Breast Cancer

Breast cancer is the most common cancer in women worldwide, claiming the lives of hundreds of thousands of women each year. Although it’s rare, men can also be diagnosed with breast cancer. With breast cancer continuing to impact so many people, it’s important to understand the disease and what strides researchers are making. More than 3.1 million breast cancer survivors live in the U.S. today. The lifetime risk of getting breast cancer in the U.S. is about 1 in 8 for women and 1 in 1,000 for men. Research shows only 5-10% of breast cancers are hereditary. Dense breasts can be six times more likely to develop cancer. If you have dense breasts, ask your doctor about extra screening tests, like ultrasound or MRI, to check for tumors that a mammography might have missed. A lump isn’t the only sign of breast cancer. Call your doctor if you notice a change in the size or shape of your breast, a nipple turned inward, fluid other than breast milk, dimples in your breast or scaly, red or swollen skin on your breast, nipple or areola.

Diagnosis

Diagnosing a breast cancer includes one or more of the following tests:

Tests and procedures used to diagnose breast cancer include:

  • Breast exam
  • Mammogram
  • Breast ultrasound
  • Removing a sample of breast cells for testing (biopsy)
  • Breast magnetic resonance imaging (MRI)

Once the physician has diagnosed the breast cancer, he or she works to establish the extent (stage) of the cancer. The cancer’s stage helps determine the prognosis and the best treatment options.

Complete information about the cancer’s stage may not be available until after the patient undergoes breast cancer surgery.

Tests and procedures used to stage breast cancer may include:

  • Blood tests, such as a complete blood count
  • Mammogram of the other breast to look for signs of cancer
  • Breast MRI
  • Bone scan
  • Computerized tomography (CT) scan
  • Positron emission tomography (PET) scan

Treatment

Your doctor determines your breast cancer treatment options based on your type of breast cancer, its stage and grade, size, and whether the cancer cells are sensitive to hormones. Most women undergo surgery for breast cancer and also receive additional treatment before or after surgery, such as chemotherapy, hormone therapy or radiation.

Surgery.  Surgery involves the physical removal of the tumor, typically along with some of the surrounding tissue. One or more lymph nodes may be biopsied during the surgery; increasingly the lymph node sampling is performed by a sentinel lymph node biopsy.

Standard surgeries include:

  • Mastectomy: Removal of the whole breast.
  • Quadrantectomy: Removal of one-quarter of the breast.
  • Lumpectomy: Removal of a small part of the breast.

Hormone blocking therapy.  Some breast cancers require estrogen to continue growing. They can be identified by the presence of estrogen receptors (ER+) and progesterone receptors (PR+) on their surface (sometimes referred to together as hormone receptors). These ER+ cancers can be treated with drugs that either block the receptors, e.g. tamoxifen, or alternatively block the production of estrogen with an aromatase inhibitor, e.g. anastrozole[1] or letrozole. The use of tamoxifen is recommended for 10 years.[2] Letrozole is recommended for 5 years. Aromatase inhibitors are only suitable for women after menopause; however, in this group, they appear better than tamoxifen.[3] This is because the active aromatase in postmenopausal women is different from the prevalent form in premenopausal women, and therefore these agents are ineffective in inhibiting the predominant aromatase of premenopausal women.[4] Aromatase inhibitors should not be given to premenopausal women with intact ovarian function (unless they are also on treatment to stop their ovaries from working.

Chemotherapy.  Chemotherapy is predominantly used for cases of breast cancer in stages 2–4, and is particularly beneficial in estrogen receptor-negative (ER-) disease. The chemotherapy medications are administered in combinations, usually for periods of 3–6 months. One of the most common regimens, known as “AC”, combines cyclophosphamide with doxorubicin. Sometimes a taxane drug, such as docetaxel, is added, and the regime is then known as “CAT”. Another common treatment is cyclophosphamide, methotrexate, and fluorouracil (or “CMF”). Most chemotherapy medications work by destroying fast-growing and/or fast-replicating cancer cells, either by causing DNA damage upon replication or by other mechanisms. However, the medications also damage fast-growing normal cells, which may cause serious side effects. Damage to the heart muscle is the most dangerous complication of doxorubicin, for example.

