Latest breast cancer discoveries

   The past twelve months were a fruitful time for breast cancer research. We hope the discoveries being made will provide hope and inspiration to all those living with breast cancer, and to the 17,586 women and 144 men expected to be diagnosed in 2017.

Featured here is BCNA’s top 10 list of breast cancer discoveries for 2016. We have chosen these discoveries for their contribution to breast cancer prevention, their breakthroughs in treatment outcomes and their contribution to the quality of life of Australians diagnosed with breast cancer.

Advances in prevention and early detection

1. Newly discovered rare genetic mutations linked to higher breast cancer risk

A global study has identified rare genetic changes that increase the risk of developing breast cancer. People who carry these rare mutations have been found to have a similar risk of developing breast cancer as those who carry the more common BRCA1 and BRCA2 gene mutations. Learning about rare genetic mutations is helpful for researchers so they can continue to investigate how best to reduce risk and treat people at high genetic risk.  

Read More at : http://mdhs.unimelb.edu.au/news-and-events/world-first-study-confirms-rare-genetic-mutations-cause-high-breast-cancer-risk

2. Osteoporosis drug may help prevent breast cancer in people at high risk

Cancer researchers at Walter and Eliza Hall Institute have found that denosumab (Xgeva), a drug most commonly used in osteoporosis treatment, is effective in preventing breast cancer in women who carry a BRCA1 gene mutation. This breakthrough may mean women with a BRCA1 gene mutation will have a less invasive option for reducing their risk of breast cancer in the future.

Read More at :https://acrf.com.au/breast-cancer/breakthrough-discovery-may-help-prevent-breast-cancer-in-high-risk-women/

3. Longer-term use of aromatase inhibitors may help stop some breast cancers returning

Researchers in the US have found that taking the aromatase inhibitor letrozole for 10 years instead of five can further reduce the risk of breast cancer coming back for some women. Letrozole may also be effective in preventing new cancers from developing in the opposite breast.

Read More at : http://www.breastcancer.org/research-news/ai-use-more-than-5-years-may-benefit-some

4. Blood test may help predict when a cancer is returning

New research shows that a blood test might accurately predict the return of cancer in people who have been previously treated for early stage cancers. The blood test, also known as ‘liquid biopsy’, looks for cancer DNA in the bloodstream from cancer cells that have resisted treatment.

Read More at : http://www.icr.ac.uk/news-features/latest-features/top-10-scientific-achievements-of-2016#2

Advances in treatment

5. New targeted therapies for a common type of metastatic breast cancer

The PALOMA2 clinical trial found the new breast cancer drug palbociclib (Ibrance) to be an effective new first line treatment for hormone receptor positive, HER2-negative breast cancer when used in combination with the hormone therapy drug letrozole. The addition of palbociclib almost doubled progression free survival from 9 to 18 months.

A subsequent trial in later line therapies has found that  palbociclib used in combination with fulvestrant (Faslodex), can slow cancer growth in around two-thirds of women with hormone receptor positive, HER2-negative metastatic breast cancer.

Read More at : http://www.icr.ac.uk/news-archive/drug-combination-slows-breast-cancer-spread

6. New targeted treatments for triple negative breast cancer

Three recent clinical trials have shown promising results in the treatment of triple negative breast cancer by using the immune system to target the growth of cancer cells.

Read More at : https://www.sciencedaily.com/releases/2016/06/160604050637.htm

7. Tykerb and Herceptin in the treatment of HER2-positive early breast cancer

New research shows that giving a combination of the targeted drugs trastuzumab (Herceptin) and lapatinib (Tykerb) before surgery is effective in rapidly shrinking some HER2-positive breast cancers.

Read more at: http://www.breastcancer.org/research-news/response-to-her2-therapies-seen-in-11-days 

Improvements in quality of life and management of side effects

8. Scalp cooling systems can help reduce hair loss during chemotherapy

Research has shown that a scalp cooling system can reduce severe hair loss by 50 per cent in some women who are going through chemotherapy.

Read more at: http://www.breastcancer.org/research-news/scalp-cooling-system-reduces-hair-loss

9. New online interventions can help women manage fear of recurrence

An Australian study testing the effectiveness of one-on-one therapy sessions using new psychological techniques has found a 22 per cent reduction in the fear of breast cancer returning.

Read more at: http://oncologynews.com.au/how-cancer-survivors-can-conquer-their-fears/

10. Research shows personalised exercise programs can help with treatment side effects in early breast cancer

An Edith Cowen University study has shown that personalised exercise programs can help reduce treatment side effects in early breast cancer. The research demonstrates that moderate, supervised exercise can increase energy levels, help with nausea and muscle loss, and may help some people to recover faster.

The findings were presented in an ABC Catalyst episode and can be viewed here.

Symptoms and Diagnosis of Medullary Carcinoma of the Breast

Signs and symptoms of Medullary Carcinoma of the Breast

   Like other types of breast cancer, medullary carcinoma may not cause any symptoms at first. Over time, a lump can form, and it may be soft and fleshy or somewhat firm to the touch. Most medullary carcinomas are small — less than 2 cm in size. Medullary carcinoma also may cause pain, swelling, redness, or tenderness in the breast.

