Today’s Breast Cancer Treatment Can Be Highly Personalized
Breast cancer is the most commonly diagnosed cancer for women in the United States. Because of its high rate of incidence, it is also the most widely researched. While a breast cancer diagnosis is never expected news, the abundance of knowledge surrounding the diseases combined with advances in treatment is helping millions of women survive—and thrive. Veronica Shim, M.D., a breast surgeon at Kaiser Permanente, is helping patients in their cancer battles. She has expertise in high-risk breast and ovarian cancers and is a leader in access and care delivery innovation.
How does your practice differ from other physicians?
I am a fellowship trained breast surgeon with a highly specialized focus on hereditary breast cancer syndrome and breast cancer care. I work with a multidisciplinary team of other specialists dedicated to breast care. This collaborative approach allows us to delve deeply into one disease type and provide our patients with comprehensive and personalized care.
We have a multidisciplinary clinic specifically dedicated to hereditary forms of breast and ovarian cancers and another multidisciplinary clinic for breast cancer.
We bring all members of the team together in both of these clinics—imaging specialists, pathologists, gynecologists, breast surgical oncologists, oncologists, radiation oncologists, plastic surgeons, as well as cancer genetic counselors—for an initial discussion on how best to treat each patient. We give our patients the option of participating in this collaborative, team approach which helps us as a team to provide a continuum of treatment–from risk reduction, diagnosis, treatment, to survivorship.
How has breast cancer treatment changed in the past decade?
Information changes daily—this is why you need a specialist. Today, we have much better tools—like the Oncotype DX breast cancer assay system—to personalize the treatment for patients. These tools help us in the shared decision making process. In the old days if the tumor was greater than 1cm, a patient was automatically prescribed chemotherapy treatment. This “one size fits all approach” is outdated.
Our knowledge about tumor biology is much more advanced. New tools allow us to personalize and tailor treatment based on a patient’s tumor type. Although each treatment modality gives an incremental benefit to the overall survival benefit, we now have very specific data about the individual, allowing us to identify those who need aggressive treatment with a much higher percentage of survivorship.
We can finally say that for most of our breast cancer patients, it is a chronic disease allowing us to focus more on decreasing the side effects from their breast cancer treatment.
What should someone do if they think they have breast cancer?
What’s hard about breast cancer is patient’s have so many options—not just mastectomy—or lumpectomy. It’s imperative to seek out a clinician who is not only knowledgeable, but who you feel comfortable working with—and whose treatment plan is supported by data.
What are some common misconceptions about breast cancer and breast cancer surgery?
Initially, a lot of patients are driven by fear, and that they’re going to die. After addressing the emotional fear, we need to get the facts. We all share and participate in the decision making process—the patients and clinicians—to maximize the effectiveness of treatment and minimize fear. Together, we decide what is the right approach for each patient.
Is there anything else you’d like to add?
It’s my honor to work with our patients and become a partner in their journey.
Kaiser Permanente, kp.org