Assessing the risk of recurrence in breast cancer

Article Abstract:

The search for ever better methods of predicting the prognosis of a cancer patient is at the forefront of today's cancer research. An article in the February 1, 1990 issue of 'The New England Journal of Medicine' presents the results of assessing the risk for the recurrence of breast cancer by a relatively simple test. The ability to predict which patients with breast disease are likely to be at high risk for cancer recurrence would be important in planning clinical treatment. In 1979, a glycoprotein (combination of protein and carbohydrate) was identified as being secreted by human breast cancer cells grown in laboratory tissue cultures. After purification this molecule, called cathepsin D, was identified as a precursor of an enzyme which acts to break down protein (i.e., a protease). This compound was found to be stimulated by the level of female hormones or estrogens, and its level was restricted by anti-estrogen drugs (which oppose estrogens). A classification system for the prognosis of breast cancer patients is related to the degree of cancerous involvement of the lymph nodes; an absence of lymph node involvement is associated with a better prognosis, and the occurrence of lymph node involvement is related to a poorer prognosis. The possibility that cathepsin D is important as a prognostic factor is interesting because it is stimulated by estrogens and many breast cancers also have receptors for estrogens. In the reported research, the value of cathepsin D for predicting the rate of breast cancer recurrence is explored in a study of 396 women. Overall survival was better for all patients who had low levels of cathepsin D; however, the predictive values were much greater for women who were node-negative (no involvement of the lymph nodes). The work appears to be promising, but both patients and physicians alike should proceed carefully until the utility of this test is completely explored in routine clinical practice. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Risk factors, Estrogen, Estrogens, Recurrence (Disease), Lymphatic metastasis, editorial, Cathepsins

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Haptoglobin-related protein (Hpr) epitopes in breast cancer as a predictor of recurrence of the disease

Article Abstract:

The ability to assess the likelihood of the spread of cancer, metastatic activity, at the time of the initial diagnosis of breast cancer would be an important component in selecting patients for intensive early chemotherapy. Currently, more than 25 percent of patients have undetectable metastases in the early stages of breast cancer. Studies show a relationship between changes in oncogenes, gene viruses that can cause cells to become malignant, and possible outcomes of breast cancer. Some human breast cancer oncogenes express haptoglobin-related protein (Hpr) or a substance that shares epitopes (a component of an antigen, a molecule capable of producing disease) with the HPR gene product. Researchers studied the activity of Hpr-epitopes in early cancer tissues from human breasts and concluded that the expression of Hpr-epitopes can be used to predict metastasis in patients with early breast cancer. Approximately 45 percent to 92 percent of patients exhibiting Hpr has recurrence of cancer, while 22 percent of those not exhibiting Hpr had recurrence. Analysis of Hpr would be useful in assessing the treatment options available to patients with early breast cancer. It may also be useful to measure blood levels of Hpr in monitoring the progression of the disease in high risk patients.

Haptoglobin

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The prognostic role of a gene signature from tumorigenic breast-cancer cells

Article Abstract:

A study identifies 186 genes that are differentially expressed in tumorigenic breast-cancer cells and normal breast epithelium to generate an "invasiveness" gene signature (IGS). Results show the IGS is strongly associated with metastasis-free and overall survival for four different types of tumors, particularly when combined with the wound-response (WR) signature in breast cancer.

Science & research, Research, Cancer cells, Clinical report

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