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Ask The Expert Cancer Partner Content

Q&A: Precision medicine can be a boon when breast cancer spreads.

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What you need to know about precision therapy.

Julia Schaefer-Cutillo, MD

Q: Today, you hear a lot about the success of precision medicine in treating cancer. What is this?

A: When a patient’s cancer has spread to other parts of the body, surgery is typically not an option. For years, the most effective treatment for metastasized cancer has been chemotherapy – drugs designed to kill cancer’s rapidly dividing cells. But healthy cells that divide rapidly are also killed by it. For many patients, precision medicine (also called targeted medicine and personalized medicine) is a game-changer that lets a patient delay chemotherapy. (Chemo is usually needed at some point to treat metastasized cancer.) Here’s how it works: By identifying the specific mutations in the DNA of a patient’s cancer cells – the mutations causing the cancer to grow — we can use a drug that precisely targets these gene mutations but few other cells, minimizing side effects. Many such drugs are in pill form, saving the patient time and money.  More drugs are being developed all the time to target more cancer-causing genetic mutations.

Q: How can precision therapy help women with metastatic breast cancer? 

A: Let’s say a woman’s breast cancer has spread to her bone or liver. This is not necessarily curable – but it is treatable. With precision medicine, we can keep it under control without going straight to chemotherapy.  Chemotherapy is very effective and its side effects are manageable. However, precision drugs usually cause even fewer side effects. That allows patients whose cancer has spread to feel well enough to continue to work, to be with their family, and to enjoy a high quality of life.

Q: Who is a possible candidate for this approach?

A: Any person with breast cancer that has spread outside the breast. For example, a 40-year-old woman whose breast cancer has spread to her bone may not want or require chemotherapy. Now she may have more options.

Q: Is it complicated?

A: It’s not complicated at all. Your doctor orders a biopsy of the tumor and the tissue is processed in a lab. DNA is extracted from the cancer cells and analyzed. A target – a specific genetic mutation – is identified that may indicate special responsiveness to a certain drug. To the relief of women who have already undergone many biopsies for cancer, the analysis doesn’t require freshly biopsied tissue; it can be performed on tissue from a biopsy of a year ago or more, or a blood sample.

Q: How is Northern Westchester Hospital using personalized medicine with breast cancer patients?

A: Our patients with metastasized breast cancer are amazing – they work, have families, and don’t have time for cancer. Precision medicine lets us treat their cancer in a more individualized manner so they can do all those wonderful things. We use precision medicine to help them live longer and happier.

The care and safety of our community during the ongoing COVID-19 pandemic is Northern Westchester Hospital’s top priority. We have put maximum safety measures in place to prevent exposure to the coronavirus for anyone who comes to the Hospital for emergent or scheduled care.

Dr. Julia Schaefer-Cutillo
Medical Oncologist
Northern Westchester Hospital


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