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Breast cancer: latest developments

Written by Gabrielle Collett-White, health journalist

Nearly 45,000 women are diagnosed with breast cancer in the UK every year.

The number of cases has risen in recent years, but thanks to early detection and improved treatment, survival rates are up.

In fact, breast cancer deaths in the UK have fallen by a fifth in the last ten years.

Research has shown that early detection by screening really works.

The 2008 audit of the NHS Cancer Screening Programme found that women with early stage breast cancer picked up by screening are likely to live as long as someone who has never had the disease.

The number one risk factor for breast cancer is age: 80 per cent of cases are in women over 50.

Screening techniques have improved, too.

Antonia Dean, clinical nurse specialist for Breast Cancer Care says: ‘The screening process now involves taking two views of each breast rather than one to improve detection.

Increasingly hospitals are using digital mammography as well. It's still X-ray technology, but the X-ray images can be viewed digitally, meaning radiographers can zoom in on any part of the breast that's unclear.'

One of the latest developments in screeningis the use of computers to read mammograms so only one radiographer is needed instead of two.

A number of research centres around the world are looking into the possibility of developing a reliable blood test for breast cancer.

In the UK trials are underway on a test developed at Nottingham University that could detect breast cancer up to four years earlier than a mammogram.

The test detects subtle changes in proteins in the blood that happen when the immune system begins to fight cancer.

It's hoped that it will lead to cancers being picked up much earlier, making treatment options more effective.

The hormone therapy drug tamoxifen has been found to reduce the chance of breast cancer returning in certain women.

A review of all tamoxifen prevention trials, where the drug is used on 'high-risk' women who are cancer free, also showed a fall in breast cancer risk of 38 per cent.

But the drug has significant side-effects and more research is needed before it can be considered as a preventative drug.

Some women are more at risk of developing breast cancer because they carry a faulty gene.

Two of the most important gene faults are known as BRCA 1 and BRCA 2.

Women who carry one or both of these genes have a 50 to 80 per cent risk of developing breast cancer in their lifetime.

Genetic tests are available for women with a high risk of having these faulty genes, and scientists are looking into other genetic links that may also increase the risk.

But research suggests only 5 to 10 per cent of breast cancer cases have a genetic link – for the vast majority of women the causes aren't clear.

While plenty of money has been spent on developing new treatments, research into a preventative vaccine is still in its infancy.

In September 2008 researchers at the Karmanos Cancer Institute in the US announced they had developed a vaccine that targeted excess HER2 protein and eliminated drug-resistant tumours in mice.

Too much HER2 protein causes an aggressive form of breast cancer that affects up to one in five women.

Research is still at a very early stage, but it's hoped that eventually it could lead to a vaccine that can control HER2-positive breast cancer - and even prevent it developing in the first place.

Leading cancer expert Professor Valerie Beral from Oxford University has also called for more investigation into vaccines for breast cancer.

She believes more research should be done on the possibility of developing a vaccine that mimics the hormones in pregnancy and lactation - known factors in reducing a woman's risk of breast cancer.

Herceptin is one of the newest treatments available. Research has shown it to help stop some breast cancers returning and it may help keep advanced breast cancer under control.

Herceptin works by disarming the protein HER2 that stimulates the spread of cancer, so it only works on HER2-positive breast cancer.

While it is now available on the NHS, Herceptin is a new drug so studies are still ongoing to determine the most effective way to treat women with this medicine.

Another treatment to look out for is called Tyverb (lapatinib).

This is a similar drug to Herceptin, but given in tablet form rather than by intravenous drip. It's designed for patients with an aggressive form of advanced breast cancer that has not responded to other treatments.

Like Herceptin, its use is limited to those cancers that overproduce the HER2 protein. But the drug has been rejected by NICE who decided that there was not enough clinical evidence to approve it on the NHS.

http://www.netdoctor.co.uk/womenshealth/breastcancernews.htm (edited)

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