Recent Advances in Breast Cancer Diagnosis and Treatment

In the past few years, the prevalence of breast cancer has increased tremendously. About 1.7 million new cases of breast cancer are detected each year. According to the World Health Organization (WHO), around 520,000 deaths occur each year due to breast cancer. Researchers are working to study better insights for the condition to prevent its occurrence and completely cure the disease.

Scientists are trying to identify new and effective ways to diagnose, treat and prevent breast cancer development. Following are some of the breast cancer breakthroughs that scientists have been focusing on to understand better:

• Causes of breast cancer
• Causes and new treatments for metastatic breast cancer
• Ways to reduce risk for breast cancer development
• Management of ductal carcinoma in situ (DCIS)
• Identifying new lab and imaging tests to diagnosis breast cancer
• Identifying new breast cancer treatment breakthroughs
• Better ways to provide supportive care for breast cancer patients

Current Research on Breast Cancer Diagnosis

Presently, researchers are trying to develop new and effective methods to allow easy and faster diagnosis of breast cancer. These methods can be non-invasive and more sensitive for detecting the condition. Researchers have developed new imaging tests which help the doctor identify breast cancer even by evaluating certain minute changes in your breasts.

Tests for Circulating Tumor Cells (CTCs)

When cancer cells become metastatic, they start detaching from the cancerous mass of cells and begin to circulate in the blood. To detect these circulating tumor cells, a sensitive lab test has been designed.

This diagnostic test also helps in identifying presence of metastatic breast cancer in patients, but does not provide any information about recurrence and survival of breast cancer patients.

Scientists are identifying ways to remove these CTCs to check activity of certain anti-cancerous drugs against these cells. This can help find new treatments for metastatic breast cancer.

Liquid Tumor Biopsy

Liquid tumor biopsy is another diagnostic test to identify presence of tumor cell DNA in the patient’s bloodstream. This test helps clinicians track the effect of certain treatment procedures from time to time. The test will also guide the clinician about changes in treatment procedure and progress of your breast cancer condition.

Scintimammography: Molecular Breast Imaging Technique

A scintimammograpy involves injection of a radioactive drug molecule known as tracer into your vein. The tracer molecule gets attached to cancerous cells in breast, which is then detected with the help of a camera.

This method is presently at research stage and more information has to be gathered about its effectiveness and reliability. Some doctors believe that this method will be effective in detecting breast cancer in dense areas of breast in case of younger women.

Molecular Breast Imaging

Molecular breast imaging (MBI) is a primary imaging test to diagnose recurrence of breast cancer. It easily detects cancer cells and scar tissues in the breast and also confirms presence of breast cancer in high risk patients. It is an effective diagnostic technique than mammograms and traditional magnetic resonance imaging.

An MBI involves insertion of a radioactive molecule which is absorbed by breast cancer cells. Using a nuclear medicine scanner, the molecule gets illuminated and allows identification of exact location of breast tumor cells. It provides a complete 3-D view of your breast and also helps your doctor to remove correct portion of the affected breast and thereby saves time during surgery.

Breast Cancer Research and Treatment

Current research on breast cancer is majorly focused to find new and effective ways to treat breast cancer. Some of the breast cancer breakthroughs are:

Chemotherapy

Chemotherapy is one of the best treatment methods for breast cancer. But it has severe side effects, which are either short-term or long-term effects. Scientists are looking for new methods to check whether a breast cancer patient requires chemotherapy or not. These methods will indicate the benefit and detriment of chemotherapy in a breast cancer patient.

Current research on breast cancer has proven that certain genomic testing tools such as 21-gene assay (Oncotype Dx) or a 70-gene assay (Mammaprint) is used to identify need of chemotherapy. These techniques are combined with clinicopathologic status of the patient to determine the risk score to whether the patient needs chemotherapy or not. These are first-generation genomic signature tests, which help us predict early relapses of the disease.

