Mayo Clinic's approach
Mayo Clinic's approach to precision medicine for breast cancer is built on:
A multidisciplinary team
The team approach is built into Mayo Clinic's structure. You will have a lead physician who coordinates your care with a team that may include internal medicine breast specialists from the Breast Clinic, medical oncologists, breast radiologists, radiation oncologists, surgeons (breast and plastic), psychologists, pathologists, laboratory professionals, nurse practitioners, physician assistants, nurses, genetic counselors, bioinformaticians, physical therapists, researchers, pharmacists and others.
An individualized approach
Your care team works with you to develop an individualized plan that meets your needs. They will talk with you about the possibility of genetic testing, which, along with your family medical history, laboratory tests and physical examination, may help your medical team understand how your cancer developed and how you might respond to various treatments. Genetic testing is useful in many ways, including:
- Avoiding ineffective hormonal therapy. Mayo Clinic researchers have identified a blood test that may indicate whether you will respond to the breast cancer drug tamoxifen. This precision approach enables doctors to prescribe another medication for patients who may not respond to tamoxifen.
- Sequencing the tumor. At Mayo Clinic tumor sequencing is increasingly used to select treatment for patients with breast cancer. For women whose treatment isn't working, this type of test can help explain why and indicate a drug that might work better. It involves doing a tumor biopsy, analyzing the tissue genetically and then basing a recommendation for treatment on the results of that analysis.
-
Tracking variants of uncertain significance. It's common for a genetic test result to indicate that a genetic mutation is a variant of uncertain significance (VUS). When this result is from a test done on the genes you're born, it doesn't indicate clearly whether you are at increased risk of cancer. Nor does it tell us if your body uses the medications in question correctly. When this result is from a test done on the cancer cells, it may reveal gene mutations for which we don't have specific drugs to attack the cancer.
Mayo Clinic is the first medical group in the world with an up-to-date registry on VUS results for the breast cancer genes BRCA1 and BRCA2. This registry helps Mayo Clinic researchers determine which VUS results cause diseases.
Genomics in everyday patient care
Because of its rich history of genomic research and its large clinical practice, Mayo Clinic is at the forefront of efforts to integrate precision medicine into clinical care. It is among the few major medical institutions to include pharmacogenomics data in its electronic medical record (EMR) system. In addition, the clinic has invested in a complete upgrade of its EMR system so that it's ready for the rapid expansion of precision medicine into routine medical care.
Familial Cancer Program
Mayo Clinic offers people with breast cancer the opportunity to participate in its Familial Cancer Program, which helps identify people at increased risk of breast cancer related to family history.
In this program, a team of doctors, genetic counselors and nurses evaluates individuals and their families to determine potential cancer risk. The team develops a customized cancer-screening plan for families who have increased risks of developing cancer. Consultations are offered to people who have been diagnosed with cancer and to family members who haven't had cancer.
Mayo Clinic in Rochester, Minnesota, Mayo Clinic in Jacksonville, Florida, and Mayo Clinic in Phoenix/Scottsdale, Arizona, are ranked among the Best Hospitals for cancer by U.S. News & World Report.
Expertise and rankings
Mayo Clinic is a leader in the emerging field of precision medicine. And breast cancer is among the first areas in which the clinic is making this approach available to patients.
Innovation and research
Mayo Clinic is making new options available to people at risk of breast cancer and those who have received a diagnosis of breast cancer. These advances are built on the clinic's rich history in advancing the science of using genomics to better predict, diagnose and treat disease. Mayo Clinic activities include:
- Launching a clinical trial for women with metastatic, estrogen receptor-positive cancer in which all participants receive tumor sequencing with interpretation.
- Identifying new DNA sequences associated with breast cancer, which is key to finding drugs that target cancer cells.
- Refining a panel of genes that likely play a role in the development of breast cancer, which may help doctors more accurately identify members of families who are at increased risk of breast cancer.
- Doing advanced (phase II) clinical trials of endoxifen, a drug developed by Mayo Clinic researchers to help people who don't respond to standard hormonal therapies, including aromatase inhibitors, fulvestrant and tamoxifen.
Nationally recognized expertise
Mayo Clinic has been chosen to serve as the nation's biobank for precision medicine. It will be the home of the National Precision Medicine Initiative Cohort Program Biobank, an NIH-funded biobank that will hold a research repository of biologic samples. The biobank will be a major force in advancing precision medicine and contributing to research and improved health care.
In addition, Mayo Clinic's precision medicine researchers joined Nobel Prize winners and other worldwide leaders as featured speakers at the 10th International Society for Applied Biological Sciences Conference. This conference is considered one of the most important events of the year in precision medicine.
Mayo Clinic's other leadership roles in precision medicine include:
Center for Individualized Medicine
The Mayo Clinic Center for Individualized Medicine explores and advances personalizing patient care through the application of genomic science and applying new therapies targeted to a person's genetic mutations.
The center hosts an annual genomics conference where international researchers and experts in the rapidly changing field of precision medicine share their discoveries.
Comprehensive cancer center
Mayo Clinic Comprehensive Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.
Mayo Clinic in Rochester, Minnesota, Mayo Clinic in Jacksonville, Florida, and Mayo Clinic in Phoenix/Scottsdale, Arizona, are ranked among the Best Hospitals for cancer by U.S. News & World Report.
Learn more about Mayo Clinic's precision medicine and cancer center expertise and rankings.