Aggressive
Breast Cancer
It
seems that breast cancer cells may have personality.
Some
types of tumors are more aggressive than others.
If
these cells could be identified at diagnosis, treatments might be
able to be tailored to the tumor type. This might make a big difference
in the drugs that are used and could lead to improved outcomes for
many breast cancer patients.
Normally,
breast cancer treatments are decided by using a standard staging
system.
Stage
I breast cancer requires less aggressive treatments than later
stages. Although this approach does provide a framework for treatment,
in one third of the breast cancer cases there will be a recurrence.
There is no proven method that a health care team can use to tell
which cancers will return.
Dr
André Ahr and colleagues at the Department of Obstetrics and Gynecology,
J W Goethe University, Frankfurt, Germany noticed that some patients
at their clinic who were identified with early breast cancer went
on to have recurrences and others remained free of cancer.
They
designed a study to find out if there were any differences in the
tumors of the patients who did not have breast
cancer recurrences. To identify differences, they went to the
cells that made up the tumors. They looked at DNA - the cancer cells
genetic material - from the tumors of 55 consecutive patients. The
tumors had 41 genetic markers in common that allowed the researchers
to group them into pathological subclasses.
Out
of the 55 patients, they defined a subgroup, which they called class
A.
The
breast cancer patients who were put into Class A showed a higher
percentage of nodal-positive tumors and metastases at diagnosis
(23 percent) than the rest of the patients (4 percent).
It
occurred to them that tumors showing the characteristics of the
class A patient's tumors might be more aggressive and this might
be an indicator that these women were more likely to have recurrences.
Follow
up on this group for 23.5 months showed that 11 of the 22 group
members - 50 percent - developed metastatic disease.
Of
the 27 women who were not identified as having class A tumors only
three had recurrences.
While
the group involved in this study was too small to make any definite
statements about tumor type and aggressiveness, Dr. Ahr and his
group suggest that further work be done on this.
Combining
"these molecular methods with the standard tumor classification
system to obtain improved patient-tailored therapies" would
make treatment decisions more effective. It might also provide a
way to determine if a survivor was at higher risk of recurrence.
This could provide doctors with a chance to use more aggressive
treatments on more aggressive tumors. It could also ease the stress
of worrying about cancer returning for those with less aggressive
tumors.
Source:
Lancet 2002; 359: 131-32.
Also
see -> Breast
Cancer Staging | Stage
I | Stage
II
Inflammatory
Breast Cancer
Elsewhere on the Web:
Stages
of Breast Cancer
Test
for aggressive breast cancer
|
