A malignant tumor in the breast is the most common cancer among women. Each year more than 180,000 new cases are diagnosed in the United States. In Minnesota, as elsewhere, breast cancer accounts for almost one out of three new cancers, and about one in five cancer deaths among women. While surgery, standard chemotherapy, and radiation treatments provide proven and established methods of attacking breast cancer, researchers are at work every day developing the next generation of breast cancer therapies. These advances in breast cancer prevention, treatment and care are expected to offer ongoing improvements in our ability to fight this disease. At the U of M Cancer Center, my colleague Jeffrey Miller and I are evaluating the effectiveness of a breast cancer vaccine made from a patient’s own tumor cells. A clinical trial is underway to test whether this vaccine can stimulate an immune response to destroy breast cancer cells, with the hope that the vaccine will prevent breast cancer recurrences. Because many patients with advanced disease do not have tumors with the appropriate size and condition to make a vaccine, we are also creating vaccines that use pre-existing breast cancer cells maintained in the laboratory, allowing us to ultimately make vaccines available to more patients. Our researchers also recently conducted clinical trials that found that a new drug combination Interleukin-2 and Herceptin safely destroys cancer cells in some breast cancer patients without the chemotherapy side effects of hair loss and nausea. In this study, Tanya Repka, Miller and I made an important discovery: while Herceptin can be effective in shrinking the tumor, Interleukin-2 boosts the number and function of the body’s natural killer cells. In another study, Michael Garwood and Doug Yee are among a handful of breast cancer researchers worldwide using magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). The MRI detects breast lumps, and MRS measures specific molecules that are known to accumulate in cancer cells. Garwood and Yee first use MRI to find the tumor, then apply MRS to determine whether the tumor is benign or malignant. They also are working to develop a MRS technique that can accurately measure cancer-related compounds in tumors. Unlike the traditional mammogram/biopsy approach to detecting and diagnosing cancer, this new technique is non-invasive and significantly improves our ability to distinguish between cancerous and non-cancerous tumors. Another advance in the fight against breast cancer is understanding genetic factors. Staff at the University’s Familial Cancer Clinic help people determine if they have inherited a high risk of breast and other types of cancers. A genetic counselor can answer questions such as: Who can have genetic testing for cancer? What are the benefits, risks, and limitations to testing? What happens if a known cancer gene is found? When are preventive mastectomies appropriate, and why do people get them? The Familial Cancer Clinic develops an individualized program for screening and prevention and discusses genetic testing. Genetic testing literally checks to see if the patient carries a known cancer gene, such as the breast cancer genes BRCA1 or BRCA2. The clinic also provides an online Q&A that offers answers to key questions about genetic testing www.peds.umn.edu/fcc/Genetic_Testing. Elena Chiorean, M.D., is an assistant professor of medicine at the U of M Medical School and a member of the University’s Cancer Center. To learn more about breast cancer, visit www.cancer.umn.edu/page/research/breast.html or call the toll-free information line at (888) CANCER MN This column is an educational service and advice presented should not take the place of an examination by a health-care professional. To ask a health-care expert at the university a question or for more health-related information, go to www.healthtalkandyou.com.
