Breast cancer diagnosis – more accurate and cheaper

Marina Moskalenko, NSU Press Service 

Novosibirsk scientists are working on a new, more effective method of typing breast cancer, with which you can choose the appropriate tactics for further treatment of the patient. At the same time, according to the researchers, the tests will cost patients twice as much.

Breast cancer is the most common form of malignant neoplasms among women. This disease also ranks second, after skin cancer, in frequency among all oncopathologies of mankind. Novosibirsk State University is trying to find more accurate diagnostic methods for such diseases that would allow detecting molecular subtypes of tumors at an early stage and selecting individual treatment for each patient in accordance with this.

Vladimir Cherny, a graduate of the NSU Faculty of Medicine, while undergoing residency in the Department of Breast Pathology at the City Clinical Hospital No. 1, strives to combine science with practice. Under the guidance of Doctor of Biological Sciences Lyudmila Fyodorovna Gulyaeva, the young scientist conducts a study of the analysis of the effectiveness of preoperative treatment of patients suffering from breast cancer, and in residency he fulfills the acquired skills in practice – he assists Professor Sergey Vasilyevich Sidorov as an oncologist surgeon. 

A young scientist tells:

– Medicine is gradually moving towards personalization, so that an individual approach to treatment is developed for each person. It's the same with breast cancer. So far, the method of immunohistochemical analysis (IHC) is mainly used to determine the subtype of a breast tumor. But we believe that this option of detecting the disease has its drawbacks: in some cases, it can be subjective. After all, with him, the morphologist, applying specific antibodies to the cells and tissues of the breast, looks at the degree of coloration of the material under a microscope and puts conditional points, so to speak, on the eye, guided only by what he could notice... At the same time, there are scientific publications confirming that such an analysis method can "skip" up to 15% of all hormone-dependent tumors.

Therefore, Novosibirsk researchers offer an alternative to immunohistochemistry in medical practice in the form of a well-known real-time PCR analysis, with the addition of other specific markers:

– Polymerase chain reaction is a widely used method in molecular biology, which makes it possible to speed up and facilitate the diagnosis of diseases. We have conducted research on clinical material ourselves, comparing these two methods. We were able to prove that PCR analysis is in no way inferior to the IHC method. The results obtained by us coincide with the results of the IHC study by 80%.

Novosibirsk scientists in their work selected a panel of breast cancer-specific micro-RNAs, which, according to their observations, most clearly demonstrate the tumor process during diagnosis.

– Classification of the oncological process is a very important part of the work, because there are often controversial results, – says Vladimir Cherny. – Now we want to use selected micro-RNAs to prototype breast cancer according to four main subtypes of the disease, which are based on receptor expression, for more effective treatment. That is, using these markers, including more accurately it is possible to determine which subtype of the tumor it is. And this will help us, firstly, to understand the molecular mechanisms of cancer, and, secondly, to choose the appropriate treatment.

This method has another advantage: scientists also found that PCR analysis is cheaper:

– It will cost less money to determine markers by this method than to conduct an immunohistochemical analysis. On average, a patient needs about 300-500 rubles for one marker, and immunohistochemistry will also cost 1000 rubles for one marker.

The very micro-RNA panel that helps Novosibirsk researchers diagnose cancer more accurately was picked up by a team of experienced bioinformatics "New Software Systems" under the leadership of Dmitry Shtokalo.

The topic of studying micro-RNA is quite popular in the world. Unique studies are being conducted in Novosibirsk, which are based on a combination of nine specially selected micro-RNAs in combination with other markers of breast cancer. NSU scientists are going to continue their research and try to convince the professional community to use the developed approaches in the routine practice of doctors:

– The experience of colleagues shows that in order to promote some new development to its real application, it sometimes takes decades, since it is necessary to justify the need for implementation, conduct clinical trials, convince the ministry, and so on. Although, if certain markers are approved by European and American clinical guidelines, the process of their implementation may take a little less time. For example, the BRCA1/2 gene, mutations in which dramatically increase the chance of developing breast cancer. (According to researchers, the probability of tumor occurrence in carriers of this mutation increases to 50-85% during their lifetime. Actually, because of a mutation in this gene, Angelina Jolie removed her breasts – preventatively, that is, while the cancer has not yet appeared), – said Vladimir Cherny. – When I started studying, this study was not popular in clinical practice in Russia. Now it will not be difficult to find a laboratory that will determine such a mutation for you.

Now NSU scientists are preparing a publication about the results of their research for a foreign publication.

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23.07.2015