New study shows biopsy of recurrent breast cancer can alter treatment

November 28, 2011, University Health Network

A second, larger clinical research study led by breast cancer specialists at Princess Margaret Hospital (PMH) has again proven that comparing a new biopsy of progressing or recurring cancer with that of the original cancer can dictate a change in treatment.

The results are published online today ahead of print in the Journal of Clinical . Principal investigator Dr. Eitan Amir, medical oncologist in the PMH Cancer Program, University Health Network, says clinicians involved immediately altered treatment in one of seven patients based on the new biopsy results.

"This was a study of specifically undertaking biopsy of areas of and altering treatment therapy based on the findings in real-time." says Dr. Amir.

"For clinicians, these findings show it is feasible to biopsy recurrence of . For patients with progressive or recurring disease, these findings may encourage them to ask their physician if a second biopsy is needed to confirm their treatment therapy is still correct."

The study team analyzed 121 biopsies from patients with progressing or recurring disease to determine any changes in the predictive markers (such as hormone or "") that influence response to breast cancer treatments. It is the presence, absence and/or combinations of these receptors that help oncologists provide effective personalized medicine to each individual.

Dr. Amir says the most important findings were the potential for negative receptors to become positive. "It is significant because this change in receptor status potentially introduces new effective for patients." This was the case for most of the women whose therapy changed after results of the second biopsy were available compared to basing the treatment plan on initial biopsy at the time of diagnosis.

This study was also the first to look at the survival of patients whose treatment was changed post-biopsy. "It's been known for over 30 years that recurring cancer can differ from the primary cancer, but nobody knew if this was important," says Dr. Amir.

"More recently we have learned that patients with a change in receptor status may have worse outcomes from breast cancer, possibly due to basing treatment on incorrect predictive markers. However, our study shows that if treatment is modified according to biopsy results from a metastatic site, the survival rates of patients with recurrent disease which is different from the original tumor were similar to those where disease was the same."

Dr. Amir's research results build on the findings of the initial, smaller PMH study of 29 biopsies that first shed light on the importance of a second biopsy in breast cancer recurrence. The earlier findings were reported in the Annals of Oncology, Oxford University Press.

"This knowledge provides more insight into why some patients whose disease progresses respond to treatment and others do not." Why receptors change during the course of disease is not yet known, says Dr. Amir, but a priority area for further research.

This study was funded by the Canadian Breast Cancer Foundation – Ontario Region. Dr. Amir's research is also supported by The Princess Margaret Hospital Foundation.

Sandra Palmaro, CEO of the Canadian Breast Cancer Foundation - Ontario Region says: "Dr. Amir's new findings provide more proof that conducting a second on patients suspected of having recurrent breast cancer can lead to changes in treatment for a significant number of patients. This can help ensure women get the treatment best suited to their individual situations, and avoid unnecessary or ineffective treatments. By finding and funding important research, the Foundation's donors are helping to create a future without breast cancer."

Explore further: Breast cancer tumor make-up changes through the course of disease

Related Stories

Breast cancer tumor make-up changes through the course of disease

September 25, 2011
New research has found that breast cancer tumours change their hormonal status throughout the course of disease, whereas the decision about the most effective treatment for the patient is usually only based on one biopsy ...

Toxicity of aromatase inhibitors may explain lack of overall survival improvement

August 22, 2011
The toxicities associated with aromatase inhibitors (AIs) may explain the lack of overall survival improvement compared with tamoxifen, according to a study published August 22 in the Journal of The National Cancer Institute.

Breast cancer surgery patients benefit from adding radiation therapy

June 4, 2011
Additional radiation treatment improves disease free survival lessening the chance of cancer recurring in women with early breast cancer who have had breast conserving surgery (lumpectomy), interim results of a new study ...

Recommended for you

Researchers develop a remote-controlled cancer immunotherapy system

January 15, 2018
A team of researchers has developed an ultrasound-based system that can non-invasively and remotely control genetic processes in live immune T cells so that they recognize and kill cancer cells.

Pancreatic tumors may require a one-two-three punch

January 15, 2018
One of the many difficult things about pancreatic cancer is that tumors are resistant to most treatments because of their unique density and cell composition. However, in a new Wilmot Cancer Institute study, scientists discovered ...

New immunotherapy approach boosts body's ability to destroy cancer cells

January 12, 2018
Few cancer treatments are generating more excitement these days than immunotherapy—drugs based on the principle that the immune system can be harnessed to detect and kill cancer cells, much in the same way that it goes ...

Cancer's gene-determined 'immune landscape' dictates progression of prostate tumors

January 12, 2018
The field of immunotherapy - the harnessing of patients' own immune systems to fend off cancer - is revolutionizing cancer treatment today. However, clinical trials often show marked improvements in only small subsets of ...

FDA approves first drug for tumors tied to breast cancer genes

January 12, 2018
(HealthDay)—The U.S. Food and Drug Administration on Friday approved the first drug aimed at treating metastatic breast cancers linked to the BRCA gene mutation.

Breast cancer gene does not boost risk of death: study

January 12, 2018
Young women with the BRCA gene mutation that prompted actress Angelina Jolie's pre-emptive and much-publicised double mastectomy are not more likely to die after a breast cancer diagnosis, scientists said Friday.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.