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Personalised ‘liquid biopsy’ could detect return of breast cancer nearly eleven months earlier than hospital scans

A personalised blood test for women with early breast cancer could detect the return of the disease nearly eleven months earlier than hospital scans, a new study at five UK hospitals has found.

The study, funded by Breast Cancer Now and other collaborators, found that the test for levels of cancer DNA circulating in the blood detected the return of the disease after treatment on average 10.7 months before patients developed symptoms or secondary tumours became visible on scans.

The test, developed by scientists at The Institute of Cancer Research, London and The Royal Marsden NHS Foundation Trust, was found to work in all types of breast cancer, and could detect the early signs of the spread of the disease around the body (outside of the brain).

Further research is now needed to understand how the test could be used in the clinic to help guide treatment and improve patient outcomes, with UK trials now underway to assess new treatments alongside the test in triple negative breast cancer.

Who is the test for?

Breast cancer is the UK’s most common cancer, with around 55,000 women and 350 men being diagnosed each year in the UK.

While more women are now surviving the disease than ever before thanks to research progress and advances in NHS treatment, recurrences are still common and happen when breast cancer cells survive initial treatment and grow into new tumours.

In cases where the disease returns and spreads to form tumours in other parts of the body, known as metastatic or secondary breast cancer, while it can be controlled for some time it unfortunately cannot be cured. Almost all of the around 11,500 women and 80 men that lose their lives to breast cancer each year in the UK will have seen their cancer spread.

‘Liquid biopsies’ ― blood tests that can detect cancer DNA in the bloodstream ― have emerged as an exciting new field in cancer research in recent years. The tests aim to monitor how a patient’s cancer is responding to treatment in real-time, detect emerging resistance to treatment and spot any recurrences at the earliest possible stage.

Analysing cancer DNA to predict recurrence

In a new prospective study of 101 women across five UK hospitals, scientists led by Professor Nicholas Turner in the Breast Cancer Now Research Centre at The Institute of Cancer Research (ICR) assessed the potential of a new personalised blood test to detect recurrence in patients diagnosed with early breast cancer who had no signs of secondary tumours.

The tests are tailored to the make-up of each woman’s tumour to enable the levels of cancer DNA in their bloodstream to be monitored.

By analysing cancer DNA from tumour samples collected before treatment, the researchers identified mutations that could distinguish cancer DNA from all other DNA in the blood and could be tracked over time. Overall, in the 101 patients, 165 different trackable mutations were found, with 78 participants having one trackable DNA mutation and 23 patients having multiple mutations.

Blood samples were collected from participants every three months during their first year after treatment, and then every six months for up to five years thereafter.

To assess the test’s ability to detect recurrence at a molecular level in different breast cancer sub-types, the researchers combined the data with a previous proof-of-principle study to establish a bigger cohort of 144 patients.

At follow-up of approximately three years, 29 of 144 patients had seen their breast cancer return. 23 of these 29 patients had cancer DNA detected in their blood prior to relapse, with the ‘liquid biopsies’ spotting the signs of recurrence on average 10.7 months before their clinical diagnosis.

‘A new treatment paradigm for breast cancer’

With the test accurately indicating the return of breast cancer across all major subtypes, the authors suggest that upcoming trials could lead to “a new treatment paradigm for breast cancer”, in which therapy could be offered at the first signs of relapse at a molecular level, rather than at a later stage once symptoms have appeared.

In addition, the researchers also conducted a sub-analysis of 80 patients who had blood samples taken at their diagnosis – with circulating cancer DNA being detected in 41 of these women. These patients were found to be 5.8 times more likely to experience a relapse during the first three years after treatment than those without detectable levels of cancer DNA prior to treatment – demonstrating that the test may also have prognostic potential in the future.

The study is published in JAMA Oncology and was largely funded by Breast Cancer Now, with additional support from The Royal Marsden Cancer Charity and the NIHR Biomedical Research Centre at The Royal Marsden NHS Foundation Trust and the ICR.

Our Breast Cancer Now Tony Robins Research Centre houses over 120 scientists and clinicians whose aim is to develop a multidisciplinary approach to tackling breast cancer.

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Professor Nicholas Turner, Professor of Molecular Oncology at The Institute of Cancer Research, London, and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, said:

“These new blood tests can work out which patients are at risk of relapse much more accurately than we have done before, identifying the earliest signs of relapse almost a year before the patient will clinically relapse.

