SCIENCE BLOG: Mapping research data gaps in breast cancer prevention
Published 6 Jul 2018
There is still a lot we don’t know about why some people get breast cancer. Often people appear to do all the "right things" but still get breast cancer. Some people might do all the “wrong things” and are fortunate enough to live long and happy lives. As to what the wrong or right things are regarding breast cancer – we have some idea, but we don’t know everything.
What we do know is that we are more vulnerable now to breast cancer than ever before. Partly because we are living longer, partly because women are having fewer children and at an older age. But these factors alone cannot fully explain the dramatic rise in incidence rates over the past few decades.  The truth is breast cancer is an incredibly complex disease with different types, many causes and many risk factors. If we are to prevent breast cancer we need to understand more about causation and prevention and the interplay between genetic and environmental risk factors.
It is this urgent need to understand more, that led a group of scientists, academics and policy makers from different breast cancer charities to gather together earlier this week, on what was one of the hottest days of the year at Reading University. Hosted by Professor Philippa Darbre, Breast Cancer UK’s first ever Science Round Table meeting aims to promote debate and collaboration and is the start of a process to map research data gaps in breast cancer prevention. It is the first science symposium of its kind held in the UK dedicated to the issue of prevention and it’s great that Breast Cancer UK has been its driving force.
We heard first from Professor Philippa Darbre who spoke about the build-up of environmental chemicals such as parabens, aluminium and UV filters in breast tissue, and whether these are present in sufficient concentrations to enable tumours to form. She highlighted the importance of accumulations in breast tissue of multiple environmental chemicals such as oestrogen mimics which may lead to the development of multiple hallmarks of cancer.
The theme of multiple exposures continued in talks by Dr Elisabete Silva and Dr Robin Mesnage who in separate projects have made some fascinating discoveries about the effects of mixtures of environmental chemicals on breast cancer cells. Dr Silva’s research used an innovative 3D model of breast cells to examine the effects of oestrogen mimics on cancer initiation. Dr Mesnage discussed his work which showed herbicide formulations (which comprise numerous compounds in addition to the active ingredient) are far more oestrogenic and toxic than the active ingredient alone, yet these co-formulants do not have to be declared by manufacturers.
In the afternoon we learned about how dietary interventions may be used for breast cancer prevention and therapy from Professor Maria O’Connell, who had some interesting insights into the role fruit and particularly vegetables can play in reducing inflammation and lowering breast cancer risk. We also heard from Dr James Thorne who discussed interventions that may help prevent triple negative breast cancer relapse, including cholesterol lowering diets high in “phytosterols” (found in plants such as broccoli and pulses) and the mechanisms that may lead to such protective effect.
Professor Val Speirs discussed the importance of high breast density as a risk factor for breast cancer and what influences result in changes to breast density She went on to describe a new project beginning in September, which examines the effects of endocrine disrupting chemicals on breast density – another exciting project that Breast Cancer UK is supporting in collaboration with Animal Free Research UK – the findings of which many of us in the room are eagerly anticipating.
Dr James Turner talked about the importance of physical activity and breast cancer prevention. He explained that vigorous exercise reduces risk in both pre and post-menopausal women, and that gentle exercise is known to be protective for post-menopausal women.
Finally Mr Lester Barr, a breast surgeon and chair of trustees at the charity Prevent Breast Cancer gave an overview of how he believes more breast cancers can be prevented. He explained how different individuals have different lifetime risks based on their breast density, family history of breast cancer and lifestyle, and SNPs (or single nucleotide polymorphisms, which can be determined by analysing an individual’s DNA). He believes if these factors can be established for each individual then mammogram screening could used in a more targeted manner, for example those at high risk are screened annually, and those at low risk screen every decade.
As well as scientific research, we are pleased to be able share and promote a recently published collaborative project from the World Cancer Research Fund, whose work on diet, nutrition exercise and cancer was also great to learn more about.
In all it was a truly fascinating and inspiring day. We learnt a great deal, shared information and expertise, ideas for future collaboration, and discussed new projects. We began the process of identifying where more research was urgently needed to help us fill some of the gaps in our understanding of breast cancer causation and prevention. There is no doubt there is still much to do, but it was uplifting to feel the passion and belief amongst everyone present that we can do more to help prevent breast cancer. And it is clear we at Breast Cancer UK have a unique role to play in supporting research, promoting collaboration and pushing prevention up the policy making and research agenda.
For a summary of the talks and the data gaps identified see here. To view speakers' slides (some have been edited) see the following: Professor Philippa Darbre, Dr Robin Mesnage, Dr James Thorne, Professor Maria O'Connell, Dr Michelle McCully, Professor Valerie Speirs, Dr James Turner, Mr Lester Barr
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 Office for National Statistics data show breast cancer incidence rates have almost doubled since 1971. A study by Tea et al. (Tea et al. (2014) Maturitas 77:68–72), found women with a BRCA2 mutation who were born before 1958 had an 11% chance of getting breast cancer by age 40 whereas those born after 1958 had a 46% chance