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The Promise
of Cancer Research
Cancer research gives hope.
Doctors and researchers at hospitals and medical centers all
across the country are learning more about what causes breast
cancer and are exploring ways to prevent it. They are also
finding better ways to detect, diagnose, and treat this
disease.
Causes and
Prevention
Doctors can seldom explain
why one person gets breast cancer and another doesn't. It is
clear, however, that breast cancer is not caused by bumping,
bruising, or touching the breast. And this disease is not
contagious; no one can "catch" breast cancer from
another person.
Scientists are trying to
learn more about factors that increase the risk of developing
this disease. For example, research is in progress to
determine whether the risk of breast cancer is affected by
environmental factors. Pesticides, magnetic fields, engine
exhausts, and contaminants in water and food are some of the
environmental factors under study. (The principal known risk
factors are listed under Risk Factors for
Breast Cancer.)
Some aspects of a woman's
lifestyle may affect her chances of developing breast cancer.
For example, some studies point to a slightly higher risk of
breast cancer among women who drink alcohol. The risk appears
to go up with the amount of alcohol consumed.
Scientists are trying to
learn whether having an abortion or a miscarriage increases
the risk of breast cancer. Thus far, studies have produced
conflicting results, and this question is still unresolved.
Some evidence suggests a
link between diet and breast cancer. Studies show that breast
cancer is more common in populations that consume a high-fat
diet than in populations that consume a low-fat diet. However,
it is not yet known whether a diet low in fat will actually
prevent breast cancer. Also, recent studies suggest that
regular exercise may decrease the risk of breast cancer in
younger women.
Research has led to the
identification of certain alterations in genes that place
women at a greater risk for developing breast cancer. Women
with a strong family history of breast cancer may choose to
have a blood test to see if they have inherited an alteration
in the BRCA1 or BRCA2 gene. Certain alterations in either of
these genes increase a woman's chances of developing breast
cancer. Special counseling before and after testing helps
women understand and deal with the possible outcomes--both
benefits and risks--of having a genetic test. For example, a
potential benefit of genetic testing is that it gives women
the ability to make informed medical and lifestyle decisions.
However, information about having a genetic alteration could
affect a woman's employment or her health, life, and
disability insurance. Women who are concerned about an
inherited risk for breast cancer should talk to their doctor.
The doctor may suggest seeing a health professional trained in
genetics.
Ongoing studies are looking
at ways to prevent breast cancer through changes in diet.
Other studies are looking for drugs that may prevent the
development of this disease. In one study, the drug tamoxifen
reduced the number of new cases of breast cancer among women
at an increased risk for the disease. For more information
about this and other prevention clinical trials, call the
Cancer Information Service.
Detection and
Diagnosis
At present, mammograms are
the most effective tool we have to detect breast cancer.
Researchers are looking for ways to make mammography more
accurate. They are also exploring other techniques, such as
digital mammography (using computers to read mammograms), magnetic
resonance imaging (MRI), breast ultrasonography,
and breast-specific positron
emission tomography (PET), to produce detailed
pictures of the tissues in the breast.
In addition, researchers
are studying tumor markers, substances that may be present in
abnormal amounts in the blood, urine, or nipple aspirates
of a woman who has breast cancer. Some of these markers are
used to follow women who have already been diagnosed with
breast cancer. At this time, however, no blood or urine test
is reliable enough to be used routinely to detect breast
cancer.
Clinical Trials
Research has led to
significant advances in the treatment of breast cancer, and
researchers continue to search for more effective ways to
treat this disease. They are also exploring ways to reduce the
side effects of treatment and improve the quality of patients'
lives. When laboratory research shows that a new treatment
method has promise, cancer patients receive the treatment in
studies called clinical trials. These studies are designed to
answer important questions and to find out whether the new
approach is both safe and effective. Often, clinical trials
compare a new treatment with a standard approach. Through
research, doctors try to find new, more effective ways to
treat cancer. Patients who take part in clinical trials may
have the first chance to benefit from improved treatment
methods, and they make an important contribution to medical
science.
Studies of new approaches
for patients with all stages of breast cancer are under way. A
new procedure, sentinel
lymph node biopsy, may eventually reduce the number of
lymph nodes that need to be removed for biopsy and possibly
prevent or lessen the severity of lymphedema. Researchers are
also testing new chemotherapy doses and treatment schedules;
the effectiveness of using chemotherapy before surgery (called
neoadjuvant
chemotherapy); and new ways of combining treatments, such as
adding hormonal therapy or radiation therapy to chemotherapy.
They are working with various anticancer drugs and drug
combinations, as well as with several types of hormonal
therapy. Some studies include biological
therapy, treatment with substances that boost the
immune system's response to cancer or help the body recover
from the side effects of treatment.
In a number of studies,
doctors are trying to learn whether very high doses of
anticancer drugs are more effective than the usual doses in
destroying breast cancer cells. Because these higher doses
seriously damage the patient's bone
marrow, where blood cells are formed, researchers are
testing ways to replace the bone marrow or to help it recover.
These new approaches (autologous
bone marrow and peripheral
blood stem cell transplants, and the use of colony-stimulating
factors) are described in the Glossary
section.
Cancer patients may want to
read a National Cancer Institute booklet called Taking
Part in Clinical Trials: What Cancer Patients Need To Know,
which explains some of the possible benefits and risks of
clinical trials. Those who are interested in taking part in a
clinical trial should discuss this option with their doctor.
Women can learn about
ongoing clinical trials through PDQ. This NCI cancer
information database also contains current information on
cancer prevention, screening, treatment, and supportive care.
Information from PDQ is available from the Cancer Information
Service and other sources listed under National
Cancer Institute Information Resources.
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