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Aggressive Breast Cancer

It seems that breast cancer cells may have personality.

Some types of tumors are more aggressive than others.

If these cells could be identified at diagnosis, treatments might be able to be tailored to the tumor type. This might make a big difference in the drugs that are used and could lead to improved outcomes for many breast cancer patients.

Normally, breast cancer treatments are decided by using a standard staging system.

Stage I breast cancer requires less aggressive treatments than later stages. Although this approach does provide a framework for treatment, in one third of the breast cancer cases there will be a recurrence. There is no proven method that a health care team can use to tell which cancers will return.

Dr André Ahr and colleagues at the Department of Obstetrics and Gynecology, J W Goethe University, Frankfurt, Germany noticed that some patients at their clinic who were identified with early breast cancer went on to have recurrences and others remained free of cancer.

They designed a study to find out if there were any differences in the tumors of the patients who did not have breast cancer recurrences. To identify differences, they went to the cells that made up the tumors. They looked at DNA - the cancer cells genetic material - from the tumors of 55 consecutive patients. The tumors had 41 genetic markers in common that allowed the researchers to group them into pathological subclasses.

Out of the 55 patients, they defined a subgroup, which they called class A.

The breast cancer patients who were put into Class A showed a higher percentage of nodal-positive tumors and metastases at diagnosis (23 percent) than the rest of the patients (4 percent).

It occurred to them that tumors showing the characteristics of the class A patient's tumors might be more aggressive and this might be an indicator that these women were more likely to have recurrences.

Follow up on this group for 23.5 months showed that 11 of the 22 group members - 50 percent - developed metastatic disease.

Of the 27 women who were not identified as having class A tumors only three had recurrences.

While the group involved in this study was too small to make any definite statements about tumor type and aggressiveness, Dr. Ahr and his group suggest that further work be done on this.

Combining "these molecular methods with the standard tumor classification system to obtain improved patient-tailored therapies" would make treatment decisions more effective. It might also provide a way to determine if a survivor was at higher risk of recurrence. This could provide doctors with a chance to use more aggressive treatments on more aggressive tumors. It could also ease the stress of worrying about cancer returning for those with less aggressive tumors.

Source: Lancet 2002; 359: 131-32.

Also see -> Breast Cancer Staging | Stage I | Stage II

Inflammatory Breast Cancer

Elsewhere on the Web:

Stages of Breast Cancer

Test for aggressive breast cancer


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