With breast cancer being the most commonly diagnosed cancer (an estimated one in eight biological women developing the disease across their lifetime), an early diagnosis gives a higher chance of eradication of the disease.
One of the indicators used in breast cancer, to determine how much it has advanced, is to check the lymph nodes in the underarm region, where early spread of the disease occurs. In fact, less than half of breast cancer patients with lymph node spread survive after 10 years of being diagnosed, as compared to more than four in five without lymph node spread. This means that better indicators and markers are required to identify individuals before the cancer spreads from the breast to other parts of the body.
Research being conducted by the Laboratory of Molecular Oncology within the Department of Pathology at the University of Malta involves analysing tumour samples and cancer cell material released into the bloodstream to identify markers of cancer spread.
The cancer cell DNA is less stable resulting in an accumulation of changes, called mutations, compared to the DNA of the cells of the rest of the body.
Sometimes a mutation gives the cancer cell an advantage, for example, the ability to divide more without control, causing the mutation to become present proportionally more in the cells making up the tumour mass.
In this research, tumour characteristics are assessed from a small tumour sample, which would have been removed during the surgical procedure, to determine how aggressive the tumour is.
These characteristics include proliferation, which refers to the ability of the cell to divide, and invasion, which refers to the ability of the cell to spread beyond the site where the tumour originated. In addition, when cancer cells die, their DNA is released into the bloodstream, which is referred to as circulating tumour DNA.
Tests can be carried out on blood samples to detect specific mutations only present in the tumour mass, thus allowing for assessment of any residual cancer disease present in the body following treatment. Moreover, the cancer cells can shed off small vesicles called exosomes which contain cellular contents and these can also be analysed to identify characteristics of that particular cancer.
The team members undertaking this research, led by Prof. Godfrey Grech as the principal investigator, are postdoctoral researcher Dr Laura Grech, PhD student, Dr Istvan Mifsud, and PhD student, Ms Jessica Debattista.
Research is crucial to further our knowledge of cancer.
A success story of the important role research plays in breast cancer has been the development of a drug called trastuzumab, which targets a specific subtype of breast cancer that overexpresses a protein cell receptor called HER2.
Another example is the use of the Oncotype DX test which can identify high-risk patients who would benefit from chemotherapy following the surgical procedure to remove the tumour. Through a better understanding of early cancer spread, better tests can be designed and novel approaches can be undertaken to help detect the disease at an earlier stage, resulting in better patient outcomes and improving the quality of life.
