Decades ago, doctors primarily relied on basic tests, such as checking for estrogen and progesterone receptors, to determine the best therapy for their breast cancer patients. Today, treatment is
tailored to their patients’ unique needs.
For those facing breast cancer, the path forward is increasingly tailored to their unique needs, their cancer’s biology and their own preferences. Today, thanks to advances in science and technology, treatment is entering a new era – one defined by personalization.
Personalized Breast Cancer Treatment: The New Era of Precision Medicine
For those facing breast cancer, the path forward is increasingly tailored to their unique needs, their cancer’s biology and their own preferences. Today, thanks to advances in science and technology, treatment is entering a new era – one defined by personalization.
Personalized, or precision, medicine in breast cancer has evolved rapidly. Decades ago, doctors primarily relied on basic tests, such as checking for estrogen and progesterone receptors, to determine the best therapy. While this approach continues to have a place in treatment planning, modern techniques enable physicians to analyze the genes and mutations within each patient’s tumor.
David M. Ellison, MD, senior partner at Charleston Oncology and a longtime leader at Roper St. Francis Cancer Care, explained that “Personalized treatment means categorizing breast cancer based on the tumor’s characteristics, its location, the patient’s age, medical history and individual preferences. Every treatment plan is uniquely tailored.”
By examining what are called “driver mutations” – the underlying genetic changes propelling cancer’s growth – oncologists can select drugs that target these specific pathways. This advancement not only improves effectiveness but often reduces unnecessary side effects.
Risk Assessment: Determining Who Needs What
Another cornerstone of personalized care is accurate risk assessment. In the past, most patients received similar adjuvant therapies – treatment given after primary treatment such as surgery to prevent cancer from returning. Now, risk is calculated using a range of information: tumor size, aggressiveness, involvement of lymph nodes, hormone receptor status, HER2 gene overexpression and advanced genomic tests like Oncotype DX and Mammaprint.
These tests analyze gene expression profiles to estimate the risk of recurrence and help determine whether treatments such as chemotherapy will offer real benefit. “For patients with lower genomic risk, we can often avoid chemotherapy and its side effects, focusing on what’s truly necessary,” Dr. Ellison said.
The result is an approach that minimizes overtreatment while aiming for the best possible outcome for each individual patient.
Managing Metastatic Disease: Customizing for Quality and Time
For those with metastatic breast cancer – when cancer has spread beyond the breast – personalized treatment is helping turn a once-dire prognosis into a more chronic, slower-progressing condition. By mapping the changing genetic makeup of their cancer, oncologists can adapt therapies over time, switching strategies as resistance develops.
Dr. Ellison explained: “We sequence treatments to adjust to cancer’s adaptations, with each therapy targeting a different mechanism. It’s about maximizing effectiveness and helping patients maintain a good quality of life for as long as possible.”
This ongoing, adaptive approach can keep the disease under control for years, sometimes more than a decade.
Clinical Trials: The Pathway to New Options
Many breakthroughs in personalized treatments have come from clinical trials, which continue to shape best practices. Trials investigate not only new drugs but also new ways to use existing ones – such as whether certain patients can safely skip chemotherapy or benefit from novel targeted therapies.
“Every treatment we use today was once part of a clinical trial,” said Dr. Ellison. This evidence-based approach ensures that patient care keeps improving, grounded firmly in scientific results.
“Charleston Oncology, and specifically Dr. Ellison, took a really personal approach to my treatment. I have a lot of comfort in knowing that their treatments are guided by the most up-to-date research and science, and I trust Dr. Ellison and his staff to always be offering me the best treatments that are out there.”
Oncologists’ treatment decisions are increasingly informed by genetic and molecular insights unique to each case. This means that therapies can be selected – and sometimes avoided – based on what science says is most likely to target each specific cancer and each specific patient and, therefore, will be highly personalized.
The Next Frontier: ctDNA and Beyond
Looking to the future, advances such as circulating tumor DNA (ctDNA) testing are poised to make breast cancer treatment even more precise. These blood tests can detect tiny fragments of cancer DNA in the bloodstream, potentially identifying cancer activity earlier and more accurately than traditional scans.
Such technology could soon help doctors determine with greater confidence who is truly cancer-free after surgery and who may need additional treatment, reducing unnecessary side effects for those already cured.
“Imagine detecting residual cancer or recurrence with a simple blood draw,” Dr. Ellison said. “While not yet standard, ctDNA testing is one of the most exciting developments on the horizon.”
For patients like Chelsea Oswald, PsyD, being able to receive these advanced treatments close to home makes all the difference. “My family has been incredible, and part of that community is my medical team that I rely on so much. To be able to get great care locally has been amazing and really vital for me because I have a husband and three young daughters.”
Diagnosed five years ago, Oswald remains on treatment today but has no evidence of cancer.
What It Means for Patients
Early detection still plays a critical role in breast cancer outcomes, with mammography remaining the gold standard. But as new tests emerge and technology advances, patients can look forward to care that is less invasive, more effective and more considerate of their long-term well-being.
Personalized breast cancer treatment is shaping a future where care fits the individual – not the other way around. With ongoing research, clinical trials and new technology on the horizon, each year brings better tools.
As Dr. Ellison put it, “We’re moving toward a world where every woman receives only the treatments that will truly help her – no more, no less. That’s the promise of personalized medicine, and it’s changing lives today.”
Charleston Oncology is part of a network of Roper St. Francis Cancer Care across the Lowcountry and is operated by Bon Secours St. Francis Hospital as an outpatient department of the hospital.
Charleston Oncology is part of a network of Roper St. Francis Cancer Care across the Lowcountry and is operated by Bon Secours St. Francis Hospital as an outpatient department of the hospital.
By Hunter H. Kerrison, MHA
