Breast cancer breakthrough could spare thousands needless treatment
Breast cancer test could save thousands of women from unnecessary surgery
7:30AM GMT 03 Dec 2013
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A breakthrough in diagnosis of breast cancer could save thousands of women from enduring unnecessary mastectomies and radiotherapy, researchers have said.
Up to 5,000 women a year are diagnosed with early signs of the disease but until now doctors have been unable to distinguish between the cases which will become dangerous, and those which do not need treatment.
Scientists say they have made a “huge step forward” in developing a simple test, which could free half such women from undergoing needless surgery and gruelling sessions of radiotherapy and hormone therapy.
There has been growing concern that routine screening for women aged between 50 and 70 has resulted in thousands of women having unnecessary treatment.
Each year, more than 4,800 women are diagnosed with Ductal Carcinoma in Situ (DCIS) - a condition where non-invasive cancerous cells are contained within the milk ducts of the breast.
Without treatment, which can involve surgery, full mastectomies, radiotherapy and hormone therapy, half are likely to develop invasive breast cancer - but until now doctors have been unable to accurately identify which of the patients will do so.
The new study by Barts Cancer Institute, at Queen Mary University of London, has identified a molecule which is commonly present in around half of the cases, and also found in almost all cases of invasive cancer.
The molecule - αvβ6 - was rarely found in healthy breast tissue.
Baroness Delyth Morgan, Chief Executive of Breast Cancer Campaign, which funded the study, said in future, simple tests for the compound could save women from “agonising” dilemmnas and enduring traumatic treatment which could have been avoided.
She said: “This research could be key to the hunt to develop a life-changing reliable prognostic test for women with DCIS. Such a test would mean women with DCIS would finally be able to make informed decisions about their treatment. They would no longer face the agonising choice between risking their breast cancer becoming invasive or facing treatment without knowing whether their DCIS will become life-threatening or not.”
The charity said that although tests would not be available immediately, it was possible they could be in use within two years - which would signal “a pivotal moment in the diagnosis and treatment of breast cancer.”
The timing depends on carrying out further research on sufficient samples of women with DCIS who choose not to have treatment.
The study’s lead author, Dr Michael Allen, said the link established was a “very exciting” breakthrough.
Professor Louise Jones, one of the study’s authors said, “We are confident these results will be validated in further studies and from there we don’t envisage any barriers to this research resulting in the development of a routine test which could take place in the clinic. This will be a huge step forward in how we treat women with DCIS.”
Breast cancer is the most common cancer in the UK and accounts for nearly one in three of all cancers in women.
In the UK, around 50,000 new cases of breast cancer are diagnosed each year.
Experts said tests for the molecule would be carried out as part of a standard biopsy given when a woman has a suspicious lump, while significant NHS savings would be made by no longer providing treatment to thousands of women who do not need it.
In the study, researchers examined 583 breast tissue samples and showed that there was a link between levels of the molecule αvβ6 and whether breast tissue was normal, had DCIS or had progressed to invasive breast cancer.
There found almost none of the molecules in normal tissues, but they were found in half of the DCIS cases - and in almost all of the cases of invasive breast cancer,
Closer examination of more than 100 cases of DCIS over a longer period found that the level of the substance was strongly associated with whether the disease progressed or recurred.
When cells contained the compound, disease recurred around nine years earlier than when cells did not - in an average of 2 years compared with 11 in cases without the molecules.
Further experiments on mice showed how molecules encouraged breast cancer cells to grow more quickly, and were dependent on other proteins which promote cancer, which could also be targeted with drugs.