“We hope that by identifying relapse much earlier we will be able to treat it much more effectively than we can do now, perhaps even prevent some people from relapsing. But we will now need clinical trials to assess whether we can use these blood tests to improve patient outcome. We have launched the first of these studies already, and hope to launch large studies in the future.”

‘Extremely exciting’ potential

Dr Simon Vincent, Director of Research at charity Breast Cancer Care and Breast Cancer Now, which funded the study, said:

“This could be a really significant breakthrough. The potential of this blood test to in future spot the signs of breast cancer returning or spreading much earlier in NHS clinics is extremely exciting.

“But we now need upcoming trials to identify whether offering treatments to patients at this stage could actually help intervene and improve their chances of survival or quality of life.

“The fact that these tests are personalised to each patient to try to find out whether any cancer cells remain and are on the move is unique. But for thousands of women, a blood test like this and the hope of new treatments to stop the disease returning just cannot come soon enough. The fear of breast cancer coming back can have a major impact on patients’ lives, and we urgently need to do more to support them, as well to increase awareness of the signs and symptoms of secondary breast cancer.

“While most aches, pains or coughs won’t mean the cancer is back, we’d encourage all women to report any new, unexplained or persistent changes to their GP or breast care team. Anyone feeling worried about their breast cancer returning can call our free Helpline on 0808 800 6000 and speak to one of our nurses.”

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Cancer trades in sugar for fatty acids in order to spread around the body

 

Scientists have uncovered a crucial change in cancer cells that allows them to spread around the body – by switching from sugar to fatty acids to fuel their growth.

Changing their ‘diet’ in this way allows tumour cells to set up shop at new sites where resources such as glucose – their preferred food source – are limited.

Researchers at The Institute of Cancer Research, London, found that a protein called AKR1B10 helps cells adapt the ways in which they get their energy.

When cancer cells have high levels of AKR1B10, it reduces their dependency on sugar and increases their ability to use fatty acids as a fuel source instead.

Shutting down cell food sources

The research raises the opportunity to screen breast cancer patients for increased levels of AKR1B10, which may help identify patients at an increased risk of metastatic relapse.

It could also lead to the development of new treatment options  that shut down cells’ ability to use fatty acids – which the study showed could reduce relapse rates in mice.

The study was published in Nature Communications and funded by Breast Cancer Now. The study focussed on breast cancer cells, but high levels of AKR1B10 are also seen in liver, lung, and pancreatic cancers.

We are building a new state-of-the-art Centre for Cancer Drug Discovery centre to create more and better drugs for cancer patients.

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The researchers first identified AKR1B10 in a screen for proteins which, when expressed at high levels, helped cancer get ahead at new locations, while low levels of the protein hinder its growth in new organs.

Cells normally avoid using fatty acids for fuel as there are toxic side effects. High levels of AKR1B10 limit these toxic side effects, allowing cancer cells to thrive in new areas in the body.

The opposite is also true – switching off the cancer cells’ ability to use fatty acids reduces their ability to form tumours at new sites in the body.

Cancer survival mechanisms

Professor Clare IsackeProfessor of Molecular Cell Biology in the Breast Cancer Now Toby Robins Research Centre at the ICR, said:

“Cancer cells have to work hard to take root and form a tumour. When tumour cells head on the move to other parts of the body, a process called metastasis, they have to work even harder to adapt to the energy and nutrient sources available to them wherever they find themselves, as well as surviving the journey.

“Our study has shown the importance of cancer cell learning how to use different nutrients and energy sources in order to survive.

“We found that high levels of the protein AKR1B10 help tumour cells adjust to new environments as cancer spreads from the breast to other organs such as the lungs.

“This research significantly improves our understanding of cancer cell metabolism and metastatic relapse and could lead to new avenues of exploration for new therapies and treatments for patients with metastatic breast cancer.”

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Targeted breast cancer drug – olaparib – given green light by EU

European Medicines Agency approves olaparib for women with BRCA-mutant breast cancer – 15 months after licensing in the US

The targeted cancer drug olaparib has been approved by the European Medicines Agency (EMA) for women and men with advanced breast cancer who have inherited BRCA gene mutations.

