John Fetting, a 30-year veteran of the Johns Hopkins faculty, readily discusses the dramatic changes in the treatment of breast cancer that have evolved during his tenure, such as how clinicians now choose a treatment protocol based on the biological characteristics of the cancer as opposed to a patient’s menopausal status. But he’s more interested in addressing what hasn’t yet happened in breast cancer prevention.
“We are not any closer to “actionable” prevention than when I started my career,” Dr. Fetting says.
He explains that while some risk factors have been identified, such as having a first pregnancy at or after age 30, they don’t represent someone at high risk. “Most women with these risk factors are not going to get breast cancer. Other than women who carry an inherited mutation, which increases risk, we just don’t have a good idea of who is at sufficient risk for breast cancer to drive action,” Dr. Fetting says.
It’s a reality he is not willing to accept.
“Now that we can sequence the breast cancer genome, we are identifying mutations which can be the targets for treatment. Why can’t we identify genetic changes in normal breast cells which indicate that these cells will develop breast cancer? If we could, we might be able to identify women at sufficient risk to merit intervention. We might also be able to reassure a lot of women who don’t possess these changes in their breasts that they are not at risk,” Dr. Fetting says.
That’s why, as he enters the final years of his career, Dr. Fetting is embarking on a fundraising crusade to support of breast cancer prevention research at Hopkins. The John Fetting Fund for Breast Cancer Prevention Research was initiated by one of his patient’s, Leslie Ries, and her husband, Tom. The five-year goal of the recently-initiated fund is $5 million dollars.
Encouraged by the field’s vastly increased understanding of the biology of breast cancer, Dr. Fetting expects these advancements to be successfully applied to prevention if the research is adequately supported. “There is strong support for research on cancer treatment. Support for prevention research is much harder to come by. Philanthropy can enable us to take advantage of the tremendous prevention opportunities presented to us by our rapidly increasing understanding of the breast cancer genome and epigenome,” he says.