breast cancer research | Breast Cancer Research

Breast Cancer Research



We always learn more about cancer. Researchers and health professionals use what they have learned in research studies to develop best practices that will help prevent, detect, and treat breast cancer. They are also trying to figure out how to improve the quality of life for people with this disease.

The following text deals with various research that is proving promising in the fight against breast cancer. We have included information from PubMed, the National Library of Medicine's research database. Each scientific article in PubMed contains an identification number (PMID), the link of which leads to a brief summary (abstract). We also reported links to the research summaries presented at the American Society of Clinical Oncology (ASCO) meetings, which are held throughout the year. Information on ongoing clinical trials in Canada can be found at. and ClinicalTrials.gov. Clinical trials are assigned an identifier called the National clinical Trial number (NCT). The NCT number leads to information on the clinical trial.

Reduced risk of breast cancer and recurrence of breast cancer
Substances and behaviours can reduce your risk of being diagnosed with breast cancer or reduce the risk of recurrence of breast cancer after treatment. Here is some important research on how to reduce your risk.

Feeding may help to reduce the density of the breast tissue. Research shows that in women who limit their consumption of high-calorie meat and foods (such as fat and oil) and eat a lot of plant foods (such as fruits and vegetables), the breast tissue is less dense. This is especially true for postmenopausal women and non-smokers (PLoS One, PMID 26208331). This is important since dense breasts have more connective tissue, glands and ducts channels than adipose tissue, which can make it more difficult to detect cancer at mammography. Having dense breasts is a major risk factor for breast cancer, which is why reducing breast density by changing its diet could also reduce the risk of being diagnosed with breast cancer. However, much longer follow-up is needed to find out if it is a way to reduce the risk of breast cancer.

Metformin (Glucophage) is a drug that helps control diabetes. Some studies suggest that the rate of breast cancer is lower among women taking metformin (Current Pharmacological reports, PMID 26405648). The examination of several studies found that metformin does not reduce the risk of breast cancer, but could improve the survival of women with this disease (Journal of breast cancer, PMID 26472977). A current Canadian clinical trial focuses on the role of metformin in reducing the risk of recurrence of breast cancer (NCT 01101438).

Anti-estrogenic medications such as tamoxifen (Nolvadex, Tamofen) or Exemestane (Aromasin) can be offered to women who are at high risk for breast cancer to reduce their risk of suffering from this disease. However, many women choose not to take these medications because they are concerned about side effects and long-term effects. Researchers are trying to find ways to administer these medications so that they cause fewer and less serious side effects. Researchers are looking at a reduction in the dose of medication or the administration of the drug over a short period of time with breaks between doses (intermittent administration). They hope that the reduction of side effects encourages more women with a high risk of breast cancer to take these medications (seminars in Oncology, PMID 2690130).
Physical activity can improve survival after breast cancer. An analysis of the physical activity that women reported having made reveals that brisk walking or other types of moderate exercise practiced for at least 2.5 hours per week can reduce the risk of dying from breast cancer by 32%. More research is needed to understand how physical activity can help improve survival (European Journal of Cancer, PMID 27529756).

Learn more about cancer risk reduction research.

Screening
Screening tests help to find breast cancer before any signs or symptoms occur. When the cancer is detected and treated in its early stages, the chances of success of the treatment are better.

The TMIST screening test focuses on the association of Digital Breast tomosynthesis with digital mammography compared to digital mammography alone. Digital breast tomosynthesis is a type of mammography that allows you to take many radiological shots of the breast from several different angles. A computer assembles the pictures to make a 3-dimensional image of the breast. Digital mammography makes it possible to obtain an electronic image of the breast rather than a radiographic film. It is sometimes called a full-field digital mammography. The study aims to determine whether the use of the Association of Digital Breast tomosynthesis and digital mammography is a more accurate way of detecting breast cancer. Several Canadian centres are participating in the study (NCT 02616432).

Diagnosis and Prognosis
A key area of research focuses on better methods for diagnosing and stadifier breast cancer. Researchers are also trying to find ways to help physicians establish a prognosis (likelihood that cancer can be successfully treated or reappear after treatment). Here are some important researches on the diagnosis and prognosis.

