Like many other patients who have overcome cancer, breast cancer survivors live in fear of relapse. Now, researchers have developed a tool by which they can predict accurately the time when the cancer is likely to return. The results of this study were published in the latest issue of the journal Nature.
The new test is the first of its kind to predict the return of breast cancer within two decades of remission. The researchers explain that there are 11 types of breast cancer and all of them have a different risk of returning or relapsing. The new test quickly determines the likelihood of the cancer returning, and segregates high-risk patients from low risk, based on the patient's DNA.
The team analyzed the genetic make-up of tumors taken from nearly 2,000 breast cancer patients and followed the patients for an average of 14 years. The scientists are now working on simplifying the test so that it can be used in the clinic. The simpler and easier-to-use version of the original test may be available for use within the next five years, say the researchers.
Treatments for breast cancer have improved dramatically in recent years. But unfortunately for some women, their breast cancer returns and spreads, becoming incurable. For some, this can be many years later - but it's been impossible to accurately predict who is at risk of recurrence and who is all clear. In this study, we've delved deeper into breast cancer molecular subtypes so we can more accurately identify who might be at risk of relapsing and uncover new ways of treating them.”
Professor Carlos Caldas, Lead Researcher, CRUK
Dr. Oscar Rueda, lead author of the paper said, “We’ve shown that the molecular nature of a woman’s breast cancer determines how their disease could progress, not just for the first five years, but also later. We hope that our research tool can be turned into a test doctors can easily use to guide treatment recommendations.”
Currently, predictions are based on tumor size, aggressiveness, the age of the patient and the tumor type. The researchers explain that analyzing the genetic make-up of tumors may be a more precise method.
They noted that one of the deadliest types of breast cancer is the “triple negative” cancer. However, if the patient survives the first five years after diagnosis and treatment, their cancer return risk is small. Some cancers, on the other hand, have a genetic picture that makes their return within 20 years a 50 percent likelihood.
There are eight types of estrogen receptor-positive cancer. Of these four have a good chance of not recurring within 20 years while the other four have a high risk of relapsing (40 to 62 percent chance).
Triple negative cancer also has a greater chance of spreading to the brain while estrogen receptor positive cancer and HER2-negative cancer has a greater chance of spreading to the bone, the team writes.
One in seven women will get breast cancer in their lifetime in the UK, and we hope that research like this will mean that if faced with the disease, even more of our daughters and granddaughters will survive. We're still a way off being able to offer this type of detailed molecular testing to all women and we need more research to understand how we can tailor treatments to a patient's individual tumour biology. But this is incredibly encouraging progress.”
Professor Karen Vousden, Chief Scientist for Cancer Research UK.
The researchers are planning a larger study with around 12000 women to establish their hypotheses and make the test a reality.
I would not recommend it clinically yet, but we really are committed to making this available. We are totally committed to having an NHS test, we haven't patented any of this.”
Prof Caldas.
New Lancet Commission on Breast Cancer: Transforming breast cancer care globally