies.

NOTE Confidence: 0.92173374

00:02:17.014 --> 00:02:17.835
We give

NOTE Confidence: 0.9811579

00:02:18.375 --> 00:02:21.435
treatments like hormonal therapy, chemotherapy,

NOTE Confidence: 0.9987296

00:02:22.770 --> 00:02:23.510
and immunotherapy

NOTE Confidence: 0.9918269

00:02:24.209 --> 00:02:25.590
to prevent the cancer

NOTE Confidence: 0.9989176

00:02:25.970 --> 00:02:28.050
from showing up again in

NOTE Confidence: 0.9989176

00:02:28.050 --> 00:02:29.030
some other place.

NOTE Confidence: 0.9042848

00:02:29.810 --> 00:02:31.330
A newer class of drugs

NOTE Confidence: 0.9042848

00:02:31.330 --> 00:02:33.110
we call targeted therapies.

NOTE Confidence: 0.9822236

00:02:33.410 --> 00:02:35.090
These can be oral or

NOTE Confidence: 0.9822236

00:02:35.090 --> 00:02:35.590
intravenous,

NOTE Confidence: 0.99747723

00:02:35.935 --> 00:02:36.834
and they specifically

NOTE Confidence: 0.97761244

00:02:37.294 --> 00:02:39.614
go after a protein on

NOTE Confidence: 0.97761244

00:02:39.614 --> 00:02:41.375
the tumor cell and are

NOTE Confidence: 0.97761244

00:02:41.375 --> 00:02:42.514
much more selective

NOTE Confidence: 0.9946521

00:02:43.294 --> 00:02:44.915
than our traditional chemotherapy

NOTE Confidence: 0.95274293

00:02:45.215 --> 00:02:46.674
agents where they can be

NOTE Confidence: 0.95274293

00:02:46.814 --> 00:02:48.275
potentially more effective

NOTE Confidence: 0.8741979

00:02:48.575 --> 00:02:50.174
and in some cases have

NOTE Confidence: 0.8741979

00:02:50.174 --> 00:02:50.915
less toxicity.

NOTE Confidence: 0.96875364

00:02:52.069 --> 00:02:54.250
Immune therapy is very important,

NOTE Confidence: 0.96875364

00:02:54.549 --> 00:02:55.049
particularly

NOTE Confidence: 0.99295855

00:02:55.669 --> 00:02:57.349
what we call triple negative

NOTE Confidence: 0.99295855

00:02:57.349 --> 00:02:59.030
breast cancers. These are tumor

NOTE Confidence: 0.99295855

00:02:59.030 --> 00:03:00.409
types that are not driven

NOTE Confidence: 0.99295855

00:03:00.470 --> 00:03:01.370
by estrogen,

NOTE Confidence: 0.97848535

00:03:01.669 --> 00:03:02.169
progesterone,

NOTE Confidence: 0.9825867

00:03:02.470 --> 00:03:03.829
or HER2, and so they

NOTE Confidence: 0.9825867

00:03:03.829 --> 00:03:04.790
tend to be our most

NOTE Confidence: 0.9825867

00:03:04.790 --> 00:03:06.495
aggressive type of breast cancer,

NOTE Confidence: 0.9825867

00:03:06.495 --> 00:03:08.014
and they have been shown

NOTE Confidence: 0.9825867

00:03:08.014 --> 00:03:09.155
to benefit greatly

NOTE Confidence: 0.99897087

00:03:09.694 --> 00:03:11.535
from the combination of chemotherapy

NOTE Confidence: 0.99897087

00:03:11.535 --> 00:03:12.275
and immunotherapy.

NOTE Confidence: 0.98521835

00:03:18.430 --> 00:03:19.250
We often

NOTE Confidence: 0.9612094

00:03:19.550 --> 00:03:21.790
talk through patients in group

NOTE Confidence: 0.9612094

00:03:21.790 --> 00:03:23.489
settings called tumor boards

NOTE Confidence: 0.9839461

00:03:23.790 --> 00:03:25.069
to really come up with

NOTE Confidence: 0.9839461

00:03:25.069 --> 00:03:26.270
the best plan. We have

NOTE Confidence: 0.9839461

00:03:26.270 --> 00:03:27.410
a big multidisciplinary

NOTE Confidence: 0.996474

00:03:28.030 --> 00:03:29.730
team that's well coordinated

NOTE Confidence: 0.99216366

00:03:30.190 --> 00:03:32.209
and works across multiple sites.