Digital breast tomosynthesis can help doctors find cancer more easily in dense breasts. It can also help the radiologist to see more clearly if an abnormal region is cancerous or not. This type of imaging examination could help to reduce the number of false positives, that is, test results that suggest that there is cancer when it is not. It could also reduce the number of women who have to go back to other exams. One of the disadvantages of this review is that it also exposes breast tissue to a higher dose of radiation than standard mammography (Diagnostic interventional Imaging, PMID 26275829; European Journal of Radiology, PMID 26499000; Radiology, PMID 26458206, PMID 25961633). However, Canadian researchers have recently discovered techniques to reduce the amount of radiation needed for this review.

Location with radioactive grain could help physicians better target areas or abnormal tissues that they cannot palpate in the breast. A radiologist inserts the radioactive grains into the suspect region during a breast X-ray or Ct. The surgeon can use these grains to more easily find the area or the abnormal tissue during the operation. Localization with radioactive grain may be an alternative to needle-positioning biopsy (Journal of Surgical Oncology, PMID 25195916). In one study, radioactive grains were shown to help the surgeon remove only the abnormal tissue and less normal tissue (British Journal of Surgery, PMID 26503897).

Circulating tumor cells are cancer cells found in the bloodstream of some women who have been diagnosed with breast cancer. The CellSearch Circulating Tumour cell (CTC) analysis is used to find these cells. Research shows that the presence of circulating tumor cells is a negative prognostic factor for breast cancer, especially when the number of tumor cells does not drop after chemotherapy (Journal of the National cancer Institute, PMID 24832787). Further research has shown that women with positive HER2 breast cancer are more likely to have tumour cells in their blood (clinical and translational Oncology, PMID 26260915). The presence of circulating tumor cells could also mean that inflammatory breast cancer is likely to recur (recurrence) and that the prognosis will be darker (Journal of the National cancer Institute, PMID 26374427).

Gene-based Tests

Gene-based tests detect differences between normal genes and genes that have changed (mutated) in cancer cells. Microlattice analysis is a type of gene-based test that allows researchers to observe many genes simultaneously in order to know which ones are active and which are not. Analyzing many genes at once to know which ones are active and which are not, is called a genetic expression profile. Researchers hope that designing more gene-based tests will help doctors identify the best treatments for certain cancers, including breast cancer. Gene-based testing will also help physicians adapt more cancer treatments to each individual depending on their genetic makeup.

In the TAILORxBreast test, Oncotype DX analysis is used to establish the risk of recurrence (re-occurrence) of breast cancer. The test is used to determine the level of recidivism risk, which is called recidivism score. This test confirmed that women with a recidivism score of 10 or less have such a good prognosis that it is very unlikely that chemotherapy would increase their survival. In the same trial, women with a recidivism score of 11 to 25 were randomly designated to receive hormone therapy alone or hormone therapy associated with chemotherapy to determine if chemotherapy is necessary for this Group of Women. The results of this part of the study are not yet known (New England Journal of Medicine, PMID 26412349).

The MammaPrint is a test that allows to analyze the activity of 70 genes involved in breast cancer. According to a recent study, this test allows early detection of low-risk genetic recurrence of breast cancer, although there appears to be a high risk of re-offending after surgery and additional treatments necessary according to the factors Standard clinics. Women with breast cancer with a low genetic risk of recurrence may not need chemotherapy and thus avoid the side effects of this treatment (New England Journal of Medicine, PMID 27557300).

Biomarkers

Biomarkers are substances, such as proteins, genes or segments of genetic material such as DNA and RNA, which are naturally present in the body. They can be measured in body fluids such as blood and urine or in tumor tissues that have been collected from the body. Researchers are evaluating the following biomarkers to see if these substances can help physicians establish a prognosis and determine which treatments will benefit a woman with breast cancer:

DNA methylation (advances in Experimental Medicine and Biology, PMID 26987530)

Expression of PD-L1 (Human Pathology, PMID 26541326)

Plasma fibrinogen (Breast, PMID 26482138)

Learn more about the diagnosis and prognosis research.

