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New Clue Predicts Breast Cancer Behavior

Wound-healing activity may identify women at risk for disease spread

FRIDAY, Feb. 11, 2005 (HealthDay News) -- Breast cancer cells have a lot in common with a cut finger.

Stanford University researchers have found that what happens on a molecular level during the wound-healing process closely resembles the cellular activity gone haywire in some breast tumors.

Making that connection may one day help clinicians predict a breast cancer patient's chances of survival, they report in this week's issue of the Proceedings of the National Academy of Sciences.

"It may help identify patients with a good prognosis, not just a bad one. Such a prognostic tool could help us to focus chemotherapy on patients who stand to benefit from it, and spare others who don't need it," suggests James W. Jacobson, chief of the Diagnostic Biomarkers and Technology Branch of the Cancer Diagnosis Program at the National Cancer Institute.

Cancerous cell growth basically resembles normal wound repair, but with a sinister purpose, the researchers explained. Normal wound healing lets cells break the rules: instead of remaining orderly and staying put, cells can migrate to the site of injury and start multiplying like crazy to rebuild tissue. Cancer cells seem to go through the same motions but with a view to kill, by aiding tumor growth.

Analyzing genetic and survival data from 295 patients with early-stage breast cancer from The Netherlands Cancer Institute, the researchers found that disease spread was much more likely to occur in patients with tumors displaying what the researchers dubbed "wound-response signatures," and that these patients also tended to die earlier than those without the signature.

In fact, they report, this wound-healing genetic activity seemed to be a better predictor of patient survival than other prognostic markers clinicians commonly use, such as tumor size, node status and patient age.

About 30 percent of women with early breast cancer will experience disease spread (metastases), in which case adding chemotherapy to surgery and radiotherapy improves their prognosis, Jacobson explained. However, 70 percent of patients whose cancer doesn't progress don't need chemotherapy.

By analyzing wound-response signature in cancerous cells, the researchers correctly identified 90 percent of patients who developed metastases.

Scientists have long sought genetic and biological disease markers, such as tumor-suppressor gene abnormalities, growth factor receptors that fuel tumor-feeding blood vessel growth, the presence of hormone receptors, growth-promoting proteins, and breast cancer genes.

Research based on deciphering the molecular underpinnings of cancer activity, however, is only beginning. But, as Jacobson enthused, "it's an area of research that holds a lot of promise and will likely be fruitful in the future. Such technologies help us to look at the broader spectrum of underlying biologies, and will also help us find new targets for treatment."

"It's just going to take a lot of hard, clinical work to figure out how to use that information for the clinically effective management of patients," he adds.

The study authors hope to eventually develop a scale clinicians can use to measure wound-repair activity, and thereby accurately predict cancer progression.

A woman's lifetime chance of developing invasive breast cancer is about one in seven, according to the American Cancer Society. This year, about 211,240 new cases of invasive breast cancer will be diagnosed among women in the United States -- that's about four times the number of noninvasive cases diagnosed each year.

More information

For more on breast cancer diagnosis, treatment and prognosis, visit the National Institutes of Health.

SOURCES: James W. Jacobson, Ph.D., chief, Diagnostic Biomarkers and Technology Branch, Cancer Diagnosis Program, National Cancer Institute, Rockville, Md.; Feb. 7-11, 2005, Proceedings of the National Academy of Sciences
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