The decision comes 15 months after the drug was approved for breast cancer in the US by the Food and Drug Administration.

NICE has paused its appraisal of olaparib for NHS patients with breast cancer while waiting for manufacturer AstraZeneca to submit new data, and is not now planning to restart its review until around July.

The Institute of Cancer Research, London, discovered the genetic targeting of olaparib – which became the first cancer drug directed against an inherited genetic fault when licensed by the EMA for BRCA-mutation ovarian cancer in December 2014.

In a statement, the ICR welcomed the approval of olaparib for breast cancer as an important step towards making it available for NHS patients – but also criticised delays in making the drug available in Europe.

‘Extremely innovative treatment’

Professor Paul Workman, Chief Executive of the ICR, said:

“It’s fantastic news that olaparib has finally been given the green light by the EMA for people with BRCA-mutant breast cancer. But it’s also been enormously frustrating for patients across Europe to have had to wait so long to get the drug.

“Olaparib is an extremely innovative treatment which was the first cancer drug in the world to target inherited genetic faults. Yet it’s taking far too long for pioneering drugs like this to reach patients and we need to do more to fast-track the most exciting new treatments into the NHS.

“The EMA and NICE have started to be more nimble and flexible in their evaluation of evidence, but there is still more they could do and much that they could learn from best practice in the US and elsewhere.”

Researchers at The Breast Cancer Now Toby Robins Research Centre lead important study programmes to understand the genetic and environmental causes of breast cancer.

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‘Excellent news for patients’

Professor Andrew Tutt, who is Director of the Breast Cancer Now Research Centre at the ICR, was part of the early laboratory research at the ICR behind PARP inhibitors in patients with BRCA mutations, and led some of the early clinical trials of olaparib for BRCA-mutant breast cancer.

Responding to the decision, Professor Tutt said:

“Although the delays have been disappointing, I am delighted olaparib has now been licensed in Europe for advanced breast cancer in women who have inherited BRCA1 or BRCA2 mutations. It is excellent news for patients with this form of breast cancer.

“Olaparib is the first drug to be approved that is directed against an inherited genetic mutation. It is a perfect example of how understanding a patient’s genetics and the biology of their tumour can be used to target its weaknesses and personalise treatment.”

Emma Clarke, 46 from Cheshire, was diagnosed with primary breast cancer in 2016, and secondary breast cancer spread to her bones in 2018. Later genetic testing discovered she carried a BRCA1 mutation. She is currently being treated with chemotherapy and is due to begin radiotherapy soon. Her daughter recently discovered she also has the BRCA1 mutation.

Emma said:

“I have done a lot of research into my type of cancer – about having a BRCA1 mutation and the possible treatments available for me. Because I have the BRCA1 mutation, and that carboplatin is working well for me at the moment, I found out that olaparib has a good chance or working well for me and that it is already available in the US.

“I’m fortunate enough to be a private patient and have asked my doctor about starting olaparib, which I will begin taking as a maintenance treatment when my radiotherapy finishes in June.

“I whole heartedly support progress in targeted therapies and getting these to patients as soon as possible. Targeted therapies are at the forefront of treatments for patients, and give such hope at extending lives while living with fewer side effects than traditional chemotherapies.

“I was really surprised to see the length of the time gap between olaparib being available in the US and it being approved by the EMA. I hope for all the other BRCA+ breast cancer patients in this country that it is available on the NHS as soon as possible.

“With advanced-staged cancers like my own, once you have good evidence that a new targeted treatment is shown to work and extend lives, it should be available to patients.”

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ASCO 2019: New blood test predicts breast cancer’s return at start of treatment

Video: Dr Ben O’Leary discusses a new blood test for women with advanced breast cancer which can predict
how well patients will respond to a new drug right at the start of treatment.

A new blood test for women with breast cancer can predict how well patients will respond to a new drug right at the start of treatment.

The new blood test detected genetic changes within women’s breast cancers which indicated that these patients were less likely to respond to treatment – and that their disease could be expected to come back quickly.

Targeted drugs have shown benefit for many women with advanced breast cancer, but some patients stop responding soon after starting treatment as their cancer evolves to become drug resistant.

In future, the new test could help identify nearly half of women with the most common form of breast cancer who are at the highest risk of early relapse – who will need further trials of new treatments to stop their cancer becoming resistant – as well as identifying those who will do very well on treatment.