Treatment

Researchers are studying new methods that could improve the treatment of breast cancer. Advances in cancer treatment as well as new processes to alleviate side effects have resulted in higher quality of life and better prognosis for many people with this disease. Here is important research on the treatment of breast cancer.

Radiotherapy

Researchers are trying to find new ways to administer radiation therapy as a treatment for breast cancer.

Radiotherapy with axillary lymph nodes may be an alternative to the removal of these lymph nodes. An ongoing clinical trial compares radiotherapy with ablation of the lymph nodes under the arm in women who have received chemotherapy and then breast surgery. In this trial, we look for any difference in the time period before breast cancer reappears and in overall survival in women who receive each treatment. It is also asked whether Lymphedema appears less frequently with one of the treatments and to determine the area of the region to be treated by radiotherapy (NCT 01901094).

Radiation to the regional lymph nodes can reduce the risk of recurrence of breast cancer. A Canadian study focused on women whose breast cancer had occurred in the lymph nodes and women whose breast cancer had not reached the lymph nodes but had a high risk of recurrence. The participants were assigned to 2 groups. One of the groups received radiation from the entire breast and the regional lymph nodes, which are under the arm, in the thorax and around the clavicle. The other group received only radiation therapy within. The results of the study show that the addition of radiotherapy to regional lymph nodes did not improve survival compared to radiation therapy administered only within. On the other hand, breast cancer has recurred less frequently in women who received radiation therapy from the regional and breast lymph nodes (New England Journal of Medicine, PMID 26200977).

The accelerated partial irradiation of the breast allows the radiation to be directed only to the breast area where the tumor is located rather than to the whole breast. Radiation is said to be accelerated since it is administered at higher doses and over a shorter period than for standard radiotherapy. In one study, the accelerated partial irradiation of the breast was directed to the area of a small tumor within before surgery to remove the tumor and part of the tissue all around (wide local excision). The results suggest that the accelerated partial irradiation of the breast may reduce the amount of mammary tissue to be removed (radiotherapy and Oncology, PMID 25701298). In another study, the accelerated partial irradiation of the breast administered by radiation therapy with intensity modulation (RCMI) was compared with the irradiation of the whole breast. RCMI is a type of conformational radiotherapy that uses special equipment to model and direct radiation beams on the tumor region while protecting neighbouring tissues. The results showed that the accelerated partial irradiation of the breast administered by RCMI resulted in fewer side effects and the same survival as the entire breast radiation (European Journal of Cancer, PMID 25605582).

Radiotherapy administered after a mastectomy is not a standard treatment. A recent study focused on the administration of radiation therapy following surgery in women with tumors larger than 5 cm in size, but whose cancer had not spread to the lymph nodes or other parts of the body. The study found that women survived longer than women who did not receive radiotherapy after mastectomy (ASCO, Abstract 1018).

Radiation can cause damage to the heart, especially when it is administered to treat the left breast. In one study, a group of women were taught to hold their breath during the administration of radiation therapy. The amount of radiation that had reached the heart muscle was then measured. The researchers compared this amount of radiation with that of another group of women who had normally breathed during treatment. They found that holding his breath lowered the amount of radiation absorbed by the heart. Experts hope that holding your breath during radiation therapy can help reduce the magnitude of damage to the heart (clinical Oncology, PMID 27890346).

Learn more about radiation research.

Chemotherapy

Here's some important research on breast cancer chemotherapy.

Early breast Cancer

When breast cancer is early, it means that the tumor measures less than 5 cm and that the cancer has not spread to more than 3 lymph nodes. This includes stages IA, IB and IIA. Researchers are trying to find other drugs, drug combinations and methods of administering chemotherapy that are more effective against early breast cancer.

