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    Prevention in Practice: Melanoma, Breast Cancer, and Beyond With Matthew Hadfield, DO, and Jasmin Hundal, MD, MS, MPH

    Expert Perspectives · Keira Smith · 2026-02-12

    Cancer prevention and early detection are among the most powerful tools in oncology. In this discussion in honor of National Cancer Prevention Month Dr. Jasmin Hundal, Hematology/Oncology Fellow at the Cleveland Clinic, and Dr. Matthew Hadfield, OncData Editor in Chief and Assistant Professor at Brown University, reflect on practical strategies for prevention across melanoma and breast cancer, as well as advances in multicancer early detection. Their conversation underscores the message adherence to evidence-based screening, risk factor modification, and thoughtful interpretation of emerging diagnostics are central to improving cancer outcomes.

    Melanoma: Early Detection Is Critical

    Melanoma is an example of a malignancy in which early detection can be curative. “When something’s stage I and you can resect it and there’s a very, very low chance of it coming back, that’s critical,” Dr. Hadfield notes. 

    Patient education remains foundational. Dr. Hadfield emphasized the ABCDE criteria for suspicious lesions: asymmetry, irregular borders, color variation, diameter ≥6 mm, and evolving features such as bleeding, itching, crusting, or growth. “If you look at something and you say, ‘I’m a little concerned about that,’ that’s the time to go talk to your primary care physician,” he said.

    Screening frequency should be risk-adapted. Patients with a history of melanoma require full-body skin exams every three to six months, while those with a family history should also undergo routine dermatologic surveillance. Importantly, melanoma can occur at any age.

    Prevention messaging remains straightforward but essential. “Sun safety is like the smoking prevention of lung cancer,” Dr. Hadfield emphasized. Severe sunburns, particularly in childhood, are major predisposing factors. He strongly discouraged tanning bed use and reinforced sunscreen adherence and minimizing UV exposure, especially in children.

    Breast Cancer Screening: Alignment and Nuance 

    Turning to breast cancer, Dr. Hundal highlighted recent alignment between Eastern Cooperative Oncology Group (ECOG) and United States Preventive Services Task Force (USPSTF) recommendations: biennial screening mammography beginning at age 40 through age 74, with continuation based on shared decision making. 

    Dense breast tissue requires particular attention. “If patients have dense breasts, they need additional supplemental screening, including ultrasound or MRI” Dr. Hundal noted. New federal regulations now require notification of breast density on mammography reports—an important step toward standardized risk communication.

    High-risk populations also warrant earlier and intensified screening. BRCA1/2 mutation carriers may begin screening as early as ages 25 to 30. Individuals with first-degree relatives affected by breast cancer should undergo genetic counseling and, when appropriate, referral to high-risk clinics. “It’s extremely important for people to know about their family history and keep it in mind when they’re advocating for themselves,” Dr. Hadfield added.

    Both clinicians acknowledged the troubling rise in young-onset cancers. While lifestyle factors such as obesity, diet, and alcohol likely contribute, Dr. Hundal cautioned that not all of this rise is explained by modifiable risk factors. Tumor biology and genetics also play key roles.

    Lifestyle, Diet, and Emerging Science 

    The discussion broadened to modifiable risk reduction across malignancies. Optimizing diet, reducing processed foods and red meat, minimizing alcohol, and avoiding tobacco remain cornerstones. However, new data suggest that diet may also influence treatment response.

    “In melanoma, a big topic is that high-fiber diets certainly promote the efficacy of immune checkpoint inhibitors,” Dr. Hadfield noted, citing growing evidence linking gut microbiome modulation to improved immunotherapy outcomes. What once seemed speculative now has compelling data, reflecting the expanding intersection between lifestyle and oncologic care. 

    Blood-Based Early Detection and MRD

    Both physicians addressed growing patient interest in blood-based early detection assays and minimal residual disease (MRD) testing. While acknowledging their promise, Dr. Hadfield emphasized caution. “When we do more and more testing, we’re going to find more and more things. And the more things we find, the more risk we could potentially introduce, because we’re chasing down everything.”

    In the absence of mature survival data, especially in MRD settings, clinicians must weigh risks and benefits carefully. Detection of molecular recurrence without radiographic disease can introduce significant anxiety without clear management pathways. Some patients may desire every data point; others prefer to limit testing to avoid distress. 

    Dr. Hundal echoed this concern, noting that ambiguous results can create additional stress to both patients and family members. Both remain hopeful that advancements in AI and diagnostics will ultimately refine early detection strategies—but stressed the importance of evidence-based implementation.

    Key Takeaways

    • Reinforce early detection in melanoma using the ABCDE framework and promote routine dermatologic screening in high-risk patients.

    • Advocate for sun safety; discourage tanning bed use, reinforce sunscreen adherence, and minimize UV exposure, especially in children.

    • Initiate breast cancer screening at age 40, with supplemental imaging for dense breasts and earlier screening for high-risk individuals.

    • Refer appropriate patients for genetic counseling and high-risk clinic evaluation.

    • Promote modifiable lifestyle changes, including diet optimization and alcohol reduction.

    • Approach blood-based early detection and MRD testing cautiously, prioritizing data-driven counseling and shared decision making with individual patients.

    About the Speakers

    Matthew Hadfield, DO, is a Medical Oncologist and Assistant Professor of Medicine at Brown University/Legorreta Cancer Center. He recently completed his Hematology/Oncology Fellowship at Brown University. Dr. Hadfield’s clinical and research interests are in phase 1 clinical trials and developmental therapeutics, as well as treatment of cutaneous malignancies and management of immunotherapy-related adverse events.

    Jasmin Hundal, MD, MS, MPH, is a third-year Hematology/Oncology Fellow at the Cleveland Clinic in Cleveland, Ohio. Previously, she completed her Internal Medicine Residency at the University of Connecticut. Dr. Hundal’s main area of interest is the overlap between cardiometabolic health and cancer, particularly for breast cancer patients and survivors. Outside of work, she enjoys traveling, cooking, and hiking.