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Breast Cancer Research

There are several studies being done around the world analyzing new breast cancer treatment options and alternatives to standard chemotherapy, endocrine and radiation therapy that are currently available to patients. In addition, new surgical and reconstruction techniques that minimize scarring and attempt to create a more natural-appearing breast are being developed in clinical trials. Some of the results of these studies appear to be quite promising.

Hyperthermia Therapy

Hyperthermia therapy has been used in limited clinical studies for the treatment of breast cancer in the United States. This kind of therapy has been used for superficial melanoma treatment as well as recurrent breast cancer lesions. For breast cancer, patients receive their normal chemotherapy treatment and then immediately have their hyperthermia treatment or hyperthermia therapy can be given with radiation therapy treatments. When given with chemotherapy, the increased temperature affects the cancer cells and concentrates the effects if the chemotherapy in that area. When given with radiation therapy, the heated area in the radiation site acts to increase the oxygen demand and thereby increases the efficacy of the radiation to the site. In early studies, it has shown to be effective but is not without side effects.1 In some cases, hyperthermia is used to treat patients who have previously had radiation and have recurred at the same site.

Drug Combinations

Drugs that are currently being used to prevent breast cancer recurrence, such as tamoxifen, are being tried against alternative drugs to see if survival may be improved. Tamoxifen carries the risk of developing endometrial cancer and blood clots when used alone. Discontinuing tamoxifen can reduce those risks but does not reduce the risk of developing a breast cancer recurrence. New studies are investigating using aromatase inhibitors (AIs) as an alternative.

A recent study of 9,856 breast cancer patients in cohort 1and 9,015 in cohort 2 was completed that gave AIs either as initial monotherapy (cohort 1) or after two to three years of tamoxifen therapy which had to be discontinued, respectively. Use of aromatase inhibitors as a monotherapy led to a significant absolute reduction in breast cancer recurrence by 9.6% and a nonsignificant reduction in mortality by 1.1%. AI use after tamoxifen therapy led to a significant reduction in recurrence and mortality by 5.0% and 1.7%, respectively.2

Breast Cancer Genetics

Advances in the field of genetics are allowing for researches to determine specific genetic markers that can define risk of both developing breast cancer and possibility of recurrence.3 While this development of “cancer genotyping” is not being used as standard of care, there is hope that in the future that this information could guide therapy and in some cases prevent unnecessary surgeries or encourage more aggressive treatment for patients with extremely high risk of recurrence.4

Genetics research is playing a larger and larger role in the treatment of several diseases and many types of cancer. The goal of genetics research is to ultimately “crack the code” that is located in our DNA and prevent all types of diseases and cancers. However, this type of research is not without its ethical and moral considerations.

Trends in Medical Research

The trends in medical research are toward developing the least invasive mechanism to diagnose and treat all conditions, especially cancer. For breast cancer, the previous standard treatment for all stages was a radical mastectomy, an extremely morbid surgery. In just the last forty years, this paradigm has dramatically shifted away from surgery as the sole treatment to several alternatives. In fact, some studies indicate that a modified radical mastectomy which includes dissection of the axillary lymph nodes is not even beneficial. However, combination therapy including surgery, chemotherapy and radiation still yields the best overall survival concerning all stages of breast cancer.

Another goal of breast cancer research is to find more effective screening tools, particularly for those with a high lifetime risk of developing breast cancer. Research is investigating the use of radiological techniques other than the standard mammogram, including ultrasound, digital mammography and MRI (Magnetic Resonance Imaging) for screening alternatives to detect breast cancer at earlier stages.5

Research Efforts Will Continue Until Breast Cancer Disappears

It seems to most people that all of the money being spent on breast cancer research should have yielded a “cure for breast cancer” by now. In fact, there is a “cure for breast cancer” as a result of research, if the cancer is detected early enough. In the last forty years, overall five-year and ten-year survival for breast cancer has improved by approximately 36% and 34% as a result of research. Over the last seventy years, overall survival in the same categories has at least doubled and tripled, respectively. Thus, research may seem to be slow but the numbers do not lie. Breast cancer research will continue until breast cancer disappears all together.

References

1 Kikumori, T., Kobayashi, T., Sawaki, M., & Imai, T. (2008). Anti-cancer effect of hyperthermia on breast cancer by magnetite nanoparticle-loaded anti-HER2 immunoliposomes . Breast Cancer Research And Treatment , 435-441.

2 Dowsett, M., Cuzick, J., Ingle, J., et al. (2010). Meta-Analysis of Breast Cancer Outcomes in Adjuvant Trials of Aromatase Inhibitors Versus Tamoxifen. Journal of Clinical Oncology , 509-518.

3 Russnes, H. G., Moen Vollan, H. K., Lingjaerde, O., et al. (2010). Genomic Architecture Characterizes Tumor Progression Paths and Fate in Breast Cancer Patients. Science Translational Medicine , 38-47.

4 Ding, L., Ellis, M. J., Li, S., et al. (2010). Genome remodelling in a basal-like breast cancer metastasis and xenograft. Nature , 999-1005.

5 Lee, C. H., Dershaw, D. D., Kopans, D., et al. (2010). Breast Cancer Screening With Imaging: Recommendations From the Society of Breast Imaging and the ACR on the Use of Mammography, Breast MRI, Breast Ultrasound, and Other Technologies for the Detection of Clinically Occult Breast Cancer. Journal of teh American College of Radiology , 18-27.

6 Focus Area 3: Cancer. (2010) Retrieved from North Dakota Healthy People 2010 Final Report at: www.ndhealth.gov/healthypeople2010/HP2010%20Final%20Report/3%20Cancer%20v2.pdf.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.