The Grapevine

Breast Cancer Is Deadly When It Spreads To The Brain, But A New Test Could Help Identify At-Risk Patients

Breast Cancer
The new test could prevent some cases of breast cancer from becoming deadly. Laura Taylor (CC BY-NC-ND 2.0)

Breast cancer is one of the most common types of cancer in the U.S. While its consequences normally remain local — mastectomies, for example — breast cancer is as capable as any other form of the disease when it comes to metastasizing. While women can sometimes survive for years despite breast cancer metastasis, the one exception is when it spreads to the brain, which usually signals that she has only a few months to live. One new study takes a step in the right direction when it comes to identifying the most aggressive forms of breast cancer early on, giving health care providers a chance to alter treatment accordingly.

In an analysis of about 4,000 patients, a team of researchers found that high levels of activity in a particular gene, called alpha beta (aB)-crystallin, was an independent predictor of relapse, specifically in the brain. The researchers, from the Institute of Cancer Research, London, found that women who tested positive in an (aB)-crystallin test were three times more likely to have cancer that spread to the brain than women who tested negative.

“Spread of breast cancer to the brain is unfortunately very dangerous, and usually leads to death within months,” said study co-leader Dr. Maggie Cheang, senior staff scientist at The Institute of Cancer Research, London, in a press release. “It’s important to find new ways to identify women who are most at risk of their cancer spreading to the brain, so that doctors can work out which women might need more intensive or new treatments to try to keep their cancer at bay for longer.”

From the patients, the team observed 969 tumors that ultimately spread to new sites in the body, 141 of which first spread to the brain. Further analysis of the tumors led to a link between aB-crystallin and a significantly higher risk of death — 36 percent of women with aB-crystallin-positive cancer died within 10 years of diagnosis, compared to 25 percent of those who tested negative for the gene.

“Our study linked a positive score in this test with quicker spread to the brain, and importantly showed the factor we were measuring is providing information on patient outcome independently of other biomarkers already measured in the clinic,” Cheang said.

The test needs to be developed further before it can be used in a clinical setting, but Cheang said the first use of the test could be to effectively identify women with specific kinds of advanced cancer, and have them participate in new treatments and clinical trials.

Source: Voduc K, Nielsen T, Perou C, Harrell J, Fan C, Kennecke H, et al. aB-crystallin expression in breast cancer is associated with brain metastasis. Npj Breast Cancer. 2015.

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