1 October 2013
Around 185,000 lives could be lost by 2030 if critical gaps in breast cancer research are not urgently addressed
Charity hopes breast cancer could be overcome within 40 years but greater investment, collaboration and renewed focus
is vital
Research facilitated by leading research charity, Breast Cancer Campaign, has identified the ten critical gaps that exist
in breast cancer research, which, if not urgently addressed, could see the loss of around 185,000* lives by 2030.
This landmark research, published today (1 October) in the international open access journal, Breast Cancer Research,
entitled: Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer,
is a unique collaboration of over 100 internationally recognised scientists, clinicians and healthcare professionals.
Co-authored by Professor Sue Eccles, The Institute of Cancer Research, London, and Professor Alastair Thompson,
University of Dundee, the Gap Analysis 2013 is the most comprehensive review of breast cancer research to have ever
taken place and provides us with what we need to know and what we need to do to overcome - prevent, cure and outlive - breast
cancer by 2050.
The top ten gaps have been identified and prioritised in key areas, such as genetics, prevention, diagnosis, treatment and
support, which, if overcome, will have a significant impact on the lives of those affected. Critical gaps include:
- Understanding how genetic changes lead to the development of breast cancer.
- Identifying sustainable lifestyle changes, such as diet and exercise, which can reduce a woman's risk of breast cancer,
as well as improving risk-reducing drugs (chemoprevention) for women at increased risk of the disease.
- Targeting breast screening to those who will most benefit, by finding accurate and practical ways to calculate someone's
individual risk of developing breast cancer.
- Understanding the molecules and processes that encourage different types of breast cancer to grow, and those that allow
breast tumours to become resistant to treatments and spread throughout the body.
- Understanding how cancer cells with different characteristics form within a tumour, why cancer cells sometimes go into
hibernation, and why some breast cancers are resistant to treatment from the outset whereas others become resistant over time.
- Developing tests to predict how well patients will respond to chemotherapy or radiotherapy.
- Understanding how to use combinations of drugs and other therapies to improve and tailor treatment for each individual.
- Developing better ways of using imaging to diagnose breast cancer, track how the disease responds to treatments and
monitor its spread throughout the body.
- Providing effective and practical support to help people deal with the emotional impact of breast cancer and the side
effects of treatment.
- Collecting tumour tissue and blood samples donated by breast cancer patients at different stages of their disease,
alongside detailed anonymous information about each patient, to help study the disease and develop new treatments.
In addition, the paper identifies five key strategic solutions to these gaps to help treat and support those impacted by
breast cancer and ultimately help more women to prevent and overcome the disease:
- Reverse the decline in resources targeted towards breast cancer research. Funding must be increased and strategically
directed to enhance our current knowledge, develop the talent pool, and apply evidence-based findings to improve clinical
care.
- Develop a fully cohesive and collaborative infrastructure to support breast cancer research, including access to
appropriate, well-annotated clinical material such as longitudinal sample collection with expert bioinformatics support
and data sharing.
- Find better ways to study breast cancer and test treatments in the laboratory, and identify accurate methods to use
in clinical practice to predict how patients respond to treatments.
- Encourage collaboration between researchers in different scientific fields, including computer technology, physics
and engineering, and support clinicians to do research.
- Improve clinical trial design to better meet the complexity of modern treatment options and involve patients in the
design process.
The findings have informed Breast Cancer Campaign's new action plan, Help us find the cures, which sets out its hopes
and ambitions for the future for the prevention and treatment of breast cancer and how the scientific community, funding
organisations, industry, policy makers and Government must now join forces to address the gaps. The charity aims to raise
£100 million over the next decade to specifically tackle the critical gaps and help make this happen.
The plan sets out eight key ambitions for overcoming breast cancer by 2050, which as a result of the Gap Analysis the
charity believes is now possible, if increased investment, focus and collaboration can be achieved. These are:
- Risk and prevention: By 2025 individual breast cancer risk will be more precisely predictable and up to 20% of all breast
cancers will be prevented.
- Unlocking Genetics: By 2030 all patients will benefit from individual care and treatment made possible by understanding
all of the genetic variables relating to breast cancer
- Early and effective diagnosis: By 2025, over 60% of breast cancers will be diagnosed before they are symptomatic
- Understanding breast cancer biology: By 2030 what causes different tumours to grow and progress will be identified
enabling us to select the best treatment for every patient
- Improving Treatment: By 2025, improved treatments for breast cancer will reduce mortality from breast cancer by half
- Tackling secondary breast cancer: By 2020, 25% fewer people will develop secondary breast cancer and by 2030 more than
half of those who develop secondary breast cancer will survive beyond 5 years.