Many scientists from The Institute of Cancer Research, London are attending the 2019 ASCO conference in Chicago. See all of our news, blog and video content from the event. 

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Early relapse

Scientists at The Institute of Cancer Research, London, analysed fragments of cancer DNA that have entered the bloodstream to study the effect of genetic changes in a woman’s tumour – often called liquid biopsies.

They took blood samples from 310 women with oestrogen receptor positive breast cancer – the most common form of the disease – who were taking part in a clinical trial of palbociclib and fulvestrant for advanced breast cancer.

The team found that 131 women – 42 per cent – had one or more of three changes in the tumour DNA circulating in the bloodstream that put them at risk of early relapse.

The research, presented today (Saturday) at the 2019 ASCO Annual Meeting in Chicago, was funded by the Medical Research CouncilBreast Cancer Now, and the manufacturer of palbociclib, Pfizer.

The p53 gene

Researchers at The Institute of Cancer Research (ICR) – a charity and research institute – and The Royal Marsden NHS Foundation Trust examined the impact of specific genetic changes within patients’ cancers at the start of treatment.

Women whose circulating tumour DNA contained changes in the well-known cancer gene, p53, saw their cancer come back after an average of 3.7 months, compared with 12.7 months in women without p53 gene changes.

An increase in the number of FGFR1 gene copies and a high level of tumour DNA in the bloodstream also shortened the average time before a woman’s cancer came back.

Women with these changes in circulating tumour DNA saw their cancer return after an average of 3.9 months compared with 12 months in women without these changes.

The study also found a link between faults in the p53 gene and the number and location of sites in the body to which cancer had spread.

Next, the blood test needs to be evaluated as part of different clinical trials to assess its value in other groups of patients, before it can start benefiting women with advanced breast cancer in the clinic.

The research follows a recent announcement by the ICR of a £15 million fundraising drive to complete a new £75 million Centre for Cancer Drug Discovery focusing on overcoming cancer evolution and drug resistance.

Predicting cancer’s next move

Professor Nicholas Turner, Professor of Molecular Oncology at The Institute of Cancer Research (ICR) and Consultant Medical Oncologist at The Royal Marsden, said:

“Exciting new targeted treatments like palbociclib are beginning to have a real impact on survival for women with breast cancer, but unfortunately many tumours which initially respond will later develop resistance and come back.

“Our study found that a new genetic test could detect right at the start of treatment those women whose cancers were most likely to develop resistance quickly to palbociclib. We could then adjust their treatment plan accordingly – trialling additional treatments from the outset to try and prevent resistance, or planning for a switch to another treatment as soon as resistance develops. We now need to assess in a clinical trial whether helping direct women’s care with this new test can offer improved survival and quality of life.”

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Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, said:

“Cancer’s ability to evolve to become resistant to treatment is the greatest challenge we face in improving patients’ survival and quality of life.

“So-called liquid biopsy tests like this one are a key part of our toolkit in staying on top of cancers’ adaptability and evolution, and picking up the earliest signs of drug resistance. Detecting the potential of cancers to evolve resistance could allow us to predict cancer’s next move and to respond with adaptable new treatment plans.

“This study is a demonstration of the exciting new ‘Darwinian’ approach to treatment we will be taking once we have raised the money to complete our new £75 million Centre for Cancer Drug Discovery.”

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Capturing cancer on the move – ICR photography competition showcases stunning images of tumour cells in action

Every year our researchers submit outstanding pictures to our Science and Medical Imaging Competition – telling a story about our pioneering work and its benefits for patients. Check out the fantastic images selected by our judges, and this year voted for by the public.

Each year, The Institute of Cancer Research runs a Science and Medical Imaging Competition – designed to cater for the moments in the lab or the clinic where science meets art.

The entries we receive for the competition have all been created in the course of our pioneering cancer research – but they are also exceedingly beautiful, and wonderfully effective at conveying broad messages about our work.

‘Divide and conquer’

The winner of this year’s competition – ‘Divide and conquer’ by ICR postdoc Dr Maxine Lam – is a great example. It shows a replicating cancer cell in vivid detail as it invades through blood vessels – and communicates something about the lethal process of cancer metastasis that words alone often struggle to convey.

