A genetic screening technique could take much of the mystery out of predicting breast cancer outcome, Stephen Friend of Rosetta Inpharmatics in Kirkland, Washington, and Laura J van ‘t Veer of the Netherlands Cancer Institute, Amsterdam, and colleagues report in this week's Nature (Vol. 415, No. 6871, 31 Jan 2002).
Breast cancer goes by only one name, but spreads very differently in different patients. The strategies to combat the disease - such as hormone therapy, chemotherapy or surgery - and their timing are crucial to a patient’s outcome. But the physical appearance of tumours is an unreliable predictor of a patient's fate.
Using a gene chip, Friend's team screened breast cancer tumours removed from women with different cancer outcomes. They found a specific pattern of gene expression that corresponds to aggressive cancers - those which spread to other parts of the body quickly. They also found a signature unique to tumours from women with the gene most often associated with familial breast cancer, BRCA1.
The active genes they identified may provide a tool to select the right treatment options for individual sufferers of breast cancer, maximizing benefits and minimizing side effects. Much further down the line, they may also make useful targets for anti-cancer drugs. "If molecular forecasting of the outcome of cancer is indeed possible, as this work suggests, it is a significant advance on existing prognostic methods," say Carlos Caldas and Samuel Aparicio of Cambridge University, UK, in an accompanying News and Views article.
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