- Living with and beyond breast cancer: By 2025 all those diagnosed with breast cancer, and the people close to them, will
receive individually tailored information and support to meet their needs to help them live with and manage the consequences
of breast cancer and its treatment.
- Biobanking and enabling research: By 2023 a fully cohesive and collaborative global infrastructure to support breast cancer
research will be in place, including the provision of tissue samples and bioinformatics, speeding up the pace of discovery and
translation into patient benefit.
Breast cancer in the most common cancer in the UK, with around 50,000 women diagnosed each year. It is the second biggest
cause of death from cancer in women, with around 12,000 losing their lives from the disease.
Corresponding author, Professor Sue Eccles, The Institute of Cancer Research said: 'We've known for some time that
breast cancer is not just one disease but our understanding has increased enormously in the five years since the first
Gap Analysis in 2008. We now know that breast cancer cells can have different characteristics, even within the same tumour,
and these can also change over time. This makes it much more complex to research and is why we need greater collaboration
between multi-disciplinary teams and an improved infrastructure, to ensure we are getting the data and tissue samples
needed to advance our research knowledge.'
Corresponding author, Professor Alastair Thompson, University of Dundee said: 'The impact of the Gap Analysis could be
immediate as it gives us scientific rationale to change clinical practice. For example, currently, metastatic disease is
not biopsied in order to tailor treatment, but this could change the way one in six women are treated and provide hope
to women with secondary breast cancer, with limited treatment options.'
Baroness Delyth Morgan, Chief Executive, Breast Cancer Campaign said: 'If we don't act now, by 2030 more than 1.2** million
women could be living with or after a breast cancer diagnosis and around 185,000 lives could have been lost to breast
cancer. We want future mothers, daughters and wives to have their breast cancer prevented, cured or for them
to outlive the disease, and hope that together we can achieve this by 2050.'
Help us find the cures: An action plan to tackle critical gaps in breast cancer research has been published through the
support of Asda's Tickled Pink campaign.
Media contacts:
Breast Cancer Campaign Press Office: 020 7749 4115, Out of hours 07436 107914
Sarah Davis: 0207 749 3727 or 07885 427 454
Claire Learner: 020 7749 3705 or 07736 313 698
Notes to editors:
- For a copy of the Gap Analysis paper 2013 or Help us find the cures, click here www.breastcancercampaign.org/documents/ga-2013/gap-analysis.html
- For infographics used, please contact the Breast Cancer Campaign press office 0207 749 4115
- From 1 October 2013, the Gap Analysis article is available to download at Breast Cancer Research
at http://breast-cancer-research.com/content/15/5/R92
- *Projected total number of female deaths from breast cancer in the UK from 2014-2030. Calculated by the Statistical
Information Team at Cancer Research UK, September 2013 based on data from Sasieni P, et al. Cancer mortality projections
in the UK to 2030 (unpublished). Analyses undertaken and data supplied upon request; September 2012. Similar data can be
found on the Cancer Research UK Cancer Statistics Website
- **Projected breast cancer prevalence in the UK in 2030. Maddams J, Utley M, Møller H. Projections of cancer prevalence
in the United Kingdom, 2010-2040. British Journal of Cancer 2012; 107: 1195-1202.
- Breast cancer is the most common cancer in the UK and accounts for nearly one in three of all cancers in women
- Breast Cancer Campaign seek out the best research, bringing the brightest minds together sharing knowledge to produce
better, quicker results to overcome and outlive breast cancer
- As of September 2013, the charity currently funds 105 projects worth £18.2 million in over 30 locations across the UK
and Ireland
- In the UK, around 50,000 new cases of breast cancer are diagnosed each year - that's around 135 a day.
- The Breast Cancer Campaign Tissue Bank, the UK's first ever national breast cancer tissue bank is a unique collaboration
with four leading research institutions to create a vital resource of breast cancer tissue for researchers across the UK
and Ireland. Visit www.breastcancertissuebank.org
- Visit breastcancercampaign.org or follow us at twitter.com/bccampaign
- To date, Breast Cancer Campaign has received over £10.7 million from Asda's Tickled Pink campaign. This has helped
fund 80 research projects in 23 locations across the UK, so scientists can continue to make life-changing discoveries
for women with breast cancer and has solely funded seven scientific fellowships. Asda has also donated £3million
to date towards the Breast Cancer Campaign Tissue Bank.
