Join us tonight at 8 for a live Smart Talk:  Facing Cancer Together Community Forum on breast cancer.  We bring together survivors and medical experts to discuss the latest research and treatment for breast cancer.  Share your questions and comments with the panel on facebook or via email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Dr. Randall Oyer, an oncologist and medical director of the cancer program at our Facing Cancer Together partner, Lancaster General Health, will appear on the program.  He has a positive message about what a breast-cancer diagnosis means for women in our community.  "My hope is that there's a very clear path, there's good, tolerable treatment and we expect the person to be cured," he says.

Sixty years ago, Dr. Oyer would not have been quite so optimistic.  Back then, the most common treatment for breast cancer was mastectomy and the 10-year survival rate was just 25%.  Today, mastectomy is considered a last resort in a woman's fight against the disease.  The 10-year survival rate for breast-cancer patients is 80%.

"The turnaround is due to a number of things," Dr. Oyer explains.  "First, there is earlier detection.  Secondly, there's greater understanding of the biology of the disease -- a greater understanding of when we should treat it as a systemic disease.  And then, thirdly, there's an understanding that there are different subtypes of breast cancer and a different approach is needed for different people.  So, the treatment is more tailored."  Dr. Oyer also is medical director of the University of Pennsylvania Cancer Risk Evaluation Program.  He welcomes your questions tonight about breast and ovarian cancer genetics and hereditary links.

Geisinger Health System noted in a recent press mailing some of the key developments over the last 60 years that have enabled these strides in treatment:

-- Lumpectomy: Often referred to as partial mastectomy or breast-sparing surgery, a lumpectomy involves surgical removal of just the breast tumor and a small amount of surrounding healthy tissue.

-- Radiation therapy: By using high-powered beams of energy, radiation therapy is used to kill cancer cells. Advancements in radiation therapy allow doctors to target very small areas, which can limit side effects and damage to healthy tissue.

-- Chemotherapy: For some women, new cancer-killing drugs will significantly decrease the chance of recurrence and increase the chance for cure.

-- Hormone therapy: Some breast cancers tend to grow in the presence of hormones. Hormone-blocking medication is very well tolerated by patients and is very effective against those breast cancers.

-- Targeted drugs: New drug treatments can block specific proteins in the breast cancer, and stop the breast cancer's growth.

-- Breast Reconstruction: New reconstruction techniques provide excellent cosmetic results for patients who do not wish to save the breast.

-- Support Services: Stress-management professionals and healthy-living experts improve the quality of life and actually increase the chance of cure.

"The evolution of breast cancer treatment continues to provide both physicians and patients more options when developing the most appropriate and effective care plan for beating the disease," Dr. James Evans, a breast surgeon at Geisinger Health System, wrote. "Medical researchers have made incredible strides in recent decades, resulting in advanced knowledge of how breast cancer works and how it can be defeated – ultimately benefiting patients who are navigating the diagnosis."

Dr. Thomas Bauer, is a surgeon with WellSpan Surgical Oncology, another partner in our Facing Cancer Together initiative.  He will appear on our forum.  Dr. Bauer has spent the last 20 years focused on breast surgery and, according to WellSpan, "has been in the top ten percent of many of the national clinical trials which have changed how breast surgery is done today."

Dr. Bauer and his colleagues are working on a prospective study on the use of Magnetic Resonance Imaging (MRI) in planning to treat breast cancer.  "Between 10-20% of the time, the MRI changes what I thought I was going to do on the patient," Dr. Bauer reveals. "There's no question about it.  It finds lymph nodes that are positive.  We biopsy the lymph node.  We do the chemotherapy before the surgery rather than after.  It shrinks tumors.  We might think we have one tumor while the MRI shows two or three satellite tumors, so we do a wider incision.  We get clear margins the first time and we don't have to do further incisions.  It has absolutely changed the way I practice and I think it is going to pay for itself.  We're going to be able to prove that to the insurance companies."

Dr. Bauer takes great encouragement from the fact that the mortality rate for breast cancer declines each year.  The more information he can glean before going to surgery means fewer mistakes and a better outcome.  "My message to women is if somebody tells you you've got a spot on the mammogram, you want to have a needle biopsy.  You don't want somebody to cut it out," he advises.

There's also a greater understanding today of the need for a holistic approach to treatment, so-called integrated medicine.  "In the past, there was this idea that there were alternative medicines or complementary therapies," Dr. Oyer says. "It meant that patients were going to do vitamins or yoga and they weren't going to do chemotherapy or surgery or radiation.  And it got the name 'alternative.'  It speaks to a maturation of our understanding that we now call it integrated medicine because it should be integrated into a patient's total therapy."  Join the conversation tonight at 8.