Listen in or read the partial transcription below as Joshua Hawkins, MD, FACS, discusses the latest advancements in breast cancer treatment. 

Partial transcription:

Disclaimer: This podcast is for informational purposes only and is not intended to be used as personalized medical advice.

Cheryl Martin (Host): There's some good news in the fight against breast cancer. And here to discuss the latest changes in breast cancer treatment is Dr. Joshua Hawkins, a general surgeon here at Skagit Regional Health.

This is be Well with Skagit Regional Health. I'm Cheryl Martin. Dr. Hawkins, so glad to have you on to talk about advancements in breast cancer treatment. But first, I'd love for you to share what led you to specialize or have special interest in breast cancer surgery.

Dr. Joshua Hawkins: I became interested in breast cancer surgery in the first year or two of my practice as I discovered that doing breast cancer care allowed me to deliver a high patient impact to my patient population, in that the impact of doing cancer surgery is great and often curative and makes a fantastic both health and emotional impact on the patient.

Host: So, how would you say the field has changed since you began your practice?

Dr. Joshua Hawkins: This is an exciting time in breast cancer care because the care delivery has become much more specialized and personalized recently. So, 10 to 15 years ago, breast cancer care was much more algorithmic with fairly standard treatment patterns that were applied to broad patient groups. And over the past five years, there have been numerous advances leading from several publications that have allowed for great personalization of breast cancer care.

Host: Talk about those significant advancements in breast cancer treatment that we should know about today.

Dr. Joshua Hawkins: There are several important updates. And one of those is that not all patients require radiation treatment after lumpectomy surgery. And more and more patients are able to safely omit radiation therapy, and this is important for our patients as well as our referring providers for educating our patients that, if radiation therapy is a major concern about even seeking care for their cancer, that they need to know that not all patients require radiation anymore and can safely omit that based on current literature guidelines.

Host: And what are the factors determining that, those who can omit radiation treatment? Are there certain categories for that?

Dr. Joshua Hawkins: There are. And those categories have been expanding each year. But to start with, one of the larger studies demonstrated that in patients who were older than 65 years old and had a tumor that was three centimeters or smaller and was hormone receptor positive, and those patients received hormonal therapy in the adjuvant setting, meaning after surgery, that they had equivalent survival and equivalent rates of recurrence even when they omitted radiation therapy.

There have been several studies that have expanded upon that since then, including one that is ongoing and will likely be published later this year or next year, which extends that age category down to age 50, and that would be slightly smaller tumors, meaning two centimeters or smaller. And those who had a test after surgery called oncotype, which determines their likelihood of needing chemotherapy, if their oncotype score was less than 18 and they met those other criteria, that they could safely omit radiation therapy.

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