Development of breast cancer prognosis research
The most common form of cancer is breast cancer, developing in the breast tissue. A well-recognised sign is a lump in the breasts, but other signs consist of: changing shape of breasts, fluid coming out of the nipple, dimpling of the skin, newly-inverted nipples and red patches of skin. One can experience pain in the bones, swollen lymph nodes, yellow skin or shortness of breath in cases with spread of the disease. Factors that can increase the risk of developing breast cancer are: obesity, alcohol consumption, lack of physical activity, early age of menstruation, hormone replacement therapy, not having children, having children late, and being female. One can also be at greater risk if they have inherited the BRCA1 and BRCA2 gene mutations.
The stage of the breast cancer is very important. Staging considers the size of lump, lymph node status and whether metastatic disease is present (i.e. cancer that has spread.) Stage 1 cancers have superb prognosis, where treatment consists of the lump being removed and occasionally radiation. For stage 2 and 3 cancers, prognosis is slightly less effective, and the patient has a higher risk of cancer recurrence. Treatments usually consist of lumpectomy of mastectomy, chemotherapy and some may receive radiotherapy. Stage 4 caners are metastatic cancers, the cancer has spread. The prognosis is poor and must be managed using combination therapies including surgery, chemotherapy, radiotherapy and targeted therapies. Grading is assessed by comparing normal breast cells and breast cancer cells. Cancer cell growth is slower and prognosis is better if the cancer cells are closer to normal. Cells that are not differentiated well will divide more quickly and will most likely spread. Recent events within scientific research has shown a ‘highly sensitive’ breast cancer blood test. It is suggested that this new test has sensitivity up to 100 times more than existing tests, according to Science Translational Medicine. The hope for being able to track cancer effectively is that it will help doctors tailor treatments for patients in the future, as well as avoiding unnecessary surgeries.
TARgeted Digital Sequencing (TARDIS) is a new technique which analyses the tumour DNA found in the blood or cancer cells. So hopefully doctors would be able to take blood samples continuously throughout treatment and see how treatments are working, enabling them to consider changing treatment plans if necessary. In research testing, at the Translational Genomics Research institute, researchers were able to identify circulating tumour DNA in all patients with cancer before they had even started treatment. Further tests were carried out on women who had received treatment before their surgery. Tests showed that the concentration of tumour circulating DNA was lower in patients who had no breast cancer cells remaining at the point of surgery. Prior to this, blood tests have “only been sensitive enough to reliably identify tumour DNA in people with advanced disease” says Dr Muhammed Murtaza. Being able to detect cancer DNA at extremely low concentrations in the blood brings hope for effective handling of early-stage breast cancers. TARDIS is precise and is very promising.