Certain second-generation genomic signatures are also identified by researchers such as PAM50 and Endopredict, which helps in predicting late relapses of the condition, to provide a follow up for next 5-10 years.

Oncoplastic Surgery

Doctors recommend breast conserving surgery such as lumpectomy or partial mastectomy to treat early stages of breast cancer. These surgeries, in some cases, result in uneven size and shape of breast in patients.

People suffering from large size breast tumors may require mastectomy rather than certain breast conserving surgery procedures. For such situations, researchers have developed new surgical techniques known as oncoplastic surgery. This method is a combination of cancer surgery and plastic surgery techniques.

This procedure focuses on reshaping your breast after initial breast cancer surgery, such as performing partial reconstruction of your breast after lumpectomy or partial mastectomy or complete reconstruction of breast after mastectomy. An oncoplastic surgery will redesign both your breasts to make them appear similar.

Triple-negative Breast Cancer

Triple-negative breast cancers cannot be treated with hormone therapy or targeted therapy such as with HER2 drugs. The only left treatment option is chemotherapy. Scientists are identifying new breast cancer treatment breakthroughs for triple-negative breast cancer patients.

Such cases can be treated by kinase inhibitor drugs. The effectiveness of new techniques is either studied individually or along with a combination with chemotherapy.

Immunotherapy

Immunotherapy involves activation of the body’s immune cell to kill cancerous cells. Doctors usually recommend immunotherapy along with chemotherapy or other targeted therapy drugs.

Immunotherapy treatment for various breast cancer breakthrough drugs is presently at its clinical trial stage. These drugs are effective for treating advanced breast cancer, patient with triple-negative breast cancer and those expressing PDL-1 gene.

Targeted Therapy Drugs

Targeted therapy drugs are specialized class of drugs which act against genes in cancer cells that have the ability for rapid growth or spread of tumor cells. Researchers are identifying new targeted breast cancer research and treatment options to reduce side effects of the drugs and kill the targeted breast cancerous cells.

These drugs include PARP inhibitors and Olaparib (Lynparza). Olaparib is a drug which works against the BRCA gene mutations which has the capacity to spread breast cancer to surrounding organs. These targeted drugs can be used for patients with HER2-negative breast cancer, who had chemotherapy before.

Endocrine-Dependent Breast Cancer

Hormonal therapy is targeted to reduce function of endocrine hormones in female body such as against estrogen and progesterone. Researchers have identified various classes of drugs which reduce estrogen biosynthesis. These include such as:

• Aromatase inhibitors (AIs), such as letrozole, exemestane and anastrozole
• Selective estrogen receptor downregulators (SERDs) such as fulvestrant
• Gonadotropin-releasing hormone agonists (GnRH), such as leuprolide and goserelin

These drugs are either taken alone or along with other class of drugs. Endocrine-dependent drugs reduce recurrence and increase survival capacity of breast cancer patients.

Palbociclib and ribociclib are some current breakthroughs in breast cancer treatment. These drugs act against estrogen receptors and slow down their growth rate. They also decrease the progression of breast cancer for about 10 months and reduce requirement of chemotherapy.

Palbociclib is usually prescribed for metastatic breast cancer patients and ribociclib for those women who have passed the menopause stage. Both these drugs block the action of proteins involved in cell division such as CDK4 and CDK6.

HER2-Positive Breast Cancer

Patients suffering from hormonal induced breast cancer or those who are detected with HER2 (human epidermal growth factor receptor 2) positive breast cancer are usually provided with trastuzumab drug. It has significantly increased the survival capacity of patients with early and late stages of breast cancer.

Researchers have identified another drug named pertuzumab, which when taken along trastuzumab is more effective than trastuzumab alone.

Latest breast cancer research has recognized an oral tyrosine kinase inhibitor drug molecule, known as neratinib, which is effective for HER2-positive metastatic breast cancer treatment. This drug shows better results as compared to pertuzumab and trastuzumab but has severe side effects and is extremely expensive.