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Breast cancer research leading the way

Thursday 30 April 2020

Most people know someone who has had an MRI, and nearly all women have had a mammogram, but the technology led by Dr Honor Hugo, Professor Erik Thompson and their collaborative research group draws on aspects of both - with potential to help thousands more breast cancer patients.

Funded by the PA Research Foundation, their work focuses on measuring mammographic density (aka breast density) as a risk factor for breast cancer and then exploring how that information can be used to help women being treated for breast cancer and improving the ability of health professionals to save lives. As well as being a dense tissue that can create an environment for cancers to grow, mammographic density shows up on a mammogram scan as white area, just as a cancer would, meaning that spotting potential cancers can be like 'trying to find a polar bear in a snow storm'.

"One reason why we want to measure mammographic density using NMR (nuclear magnetic resonance imaging) is we can then potentially purpose it for measuring mammographic density change in women on anti-estrogen therapies because that is a good indicator that they're responding to the therapy and they will do well on those therapies," Dr Hugo said.

"What we're looking at is a novel technology, it's called an NMR single-sided MRI technology, a scaled-down version of the clinical MRI. The advantage of this technology is it is portable, it's low cost, but also it's a way to measure mammographic density."

As the research group continue their exploration of mammographic density, they are hopeful their work will also lead to improvements in the ability to predict who may be at increased risk of getting breast cancer, so potential prevention measures can be made as well as better treatment options being made available to those already diagnosed.

"The other side of the program is trying to understand what is the basis of the breast cancer risk associated with mammographic density so we could be in a better position to predict, prevent, and treat breast cancer," Dr Hugo said.

Thanks to PA Research Foundation research awards, the research group are now analysing several different treatment options for breast cancer patients.

"We are investigating the connection and a correlation between the NMR measurements we've collected in the MRI and the mammogram, with the hope to then use that NMR technology to monitor women on Tamoxifen," Dr Hugo said.

"Potentially also, we can get a sense of the timeframes and extent of changes to mammographic density by looking at women who have just gone onto external hormone replacement therapy, where their density will increase, or alternatively, looking at women who have just come off Hormone Replacement Therapy.

"The key will be to find the instrument calibrations that produces the biggest change that we're able to detect."

Once developed, Professor Thompson feels that the technology has the potential to be rolled out beyond the PA Hospital and into hospitals and medical centres nationwide, thereby reaching more patients and potentially improving our use of Tamoxifen and other hormonal therapies for breast cancer.

"The scope for this work potentially, in the long-term is that this is a portable technology that's low cost, so it could be implemented in rural hospitals for the monitoring of women who are on Tamoxifen who need to travel many kilometres to be monitored," he said.

"There's a lot of burdens there on the family in the cost and the time, and all that sort of thing, so we hope to alleviate that through this new technology."

Recently, the team has uncovered a new development that will see them researching what is known as heparan-sulfate-proteoglycans – inhibitors of which reduce the water percentage in breast tissue, and in turn mammographic density, which they hope will lead to better outcomes through improved mammographic accuracy and possibly also reduced breast cancer risk.

With COVID-19 halting physical progression of lab work, both researchers are looking forward to the resumption of research confirming the utility of the NMR to measure mammographic density and continuing a study of human breast tissue, on top of repeating and reviewing experimental data obtained from using hormonal treatments as a means to repress oestrogen signalling which has been demonstrated to drive mammographic density.

Without the support of the PA Research Foundation's donor base, the team's groundbreaking work would not have reached its current point and with one in eight women getting breast cancer, Professor Thompson believes funding medical research has never been more important.

"About half a million women globally are dying every year from breast cancer. In one sense, we're doing well, but in another, because the risk is one in eight women, the numbers are still high," he said.

"I wouldn't be trying to talk anybody into donating, but I would like to emphasise that it's an important and widespread issue."

Dr Hugo said both researchers were grateful to anyone who had donated to the Foundation.

"Thank you. You've invested in something that's worthwhile. I'm not just saying that because I'm a researcher, but as a woman as well."

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