Research key to stopping the spread and improving survival for secondary breast cancerOctober 13th, 2016
Thanks to progress made in early detection and better treatments, 90 per cent of those diagnosed with breast cancer in Australia will still be alive in five years[i].This is an enormous improvement over the figures reported just a few years ago: in 1994, only 76% of women were likely to survive after 5 years.
However, up to a third of breast cancer ‘survivors’ will go on to develop the secondary stage of the disease also known as metastatic breast cancer.[ii] This is where cancer cells spread and grow in other organs (for example, brain, lungs and bone).
Treating this advanced stage of the disease is much more challenging and the likelihood of being alive in five years drops alarmingly to just 22 per cent.[iii]
This year, 3,046 Australian women and 27 men are predicted to die from breast cancer; an average of eight people every day. [iv]
Dr Alessandra Muntoni, Director of Research Investment at the National Breast Cancer Foundation (NBCF) says these numbers tell two very different stories about breast cancer survival.
“On the one hand we have a major success story for the early detection and treatment of the primary disease, when the tumour is confined to the breast. The chances for this stage of the disease to be successfully managed are much higher, and the prognosis is good in a large number of cases.
“It’s a different story for those with secondary breast cancer – for these women the long term survival rate is alarmingly low and successful therapeutic options are more limited.
“By investing in breast cancer research we have made significant progress and saved countless lives.
But to continue our mission towards zero deaths from breast cancer much more research is needed, so
that we can better understand how breast cancer returns and spreads and develop effective
treatments to address this” says Dr Muntoni.
Exactly how tumours spread is still unclear and NBCF-funded researchers, along with researchers around the world, are investigating what triggers cancer to spread beyond the breast. This fundamental knowledge about breast cancer biology is the key to developing ways to stop the spread and/or treat it effectively.
Prof Mark Ragan – The University of Queensland, Institute for Molecular Bioscience
The process of tumours spreading to other parts of the body (metastasis) involves the activity of a characteristic set of proteins. Prof Ragan and his team will apply computational science and informatics to identify these proteins and map their networks of interactions, ultimately hoping to discover whether they provide clues to where the tumour cells will settle, i.e. brain, bones, lungs or liver.
Dr Ewa Michalak – Walter and Eliza Hall Institute
Approximately one-third of breast cancer patients will have tumours that become resistant to standard chemotherapy, and their tumours may relapse and subsequently metastasise. This is thought to be due to the existence of a small population of drug-resistant cells, which may initiate and maintain the tumour. The cells have been termed ‘breast cancer stem cells’ and may originate from normal breast stem cells. Dr Michalak and her team aims to understand how healthy breast stem cells are maintained in the breast and how this process goes awry in breast cancer. They are studying a group of proteins known as epigenetic modifiers which instruct cell identity and behaviour. This knowledge will aid in the earlier detection of tumours and in design and development of new therapies for patients with advanced and metastatic disease.
Research thus far has discovered that metastatic breast cancer is:
- Aggressive and challenging to treat
- Able to travel through the blood and lymph system to other parts of the body
- Often spreads to distant organs (e.g. to the brain, lungs, liver and bones)
- Able to remain dormant in the body for many years, sometimes a decade, before becoming active impacts long-term survival rates.
- Is the major cause of breast cancer deaths[v]
Researchers are still seeking the answers to many questions about metastatic breast cancer, such as:
- Why does breast cancer come back?
- How can the time and point of origin of metastases be detected?
- Are there biological or genetic risk factors for metastasis?
- Which tumours are more likely to metastasise?
- How can the spread of cancer be prevented or blocked?
- How can the site of metastasis be predicted?
[i] Australian Institute of Health and Welfare & Cancer Australia 2012. Breast Cancer in Australia: an overview. Cancer series no. 71. Cat no. CAN 67. Canberra: AIHW
[ii] Global Status of Advanced / Metastatic Breast Cancer, 2005-2015 Decade Report, March 2016 http://www.breastcancervision.com/sites/default/files/Decade%20Report_Full%20Report_Final-Linked.pdf
[iii] According to the American Cancer Society, five-year survival rates for metastatic breast cancer are 22 per cent. There are no Australian figures for survival rates by breast cancer stage.
[v] Global Status of Advanced / Metastatic Breast Cancer, 2005-2015 Decade Report, March 2016 http://www.breastcancervision.com/sites/default/files/Decade%20Report_Full%20Report_Final-Linked.pdf