SurvivorNet recently spoke with Dr. Harold Burstein, one of the pre-eminent voices in breast cancer care, about how a new era of treatment is reshaping outcomes for patients at every stage of disease. A breast oncologist at Dana-Farber Cancer Institute, Dr. Burstein says the field is in the midst of an “enormous trend” toward more effective—and often less intensive—therapies.
He points to the rapid emergence of new drug classes, including antibody-drug conjugates, immunotherapy, improved anti-estrogen therapies, and targeted treatments. While these advances remain critical for patients with metastatic breast cancer, many are now moving into early-stage treatment, helping patients do better earlier in their disease course.
At the same time, innovation is allowing clinicians to safely scale back care for patients with lower-risk disease. One major advance is the use of axillary ultrasound: when results are negative, many patients can now avoid lymph node surgery altogether. Radiation therapy has also been significantly shortened—from 25 treatments to as few as five in some cases. Tools like the Oncotype DX recurrence score further personalize care, meaning most patients with ER-positive breast cancer no longer need chemotherapy.
Together, these shifts reflect a more precise, patient-centered approach—dialing treatment up or down based on risk—while delivering therapies that are proving better than those of the past.