Unique study to combat a killer

Statistics show that one in 10 women will develop breast cancer leading researchers at Wythenshawe Hospital to design the world’s largest study of its kind to predict risk.

Reporter DAWN MARSDEN takes a closer look at the devastating condition and what the survey hopes to achieve.

RESEARCHERS at Wythenshawe Hospital’s Nightingale and Genesis Prevention Centre are on the lookout for women of all shapes, sizes, ages and backgrounds to help them out.

A total of 60,000 women are needed to help experts look more closely at how to predict the risk of breast cancer over the next five years.

All women who attend breast screening sessions will have the opportunity to take part.

Participants will fill in a questionnaire based on lifestyle and family history of the disease and their mammograms will be used to check breast density.

One in six women will be asked to provide a saliva and DNA sample.

Experts have known for some time that certain factors including diet, exercise, age, pregnancy and menopause can either add to or reduce the chances of breast cancer.

But this study is unique because by taking saliva samples it will also be possible to extract and analyse DNA which will provide information on known genetic variations that can increase risk by between eight and 40 per cent. In combination, these factors may treble the risk of being diagnosed with breast cancer.

The research team, led by Professor Gareth Evans of the Nightingale Centre and Genesis Prevention Centre, expect the findings of the five-year trial, code-named PROCAS (Predicting the Risk of Cancer at Screening) will result in changes to the length of time women are recalled for breast screening based on their individual risk of developing breast cancer.

He said: “Women will be recruited by invitation only. Once we have the information we require, our researchers, through computer programming, will be able to calculate a woman’s risk.

“All will be given the option of knowing their outcome and if it’s high, advice and guidance will be offered to talk through the choices available.”

Women who choose to take part can join the study when they attend their routine NHS breast screening mammogram.

The research is funded by a £1.59m National Institute for Health Research (NIHR) Programme Grant.

Additional support is being provided by the Genesis Appeal — the UK’s only charity entirely dedicated to breast cancer prevention — which is funding the DNA sample collection kits. The Genesis Appeal helped to fund the Genesis Breast Cancer Prevention Centre, which is Europe’s first ever, purpose built centre of its kind.

The £14m state of the art project, based at Wythenshawe Hospital, brings together internationally recognised medical experts and houses pioneering work into diagnosis, education and research into the prevention and treatment of breast cancer.




What is breast cancer?



Breast cancer is an uncontrolled growth of breast cells. Cancer occurs as a result of abnormal changes in the genes responsible for regulating the growth of cells and keeping them healthy.



The genes are in each cell’s nucleus, which acts as the “control room” of each cell.

Normally the cells in our bodies replace themselves through an orderly process of cell growth — healthy new cells take over as old ones die out.

But over time mutations can ‘turn on’ certain genes and ‘turn off’ others in a cell.

That changed cell gains the ability to keep dividing without control or order producing more cells just like it and forming a tumor.

A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous).

Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade near-by tissues or spread to other parts of the body.

Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body.

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast.

Breast cancer usually begins either in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple.

Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes.

If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body.

Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material).

However, only five to 10 per cent of cancers are due to an abnormality inherited from your mother or father.

Around 90 per cent of breast cancers are due to genetic abnormalities that happen as a result of the ageing process and the wear and tear of life in general.

While there are steps every person can take to help the body stay as healthy as possible (such as eating a balanced diet, not smoking, limiting alcohol, and exercising regularly) breast cancer is never anyone’s fault.




Symptoms



THESE can vary widely from lumps to swelling to skin changes but some women have no symptoms at all.



Women should regularly self-examine and anyone over 40 or those with a strong family history of the disease should have their breasts screened annually — the earlier it is found, the better the chance of treating it successfully. Diagnosis can take weeks as a number of different tests are needed to secure an accurate result.