The San Antonio Breast Cancer Symposium is energizing, educational and humbling. It is amazing to be around so many knowledgeable and dedicated people working to make a difference in the screening, treatment and prevention of breast cancer. Presentations here span the continuum from the basic science of using mouse models to better understand how tumor cells morph as they metastasize, to Phase 3 clinical trials trying to determine the most effective and least toxic neoadjuvant therapies, to poster sessions that review breast cancer epidemiology and outcomes in military and non-military populations here in the U.S.
The presentations are in English, but during the breaks it is like the Tower of Babel with many languages being spoken– and I marvel that these scientists are not only skilled in research but also able to describe their complex work to a large audience in a language that is not their mother tongue. I pale at the thought of giving a lecture about medical care in Swedish or Mandarin!
As a clinician with expertise in public health and a passion for evidence-based medicine and the appropriate use of screening technologies, I approach the lectures looking for information that can be applied in the clinical setting right now. On the one hand, I’ve realized that I need to be patient as much of what is being presented is in the early phase of study and that the clinical benefits will come in time. On the other hand, there are findings that may impact care in the more immediate setting such as doing a better job of including patient reported outcomes when evaluating a medical therapy, surgical procedure or radiation plan. There are also a number of Phase 3 studies (studies that involve large groups of people to confirm effectiveness and identify side effects) whose findings could be considered more immediately. As one of the presenters said, we have not yet found the Holy Grail – and in fact, the answer is more likely to be a whole bunch of grails. While not as thrilling as a new ‘silver bullet,’ the fact that we’re learning more about the complexity of tumors broadens the possibilities for successful treatment.
More later in the conference, and in the meantime I will continue to immerse myself in this feverishly intense feast of scientific advances.