Help us find the cures actions
Examples of what Campaign will do:
Risk and Prevention:
Research
- Look to fund or facilitate a meta-analysis of existing evidence on the role of calorie restricted weight loss in the
prevention of breast cancer occurrence or relapse after surgery.
- Fund research that will provide insight into which women at high and moderate risk of the disease will benefit most
from chemoprevention drugs tamoxifen and raloxifene.
Policy - we call on:
- Public Health England (PHE) to conduct an audit of existing lifestyle information and advice aimed at preventing
breast cancer. PHE should work with NHS Choices, Health & Wellbeing Boards, and National Institute for Health and Care
Excellence (NICE) to integrate relevant lifestyle messages around weight, physical activity and alcohol intake, into
guidance targeted at those at increased risk of breast cancer, as well as broader health messaging for maximum impact.
Unlocking genetics:
Research
- Fund research into how genes influence the outlook for younger women.
Policy - we call on:
- Genomics England to assess evidence highlighted by the Breast Cancer Campaign Gap Analysis 2013 and review their
decision not to focus on breast cancer in the 100k Genome Project.
Early and Effective Diagnosis:
Research
- Continue to fund a large scale clinical trial in women with a family history and increased risk of breast cancer,
to determine how effective mammography is in detecting breast cancer earlier in these women.
Policy - we call on:
- Public Health England to fully evaluate the impact of the national roll out of the women over 70 and breast cancer
component of the Be Clear On Cancer campaign across England in 2014. If effective, promotion of this campaign should
continue in future years. The Scottish Detect Cancer Early Campaign must also be continued
Understanding Breast Cancer Biology:
Research
- Fund further research into triple negative and basal like breast cancer; types of breast cancer with poorer outcomes
partly due to there being no targeted treatments.
Policy - we call on:
- STEMNET to publicise and promote a breast cancer curriculum package to STEM ambassadors for use in outreach and
careers awareness projects.
Improving treatment:
Research
- Create a new dedicated pre-clinical and clinical development grant funding stream for researchers to translate
new and promising therapeutic or diagnostic discoveries more closely aligned to clinical trials.
Policy
- NHS England to commission a breast cancer audit, as committed to by the Department of Health in 2011
Tackling Secondary Breast Cancer:
Research
- We will expand our collection of metastatic samples, as well as begin collection of sequential tissue samples via
The Breast Cancer Campaign Tissue Bank, to enable scientists to better study treatment response, treatment resistance,
indicators of disease relapse and disease progression from primary to metastatic.
Policy - we call on:
- NHS England to commit to an annual review of compliance with the Breast Cancer Quality Standard statements relating
to the need for patients with local and regional recurrence and/or distant metastatic to be treated and cared for by a
multi-disciplinary team (MDT) and for patients with recurrence or secondary breast cancer to have access to a Clinical
Nurse Specialist (CNS). The findings must be published and the NHS held to account.
- NICE to review their guideline Advanced breast cancer: diagnosis and treatment to take into account recent evidence
of the benefits a biopsy of recurrent or metastatic breast cancer can deliver.
Living with and beyond Breast Cancer:
Research
- Commission a series of collaborative psychosocial workshops to tackle how best to effectively implement proven
intervention programmes.
Policy - we call on:
- NICE to ensure that future reviews of the NICE guideline Breast cancer (early & locally advanced): diagnosis
and treatment take account of the emerging evidence that a significant proportion of women fail to regularly take their
recommended prescriptions following their initial treatment, and reviews should consider what interventions could be put
in place to support women to do so.
Biobanking and enabling research
Research
- Invest in a significant expansion of our Tissue Bank to address existing gaps in tissue, data, biomarkers and models,
to become one of the world's leading banks for breast cancer related research materials.
- Pioneer UK-wide breast cancer bioinformatics through the Tissue Bank and share learning around that data. We will join
forces with other experts in the field to develop training and careers support in bioinformatics and pathology to ensure
we have the scientists of the future to drive scientific progress in these critical areas. Specifically, we will work with
The Barts Cancer Institute to create a national bioinformatics training programme for breast cancer researchers.
Policy - we call on:
- Health Education England, in collaboration with the Higher Education Funding Council for England (HEFCE), to undertake a
full audit on the need and current provision of bioinformatics training and for this audit to underpin its training strategy
for genomics and bioinformatics
For media enquiries contact:
Roddy Isles
Head, Press Office
University of Dundee
Nethergate, Dundee, DD1 4HN
TEL: 01382 384910
E-MAIL: r.isles@dundee.ac.uk
MOBILE: 07800 581902 |
