Healing after tumor removal linked to recurrence of breast cancer
- An MIT study of mice has found a link between the healing process after breast cancer tumor removal and the spread of cancer cells
- One in four women who have a lumpectomy or mastectomy will experience a cancer relapse
- Anti-inflammatory medications such as aspirin were found to stop the spread of cancer cells during recovery
Megan Sheets For Dailymail.com
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Surgery to remove tumors in breast cancer patients may cause the cancer to spread, but cheap drugs such as aspirin may be able to prevent recurrence, a new study has found.
For decades, doctors have struggled to understand why breast cancer commonly recurs in the first year after a patient has a lumpectomy or mastectomy to remove cancerous tissue.
The majority of the more than 40,000 people who die from breast cancer each year are killed not by the initial tumor, but by its spread to other areas of the body called metastasis.
New findings from researchers at the Massachusetts Institute of Technology have revealed the immune system response that leads to the recurrence and identified anti-inflammatory medications that could stop that mechanism and prevent tumors from coming back.
A study of mice has found that while breast cancer surgery could lead to the spread of tumor cells, cheap medications can stop metastasis
About one in eight women in the US will develop breast cancer in her lifetime, and an estimated 330,000 new cases are expected to be diagnosed in 2018.
One of the first treatment options recommended for women with breast cancer is to surgically remove the cancerous tissue, known as a lumpectomy when only a portion of the breast is removed or a mastectomy when the entire breast is removed.
The cancer has been found to recur in about 25 percent of women who’ve had a lumpectomy or mastectomy.
The risk of recurrence in these patients is highest in the first 12 to 18 months after surgery, but doctors have spent decades trying understand why.
Previous research drew an association between the surgeries and the subsequent spread of cancer cells but no study has ever been able to find a causal link, so many experts assumed that relapse may simply be a natural disease progression in some patients.
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For a study published Wednesday in the journal Science Translational Medicine, a team of researchers at MIT introduced tumor cells to a group of mice to investigate what might be causing tumor recurrence after surgery.
When those mice underwent simulated surgeries, the tumor size and incidence grew dramatically, even when the surgical site wasn’t near the injected cells.
The findings led the researchers to conclude that the spread may be triggered by the wound-healing process.
‘It’s not the actual surgery, but instead it’s the post-surgical wound response,’ said Robert Weinberg, a biologist at the Massachusetts Institute of Technology who has spent years researching the spread of cancer.
To close an open wound, the immune system triggers cells to move to new locations and divide, and blood vessels to grow.
Breast cancer in the US
About 12.4 percent of American women will develop breast cancer in their lifetime.
It is the second-most commonly diagnosed cancer for women in the US behind skin cancer and also has the highest mortality rate, although death rates have been decreasing for the past two decades.
As of January 2018, there are more than 3.1 million women with a history of breast cancer in the US.
A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer, but about 85 percent of women affected have no family history of the disease.
The cost of breast cancer treatment in the US is expected to hit $20.5 million by 2020.
Source: BreastCancer.org
This inflammatory response interrupts the mechanism by which the immune system restrains cancer cells that have already wandered far from the tumor site, allowing them to grow and become new, more dangerous tumors.
After identifying the link between the wound-healing process and the spread of cancer cells, Weinberg’s team treated the mice with an anti-inflammatory drug called meloxicam to see if it could block the immuno-suppresive effects of the wound healing.
The drug was able to keep the immune system’s brake on the spread of cancer cells during the recovery process, resulting in minimized recurrent tumors or no recurrence at all.
Additionally, the meloxicam wasn’t found to impede the recovery process in the wounded mice.
The findings support limited previous research into the effectiveness of anti-inflammatory medicines in stopping the spread of cancer cells.
In a small study published in 2012 researchers found that breast cancer patients who received an anti-inflammatory drug called ketorolac after surgery were five times less likely to have their cancer spread than those who didn’t get the medication.
He said that some doctors are hesitant to prescribe anti-inflammatory medicines after surgery because they can cause bleeding problems, but that today there are methods for controlling those side effects.
A similar body of research by Harvard gastroenterologist Andrew Chan, who studies the relationship between cancer and aspirin, suggests that aspirin may be even more effective in stopping the growth of cancer cells than anti-inflammatory medications.
Weinberg added that the immune system’s control on spreading cells is just one mechanism by which the body works to prevent tumor growth, adding that he continues to search for and study others mechanisms.
‘This is an important first step in exploring the potential importance of this mechanism in oncology,’ he said.
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