In Newcastle/Gateshead, a city famous for its bridges, the UK breast cancer research community gathered this Breast Cancer Awareness Month to focus on bridging gaps in breast cancer research.
At a special one-off conference, called 'Breast Cancer – Bridging gaps in our knowledge to improve patient outcome' put on by The British Association of Cancer Research, we heard the research community respond to our 2013 Gap Analysis publication. Here are some of the highlights from the event:
Risk needs re-assessing
We recently blogged about breast cancer risk and prevention and a lot of what we heard at the first day of the conference expanded on that theme. Professor Doug Easton spoke of how “a revolution” in technology speed and costs has meant we now know about over 100 small genetic changes that are linked to an individual’s risk of developing breast cancer (knowledge that comes, in part, from our Generations Study).
Now this knowledge needs to be combined with information about family history, lifestyle choices and breast density to make our measures of breast cancer risk more accurate, and we heard from other researchers on how we can go about that.
Meanwhile, patient advocates in the audience reminded us that as we get better at calculating people’s risk, we also need to get better at explaining that risk so that everyone can understand their own risk of breast cancer and know what they can do about it.
Powering up prevention
So once we know someone’s risk of getting breast cancer, how do we prevent them getting it? Professor Jack Cuzick’s talk reminded us that the drugs tamoxifen, raloxifene and anastrozole are options we have for prevention.
But Prof Cuzick acknowledges that prevention research is only at its beginning and there are a whole lot of avenues still to investigate, possibly including drugs like aspirin and statins.
Of course, drugs aren’t the only way to prevent breast cancer, and we heard from Dr Michelle Harvie about her study which is offering women a 'health check' when they attend breast screening, then supporting them to lose weight and help prevent breast cancer and other diseases.
Improving early detection
For cancers we can’t yet prevent we need to focus on catching them early, but we know that early detection through screening will pick up some cancers that would never be harmful during a woman’s life time.
That’s why Professor Louise Jones’ work is so important. As we’ve reported before, Professor Jones thinks that the key to knowing which very-early cancers (called DCIS) will and won't be harmful is looking for molecular changes in the cells lining the walls of the breast’s milk ducts, and her team have made major progress in this area which they are continuing to build on.
From identifying and targeting cancers, we moved through to cancers which are resisting treatment. Professor Mitch Dowsett gave a great overview of where we are now with treatments for breast cancers driven by oestrogen and what we know about resistance.
To better understand the problem of cancers that become resistant to hormone drugs called aromatase inhibitors, Prof Dowsett’s team are currently studying samples collected from a trial called POETIC.
Dr Jason Carroll is taking a different approach to hormone resistance by asking the, somewhat radical, question: is progesterone actually good for breast cancer? For years it’s been thought progesterone helps many breast cancers to grow.
Dr Carroll’s research is turning this idea on its head. Now his team are aiming to start a trial where progesterone is added to treatment with drugs that block oestrogen, such as tamoxifen or aromatase inhibitors.
Stepping up to secondary breast cancer
The two key talks on secondary breast cancer both spoke of their hopes of new treatments to stop breast cancer spreading, each using two different approaches.
Professor Yibin Kang from Princeton University, USA is using a huge array of leading-edge approaches, from genetics to computational biology, to understand how and why breast cancer spreads. This has now led him to genes he could target to stop this process.
In contrast, Professor Rob Coleman has focussed on data from clinical trials, which he and colleagues have collated and re-analysed to show that drugs called bisphosphonates can save lives from breast cancer in women who have gone through the menopause. This is a practice-changing discovery we blogged about earlier this year.
Chemistry could save lives
Professor Andy Tutt moved us on to the aggressive triple-negative type of breast cancer. He started by mentioning this year’s Nobel Prize for Chemistry. One of the joint winners was Tomas Lindahl, a cancer researcher who helped to show how DNA repairs itself – work so important it merited a Nobel Prize.
It is also the basis for a lot of work being done to try and treat triple negative breast cancer, and Prof Tutt gave a round-up of current progress in tackling this type of breast cancer.
Predicting the future
The final scientific talk of the conference came from Professors Alastair Thompson and Sue Eccles, who reflected on the past 25 years of breast cancer treatment and research and the future – something they both felt “hugely optimistic” about.
So we left the conference fired up and ready as a charity to help the research community, and patients to face the challenges that lie ahead of them – as Prof Eccles put it: “I can’t predict the future but the best way to predict a successful future is to create it together ourselves”.