Detecting an Aggressive Form of Breast Cancer

Researchers from Dartmouth Medical School found out that nestin could represent a selective biological marker for basal epithelial breast tumours, a highly aggressive cancer with similarities to mammary stem cells, the regenerative cells believed to be the site of breast cancer initiation. "Patients with this type of breast cancer are at high risk for recurrence," said James DiRenzo, Ph.D., assistant professor at Dartmouth Medical School. "Ideally, a marker like nestin would enable clinicians to monitor these patients through frequent tests of a biomarker and, in doing so, detect the cancer before it has a chance to come back."

Basal epithelial tumours lack important molecular targets such as the oestrogen receptor, progesterone receptor and Her2. This not only makes positive diagnosis difficult, say researchers, but also eliminates several important lines of therapy, such as tamoxifen or Herceptin, that work well for other breast cancer subtypes.

"Currently, there is no direct means of determining if a breast cancer is a basal epithelial tumour – doctors only know for certain once the other forms of breast cancer are ruled out," DiRenzo said. "This type of breast cancer is generally difficult to manage, but several important studies have shown that it is more likely than other breast cancer subtypes to respond to certain types of therapy, which highlights the need for a definitive diagnostic marker."

According to the DiRenzo, another important next step will be finding an efficient means of detecting nestin in a clinical screening setting. While it seems unlikely that a blood test would be sufficient, DiRenzo believes that a non-invasive test that collects samples from mammary ducts may enable the development of a screening tool for at-risk patients.; Source: American Association for Cancer Research