December 3, 2013

expert reaction to pre-invasive breast cancer and a molecular marker for whether the lesion will become invasive

A new biomarker could help identify abnormal breast cells that will develop into tumours, according to research published in Clinical Cncer Research.

Professor Peter Barrett-Lee, Academic Breast Unit, Velindre Cancer Center, Velindre NHS Trust, said:

“This is an interesting new scientific finding and could prove important in the future, but at the moment the results of the study need to be replicated by others, and so any potential prognostic uses and treatment related to this may be many years away.”

Professor Shirley Hodgson, Professor of Cancer Genetics, St George’s, University Of London, said:

“DCIS (ductal carcinoma in situ) is quite a common breast neoplastic lesion often detected by screening, and many cases do not progress to invasive cancer. However it has not been possible until now to know which cases will progress, so treatment for all cases tends to be uniform. This paper describes a new test that may be able to differentiate clearly between those cases which will progress to invasive cancer and those that will not.

“This study has shown that the expression of a marker known as avb6 is significantly associated with progression to invasive cancer (p<0.006) and with recurrence over a median follow-up of 114 months in a series of matched DCIS cases treated with local excision. The researchers have shown that this marker protein changes myoepithelial cells in breast tissue to promote tumor cell invasion in vitro and enhances mammary tumor growth in vivo. This action can be reversed by inhibiting this pathway.

“This could mark a groundbreaking advance in the way that DCIS is managed and treated, allowing chemotherapy to be used only in the progressive cases, and also suggests novel cancer therapies that can be developed based on inhibition of this cancer pathway.”

Dr Gillian Farnie, Research Associate and Breast Cancer Campaign Fellow, Institute of Cancer Sciences, University of Manchester, said:

“The exciting research carried out by Dr Michael Allen and Professor Louise Jones makes significant steps forward in our understanding of the biology of DCIS (ductal carcinoma in situ) and its progression to invasive cancer.  These results, if validated by other research groups, could provide a new marker for identifying DCIS that are more likely progress to invasive disease, however more importantly may highlight a group of DCIS patients where no treatment is necessary.  This would be a major breakthrough in the management of DCIS and although this research is not ready for clinical application yet it shows great promise for the future.”

‘Altered microenvironment promotes progression of pre-invasive breast cancer: myoepithelial expression of integrin DCIS identifies high-risk patients and predicts recurrence’ by Michael D Allen et al. published in Clinical Cancer Research on Tuesday 3 December.