The neratinib (HKI-272) is a type of targeted medicine. It is a tyrosine kinase inhibitor that blocks certain proteins that help cancer cells grow. A recent study has focused on the administration of neratinib in women with early HER2 positive breast cancer. The treatment consisted of the administration of chemotherapy (doxorubicin and cyclophosphamide) followed by paclitaxel and then trastuzumab. At the end of these treatments, a group of neratinib women were administered for 12 months and another group, a placebo. The results of the study show that women who were administered neratinib had better survival without recurrence than women who did not receive the drug (the Lancet Oncology, PMID 26874901). However, there has not been enough time since the study was completed to determine whether survival was significantly longer in women who received neratinib.

Bisphosphonates are medications that help strengthen the bones by preventing the body from degrading them. A recent analysis of a large number of studies (meta-analysis) has shown that bisphosphonates reduce the rate of recurrence of breast cancer in bone and improve the overall survival of women with early breast cancer. These benefits were only observed in women who were already postmenopausal when their treatment began (the Lancet, PMID 26211824).

Triple negative breast Cancer

Triple negative breast cancer is a cancer whose cells do not exhibit estrogen and progesterone receptors and do not have additional copies of the HER2 gene. Standard breast cancer treatments, such as hormone therapy and targeted treatment, cannot be administered for this type of breast cancer. Researchers are trying to find better ways to treat women with triple negative breast cancer and improve their survival.

Cisplatin (Platinol AQ) and Gemcitabine (Gemzar) were compared with paclitaxel (Taxol) and gemcitabine in women with triple negative breast cancer that had spread to other parts of their body. The results show that the combination of cisplatin and gemcitabine improved survival and resulted in fewer side effects. The researchers suggest that it could be the first association of chemotherapeutic agents administered to treat triple negative metastatic breast cancer (Lancet Oncology, PMID 25795409).

The TNT test was conducted with women with triple negative metastatic breast cancer, which were randomly distributed in groups receiving either carboplatin or docetaxel. The trial showed that women with hereditary mutations of the BRCA1 or BRCA2 gene reacted better and longer to carboplatin-based treatment (flattened, flattened AQ). The results of this trial also showed that women who did not carry a mutation in the BRCA gene were no more likely to respond to carboplatin than to docetaxel. Researchers indicate that knowing the BRCA status of a woman with triple negative breast cancer is important in choosing which chemotherapeutic agents to propose to her (San Antonio Breast cancer Symposium, Abstract S3-01).

metronomic maintenance chemotherapy is the administration of medications in small doses daily over a long period of time once the primary chemotherapy treatment is completed, to prevent recurrence. This can also reduce side effects and thus allow treatment to be easier to take than to receive high doses of medications within a few weeks of interval. Doctors believe that metronomic maintenance chemotherapy could be effective against triple negative breast cancer since this often reoffends once chemotherapy is over. In a recent study, metronomic-based maintenance chemotherapy with methotrexate and cyclophosphamide (Cytoxan, Procytox) was administered to women with triple negative breast cancer for one year after they completed their Carboplatin-based chemotherapy. The results showed that women who received metronomic maintenance chemotherapy had higher survival rates than women who did not receive this treatment (ASCO, Abstract e12087).

Learn more about chemotherapy research.

Hormone therapy

Researchers are trying to find new ways to treat breast cancer with positive hormone receptors, especially in premenopausal women.

The SOFT study focused on the role of inhibition of ovarian activity in premenopausal women with positive hormone receptor breast cancer. The inhibition of ovarian activity is done using medications administered to stop the functioning of the ovaries. In the study, three groups were compared. The first group of tamoxifen (Nolvadex, Tamofen) alone was administered to the second group of tamoxifen associated with inhibition of ovarian activity, and to the third group of Exemestane (Aromasin) associated with inhibition of ovarian activity. The results of the trial found that inhibition of ovarian activity associated with either drug improved survival without recurrence, but that inhibition of ovarian activity associated with Exemestane was even more Effective. On the other hand, these results were obtained only in women who were always premenopausal at the end of the treatment. No significant benefit was observed in women who became postmenopausal at the end of treatment (New England Journal of Medicine, PMID 25495490).

