What’s New: Progress in Breast Cancer Treatment
By: Kiara Sahi, Contributing Writer.
Edited by: Fauzia Haque, Editor; Eve Nevelos, Editor in Chief
In 2020, 2.3 million women were diagnosed with breast cancer and 685,000 people died due to breast cancer. Over the past five years, the number of women diagnosed with breast cancer increased to a staggering 7.8 million, making breast cancer the most prevalent type of cancer in the world (WHO). Cancer takes precious lives every day, and while there is no cure yet, scientists are consistently making progress in evolving enhanced and improved treatment options.
Breast cancer: The basic breakdown.
There are several types of breast cancers based on the particular cells that ultimately turn into cancer. Invasive ductal carcinomas account for 85% of all breast cancers and begin in the epithelium of the ducts present in the glandular tissue of the breast, while invasive lobular carcinomas account for 15% of all breast cancers and begin in the epithelium of the lobules present in the glandular tissue of the breast. Both forms of cancer are capable of metastasis and can spread to surrounding breast tissue, nearby lymph nodes, and different parts of the body (WHO). Another form of breast cancer is “Triple-negative breast cancer,” a particularly aggressive form of breast cancer in which the estrogen, progesterone, and human epidermal growth factor (HER2) receptors are missing in the cancer, thus limiting treatment options. Other, less common forms of cancer include Paget’s disease, inflammatory breast cancer, and medullary breast cancer (Center for Disease Control and Prevention). The risk of breast cancer increases for those people who have a family history of breast cancer. Certain inherited gene mutations, mostly breast cancer gene 1 (BRCA1), breast cancer gene 2 (BRCA2), and partner and localizer of BRCA2 (PALB2), also increase the risk of breast cancer, with those who test positive for these mutations considering surgical risk reductions, such as a mastectomy. Such invasive procedures, however, are only undertaken for a very limited number of patients after thorough evaluation and consideration of every option available for treatment. Breast cancer can occur at any time after the onset of puberty, while the majority of cases develop during late adulthood (WHO).
Progress made pertaining to breast cancer.
Scientists have made progress by leaps and bounds in cancer research and improvements. The most recent enhancements of which are:
Artificial intelligence in Mammograms
Mammograms are X-ray images of the breast that are used for early detection and diagnosis of breast cancer. The interpretation of these mammograms, however, leaves room for error. According to WebMD, radiologists are making use of artificial intelligence to interpret and analyse mammograms for increased accuracy. The application of deep learning algorithms to mammography has improved the general accuracy of imaging, risk prediction and diagnosis of breast cancer. Deep learning models are usually fed a data set, that is, imaging of breast cancer of a wide range of patients, by virtue of which they develop a sensitivity to signs of breast cancer in the given mammogram. The use of hybrid systems that work as a decision aid, as well as facilitating interactive feedback, prompts the presentation of the most evident findings from the mammogram to improve the interpretations made by radiologists (NIH).
2. Targeted therapy
Targeted therapy makes use of drugs to target specific cells that produce too much of HER2. These drugs enter the bloodstream and can reach almost all parts of the body, thus being effective in those cases of breast cancers that have metastasized. Targeted therapy makes use of monoclonal antibodies that attach themselves to the HER2 protein present on the cancer cells and stop their growth. Monoclonal antibodies are usually given along with chemotherapy but may also be prescribed alone after failure of chemotherapy. They may be administered orally or as a subcutaneous shot. Other drugs used in targeted therapy include kinase inhibitors. Kinase proteins are usually those proteins that convey signals within the cell, including signals regarding cell growth. HER2 is a kinase protein and is blocked by the action of kinase inhibitors, hence the overproduction of HER2 and proliferation of cancer cells is hindered by their action (American Cancer Society).
3. Liquid biopsies
Liquid biopsies are tests carried out on blood samples that are used to analyse the given sample and detect signs of cancer cells from a tumour or DNA pieces from tumour cells circulating in the blood (NIH: National Cancer Institute). Liquid biopsies are not only used to detect early signs of breast cancer but are also used to predict progression and relapse. Liquid biopsies can also track mutations in tumours and help doctors in making the required adjustments to the course of treatment.
Clinical trials and continual research on breast cancer is an ongoing process that has significantly contributed to the detection, diagnosis, and treatment of breast cancer, with rapidly evolving treatment options shaping a promising future in the world of oncology.