MBCC Embraces Revolution in Breast Cancer Care

Patrick I. Borgen, MD

The landscape of breast cancer care is shifting rapidly, but that doesn’t worry the organizers of the 32nd Annual Miami Breast Cancer Conference.®

In fact, they are more than up to the task, because that’s what this dynamic meeting is all about: delivering the most up-to-date insights on the real-world challenges clinicians encounter every day in their practices.

“There has never been a more exciting or challenging time to be involved with breast cancer,” said Program Chair Patrick I. Borgen, MD.

“When we think about where we were 10 years ago—with a monolithic, one-size-fits-all approach to breast cancer—those days are over,” he continued. “Breast cancer is not a single disease, but a large family of diseases,” and bringing a team approach to this new era of personalized medicine is “really what Miami is all about in 2015.”

The Miami Breast Cancer Conference faculty includes 25 experts in the field of breast cancer, and importantly, said Borgen, they represent all types of specialists involved in breast cancer care: not only surgical, medical, and radiation oncologists, but also experts in genetics, plastic surgery, pathology, and social work. “This really is a team sport. If we’re going to get this right for our patients, it’s really about the team and not the iconic superstar of the past.”

Borgen, chairman of the Department of Surgery at Maimonides Hospital and director of the Brooklyn Breast Cancer Program, has been coming to the Miami Breast Cancer Conference since its earliest years and joined on as a faculty member in 1992. He said that “there was always a reason to come back,” with the meeting’s trifecta of quality speakers, breadth of perspectives, and concise format of short, focused talks.

“Each speaker has 15 minutes to make their point,” said Borgen. That was revolutionary when Daniel Osman, MD, [the meeting’s founder and chair for three decades], came up with the idea, and we have stuck with that format.”

“That’s what the audience wants. They are busy, in-the-trenches, practicing doctors who, while certainly interested in the basic science, really want information that they can hear on Friday and use on Monday, and our case-based format really helps us to achieve that goal.”

Challenging Cases, Robust Debate

At last year’s Miami Breast Cancer Conference, organizers introduced a tumor board format. Borgen said that this format is especially suited to the conference’s practical focus and was well received last year. “Tumor boards are how we learn at our hospitals back home, and they’re how we manage our patients.”

The organizers have put together about 90 clinical thumbnail sketches, featuring actual patients with actual problems, asking attendees: “What would you do, what would your next move be?” before and after the session. Borgen said that last year it was gratifying to see a number of times when the speaker “moved the needle” based on the audience responses.

Also returning this year are two Medical Crossfire exchanges that Borgen will be moderating. The question, “Will we ever cure metastatic breast cancer?” will be debated, featuring “two giants in the field,” said Borgen: George W. Sledge, Jr, MD, and Clifford A. Hudis, MD.

Borgen will moderate a debate between Miami Breast Cancer Conference program director J. Michael Dixon, MD, and Pat Whitworth, MD, on whether genetic susceptibility panel testing is ready to be used in clinical practice. He anticipates a very exciting debate on this topic, noting that although there has been an explosion in testing options that go well beyond BRCA, “what do we do with this information?”

Along with these practice-changing developments in genomics, this year’s meeting will also spotlight what Borgen describes as “the holy grail” in the field of breast cancer: harnessing the ability to turn a woman’s immune system against her breast cancer. Elizabeth A. Mittendorf, MD, PhD, will be updating conference attendees on vaccines being tested in the breast cancer setting and other immunotherapy strategies on Saturday.

New to the conference this year are two sunrise sessions developed in response to attendee feedback showing a lot of interest in what Borgen described as “How I Do It” sessions. At 6:45 AM on Saturday, Dixon will be hosting a video-based surgery review, and at 7 AM on Sunday, Deanna J. Attai, MD, breast surgeon and co-chair of the groundbreaking #BCSM weekly tweet chats, will offer oncologists a primer on how they can become actively—and positively—involved in social media.

Conference attendees have an avenue this year to share their own cases through a new interactive platform whereby audience members are encouraged to submit their own cases and questions. They can be emailed to cases@gotoper.com, and a panel of experts will review them prior to a case discussion at 10:20 AM Sunday.

A Focus on the Patient Experience

“At the end of the day,” said Borgen, “it’s all about the patient. How will our patients benefit from what we learn at these meetings?” Thus, this year’s conference will feature a number of talks around that theme, including four sessions on innovative approaches to pain management.

Attendees also will hear a firsthand account of breast cancer from the patient’s viewpoint at Saturday morning’s keynote address, which will feature award-winning journalist, beloved television host, and health advocate Joan Lunden, who is currently receiving treatment for triple-negative breast cancer. Lunden will be speaking about the perspective of a patient with cancer from the insight of her own personal journey as well as through the voices of hundreds of women who write to her each day.

“Joan has been a heroic and courageous breast cancer patient,” said Borgen. “She is still receiving chemotherapy, and she has been very public about what it’s like and what women can expect. I think it’s made a huge difference, and we have a lot to learn from her experience.”

Lunden will also provide insight into the breast cancer screening debate, particularly for women like her who have dense breasts, having had her own breast cancer discovered through an ultrasound following a normal mammogram. Borgen noted that mammograms miss approximately 15% of breast cancers. Controversy around breast screening persists, making it another one of the meeting’s “hot topics.”

Always Looking Forward

Conference organizers continue to be impressed by the research shared by young investigators, and their work will be on display again this year. “Last year, we had over 60 posters,” Borgen said. “These posters stimulate a lot of debate and conversation, and we’re really excited that we’re attracting the next generation of doctors to Miami.

“There’s a real feeling of family and camaraderie at this conference,” he added. “We’re all on the same team, fighting the same enemy.”

Borgen said that, compared with other solid tumors, “there is nothing that is even close to breast cancer in our depth of understanding of the disease. Yet each time we peel back a layer, we discover five more.”

Still, he added, “it is a good problem to have.”

“Treatments are less toxic, outcomes are certainly getting better, imaging is better,” and there are an abundance of new agents in the development pipeline. “There is a lot to be excited about.”

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