Breast cancer app misses mark on providing the latest treatment information

By: Alberto Montero, MD

October is breast cancer awareness month. According to the World Health Organization, breast cancer is the second most common cancer in the world and, excluding skin cancer, is the most common malignancy diagnosed in women ¹ . Clearly breast cancer is a major public health issue. Treatment of early stage breast cancer can be quite complex, and typically differs based on breast cancer subtype.

Many of these treatments can last for weeks to years. For example, radiation therapy typically is given daily Monday through Friday for 5-6 weeks, and anti-estrogen therapy is typically an oral medication given daily for 5-10 years. It is well known that good breast cancer outcomes rely on patients adhering to treatments recommended by their physicians.²

Due to these complexities, it is important for patients affected with breast cancer to be well informed and be able to successfully navigate visits with many different specialists and different treatments. This is what the Breast Cancer Treatment Planner hopes to accomplish. This app is designed first and foremost to help breast cancer patients navigate these complexities by providing a way to for them to organize all of these treatments and appointments in one location.

The heart of the Breast Cancer Treatment Planner is a calendar which keeps track of appointments, medications, and other activities which looks like this:

The pill reminder is particularly useful, and allows patients to enter an oral medication like tamoxifen which needs to be taken daily, and set a reminder.

While that treatment planning is the heart of this app, it does provide some basic information on breast cancer embedded within the application.

It also provides external links to the National Cancer Institute (NCI) website for additional information including links for clinical trials. Finally, the app does have a section for patients to track insurance claims and medical expenses which allows patients to store images like this.

Evidence Behind the App

While the information provided in the breast cancer section is technically accurate, it is somewhat antiquated; for example, it refers only to ductal and lobular breast cancer. No mention is made of the fact that there are at at least three primary breast cancer subtypes based on estrogen or progesterone receptor (ER/PR) and HER-2/neu expression: (1) hormone receptor positive breast cancer that are positive for ER and/or PR; (2) HER-2 positive breast cancer; and (3) triple negative breast cancer that is negative for expression of ER, PR, and HER-2/neu.³

This is critical for patients to understand since prognosis and treatment vary rather significantly between these subtypes. The use of the old morphologic descriptors of ductal or lobular are truly irrelevant in the current molecular era of oncology, and aren’t helpful to clearly explain the rationale for use of anti-estrogen therapies or anti-HER2 monoclonal antibody therapy. The treatment section provides very basic information with external links, however the links for surgery, radiation therapy, hormone therapy, chemotherapy, and targeted therapy all take you to a section on breast reconstruction on the NCI website. The calendar and notes sections are rather basic as well and don’t provide any more functionality than what any calendar or notes program provide.