Metastasis is one of the most challenging aspects of cancer, because it often makes the difference between life and death. Once cancer has spread to other parts of the body we have few effective treatments, and the disease is often fatal.

Scientists are therefore keenly interested in understanding how cancer cells spread so they can find ways of stopping it from happen.

And that has led to the development of ever more sophisticated and powerful imaging technologies so researchers can watch the process in action over time.

“I’m really excited and honoured to have won”

Dr Lam’s winning image was taken using a technology called confocal microscopy, and shows a cancer cell in pink invading through a layer of blood vessel cells, in yellow and cyan. The cancer cell has created a gap in the layer of blood vessel cells as it invades.

The picture illustrates a key step in metastasis called extravasation – where cancer cells move out of a blood vessel into tissue to spread to secondary tumour sites. Despite the importance of this step, very few models exist in the lab to directly visualise and understand it.

Dr Lam’s lab in the ICR’s Division of Cancer Biology uses a unique set-up to provide previously unseen detail into this process.

In the image white DNA inside the cancer cell has condensed into bright rods. This means that the cancer cell is in the process of dividing itself, even as it is invading – a remarkable yet terrifying sight. Dr Lam’s lab is using images like this to identify factors that could prevent cancer cells from being able to move and spread.

Dr Lam said: “I’m really excited and honoured to have won the ICR Science and Medical Imaging competition. This image captures two important moments in the life of a cancer cell, when it divides to make new copies of itself and when it leaves the circulation and invades new tissues, which is one of the most dangerous aspects of cancer.

“Seeing this process in action helps us to better understand how cancer spreads, and I hope this will help with developing new treatments.”

The public’s favourite

Dr Lam’s image was awarded the main prize in the competition by a panel of judges from the ICR and our partner hospital The Royal Marsden NHS Foundation Trust.

We also this year carried out our first ever public vote, asking our supporters on social media to choose their favourite from the judge’s shortlist.

There was lots of agreement between the judges and the public, but the vote picked a different winner – a stunning time-lapse image of a breast cancer cell on the move by PhD student Patricia Pascual Vargas.

Patricia Pascual Vargas’ photograph: Time-lapse image of a breast cancer cell on the move

Cancer cells can take on many shapes, squeezing through tissues and finding their way into places they shouldn’t be, using a complex network of adhesion molecules on their surfaces to move around.

Patricia’s image was taken using another type of technology called a total internal reflection fluorescence microscope (TIRF), and shows a very aggressive type of triple-negative breast cancer cell sensing its environment, by making contact through structures called focal adhesions.

This time-lapsed image uses different colours to show the position of focal adhesions over time. The yellow and red colours represent shorter adhesion times, and show that the cell is moving down and to the left.

Patricia and her colleagues are looking at how targeting certain genes affects the formation of adhesions, changing the cell’s shape and how it moves. It could be possible to prevent cancer cells from spreading around the body, making cancer easier to treat.

Patricia said: “I’m thrilled to have won the first ever public vote. My image helps to demonstrate that cancer cells aren’t static – they move and change shape, and this important characteristic helps them to adapt to their environment. By pinpointing how cancer cells do this we could prevent them from changing shape and stop them from spreading, which could save patients’ lives.”

Our fantastic shortlist

With another year of so many astounding entries, it’s important to recognise all of the fantastic images that made it onto our shortlist.

Dr David Mansfield

Cell death caused by radiotherapy – before and after, taken by Dr David Mansfield, Division of Radiotherapy and Imaging.

David Mansfield’s photograph: Cells within a tumour visualised before (left) and after (right) radiotherapy

This image shows cells within a tumour visualised before (left) and after (right) radiotherapy. Coloured immune cells move in to clear up the tumour cells in white, left behind after treatment. This helps the body gain vital anti-tumour immunity and long-term protection from recurrent disease.

Multiple members of the Clinical Studies Division

Detecting immune cell populations in a liver biopsy by Dr Mateus Crespo Dr Bora Gurel, Ana Ferreira, Rita Pereira, and Professor Johann de Bono, Division of Clinical Studies.

Photograph by multiple members of the Clinical Studies Division: Detecting immune cell populations in a liver biopsy

This multi-coloured image was taken using multiplex immunohistochemistry to light up a liver biopsy from a patient with metastatic cholangiocarcinoma, an aggressive cancer of the bile duct. Liver cells in yellow are being infiltrated by immune system T-cells in red and green.