Diagnosis

Tests that obtain images of the tissue inside the breast, such as mammography and ultrasound, sometimes can find a medullary carcinoma. On these tests, medullary carcinoma appears as a small, well-defined lump. However, some research suggests that mammography is not reliable at detecting medullary carcinomas. One study showed that these cancers were more likely to be found during self-examination or examination of the breasts by a doctor.

Diagnosing medullary carcinoma usually involves a combination of steps:

• A physical examination of the breasts. Your doctor may be able to feel the lump in the breast.
• A mammogram to locate the tumor and check for evidence of cancer in other areas of the breast.
• Ultrasound to obtain additional images of the breast and check for other areas of cancer.
• Biopsy to remove some or all of the lump to look at it under the microscope. A few cells from the lump can be extracted using a special needle, or the lump can be removed through a small incision. Biopsy is the key to accurate diagnosis, because imaging tests alone can’t tell the difference between medullary carcinoma and other types of breast cancer.

Also Read :What is Medullary Carcinoma of the Breast

When looked at under a microscope, medullary carcinoma has a number of important features that a pathologist looks for:

• A clear, well-defined boundary between tumor tissue and normal breast tissue. Medullary carcinoma pushes against the surrounding healthy tissue, but doesn’t grow into it in the same way invasive ductal carcinoma usually does.
• Large-sized cancer cells with a high-grade appearance, meaning that they look very different from normal, healthy breast cells. However, medullary carcinoma cells do not behave like high-grade cancer cells, which are aggressive and grow and spread quickly. Medullary cancer cells also tend to blend together in a distinctive “sheetlike” pattern; it’s hard to see each cell’s individual membrane (outer lining).
• Immune system cells (white blood cells called lymphocytes and plasma cells) at the edges of the tumor. Immune system cells work to fight off diseases and any substances they see as a threat to the body. It’s believed that these cells help keep the medullary carcinoma in check, preventing it from growing and spreading quickly.

If the tumor has all of these features, it is considered to be a “true” medullary carcinoma. Sometimes the tumor has only some of these features but not others, or there may be some invasive ductal carcinoma cells mixed in. In these cases, your doctor may call the tumor “atypical medullary carcinoma.”

In addition, medullary carcinoma cells often express a protein called p53. The pathologist may test for p53 to help decide if the cancer is truly medullary.

There are some other key features of medullary carcinoma:

• Hormone-receptor-negative: Medullary carcinoma usually tests negative for hormone receptors.
• HER2-negative: Medullary carcinoma also usually tests negative for receptors for the protein HER2/neu.

Diagnosing medullary carcinoma can be challenging. It may be hard to tell the difference between medullary carcinoma cells and cells that make up a usual invasive ductal carcinoma. If you receive a diagnosis of medullary carcinoma, ask your doctor whether the pathologist who looked at the sample has experience diagnosing this type of cancer. You also may want to get a second opinion from another hospital pathology lab.

Medullary Carcinoma of the Breast

Medullary carcinoma of the breast is a rare subtype of invasive ductal carcinoma (cancer that begins in the milk duct and spreads beyond it), accounting for about 3-5% of all cases of breast cancer. It is called “medullary” carcinoma because the tumor is a soft, fleshy mass that resembles a part of the brain called the medulla.

 Medullary carcinoma can occur at any age, but it usually affects women in their late 40s and early 50s. Medullary carcinoma is more common in women who have a BRCA1 mutation. Studies have shown that medullary carcinoma is also more common in Japan than in the United States.

Medullary carcinoma cells are usually high-grade in their appearance and low-grade in their behavior. In other words, they look like aggressive, highly abnormal cancer cells, but they don’t act like them. Medullary carcinoma doesn’t grow quickly and usually doesn’t spread outside the breast to the lymph nodes. For this reason, it’s typically easier to treat than other types of breast cancer.

Read : Symptoms and Diagnosis of Medullary Carcinoma of the Breast

Symptoms of DCIS

   

DCIS generally has no signs or symptoms. A small number of people may have a lump in the breast or some discharge coming out of the nipple. According to the National Cancer Institute, about 80% of DCIS cases are found by mammography.

Read Also : What is DCIS Breast Cancer

Read Also : Diagnosis of DCIS

Tubular Carcinoma of the Breast

Tubular carcinoma of the breast is a subtype of invasive ductal carcinoma (cancer that begins inside the breast's milk duct and spreads beyond it into healthy tissue). Tubular carcinomas are usually small (about 1 cm or less) and made up of tube-shaped structures called "tubules." These tumors tend to be low-grade, meaning that their cells look somewhat similar to normal, healthy cells and tend to grow slowly.

At one time, tubular carcinomas accounted for about 1-4% of all breast cancers. Now that screening mammography is widely used, however, tubular carcinomas are being diagnosed more frequently — often before you or your doctor would be able to feel a lump. Exact numbers aren't available, but studies suggest that tubular carcinomas may account for anywhere from just under 8% to 27% of all breast cancers.

Studies also suggest that the average age of diagnosis for tubular carcinoma is the early 50s, although women can be diagnosed with it at any age. This type of cancer is rare in men.

Even though tubular carcinoma is an invasive breast cancer, it tends to be a less aggressive type that responds well to treatment. It isn't likely to spread outside the breast and is considered to have a very good prognosis.