Women with the deadliest form of breast cancer could be saved after a simple test found by scientists
Thousands of women with the deadliest form of breast cancer can be saved by a simple test that tells doctors in 24 hours how well they will respond to chemotherapy
- Triple negative breast cancer is so aggressive that it can resist chemotherapy
- About a third of women will see their cancer return within three years
- Test can detect a protein that blocks the chemo with results within 24 hours
- According to researchers, it could be available within ten years of testing
Women with the most deadly form of breast cancer have hope of a simple test that shows whether they will respond to treatment.
Triple-negative breast cancer, most common in women under 40 years of age and affecting more than 8,000 women in the UK each year, is so aggressive that chemotherapy can survive.
About a third of the women see standard chemotherapy fail and the cancer returns within three years.
Scientists, however, have discovered a test that identifies these women so that they can get another type of chemotherapy that probably works better.
The test is for a protein called NUP98, which is thought to activate genes that help cancer cells survive chemotherapy.
It can be found using a simple biopsy of breast tissue, with results available to doctors within 24 hours.
Women with the most deadly form of breast cancer – triple negative – have hope for a simple test that shows whether they will respond to treatment
High protein women are 10 times more likely to see their cancer recurring, increasing their risk of dying, and half as likely to benefit from standard chemotherapy, researchers who looked at results for more than 500 women found it.
They say the test could be available to women within ten years, after trials with the first breast cancer patients in five years.
Dr. Niamh Buckley, who led the study of breast cancer patients at Queen’s University Belfast, said: “We know that triple negative breast cancer is a very aggressive form of the disease.
‘For women who have been diagnosed, we want to adjust their treatment to the best possible chances of survival.
“This test will hopefully help us identify women who need alternative chemotherapy and who can prevent breast cancer from returning to these women and saving their lives.”
About one in seven breast cancers is threefold negative, which means that they are negative for ‘receptors’ on cancer cells that receive signals to divide.
Other types of breast cancer, such as “estrogen receptor-positive” breast cancer, can be treated with panacea such as tamoxifen that damage the machines that allow the cells to multiply.
But women with triple negative breast cancer do not have such drugs, which means that surgery and chemotherapy are their only chance of survival. That is why it is so important that standard chemotherapy, using drugs called anthracycline therapy, works.
The newly discovered test, reported in the BMC Cancer journal, could help identify one in three women for whom this type of chemotherapy will not work.
It picks up those women with a high NUP98 level, which blocks the chemotherapy that is meant to kill cancer cells by destroying their DNA.
It is not entirely clear how the protein works, but it can activate genes that repair DNA damage or help cancer cells survive by blocking the signal that kills them when damaged.
If these women can be selected, they can receive treatment that works earlier so that their cancer does not return or spread to their liver or brain and becomes terminal.
Instead, they may receive another type of chemotherapy, such as a type that uses drugs called “taxanes” to prevent cancer cells from dividing.
The test, found using breast tissue from more than 100 women with triple negative breast cancer and confirmed using a database of another 450 patients, uses a substance that reacts with NUP98.
The protein is labeled with a brown dye in women’s breast tissue, so that it can be easily seen in the laboratory.
Women with a high, rather than a low, NUP98 level are seven to ten times more likely to see breast cancer recur after chemotherapy.
Baroness Delyth Morgan, chief executive of Breast Cancer Now, who funded the study, said, “This is a promising discovery. It is really encouraging that testing at NUP98 levels can help ensure that patients receive the type of chemotherapy that is likely to be effective for them as quickly as possible. “
WHAT IS BREAST CANCER, HOW MANY PEOPLE FIND IT AND WHAT ARE THE SYMPTOMS?
Breast cancer is one of the most common cancers in the world. Every year there are more than 55,000 new cases in the UK and the disease claims the lives of 11,500 women. In the US, it hits 266,000 each year and kills 40,000. But what causes it and how can it be treated?
What is breast cancer?
Breast cancer originates from a cancer cell that develops in the mucosa of a duct or lobule in one of the breasts.
When the breast cancer has spread into the surrounding breast tissue, this is called an “invasive” breast cancer. Some people are diagnosed with ‘carcinoma in situ’, where no cancer cells have grown beyond the canal or the lobes.
Most cases develop in women older than 50 years, but younger women are sometimes affected. Breast cancer can develop in men, although this is rare.
Staging means how large the cancer is and whether it has spread. Stage 1 is the earliest stage and stage 4 means that the cancer has spread to another part of the body.
The cancer cells are sorted from low, which means slow growth, to high, which grows fast. High-quality cancers return more often after they have been treated for the first time.
What causes breast cancer?
A cancerous tumor starts with one abnormal cell. The exact reason why a cell becomes cancer is unclear. It is thought that something damages or changes certain genes in the cell. This makes the cell abnormal and multiplies ‘out of control’.
Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the risk of breast cancer, such as genetics.
What are the symptoms of breast cancer?
The usual first symptom is a painless lump in the breast, although most breast lumps are not cancerous and are fluid-filled cysts that are benign.
The first place that breast cancer usually spreads to is the lymph nodes in the armpit. If this happens, you will get a swelling or lump in the armpit.
How is breast cancer diagnosed?
- First assessment: a doctor examines the breasts and armpits. They can perform tests such as a mammography, a special x-ray of the breast tissue that may indicate the possibility of tumors.
- Biopsy: A biopsy is when a small piece of tissue is removed from a part of the body. The sample is then examined under the microscope to search for abnormal cells. The sample can confirm or exclude cancer.
If it is confirmed that you have breast cancer, further tests may be needed to assess whether it has spread. For example, blood tests, an ultrasound scan of the liver or an X-ray of the breast.
How is breast cancer treated?
Treatment options that can be considered are surgery, chemotherapy, radiotherapy and hormone treatment. A combination of two or more of these treatments is often used.
- Surgery: breast-conserving surgery or removal of the affected breast, depending on the size of the tumor.
- Radiotherapy: a treatment that uses high-energy radiation beams, aimed at cancerous tissue. This kills cancer cells or prevents cancer cells from multiplying. It is mainly used in addition to surgery.
- Chemotherapy: a treatment for cancer by using anti-cancer drugs that kill cancer cells or prevent them from multiplying
- Hormone treatments: some types of breast cancer are influenced by the ‘female’ hormone estrogen, which can stimulate cancer cells to divide and multiply. Treatments that lower the level of these hormones or prevent them from working are often used in people with breast cancer.
How successful is a treatment?
The outlook is best for those who are diagnosed when the cancer is still small and has not spread. Surgical removal of a tumor at an early stage can then give a good chance of a cure.
The routine mammography that is offered to women between 50 and 70 years of age means that more breast cancers are diagnosed and treated at an early stage.
For more information visit breastcancercare.org.uk or www.cancerhelp.org.uk