Good News for Early Stage Breast Cancer

Ilse Fredericks recently reported about a new study which used the research translation database tool.

Dr Kathleen Grant and her co-authors were among a group of women in science who were recently featured on the cover of the SA Journal of Science.

The issue was dedicated to women in science and emanated from the 2nd International Women in Science without Borders conference which was held in Johannesburg.

Grant said the results from the study allowed for the molecular identification of a group of women with what is called, luminal A breast cancer, who after having their tumours surgically removed, have a low-risk of distant cancer recurrence and do not have to undergo chemotherapy, thereby safely avoiding the unpleasant side effects of this treatment.

“Conversely, we are able to identify tumours which will respond to chemotherapy or other more aggressive treatments, with greater accuracy than when using conventional laboratory testing techniques. Combining conventional laboratory diagnosis with this new genomic testing, ensures that the right treatment is given to the right patient, and oncologists can avoid over treating early stage breast cancer patients who will gain no benefit from chemotherapeutic regimes.”

Grant said that to diagnose breast cancer, a sample of tissue is removed and sent to the laboratory where a histopathologist stains and examines the tissue microscopically. The appearance of the cells and how they stain enable the diagnosis of the type of breast cancer but this does not explain the genetic makeup of the tumour fully.

“Breast cancer genomic tests further analyse the tissue sample from the cancer tumour to see the expression level of certain genes. This level of activity relates to the behaviour of the cancer and we can calculate the risk of the cancer coming back (recurrence) as well as predict if the cancer will respond to chemotherapy or not.”

She said these tests help in the cancer treatment decision making for the particular patient. 

It is not the same as genetic testing which can be done on the blood or saliva of a healthy person to establish if they have an abnormal change, called a mutation, in certain genes known to carry  a higher risk for developing breast cancer in that particular individual.

“Our research focuses on early stage breast cancer cases, as patients presenting with advanced cancers will have to be treated differently and possibly more aggressively. In our cohort of patients we compared the conventional laboratory testing to MammaPrint/BluePrint genomic molecular subtyping.”

MammaPrint is the only genomic breast cancer test that is recommended in guidelines by the National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) for lymph-node positive patients, is FDA approved, and has the highest level of evidence for early-stage breast cancer patients with estrogen receptor-positive, lymph-node negative and positive breast cancer.

“Our efforts have also lead to medical funders in South Africa paying for this test.”

Grant, who has worked at CPUT for 12 years, said her field of cytopathology focuses on the diagnosis of cancers and their precursor lesions

“I’ve always been interested in how cancer develops and how to prevent it. Breast cancer lies closer to my heart as it’s mainly a women’s disease. Men do get breast cancer too and like most women in South Africa I have family and close friends who have survived or succumbed to breast cancer. The fact that we are now beginning to personalize breast cancers and tailor treatment to the individual patient, especially for women who are usually the centre of their families and often the sole bread winner in the South African context, being able to avoid chemotherapy treatment for early disease is just awesome!”