WASHINGTONWithout even waiting for the research of
tomorrow, we could save tens or hundreds of thousand of lives if we
could apply 100% of what we know now about breast cancer diagnosis
and treatment, said Gabriel Hortobagyi, MD, chairman of Breast
Medical Oncology, M.D. Anderson Cancer Center. There is still a
persistent gap between what we have learned and its application into
clinical practice, simply because the translation of research into
clinical practice is very slow.
Dr. Hortobagyi spoke at a panel about priorities in breast cancer
treatment and research at the Susan G. Komen Breast Cancer
Foundations fourth annual research conference.
Although the benefits of a multidis-ciplinary approach seem
self-evident, he continued, it has taken several decades
to develop a truly multidisciplinary approach to diagnosis and
treatment. A multidisciplinary approach is important, he said,
not only for patient care but also for the direction in which
research is heading. It is important for all members of the breast
cancer team to interact fully and frequently so as to develop a
balanced research and care program.
Fellow panelist Nancy E. Davidson, MD, professor of oncology, Johns
Hopkins School of Medicine, agreed. I see a lot of interplay
between the laboratory and the clinic, she said. Many of
the questions we deal with in the lab are based on real clinical
problems we see in our patients every day.
Clifford Hudis, MD, chief, Breast Cancer Medicine Service, Memorial
Sloan-Kettering Cancer Center, said, What can we do to enhance
life now? We need to apply what we now know to all women, regardless
of their socioeconomic status. It is terrible that socioeconomic
status still predicts outcomes, when there is little evidence to show
that fundamental biology is different among women of different ethnic
and economic groups.
Dr. Hortobagyi said that the time has come to expend the political
effort needed to break down barriers to the optimal use of screening
mammograms. We have to emphasize our strengths and
accomplishments, he said, in the push for increased screening.
He added that developing useful biomarkers of early disease
might lead us to earlier diagnoses at little risk and
toxicity. Another avenue for improving current treatment, he
said, lies in combining treatment modalities.
Dr. Davidson reminded the audience that information about new
therapies and prevention strategies must be disseminated to do any
good. We need to educate both health care providers and
consumers if we are going to take what we know and apply it to
Susan Braun, president and CEO of the Komen Foundation, said that the
organization has sponsored an imaging grants program to look at early
detection and is looking at ways to overcome barriers to inclusion in
The Foundation is a member of a cancer advocacy consortium that is
working with insurers and federal officials to obtain third-party
reimbursement for treatment in clinical trials. Ms. Braun said that
the consortium is negotiating for appropriate regulation or