NOTE Confidence: 0.9985156

00:03:33.534 --> 00:03:34.995
We're focused on

NOTE Confidence: 0.9985279

00:03:35.775 --> 00:03:36.275
providing

NOTE Confidence: 0.998985

00:03:36.735 --> 00:03:38.415
the very best care to

NOTE Confidence: 0.998985

00:03:38.415 --> 00:03:39.954
the patients we see today

NOTE Confidence: 0.9871182

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and trying to make that

NOTE Confidence: 0.9871182

00:03:42.415 --> 00:03:44.034
care better in the future

NOTE Confidence: 0.9871182

00:03:44.174 --> 00:03:45.390
by conducting research.

NOTE Confidence: 0.9863131

00:03:47.310 --> 00:03:48.430
We are all kind of

NOTE Confidence: 0.9863131

00:03:48.430 --> 00:03:50.130
practicing at the highest standard,

NOTE Confidence: 0.9863131

00:03:50.190 --> 00:03:51.470
and we all have access

NOTE Confidence: 0.9863131

00:03:51.470 --> 00:03:53.150
to the same opportunities to

NOTE Confidence: 0.9863131

00:03:53.150 --> 00:03:53.890
do research

NOTE Confidence: 0.9647075

00:03:54.350 --> 00:03:55.630
and then to enroll our

NOTE Confidence: 0.9647075

00:03:55.630 --> 00:03:57.650
patients in other research trials.

NOTE Confidence: 0.96657354

00:03:58.055 --> 00:03:59.575
This allows patients to have

NOTE Confidence: 0.96657354

00:03:59.575 --> 00:04:01.815
the latest access to both

NOTE Confidence: 0.96657354

00:04:01.815 --> 00:04:03.415
changes in standard of care

NOTE Confidence: 0.96657354

00:04:03.415 --> 00:04:04.615
as well as the latest

NOTE Confidence: 0.96657354

00:04:04.615 --> 00:04:06.075
in clinical trials,

NOTE Confidence: 0.9978682

00:04:06.535 --> 00:04:08.215
which are bringing forward the

NOTE Confidence: 0.9978682

00:04:08.215 --> 00:04:09.035
most exciting,

NOTE Confidence: 0.99967015

00:04:09.575 --> 00:04:11.755
evolving treatments for breast cancer.

NOTE Confidence: 0.9832885

00:04:13.640 --> 00:04:15.240
Our ways of treating breast

NOTE Confidence: 0.9832885

00:04:15.240 --> 00:04:17.000
cancer have changed over the

NOTE Confidence: 0.9832885

00:04:17.000 --> 00:04:17.500
years,

NOTE Confidence: 0.99877745

00:04:17.880 --> 00:04:19.720
and we now cure ninety

NOTE Confidence: 0.99877745

00:04:19.720 --> 00:04:21.080
percent of women with breast

NOTE Confidence: 0.99877745

00:04:21.080 --> 00:04:21.580
cancer.

NOTE Confidence: 0.9893073

00:04:22.360 --> 00:04:24.060
And science marches on.

NOTE Confidence: 0.99772674

00:04:24.680 --> 00:04:25.900
There are new medicines

NOTE Confidence: 0.9871342

00:04:26.354 --> 00:04:27.794
every year. There are new

NOTE Confidence: 0.9871342

00:04:27.794 --> 00:04:29.175
treatments every year.

NOTE Confidence: 0.9971733

00:04:30.194 --> 00:04:31.875
The vast majority of those

NOTE Confidence: 0.9971733

00:04:31.875 --> 00:04:33.255
women are cured today

NOTE Confidence: 0.9719435

00:04:33.634 --> 00:04:35.255
and go on and lead

NOTE Confidence: 0.998006

00:04:35.714 --> 00:04:37.974
totally normal lives afterwards.

NOTE Confidence: 0.9995755

00:04:39.060 --> 00:04:40.920
That's my hope for everyone

NOTE Confidence: 0.9990681

00:04:41.380 --> 00:04:42.600
in the future.