Breast cancer is the most common cancer affecting American women, with more than 300,000 diagnosed each year. While breast cancer continues to be a top concern in women’s health, a positive development has been that more and more women are detecting it early, when it is most treatable.
Yale has long been a leading breast cancer research center, conducting studies tackling nearly every aspect of breast cancer diagnosis and treatment. Anees Chagpar, M.D., associate professor of surgery and director of the Breast Center – Smilow Cancer Hospital at Yale-New Haven, is the lead author of a groundbreaking breast cancer trial that took place at Yale, and was published last year in the New England Journal of Medicine. The SHAVE trial demonstrated that a surgery technique called cavity shaved margins, which removes extra tissue around the edge of the location in a breast where a tumor is removed, reduces the chance for additional surgery by half. This is a significant discovery: because cancer cells are not visible to the naked eye, 20 to 40 percent of breast cancer surgeries result in “positive margins” or cancer cells at the edge of the specimen, requiring an additional trip to the operating room to ensure that no cancer cells are left behind. As a result, the technique “has now been adopted at many centers all over the world as a new standard,” says Chagpar. An additional multicenter national study is currently ongoing to determine if cavity shaved margins will be successful in health care settings beyond Yale, including smaller private practices and community-based hospitals. “We anticipate that this will be the case,” says Chagpar. “but this will be the landmark study which proves it for a fact.”
One of the world’s first trials to examine immunotherapy as a treatment for breast cancer is also enrolling now at Yale. Immunotherapy is a novel way of treating cancer in which uses the body’s own immune system to attack cancer cells, and has shown considerable promise in treating melanoma and lung cancer. “Yale is very proud to be leading that charge in the breast cancer arena,” says Chagpar. The trial addresses a particularly aggressive form of breast cancer, called triple negative cancer, for which there are few other therapies that are effective. The trial is led by Lajos Pusztai, MD, professor of medicine and chief of breast medical oncology.
Yale is very proud to be leading that charge in the breast cancer arena.
Anees Chagpar, M.D.
Another study examines health disparities in the severity of breast cancer. “We know that African-American women tend to get more aggressive cancers that Caucasian women, but we don’t really know why,” says Chagpar. “Some researchers have thought this might have something to do with insulin resistance.” Insulin resistance can lead to diabetes, a condition common in African-Americans. In the study, which is currently enrolling, researchers examine blood samples and biopsy results from African-American and Caucasian women who have been diagnosed with breast cancer to compare the expression of insulin growth factor receptor, to further evaluate the role of this receptor in breast cancer disparities.
The studies above represent a few of many breast-cancer related clinical trials that are currently taking place at Yale. For more information, visit yalestudies.org.