Secondary tumors, primary focus
New project explores genetic and emotional sides of metastatic breast cancer
By Rob Levy
Alma Kretchmer, a breast cancer patient who travels from New York for treatment at Dana-Farber, confers with Nancy Lin, MD.
Frightening as a diagnosis of breast cancer is, the discovery that tumor cells have traveled from the breast to other parts of the body can be even more so.
Most breast cancers caught early can be treated before they spread, or "metastasize," to other organs or tissues. However, sometimes breast cancer has already gone beyond the breast and underarm lymph nodes before it is detected. Other times, breast cancer cells escape from the breast before surgery and grow into a secondary tumor—generally in the bones, lungs or liver—years after the original diagnosis. When such secondary tumors do arise, they present very different treatment and emotional challenges than the primary breast tumor did.
Metastasis occurs in 20-25 percent of all breast cancer patients, with rates varying widely depending on the type of tumor a woman had. About half of metastases are diagnosed within five years of the initial treatment, but some take 10 or more years to appear. It's estimated that 200,000 women in the United States are currently living with recurrent breast cancer.
Women are living with metastatic disease longer as treatments have improved in recent years, but much about metastasis remains mysterious. What determines whether a breast tumor is likely to spread? Within a single tumor, are some cells likely to metastasize and others not? Do cells that have already metastasized differ biologically from those in the parent tumor? Is there a way to read a tumor's future in its genes?
Recent scientific advances—particularly the introduction of technology that makes it possible to distinguish cancer cells by the differing patterns of activity among their genes—have raised hopes that some of these questions can soon be answered. One of the most ambitious efforts to accomplish that is under way at the Women's Cancers Program (WCP) at Dana-Farber.
Researchers at the WCP have joined with colleagues at Brigham and Women's Hospital and Massachusetts General Hospital to study the genetic trail of metastatic breast cancer, as well as the emotional and psychological toll on women who develop the disease. The aim is to learn whether genes hold clues about tumors' ability to metastasize. They'll also document the variety of ways in which women cope with the diagnosis. The results may reveal new strategies for preventing breast tumors from spreading, for treating tumors that have already spread, and for helping women with the disruption to their lives, families, and careers that metastatic breast cancer can cause.
- Next: The evolving tumor
- Page: 1 | 2