Parames Thavasu

The exploding nuclei – using combination drug treatments to overcome DNA damage repair mechanisms in cancer cells, by Parames Thavasu, Division of Cancer Therapeutics.

Parames Thavasu’s photograph: cells of an aggressive form of breast cancer called triple-negative breast cancer

This image shows cells of an aggressive form of breast cancer called triple-negative breast cancer, which is difficult to treat and has poor outcomes. After treating with a drug combination that causes damage to DNA at different stages of cell division, ‘explosive’ damage to cancer cells has occurred.

Dr Rebecca Marlow

Proliferating cells in a tumour organoid of triple-negative breast cancer, by Dr Rebecca Marlow, Division of Breast Cancer Research.

Dr Rebecca Marlow’s photograph: Proliferating cells in a tumour organoid of triple-negative breast cancer

This image shows tumour organoids of triple-negative breast cancer, a hard-to-treat form of the disease, grown from tissue samples donated by patients.

The nuclei of cells are marked in blue, while the cytoskeleton that helps cells maintain their shape is green. Proliferating cells are pink, where cells in the organoid are growing and dividing.

Cutting-edge research

These eye-catching images illustrate just some of the cutting-edge research being carried out at the ICR, taken using sophisticated equipment purchased thanks to generous donations from our supporters.

From images like these our researchers are gaining unprecedented insights into the mechanisms that drive cancer, and new ways to target the disease to help treat patients.

Dr Chris Bakal, who leads the teams in which Maxine and Patricia work, and is a previous winner of the competition himself, said:

“It is a cancer’s ability to spread round the body which often makes it fatal. It is incredibly valuable to be able to image this process over time to give us the insights into cancer biology that we need to discover new treatments.

“Our winners have used cutting-edge imaging technology to create measurable, single-cell imaging in 3D environments, to provide a vivid picture of exactly how cancer cells metastasise.”

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What are the Breast Reconstruction Options After a Mastectomy?

Deciding and planning to go for breast reconstruction options after a mastectomy is a huge emotional journey. With the advent of newer plastic surgery techniques, the results are quite natural and satisfactory. Ideally, a woman should be given a choice among the various reconstruction options.

The process begins by consulting plastic surgeons who specialise in reconstructive techniques. Understanding your option will help you make an informed decision that suits your needs. As many as 30% of women undergo breast reconstruction surgery after a mastectomy.

When it comes to breast reconstructive surgery, there are some options available mimicking the size, shape, and texture of your original breast tissue. Some of them might involve implants while others use grafts from your own body for reconstruction.

Here is a guide about what options are available which will best suit your needs.

Implant Reconstruction

This involves placement of saline or saline implants under the muscles in your chest where the breast tissue has been removed. If there is insufficient muscle left after surgery to carry out reconstruction, the surgeon makes use of an inflatable implant that is gradually filled with saline or silicon over time which allows for the skin of the growth to follow.

Suitability: Small breasts and petite frame

Duration: surgery takes around two hours with a recovery time of two weeks

Pros: Can be used for a double mastectomy as this is best known for symmetrical results

Cons: Not suitable if you intend to undergo radiotherapy afterward as hardening may result.

DIEP or TRAM Flap Reconstruction

DIEP Flap

A DIEP flap involves no muscle and consist of fat, skin and blood vessels cut from lower part of your body and implanted in place of your breast tissue.

TRAM Flap

This is a flap of rectus abdominis, a muscle from your lower abdomen (6 pack muscle) which could be free or pedicled.

Pros: the result is a breast soft in consistency and feels natural. The operation often lasts a lifetime.

Cons: This type of reconstruction is not possible for candidates already bearing scars on their abdomen from previous surgeries. These can droop over time.

LD Flap Reconstruction

LD stands for latissimus dorsi and is a muscle just below your shoulder blade. For reconstruction, it is brought round under the armpit and put over an implant to make a new breast.

Pros: This surgery is comparatively simpler than a DIEP or TRAM flap and requires lesser recovery time. Higher success rate come from the original blood supply that the flap carries with itself to its grated space.

Cons: people who have thicker or paler skin on their back may not have a colour match on the ventral surfaces of their body, i.e., where the breasts are.

