Examining molecular patterns could help to ascertain how breast cancer will develop and if it could return after treatment, British researchers have reported.
In the first study of its kind, scientists at the Cancer Research UK Cambridge Institute at the University of Cambridge, with Professor Christina Curtis at Stanford University, California, USA, created a statistical tool that could better predict if a women’s breast cancer could come back.
They did this by examining the patterns of genetic changes in tumours from nearly 2000 women with breast cancer, whose progress was followed for more than 20 years.
The scientists now say the next step is to create a routine test that could help doctors offer women a more accurate prediction of if or when their disease may return.
Professor Carlos Caldas, lead researcher at the Cancer Research UK Cambridge Institute, said: “Treatments for breast cancer have improved dramatically in recent years, but unfortunately for some women, their breast cancer returns and spreads, becoming incurable. For some, this can be many years later – but it’s been impossible to accurately predict who is at risk of recurrence and who is all clear.
“In this study, we’ve delved deeper into breast cancer molecular subtypes so we can more accurately identify who might be at risk of relapsing and uncover new ways of treating them.”
Previous research from this group of scientists had already revealed that breast cancer can be classified into one of 11 different molecular subgroups.
The latest findings, published in Nature, reveal how these molecular subtypes have distinct clinical ‘trajectories’, which cannot be predicted by looking at commonly used characteristics alone because they vary significantly.
The team found that among women with triple-negative breast cancer, there was a distinct subgroup whose outlook is initially poor, but for whom the disease is unlikely to come back in those who survived five years.
They also identified subgroups of women with oestrogen receptor-positive (ER+) tumours, who were at a higher risk of their cancer coming back up to 20 years after they were first diagnosed.
Dr Oscar Rueda, first author and senior research associate at the Cancer Research UK Cambridge Institute, said: “We’ve shown that the molecular nature of a woman’s breast cancer determines how their disease could progress, not just for the first 5 years, but also later, even if it comes back.
“We hope that our research tool can be turned into a test doctors can easily use to guide treatment recommendations.”
Professor Karen Vousden, Cancer Research UK’s chief scientist, added: “This study provides some valuable new insights into how we might identify women whose breast cancer is likely to return.
“We’re still a way off being able to offer this type of detailed molecular testing to all women and we need more research to understand how we can tailor treatments to a patient’s individual tumour biology. But this is incredibly encouraging progress.”
Rueda, O et al. Dynamics of breast cancer relapse reveal late recurring ER-positive genomic subgroups. Nature 13 March 2019.
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