5 Breast Cancer Breakthroughs You Haven’t Heard About

Since October 1985, major breast cancer charities have sponsored the now-famous Breast Cancer Awareness Month, an initiative that helps raise an estimated $6 billion annually in the name of breast cancer research.  In honor of the 2016 Breast Cancer Awareness Month, we’ve gathered the top 5 insights and innovations in breast cancer research – all hot off the presses in the last month.

1. Obesity does affect breast cancer risk, but only in some women

The link between obesity and cancer risk is well established: a 2007 study estimated that 4% of cancers in men and 7% of cancers in women in the US were due to obesity.  But the relationship between BMI and risk of breast cancer is a bit more nuanced.  A recent analysis of nearly 150,000 women found that a high BMI was actually associated with decreased breast cancer risk – but only before menopause.  Among post-menopausal women, obesity appeared to increase the risk of breast cancer.  Interestingly, when the researchers calculated each woman’s predicted BMI based on genotype, the genetically predicted high BMI was protective against breast cancer in all women, suggesting that high BMI in later life may be the result of lifestyle and environmental factors, which in turn likely contribute to breast cancer risk.

2.Artificial Intelligence detects breast cancer 30 times faster than humans

Although radiologists can detect breast cancers amazingly well – a recent study found that they can spot suspicious lesions at better than chance levels after viewing a mammogram for just half a second – they may soon get some help from artificial intelligence.   Researchers in Houston have developed AI software that can not only identify concerning lesions on mammogram, but also predict likely pathology, with 99 percent accuracy and at 30 times human speed.  The authors of the study, published last month in Cancer, hope that employment of this software could soon slash the number of unnecessary breast biopsies.  Given that almost 20% of the 1.6 million breast biopsies performed each year are false-positives, this software could potentially save millions of dollars and spare countless women from the well-described psychological stress of benign breast biopsies.

3.Cryoablation could be the new lumpectomy

Over the last several decades, trends in the surgical management of early breast cancer have favored less invasive techniques.  Whereas mastectomy was at one point considered the gold standard for resection of even unifocal, early stage lesions, lumpectomy with radiation is now established as a sound, and often preferred, alternative.  Lumpectomy, however, may soon be replaced by an even less invasive technique: cryoablation.  A recent phase II clinical trial involving 86 patients and 87 cancers found that cryoablation successfully treated 92 percent of all cancers, and 100 percent of lesions less than a centimeter.  Although cryoablation is well established in treating other malignancies – typically prostate and renal – this trial is the first multicenter study to investigate the use of cryoablation in breast cancer.  

 4.Immediate Breast Reconstruction soothes the double mastectomy process

Improved surgical techniques over the last decade have allowed for immediate breast reconstruction (IBR) following double mastectomy, either using autologous fat transfer or prosthetic implants on the day of mastectomy.  Unsurprisingly, studies have indicated superior post-operative psychological benefits following IBR as opposed to delayed breast reconstruction (DBR), which occurs weeks, months, or years after mastectomy.  Lesser-known studies, however, have shown that IBR patients endure greater pre-operative psychological stressors attributable to fear of potential complications of more complex procedures.   A recent study in the journal of Plastic and Reconstructive Surgery surveyed women before and after IBR, and found that improved psychological outcomes after IBR likely outweigh any pre-operative stressors.  The study also found that among women who underwent DBR, impaired body image, sexual function, anxiety, and depression took up to 18 months to recover.  Thus, the authors propose that every effort to pursue IRB should be taken for women who are oncologic candidates.  

5.An implantable device could delay metastatic spread of breast cancer

Researchers at the University of Michigan found that implanting a filter-like device in mice with localized breast cancer can “capture” metastatic cells before they reach distant parts of the body.  The device, a scaffold made of FDA approved materials commonly used in sutures and wound dressings, is biodegradable and lasts up to two years in vivo.  By attracting supportive cells (e.g., fibroblasts, immune cells, and endothelial cells) to its surface, the scaffold becomes a welcoming microenvironment to tumor cells and is in turn able to “attract” cancer cells to itself, sparing other organs commonly hit by metastasis, like the brain, liver, and lung.  In preliminary trials, mice implanted with this device had significantly less metastatic tumor burden 2 weeks after tumor inoculation compared to mice without the device.  A clinical trial examining device implantation in humans with early-stage breast cancer is now in the works.   

By Nicole Van Groningen

@Nvangroningenmd