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NARRATOR: A small lump's often the first sign that something's not right. With breast cancer, this lump is just a bunch of cells that grow in a place they're not supposed to. Your body can normally spot cancerous cells like this, but some cancer cells can trick the immune system to pass them by, so they grow freely. Left unchecked, the irregular cells can break away and spread to other parts of your body to make new growths. When that happens, it's called metastatic breast cancer. Used to be, there were only three ways to fight cancer.

SANDRA GREGORY: Breast cancer was the domain of surgeons and breast cancer was treated predominantly with a radical mastectomy.

NARRATOR: You could cut it out with surgery, blast it with radiation, or minimize it with chemotherapy. But each of these methods was intrusive and often caused damage to healthy parts of the body. But now, that's changing.

SANDRA GREGORY: The future of breast cancer treatment is very exciting. We have a lot of new agents coming down the pike and we're very excited and very hopeful.

NARRATOR: And these new treatments are especially promising for women with metastatic breast cancer.

SANDRA GREGORY: The really hot area now for advanced breast cancer is definitely immunotherapy.

NARRATOR: Researchers wanted to find a way to use the body's immune system as a partner in crime to help wipe out cancer. They started by trying to understand how cancer gets around the body's warning system to avoid being attacked. Once they discovered that, they found ways to stop it. With immunotherapy, you can teach your own body how to fight against the cancer cells. So how does that work? Well, the immunotherapy instructs your T cells, who are the fighter pilots of your immune system, to attack specific cancer cells. And this allows your own immune system to help fight your cancer.

SANDRA GREGORY: Immunotherapies are often given as a second-line approach if a patient has metastatic disease and has a failure to more conventional chemotherapy. This is certainly the bright spot for the next 5 or 10 years in advanced breast cancer.

NARRATOR: Another mode of attack is through hormones. See, breast cancer can be fueled by different hormones; estrogen or progesterone. By testing the biomarkers of your cancer, they can use that information against it.

SANDRA GREGORY: Hormone therapy is excellent in the total comprehensive package towards treating advanced breast cancer. It's often an estrogen blocker, meaning it's a medication that gets into the estrogen receptors and blocks the estrogen receptors on the outside of the tumor cells. We also have anti-estrogen therapy to actually slow down the production of estrogen.

NARRATOR: So if the cancer cells are fueled by hormones, hormone therapy can effectively starve the cells to keep them from multiplying. With metastatic breast cancer, it's best to reach all parts of the body, any place cancer's spread. With targeted drug therapy, you can do that, but it used to be in the 1990s this type of cancer drug would damage or cause side effects in lots of cells throughout your body, even normal ones. But now, with biological advances, targeted cancer therapies can pinpoint the cancer cells more specifically without harming normal cells that are nearby.

SANDRA GREGORY: We're able to treat patients in shorter courses now than we used to, so their lifestyles are much more unaffected by treatment. They can continue with a very normal life. The future for patients with advanced breast cancer is so much more optimistic now than it was 30 or 40 years ago.

NARRATOR: Even classic treatments, like radiation therapy, have gotten better over time.

SANDRA GREGORY: It used to be that a lot of breast cancer patients had very stiff chest walls from radiation therapy, a lot of scar tissue. So we have very directed treatment now through computer spatial visualization, computer planning, so that patients don't have side effects the way they used to.

NARRATOR: Advancements in body imaging make it possible for radiation to be very tightly focused, resulting in far less scarring and damage to the surrounding tissue. Using these kinds of therapies has resulted in improved outcomes for patients, better quality of life, and fewer side effects.

SANDRA GREGORY: We're able to treat patients in shorter courses now than we used to. It used to be that a standard course of breast cancer took 6 weeks or 6 and 1/2 weeks. And now, we have large trials supporting treating patients over 2 or 3 weeks, so their lifestyles are much more unaffected by treatment.

NARRATOR: You no longer need to have the same generic treatment as everyone else, because your cancer isn't like everyone else's. No two cases are the same.

SANDRA GREGORY: The most tremendous gains in cancer research have to do with DNA sequencing.

NARRATOR: In future, thanks to the exciting work scientists have done in mapping the 140,000 genes of the human genome, precision medicine and personalized treatments will become more available to everyone.

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