A welcome advance

Breast cancer

Research published in the journal Nature describing five new genes associated with breast cancer is another step forward in our understanding of the causes of the disease. The global study of some 560 breast cancer genomes (genetic codes) could, scientists from the Wellcome Trust Sanger Institute said, lead to more individualised treatments for patients.

Their research focused on mutations that encourage the disease to grow and the patterns of these mutations in each tumour. They found that women with genes that leave them at a higher risk of developing breast and ovarian cancer, have entire genomes that are different to each other and distinctive from other breast cancers.

Breast cancer is the most common malignant tumour in Irish women, with just under 2,900 cases each year. This represents almost one third of all major malignancies diagnosed in women here. And while the five year survival – at 82 per cent – is high, it is the second commonest cause of death from cancer for women in the Republic. What might this latest research mean for them?

Although theoretically facilitating the identification of a treatment most likely to be successful for a woman (or man) diagnosed with breast cancer, the field of genomic personalised medicine has yet to fulfil its early promise. It was hoped that genetic tests would determine the choice and optimal dose of medication for each individual patient. However last year Swedish researchers discovered that many more gene variants affect how a person responds to medication than previously thought – making current analytic techniques too coarse to plot individual treatments.

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But progress is being made as outlined in a recent report by the National Cancer Registry on female breast cancer trends. It showed that trends for increasing survival and decreasing mortality are largely due to improvements in treatment. There is now much greater use of breast conserving surgery in combination with radiotherapy.

Notwithstanding this latest breakthrough, improvements in cancer treatment are more likely to occur in small steps rather than sudden leaps.