New test for breast cancer disease progression


Breast cancer is the most common cancer in the UK. One in 8 women in the UK will be diagnosed with breast cancer at some point in their lives and whilst advances in early detection and treatment means that fewer people are dying from breast cancer, the number of cases in England has increased by 90 per cent since 1971.

Delayed Diagnosis

It was therefore exciting to read in the news that a blood test to see how well women are responding to breast cancer treatment could be available on the NHS in two years. The test was described as a "liquid biopsy which might eliminate the need for many invasive and potentially dangerous tumour biopsies in years to come".

The papers were referring to a small study carried out by researchers from the University of Cambridge and the Cancer Research UK Cambridge Institute, and other institutions in the US which compared tests to monitor the size of metastatic breast cancer which is cancer that has spread to into other parts of the body. Metastatic cancer is incurable but can be controlled with treatment in an attempt to prolong life. This study looked at a new blood test designed to detect fragments of tumour DNA in the blood, to see if it could accurately assess how well women were responding to chemotherapy.

Potentially, such a test could be more sensitive than a conventional CAT scan and would be a useful and complementary tool for assessing disease progression and how well a woman is responding to treatment so that if new tumours are spotted, patients are switched to alternative drugs. The aim of treatment is to slow the spread of the cancer down and to try and maintain quality of life and despite what is reported in the papers there is nothing to suggest that such a test would save thousands of lives as stated in the papers.

The test is still very much in the research stages, there is no indication as to when, or if, it will be made available in clinical practice, and further, the test does not apply to all breast cancer or to cancer in general, as the newspapers suggest.

Unfortunately, despite the awareness of the need for early detection and treatment, simple mistakes are still made by some doctors which result in a failure to diagnose the cancer in a timely manner which may result in unnecessary breast removal and reconstruction surgery, and longer courses of chemotherapy and radiotherapy and the psychological problems associated with the removal of a breast. These mistakes include failing to carry out an appropriate examination, or further assessment which would have confirm the disease, failing to offer routine screening and failing to refer for a specialist opinion.

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