"You've got breast cancer."
More than 3,500 women in Alberta will hear those words each year.
It's a scary diagnosis, and the treatments - surgery, radiation, hormone, genetic or chemotherapy - are no picnic.
But the truth is breast cancer has one of the highest survival rates of any type of cancer, and it's improving all the time, thanks in part to research underway at the University of Alberta.
Alberta currently has 73 active breast cancer clinical trials, many led by U of A faculty from across the College of Health Sciences, the Cancer Research Institute of Northern Alberta and the Cross Cancer Institute.
From identifying the best foods to eat while fighting breast cancer, to targeting mammary gland proteins that misfire, improving techniques for diagnosing breast cancer, and optimizing therapy after treatment, U of A breakthroughs are improving outcomes and quality of life for breast cancer patients.
In honour of Breast Cancer Awareness Month in Canada, here are six more U of A breast cancer innovations to know about.
Prescribing exercise
Groundbreaking U of A-led research shows that movement is medicine for colon cancer patients - not just helping them feel better through treatments like chemotherapy and radiation, but actually making those treatments more effective and reducing the chances of the cancer coming back.
Work is underway to extend those benefits to breast cancer patients, no matter where they live.
Dr. Myriam Filion, who recently got her PhD from the Faculty of Kinesiology, Sport and Recreation, conducted research out of the U of A's Exercise Oncology Research Laboratory and found that while rural patients understand the benefits of exercise after diagnosis, they need guidance to get started and stick with it.
Filion is now doing post-doctoral research with the Department of Surgery and continues to focus on how to use digital technology to bridge the gap for cancer patients. She will now use the BE-FIT app developed by the U of A's Dr. Rachel Khadaroo to study how to better integrate into breast cancer care, including around the time of surgery.
Is radiation enough?
When a woman is diagnosed with early-stage breast cancer, the primary treatment is breast-conserving surgery, also known as a "lumpectomy." Patients are often also offered subsequent "adjuvant" treatment with hormones and radiation as a way to ensure the cancer doesn't come back.
Many women worry about toxic side-effects from hormone therapy, so they choose radiation alone. A U of A team set out to discover whether those low-risk patients could expect positive results from that choice.
Dr. Kurian Joseph, radiation oncologist and associate professor of oncology, led a population-based study showing that adjuvant radiation therapy, hormone therapy or a combination of both resulted in a statistically significant improvement in overall survival compared with surgery alone.
Just one surgery
Oncoplastic surgery is becoming increasingly available to Alberta breast cancer patients. The approach allows general surgeons to remove tumours and immediately do whatever reconstruction might be needed, so patients only need to go into surgery once.
Leading this transformation is the Alberta Breast Surgical Oncology group, a team of U of A clinicians and researchers who are conducting trials and evaluating outcomes with the goal of minimizing cosmetic defects, ensuring clearer margins and lowering recurrence rates.
Lessening pain
Post-mastectomy pain syndrome affects one in three breast cancer survivors, according to the Canadian Breast Cancer Network. Persistent pain is defined as pain that lasts more than three months after surgery. One proposed solution is to give patients a local anesthetic called lidocaine, delivered at the same time they are given general anesthetic right before surgery begins.
Dr. Simone Derzi, associate professor of anesthesiology and pain management, is helping to carry out a multicentre, randomized, placebo-controlled trial of 1,602 patients undergoing breast cancer surgery, led by the University of Toronto.
The hope is to show this inexpensive, widely available and easily administered intervention reduces pain and suffering, decreases the costs of chronic pain management, cuts down on opioid use and improves quality of life for patients after surgery.
Avoiding lymphedema
Patient recruitment is now underway in Edmonton for a study looking at the best way to diagnose and remove cancer when it has spread from the breast to the lymph nodes in the armpit.
General surgery resident Dr. Heidi Joyce is doing her MSc in clinical epidemiology in the School of Public Health, and is studying how different approaches to axillary lymph node surgery - targeted dissection of just some nodes, sentinel lymph node biopsy, and axillary node dissection - removing 10 or more possibly affected nodes - affect patients with early-stage breast cancer.
The results will affect the future of cancer care, finding the best balance between effective treatment and minimizing complications such as lymphedema, a painful and chronic swelling of the arm.
This research complements work supported by the U of A's new Dianne and Irving Kipnes Health Research Institute to bridge the gap between scientific discoveries and health outcomes for lymphedema patients.
Implementing new technology
Under the direction of Dr. Lashan Peiris, assistant professor of general surgery, a new technology called "Magtrace" will now be used in advance of breast cancer surgeries to identify the location of the tumour. It's a magnetic, non-radioactive "seed" that is placed in breast tissue days or weeks before lumpectomy surgery to replace uncomfortable hook-wires. The same technology can also be used for sentinel lymph node biopsy, thereby avoiding the need for nuclear medicine injections within the 24 hours prior to surgery.
The surgeons expect implementation of the new technology to increase operating room efficiency, improve workflow through the operating room, and lessen strain on patients.
