Breast cancer risk identified

Breast cancer can be unpredictable

Scientists have developed a way to identify which breast cancer patients are most at risk of dying from the disease.

More than half of women with locally advanced breast cancer are likely to relapse within five years despite chemotherapy and radiotherapy.

And one in five low risk disease patients will develop a secondary cancer within 10 years.

Until now, doctors have often been unable to predict which women are more at risk.

However, scientists from the European Institute of Oncology in Milan have begun to develop a new test which they hope will resolve this problem.

Researcher Dr Pier Francesco Ferrucci says that the key could be a protein called maspin, which is produced by cells within the breast called epithelial cells.

Maspin has recently been shown to have the ability to suppress tumours - probably as a result of inhibiting the growth of new blood vessels needed to feed the cancer cells.

This has the possibility of becoming a test that could routinely help doctors identify at least some of the women more at risk of relapse

Dr Pier Francesco Ferrucci, European Institute of Oncology

Dr Ferrucci's research has involved studying a group of 48 women who have had surgery and aggressive chemotherapy to treat their high risk breast cancer.

All were tested for the presence of breast epithelial cells in the bone marrow and peripheral blood system.

They were found to have tiny secondary tumours, typically in the bone marrow, that would not show up as a solid mass but that could be seen under a microscope on tissue samples.

For women such as these the outlook is generally not good.

Relapse clue

The researchers tested these women for the presence of a range of substances associated with breast cancer.

Dr Ferrucci and his colleagues found that in general, women with higher levels of maspin were less likely to relapse.

The effect was particularly pronounced in ten of the women, who all had 20 or more lymph nodes affected by the disease.

After around 15 months observation, eight of these women had not relapsed and all had high maspin levels.

Dr Ferrucci said: "In our study we have simply found an association between the amount of maspin produced by breast cells and reduced risk of relapse in a particular group of high risk breast cancer patients.

"Our findings are backed-up by similar results recently published on other tumours derived from epithelial cells.

"With further evaluation, this has the possibility of becoming a test that could routinely help doctors identify at least some of the women more at risk of relapse so that they can be given more appropriate care and treatment."

However, Dr Ferrucci stressed that more research was needed before a test could be developed.

Jackie Graveney, of the charity Breakthrough Breast Cancer, said: "This research is an extra tool in trying to identify women who may be at a higher risk of a reoccurrence of breast cancer.

"But we need more research to see how this could be used in every day practice to benefit patients."

The research will be presented at the European Society of Medical Oncology conference in Hamburg on Monday.