New, cheaper blood test could help detect breast cancer recurrence earlier
New research from our scientists has shown that more people could benefit from a new type of blood test that can predict breast cancer recurrence, months before it’s picked up on a scan.
Dr Isaac Garcia-Murillas, based at the Breast Cancer Now Toby Robins Research Centre at The Institute of Cancer Research, London showed that a new ‘tissue-free’ blood test can effectively detect early signs of coming back. The test would be cheaper and easier to use as it doesn’t rely on analysing tumour tissue collected at diagnosis.
In the future, accurately predicting which tumours are likely to come back and spread after initial treatment could help identify who may need further treatment, while reassuring people at low risk.
Glossary term
Triple negative breast cancer
The name given to breast cancer that is:
- Oestrogen receptor negative (ER-negative)
- Progesterone receptor negative (PR-negative)
- HER2-negative
Clues in the blood
When breast cancer comes back and spreads to other parts of the body, it’s known as metastatic (secondary) breast cancer. When this happens, we can treat it but it currently can’t be cured.
Liquid biopsies are very sensitive blood tests that look for tiny pieces of cancer DNA in the blood. They can spot breast cancer coming back before the tumours become visible on hospital scans.
Right now, these tests are not suitable for everyone. This is because they're highly personalised, and doctors first need to gather detailed information about the tumour to develop a blood test tailored to the person. This isn’t always possible, and it makes it difficult to use these tests widely in hospitals as part of routine follow-up. Now, Isaac and his team have shown that a new ‘tissue-free’ liquid biopsy blood test, which doesn’t require prior information about the tumour, works as well as the ‘tissue-informed’ test at detecting breast cancer coming back.
This study helps us better understand which blood tests are most effective at detecting the earliest signs that breast cancer has returned. We've shown that this tissue-free approach performs well and could make ctDNA testing available to more patients, particularly when a tumour sample isn't available.
Calculating the risk
To directly compare the liquid biopsy tests, the researchers studied blood and tumour samples collected as part of the C-TRAK TN clinical trial. This was the first study to investigate whether monitoring cancer DNA in the blood could predict recurrence in people with early triple negative breast cancer who were at moderate to high risk of their cancer returning.
They found that detecting cancer DNA in the blood is a very strong predictor of whether or not breast cancer was likely to return. On average, liquid biopsies predicted recurrence around 7.9 months before the cancer showed up on standard scans.
And they also found that the new tissue-free blood test performed just as well as more complex approaches that rely on the information from tumour tissue samples.
For the 8,000 women diagnosed with triple negative breast cancer each year, the need for better ways to predict recurrence is particularly urgent.[JW1.1] Tests that can identify who is most at risk could give treatment teams a crucial window to offer additional therapies that could potentially stop more people from developing incurable metastatic breast cancer.
Tailored treatment, made simple
These findings bring researchers another step closer to using blood tests to personalise follow-up care.
More research is needed. But if future studies show that acting on these early warning signs can help stop cancer progressing, doctors could identify people at higher risk, provide extra treatment earlier, and stop the disease before it spreads.
More accurate blood tests could also reassure people at lower risk that their cancer is less likely to return, helping ease the anxiety many experience after treatment.
Over 8,000 women are diagnosed with triple negative breast cancer each year in the UK. And with one person tragically dying from breast cancer every 45 minutes, breakthroughs like this are urgently needed.
This project was funded by us and supported by funding from Cancer Research UK, Guardant Health, ICR Clinical Trials and Statistics Unit, Le Cure (Royal Marsden Cancer Charity) and NIHR BRC at ICR & RMH. It was published in JAMA oncology.
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