Radiation.  Radiotherapy is given after surgery to the region of the tumor bed and regional lymph nodes, to destroy microscopic tumor cells that may have escaped surgery. It may also have a beneficial effect on tumor microenvironment. Radiation therapy can be delivered as external beam radiotherapy or as brachytherapy (internal radiotherapy). Conventionally radiotherapy is given after the operation for breast cancer. Radiation can also be given at the time of operation on the breast cancer. Radiation can reduce the risk of recurrence by 50–66% (1/2 – 2/3 reduction of risk) when delivered in the correct dose and is considered essential when breast cancer is treated by removing only the lump (Lumpectomy or Wide local excision).

[1] Ting Bao; Michelle A Rudek (2011). “The Clinical Pharmacology of Anastrozole”. European Oncology & Haematology. 7 (2): 106–8

[2] Burstein, HJ; Temin, S; Anderson, H; Buchholz, TA; Davidson, NE; Gelmon, KE; Giordano, SH; Hudis, CA; Rowden, D; Solky, AJ; Stearns, V; Winer, EP; Griggs, JJ (27 May 2014). “Adjuvant Endocrine Therapy for Women With Hormone Receptor-Positive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Focused Update”. Journal of Clinical Oncology. 32 (21): 2255–69

[3] Early Breast Cancer Trialists’ Collaborative Group (23 July 2015). “Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials”. The Lancet. 386: 1341–1352.

[4] Petit T, Dufour P, Tannock I (June 2011). “A critical evaluation of the role of aromatase inhibitors as adjuvant therapy for postmenopausal women with breast cancer”. Endocr. Relat. Cancer. 18 (3): R79–89

Diagnostics Companies

These companies are candidates of the Cancer consortium. See full profiles.

Travera: Travera is using a breakthrough technology to measure which cancer drugs work against each individual’s unique cancer. This revolutionary diagnostic test will enable oncologists to quickly determine which drugs to prescribe based on the actual responses of their patients’ tumor cells

BIOMARKER TECHNOLOGIES: Biomarker Technologies, LLC is a translational, in-vitro diagnostic company focused on breast cancer detection.  The Company is poised to bring the BT Test to market as fast as possible with both U.S. and global approvals.

Bioptics: At Bioptics we are committed to developing the best imaging technology available for the detection and treatment of breast cancer. Our products offer you the performance you need when and where you need it creating clinical value for you and your patients.

Infrared Sciences Corp. (ISC) is a New York based technology company focused on early detection of breast cancers.

GRAIL: STRIVE is a study to validate a test to detect breast cancer, and to train and develop a test to detect multiple cancers at early stages.

Agendia: The MammaPrint test has shown a clinically validated ability to predict the risk of breast cancer recurrence in the first five years after diagnosis, which is the period in which chemotherapy produces most of its benefits to a patient.  MammaPrint is the only breast cancer recurrence assay backed by peer-reviewed, prospective outcome data.

Provista Diagnostics: Videssa Breast is Provista’s lead diagnostic, and the first and only blood test for the early and accurate detection of breast cancer.

Biotheranostics, Inc.: Biotheranostics has commercialized a proprietary, highly differentiated product focused on early stage breast cancer, Breast Cancer Index (BCI).

Oncocyte: OncoCyte’s pipeline breast product is being developed to reduce the number of patients with indeterminate mammograms being sent for biopsies.

Myriad Genetics, Inc.: The BRACAnalysis ® test assesses a person’s risk of developing hereditary breast or ovarian cancer based on the detection of mutations in the BRCA1 and BRCA2 genes.

Foundation Medicine: FoundationOne CDx is the first FDA-approved broad companion diagnostic (CDx) that is clinically and analytically validated for solid tumors, including breast cancer.

Genomic Health: The Oncotype DX portfolio of breast, colon and prostate cancer tests applies advanced genomic science to reveal the unique biology of a patient’s tumor in order to optimize cancer treatment decisions.

Nanostring: Prosigna manages patients with early-stage breast cancer with a highly accurate assessment of risk.