The administration of hormone therapy alone, rather than hormone-related therapy, could be a treatment option for women over 60 years of age whose breast cancer is slowly evolving. Preliminary results from a Canadian trial show that women in this group had a low risk of recidivism when they were only being administered hormone therapy. Participants are still accepted for this trial, and the researchers hope that the results will confirm these preliminary results (Journal of clinical Oncology, PMID 25964246; NCT 01791829).

Fulvestrant (Faslodex) was compared with anastrozole (Arimidex) in women postmenopausal with advanced breast cancer with positive hormone receptors, which had not been treated with hormone therapy. The study showed that women who were administered fulvestrant had longer survival without evolution compared to women who had been administered anastrozole (the Lancet, PMID 27908454).

Anastrozole (Arimidex) was compared with tamoxifen in postmenopausal women with positive hormone receptors in situ ductal carcinoma (DCIS). Tamoxifen is sometimes administered after surgery and radiotherapy to reduce the risk of DCIS reappearing in women treated with lumpectomy. The results of the study show that women who were administered anastrozole had a lower risk of recidivism compared to women who had been given tamoxifen. This effect was particularly strong among women under 60 years of age (the Lancet, PMID 26686957).

Breast reconstruction Surgery

Researchers are trying to figure out how to improve reconstructive surgery. One of the challenges is to find the best way to insert an implant during mastectomy (when there is no longer any natural tissue to hold the implant in place), rather than perform other surgeries later to insert a tissue expander and then Later the implant.

The SERI surgical scaffold is a material made of natural silk, which gradually disintegrates and the body assimilates little by little. In a recent study, the SERI surgical scaffold was evaluated to make a pouch in the area where the breast was removed during surgery. Then the surgeon put an implant in the pouch to form the breast. The results of the study showed that the women who were placed on the surgical scaffold SERI were very satisfied with the aesthetic results. They also found that the material used in the surgical scaffold SERI did not cause more complications than other breast reconstruction techniques, such as tissue transfer (Plastic and reconstructive Surgery, PMID 25502862).

The acellular dermal graft (AlloDerm, DermaMatrix) is a type of implant that uses special skin tissue from human donations. To prevent rejection, cells from the donated tissue are removed so as to leave only connective tissue made of collagen (a type of protein). The BREASTrial clinical trial focuses on the benefits, disadvantages and safety of cell-free dermal grafts in one-step reconstruction after a mastectomy (Plastic and Reconstructive Surgery, PMID 25539330).

Learn more about cancer surgery research.

Support Care

Living with cancer can be quite a challenge from many angles. Supportive care can help people cope with cancer, treatment and possible side effects. Here is important research on breast cancer supportive care.

Luteinizing Hormone Release hormone (LHRH) analogues may help preserve ovarian function in young women diagnosed with breast cancer. In a recent meta-analysis, it was found that the use of LHRH analogues called Goserelin (Zoladex) and Triptorelin pamoate (Trelstar) during chemotherapy could reduce the magnitude of ovarian damage caused by agents Chemotherapy administered to treat breast cancer and appears to decrease the risk of premature menopause. More research is needed to determine whether the administration of LHRH analogues associated with chemotherapy can help preserve a woman's ability to become pregnant after the end of treatment and whether this approach is safe for women with Positive hormone receptor breast cancer (ASCO, Abstract 1050). Learn more about fertility options research.

Skin changes caused by radiation within the breast include redness, dry skin and flaking. The researchers used a skin cream that contained steroids to see if the cream could reduce the severity of skin reactions. A steroid-based cream was administered to a group of women and a moisturizing cream to the other group. Both groups of women used their cream during radiotherapy and during the 2 weeks following the end of treatment. The results show that women who had been given steroid cream had significantly fewer skin changes during radiotherapy and Oncology (PMID 27913066).

Learn more about Cancer research

Researchers are always trying to find out more about breast cancer. The clinical trial is a research study in which new ways of preventing, detecting, treating or relieving breast cancer are assessed. The clinical trial provides information on the safety and efficacy of new approaches to determine whether they should be offered on a larger scale. Most of the standard breast cancer treatments first showed their efficacy in clinical trials.