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Breast Cancer Should Be 10 Different Diseases PDF Print Email

Breast Cancer Should Be 10 Different Diseases


According to an international study which analysed breast cancers in 2000 women, breast cancer should be thought of as 10 separate diseases By treating different categories and tailoring treatment and drugs for the specific type of cancer patients can benefit from improved outcomes and predict survival more accurately.

The study was carried out by researchers from Cancer Research UK, the University of Cambridge, the University of Columbia, Canada and a number of other institutions worldwide. It was funded by Cancer Research UK, the British Columbia Cancer Foundation and the Canadian Breast Cancer Foundation. The study was published in the respected and peer-reviewed scientific journal Nature.  Breast cancer is effectively ten different diseases and this “breakthrough research” could revolutionise the way we treat breast tumours.


During the study, researchers analysed 2,000 frozen samples of breast cancer tumours, taken from women diagnosed with the disease over the past 10 years. From this analysis, scientists found breast cancer could be classified into 10 different broad types according to their common genetic features. These different subgroups were associated with different outcomes for patients.


Understanding the genetic makeup of tumours is important as their genetics can potentially influence whether they are resistant or susceptible to particular drugs, and also their behaviour within the body. The aim of the study was to find out if the genetic characteristics of the tumours could be classified and matched according to clinical outcomes.


The study used a sizeable sample and has shown that breast cancer tumours can be classified into new subtypes with varying outlooks. As such, this research is a valuable contribution to scientists’ understanding of the genetic basis of breast cancer and it may also help to explain why, at present, some tumours appear to respond well to treatment while others do not. It is possible that doctors may be able to use this information to predict the outlook for individual breast cancer patients better in the future and tailor treatments accordingly.


The study will not affect the way women are currently treated for breast cancer. Before these findings can affect clinical practice, more work is required to understand how tumours classified under each subgroup behave, and also which treatments work best.

Professor Carlos Caldas from Cancer Research UK said “Essentially, we've moved from knowing what a breast tumour looks like under a microscope to pinpointing its molecular anatomy – and eventually we'll know which drugs it will respond to”.



It will take several years before researchers will know how treatments for breast cancer could be tailored to the new subtypes.


Women currently living with the condition should be aware that breast cancer generally is one of the cancers with the best outlooks. More than 80% of women diagnosed with breast cancer will still be alive five years later, and survival rates are continuing to improve. Of course, a lot more work is needed in the fight against breast cancer, but it is worth remembering that, in recent decades, there have been massive improvements in the treatment of breast cancer, and women given a diagnosis at the present time have a good chance of long-term survival.


The researchers were able to classify the tumours into 10 different subtypes, based on similarities in their genetic characteristics. They found that the different subgroups had different clinical outcomes, including how likely women with different tumour types were to die from their breast cancer.


As part of their study, the researchers also identified several genes within the tumours that look like they may be involved in driving tumour growth. Many of these genes have not previously been thoroughly studied.


Overall, the researchers say that their findings show a new way to divide breast cancers into subgroups based on their genetic characteristics. As part of a press release Professor Carlos Caldas from Cancer Research UK, who was one of the lead authors, said:

"Our results will pave the way for doctors in the future to diagnose the type of breast cancer a woman has, the types of drugs that will work, and those that won't, in a much more precise way than is currently possible. This means that women who are diagnosed and treated fairly uniformly today will in the future receive treatment targeted to the genetic fingerprint of their tumour.” Professor Caldas also argues that the variations in tumour genetics mean that we should now consider breast cancer to be an umbrella term for a number of diseases.


The new research provides a large, thorough look at the genetic behaviour of breast tumours that each have different outlooks. This provides a valuable contribution to attempts to understand the genetic basis of breast cancer and why some treatments work and some don’t in different patients.

Further work is needed to understand how tumours classified under each subgroup behave and also how they respond to different treatments. Cancer Research UK is going to begin using the new subgroups in its clinical trials of treatments for breast cancer.


Bespoke cancer treatment

At the forefront of cancer research is the move towards “personalised treatment”, in which doctors look at the unique genetics of a tumour and create a bespoke treatment plan for the patient designed to take advantage of a tumour’s vulnerabilities. For example, if a breast tumour carries a gene that might make it resistant to the first choice drug, doctors might instead opt for a drug the tumour has no genetic resistance to.


A whole range of cancers are being analysed in this way, not just breast cancer, and it is hoped they represent a big step forward.