A Breakthrough in Breast Cancer Research

Breast cancer doesn’t really have much in common with sex. But I know it's hard to be very interested in sex when you have cancer or are recovering from cancer treatments or are working to feel good about your body again after having had cancer.

However, anyone interested in staying vibrant and healthy (not to mention sexy) should be interested in the breakthrough research on breast cancer just announced in the journal Nature.

Turns out, genetic mutations caused by cancer and the unique genetic “fingerprint” they leave may be the new frontier for cancer treatment and could suggest treatments targeted to specific genetic mutations.

This research, which is the scientific equivalent of putting a man on the moon, is an outcome of the Cancer Genome Atlas, a federally funded study to map genetic changes caused by common cancers. Breast cancer is the third (after colon and lung cancer) to come under intense analysis, with several hundred researchers tracking the genetic changes caused by unmetastized tumors from 825 women.

As a result, four new subtypes of breast cancer based on 30 to 50 genetic mutation have been identified, which suggest new approaches to treatment and also explains why some one-size-fits-all treatments may not work.

“When treating breast cancer, we offer specific therapies that have been tested on large populations of cancer patients,” said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City in an article for HealthDay News. “…This research helps move us to the point where we will look at a tumor's genetic makeup and tailor a specific treatment that will attack the tumor cells based on the tumor's genetic fingerprint.”

This research may alter cancer treatments by

• Basing treatment on the genetic signature of the cancer rather than its location in the body. For example, one of the less common but most deadly breast cancers is genetically very different from other breast cancers but very similar to ovarian cancer, suggesting that treatment for this breast cancer could also be similar to that for ovarian cancer.
• Avoiding unnecessary, ineffective, and potentially harmful treatment. For example, one of the most common cancers, whose growth is fueled by estrogen, was routinely treated by an estrogen-blocking drug. The genetic study identified two different types of this common cancer, which suggests more targeted treatments. So, besides receiving appropriate treatment, cancer patients may also be able to avoid potentially harmful treatment. “Targeted therapies allow for more effective treatment of tumors, while minimizing the treatment of tumors with less effective therapies and their subsequent side effects,” said Dr.Bernik.
• Suggesting new avenues for research. When these subtle genetic differences are identified, new research and treatments can begin. For example, some women with the same HER2-enriched gene respond to treatment by the drug Herceptin, and other women don’t. Now, ongoing clinical trials will try to identify the differences in the genetic makeup of the HER2 tumor that may explain the different responses to treatment.

While this research may be seismic for oncologists, it will be years before the laborious process of testing and approvals are complete and we begin to see the results on the ground and in our doctors’ offices.

Still, this affirms the need for informed, individual health decisions, weighing all factors, instead of applying one-size-fits-all thinking. And, taking the long view, this is great news for our daughters and granddaughters.