In October, we are surrounded by reminders of breast cancer. The often cited statistic is that one in eight women will get breast cancer at some point in their lives, but that actually is a misunderstanding.

If a woman lives to be 80, she has a 14 percent chance of contracting the disease. At 50, the chance is only about 2 percent. And when breast cancer is caught early, women have a more than 90 percent chance of surviving the disease.

We talked to Dr. Stefan Glück (pronounced Gluke), medical oncologist at the Braman Family Breast Cancer Institute at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, about the latest research and treatments.

Q: What do we know about breast cancer that we didn't know 10 years ago?

A: We much better know how to identify different subtypes of breast cancer. We always knew the size was important, and the lymph node numbers and whether it has spread. Now we know also whether the cancer is sensitive to estrogen and whether it has a feature that we call HER-2 (human epidermal growth factor receptor), which identifies the aggressiveness of the cancer. We also can subclassify breast cancers on a molecular level. There are five different cancers.

Q: Can you talk about the different types of breast cancer?

A: We look at the size of the cancer, the number of lymph nodes involved and the surgery. Those issues drive whether a woman will need radiation. Then the pathologist measures estrogen receptor, progesterone receptor and human epidermal growth receptor, the HER-2. The first two are good prognostic markers, whereas the HER-2 is a bad prognostic marker. If both good ones are positive, then it tends to be a less aggressive cancer and patients tend to do better over the years with fewer recurrences. The patient who has ER, PR negative breast cancer has many more recurrences, particularly in the first three to five years. The HER-2 doubles the recurrence rate if it is positive. The good news is we can counterbalance it with treatment. If a patient has an HER-2 positive breast cancer, we treat her with Herceptin. Herceptin is an immunotherapy because it's an antibody and you infuse it every three weeks for one year. It decreases the recurrences by half. Then you have the cancer that is negative for ER, PR and HER-2. We call it triple negative breast cancer. The only thing we can use is chemotherapy.

Q: What are some of the newer treatments?

A: I think that is the most exciting part of my job now. In this topic, we have made probably the most progress in the last 10 years. I am writing a review article that will be called, ``Is this the beginning of the end of chemotherapy?'' I believe it's the beginning, but not more. As we identified the estrogen receptor and the progesterone and the HER-2 receptors, we identified a dozen, if not two, similar molecule targets. As the scientists identified those, many scientists found compounds or monoclonal antibodies and patented those and sold them to companies. There are 600 such compounds under clinical evaluation. They target a very specific molecule within the cancer cell that is important for the cancer cell to survive. If one disturbs one such molecule, then the cancer cell usually dies. It's extremely promising, but it's only the beginning. Sometimes, instead of removing the cancer and then treating the patient, we treat the patient with medicine and then remove the cancer. The cancer will be easier to remove if it's smaller. The better the cancer shrinks, the better I know that the patient actually will be cured. Last, as cancer grows, some of the cells can shed off the primary cancer and go to the bloodstream or the lymph stream and circulate through the body and set down somewhere in the lung or the bone and produce metastases. If we treat the cancer early, before we even remove it, with systemic treatment, we avoid or reduce the chances of spread.

Q: What is the breast cancer gene?

A: Everybody has the gene. It's the mutation of the gene. In the average population about 3 to 4 percent have mutations of this gene. In Ashkenazi Jews and African Americans, it's up to 8 percent. If a person has the mutation of such a gene, it predisposes them to cancer. If a woman has such a mutation, BRCA1, her lifetime risk to get cancer will not be 14 percent, but it will be 80 percent. Even worse, her lifetime risk to have ovarian cancer is about 60 percent. Many of these women, particularly if they already have children, choose to have prophylactic ovariectomy or prophylactic bilateral mastectomy. Q: What are the drawbacks of mammograms as a screening tool and should women get them anyway?

A: We don't really have better methods. Ultrasound is not a good method for screening. If there is something unclear, to doublecheck, it's an outstanding method. MRI is a good alternative for patients whose mammograms are impossible to read. . . . For screening, unfortunately, we have nothing better than mammograms yet.

Health Q&A runs every other week.