Bio and Pharma Therapeutics Companies

These companies are candidates of the Cancer consortium. See full profiles

Armune BioScience, Inc.: Armune Bioscience is an early-stage biopharmaceuticals company focused on the development and commercialization of high value, protein signature-based diagnostic tests for prostate, lung and breast cancer.

Advanced Imaging Technologies: Advanced Imaging Technologies, Inc. (AIT) aims to provide medical professionals with an integrated and intuitive solution for imaging women with varying breast tissue types, especially those with dense breast tissue.

Biomerieux:  The company is working on the development of a diagnostic “companion” test for a new breast cancer drug, that would make it possible to identify patients likely to have a positive response to this new treatment.

Pharmacyte Biotech: For PharmaCyte Biotech’s breast cancer treatment, the cells that are encapsulated using the Cell-in-a-Box® technology contain an isoform (known as CYP2B1) of the cytochrome P450 enzyme system that are efficient at activating cyclophosphamide, an anti-cancer drug.

Immunomedics Inc: Sacituzumab govitecan has received Breakthrough Therapy designation from the FDA for the treatment of patients with triple-negative breast cancer (TNBC) who have failed prior therapies for metastatic disease.

Innate Pharma: It’s program aims at developing an anti-CD73 antibody for immuno-oncology. CD73 is a membrane-bound extracellular enzyme overexpressed in several cancer types. Its expression has been linked to poor prognosis in triple negative breast cancer.

FLX Bio Inc.:  In several cancer types such as breast cancer and colorectal cancers, the increased accumulation of myeloid-derived suppressor cells can be an indication of disease severity. FLX’s therapeutic targeting of MDSCs represents a promising way to boost antitumor immunity.

Astrazeneca: Lynparza, presently marketed for advanced ovarian cancer, is also in different studies for a range of tumor types including breast cancer.

Genentech: Clinical trials are ongoing evaluating Taselinib for solid tumor and metastatic hormone receptor-positive breast cancer, and metastatic HER2-negative breast cancer.

Puma Biotechnology: Puma Biotechnology is currently focused on developing Neratinib for the treatment of HER2-Positive Early Stage Breast Cancer. *

Syndax Pharmaceuticals: A Randomized Phase 3 Trial of Endocrine Therapy Plus Entinostat/Placebo is underway in Patients With Hormone Receptor Positive Advanced Breast Cancer.

Devices Companies

These companies are candidates of the Cancer consortium that work in the areas of devices and surgical techniques, radiation therapies. See full profiles.

Atossa Genetics, Inc.: With US distribution agreements with top healthcare companies, Atossa Genetics offers proprietary medical devices and laboratory services in women’s health and is looking to develop their presence in the European and Asian markets.

Endomagnetics: The SentiMag and Sienna device system was developed to increase access to the standard of care in breast cancer staging by providing an alternative approach to detecting sentinel lymph nodes.

Life Medical Technologies provides life-enhancing, innovative medical products to the public through partnerships with various organizations and institutions in its efforts to fight breast cancer and other life-threatening illnesses.

MacKay Life Sciences (Prior Biofield Corp.): Biofield Corp. is a development stage company developing a device to assist in detecting breast cancer with a non-invasive procedure.

Organizations/Resources

Susan G. Komen, formerly known as Susan G. Komen for the Cure and originally as The Susan G. Komen Breast Cancer Foundation, often referred to as simply Komen, is the largest and best-funded breast cancer organization in the United States.

The National Breast Cancer Foundation (NBCF) is the leading community-funded national organisation in Australia, supporting and promoting research for the prevention and cure of breast cancer.

The Breast Cancer Research Foundation (BCRF) is an independent, not-for-profit organization which has raised $569.4 million to support clinical and translational research at medical institutions worldwide. BCRF currently funds over 200 researchers in 6 continents and 13 countries.

Breastcancer.org is a nonprofit organization dedicated to providing the most reliable, complete, and up-to-date information about breast cancer.

The American Breast Cancer Foundation (ABCF) mission is to provide education, access and financial assistance to aid in the early detection, treatment, and survival of breast cancer for underserved and uninsured individuals, regardless of age or gender.

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