- 44,000 Britons and 210,000 Americans are diagnosed with ER+ breast cancer each year
- They remain at risk for decades of the cancer recurring in another part of their body
- Researchers have now discovered the mechanism that triggers this cancer “time bomb”.
Researchers have discovered why breast cancer cells that have spread to the lungs can wake up after years of sleep and form incurable tumors.
Around 44,000 Britons and 210,000 Americans are diagnosed with the most common form of breast cancer – estrogen receptor positive (ER+) – each year.
These patients, even after successful treatment, remain at risk of their cancer returning to another part of their body decades after their initial diagnosis.
Now experts have uncovered the mechanism that triggers this cancer “time bomb” in the lungs – one of the most common places cancer can spread.
And an existing cancer drug can slow the growth of these secondary tumors, their study in mice suggests.
ER+ breast cancer patients remain at risk of cancer cells surviving in a quiescent state in their organs for years after treatment is complete.
To understand the signals that prompt these cells to take action and form tumors, researchers at the Institute of Cancer Research (ICR) in London studied mice with ER+ breast cancer who underwent scans.
The results, published in the journal Nature Cancer, suggest that molecular changes in the lungs promote the growth of secondary tumors.
The PDGF-C protein — which is vital for tissue growth and survival — plays a key role in determining whether inactive breast cancer cells are asleep or “waking up.”
When protein levels rise, which occurs with aging or when lung tissue becomes damaged or scarred, it can cause the dormant cancer cells to grow and develop into secondary breast cancer in the lungs.
The researchers then looked at whether blocking PDGF-C activity might help prevent these cells from ‘waking up’.
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They gave mice an existing cancer growth blocker called imatinib, which is currently used to treat patients with chronic myeloid leukemia.
Mice were treated with the drug either before or after tumor development.
Cancer growth in the lungs was significantly reduced in both groups, according to the Breast Cancer Now-funded study.
Study author Dr. Frances Turrell, a post-doctoral researcher in the Breast Cancer Research Unit at ICR, said: “We found how aging lung tissue can induce these cancer cells to ‘wake up’ and develop into tumors, and uncovered a possible strategy to ‘defuse’ them those “time bombs”.
“We now plan to better disaggregate how patients might benefit from the existing drug imatinib, and long term aim to develop more specific treatments targeting the ‘reawakening’ mechanism.”
Rachel Davies, 38, who lives in Swansea, was diagnosed with ER+ breast cancer in 2021 and underwent a mastectomy, lymph node removal, chemotherapy and radiation therapy.
After a scan in May 2022, three months after completing treatment, she was told the cancer had spread to her sternum and later to her spine. She is now on a targeted cancer drug called Ribociclib and hormone therapy.
Ms Davies said: “I’ve seen some women finish treatment and ring that bell and celebrate the end and that always worries me as you can never be complacent that it won’t come back.
“It was heartbreaking to find out the cancer had spread when I thought it was all in the past.
“That’s why it’s so important that research into secondary breast cancer takes place so we can find new ways to prevent women from going through what I’m experiencing.”
She added: “Research like this gives me hope for women who are being treated for breast cancer in the future. I don’t want to waste my precious time being bitter or angry.”
Professor Clare Isacke, Professor of Molecular Cell Biology at ICR and co-author of the study, said: “This is an exciting advance in our understanding of advanced breast cancer – and how and why breast cancer cells form secondary tumors in the lungs.
“Next, we need to determine when these age-related changes occur and how they differ from person to person so that we can develop treatment strategies that prevent cancer cells from ‘reawakening’.”
dr Simon Vincent, Director of Research, Support and Influence at Breast Cancer Now said: “This exciting discovery brings us a step closer to understanding how to slow or stop the development of ER+ secondary breast cancer in the lungs.
“It has the potential in the future to benefit thousands of women living with this ‘time bomb’ and ensure fewer patients receive the devastating news that the disease has spread.”
Breast cancer is one of the most common types of cancer in the world, affecting more than two MILLION women each year
Breast cancer is one of the most common types of cancer in the world. There are more than 55,000 new cases in the UK each year and the disease claims the lives of 11,500 women. In the US, it strikes 266,000 and kills 40,000 each year. But what causes it and how can it be treated?
What is breast cancer?
Breast cancer develops from a cancer cell that develops in the lining of a milk duct, or lobule, in one of the breasts.
When breast cancer has spread to surrounding breast tissue, it is called ‘invasive’ breast cancer. Some people are diagnosed with “carcinoma in situ,” where no cancer cells have grown beyond the duct or lobe.
Most cases develop in women over the age of 50, but younger women are sometimes affected. Breast cancer can develop in men, although this is rare.
Staging means how big the cancer is and whether it has spread. Stage 1 is the earliest stage and stage 4 means the cancer has spread to another part of the body.
Cancer cells are graded from low, meaning slow growth, to high, meaning fast growth. High-grade cancers are more likely to come back after being treated first.
What Causes Breast Cancer?
A cancerous tumor starts from an abnormal cell. The exact reason why a cell becomes cancerous is unclear. Something is thought to damage or change certain genes in the cell. This causes the cell to become abnormal and multiply “out of control”.
Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the chance of developing breast cancer, such as: B. Genetics.
What are the symptoms of breast cancer?
The usual first symptom is a painless breast lump, although most breast lumps are noncancerous and are fluid-filled cysts that are benign.
The first place where breast cancer usually spreads is in the armpit lymph nodes. If this occurs, you’ll develop a swelling or lump in an armpit.
How is breast cancer diagnosed?
- Initial assessment: A doctor examines the breasts and armpits. They may do tests like a mammogram, a special X-ray of breast tissue that can indicate the possibility of tumors.
- Biopsy: In a biopsy, a small sample of tissue is taken from a part of the body. The sample is then examined under a microscope to look for abnormal cells. The sample can confirm or rule out cancer.
If you are confirmed to have breast cancer, further tests may be needed to determine if it has spread. For example, blood tests, an ultrasound of the liver, or a chest X-ray.
How is breast cancer treated?
Treatment options that may be considered include surgery, chemotherapy, radiation therapy, and hormone treatment. A combination of two or more of these treatments is often used.
- Surgery: Breast-conserving surgery or removal of the affected breast, depending on the size of the tumor.
- Radiation therapy: A treatment that uses high-energy rays focused on cancerous tissue. This kills cancer cells or stops cancer cells from multiplying. It is mainly used in addition to the operation.
- Chemotherapy: A treatment for cancer through the use of anti-cancer drugs that kill or stop cancer cells from multiplying.
- Hormone Treatments: Some types of breast cancer are influenced by the “female” hormone estrogen, which can stimulate cancer cells to divide and multiply. Treatments that lower the levels of these hormones or stop them from working are often used in patients with breast cancer.
How successful is the treatment?
The outlook is best for those diagnosed when the cancer is small and has not spread. Surgical removal of a tumor at an early stage can then offer good chances of recovery.
The routine mammogram offered to women in their 50s and 70s means more breast cancer is being diagnosed and treated at an early stage.
For more information visit breastcancernow.org or call toll free on 0808 800 6000