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Letter Thank You From Marsden

We are very grateful to Breast Cancer Research Aid for your support of The Royal Marsden’s C-TRAK trial,
an innovative research project that has the potential to change the lives of women diagnosed with triple
negative breast cancer in the UK and world-wide.
The Royal Marsden was founded thanks to contemporary philanthropists and your generosity is
continuing this important tradition. Thank you for helping us to drive forward advances in breast cancer
research and provide patients with the best quality of life.

 

Read the full letter here.

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Potential new treatment for advanced cancers

A potential treatment for therapy-resistant breast cancer patients has been uncovered by researchers at Cardiff University.

The European Cancer Stem Cell Research Institute, based with Cardiff University, has repurposed a current cancer therapy, TRAIL, to find a new treatment for advanced cancers that are resistant to anti-hormone therapy.

Up to 75% of women diagnosed with breast cancer will have a cancer driven by oestrogen signalling and almost all of these women will receive anti-hormone therapy, like Tamoxifen or Aromatase inhibitors, to treat their cancer. Unfortunately, up to 40% of patients receiving these hormone therapies will develop a resistance to them, leading to relapse with aggressive cancer.

Dr Luke Piggott, European Cancer Stem Cell Research Institute at Cardiff University, said: “Part of our research focus is to develop new therapies, with low levels of side effects, for breast cancers that are resistant to anti-hormone treatments.

“TRAIL has already been tested in multiple types of cancer, but hasn’t yet proved beneficial to patients. But we believe we have demonstrated that patients who develop resistance to treatment will benefit from TRAIL therapy, as we have identified specific changes in the cancer cells from these patients, which mean that their tumours become sensitive to TRAIL treatment.

“Additionally, we have shown in this patient group that TRAIL treatment targets a specific type of cell in a tumour called a cancer stem cell. Cancer stem cells differ to the other cancer cells, as they are the cells responsible for initiating tumour growth and spread, and have also been shown to be resistant to therapy.”

Dr Richard Clarkson’s team of researchers at the European Cancer Stem Cell Research Institute tested TRAIL on tumour samples collected from cancer patients who had developed resistance to anti-hormone therapy.

Their findings showed that TRAIL selectively killed cancer stem cells from these patients but that tumours that had not developed resistance to tamoxifen were unaffected by TRAIL.

Dr Richard Clarkson said: “Cancer stem cells are the cells responsible for relapse and for the spread of cancer, so by targeting these cells, along with the bulk of the tumour, we could transform the way we treat cancer, especially for those that are resistant to anti-hormone treatments.”

82 percent of the anti-hormone resistant tumour samples showed a significant response to TRAIL, whereas only 8 percent of tumour samples that had not previously seen anti-hormone therapy responded.

The experimental models showed tumour shrinkage after being treated with TRAIL and there was also a reduction in the number and size of tumours that have spread to other organs, a process known as metastasis.

Dr Clarkson added: “Although we have more research to do before this new drug gets into clinic, TRAIL represents a very promising therapy for a population of patients where there is currently very few options.”

Link to original article

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The Royal Marsden Hospital

We are very grateful to Breast Cancer Research Aid for your support of The Royal Marsden’s C-TRAK trial, an innovative research project that has the potential to change the lives of women diagnosed with triple negative breast cancer in the UK and world-wide.

The Royal Marsden was founded thanks to contemporary philanthropists and your generosity is continuing this important tradition. Thank you for helping us to drive forward advances in breast cancer research and provide patients with the best quality of life.

C-TRAK: Developing a novel way to detect and treat breast cancer
Breast cancer is the most common cancer in the UK, with around 55,000 women diagnosed every year. Of those women, 15 per cent will be diagnosed with triple negative breast cancer (TNBC).

Standard treatment for this type of cancer includes surgery and chemotherapy. However, TNBC is difficult to treat because it does not respond to common therapies, such as tamoxifen or Herceptin.

Furthermore, TNBC is more likely to recur than other breast cancers. Sadly, by the time TNBC returns and has grown large enough to be seen on a CT or MRI scan, the disease is often untreatable.

To meet this challenge, The Royal Marsden is leading C-TRAK: a two-part clinical trial that will assess if a blood test can detect TNBC as soon as it recurs and investigate a new therapy option to successfully treat the disease before it becomes life-threatening.

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