Detecting breast cancer 5 years before clinical signs

The possibility of an easy, non-invasive detection method arises.

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  • A blood test that spots breast cancer five years ahead of clinical signs could give new meaning to "early detection."
  • Auto-antibodies for tumor antigens predict the presence of the disease.
  • Researchers say the blood test could be clinic-ready in 4-5 years.

Researchers from the University of Nottingham have developed a method of blood screening they believe could ultimately lead to the detection of breast cancer five years before clinical indicators appear. Such extremely early detection would presumably offer patients and their doctors an unprecedented head start at preventing the disease's progression. The availability of such an advanced warning would be a potent addition to the growing arsenal of weapons against breast cancer that include a breast-cancer vaccine.

Antigens and their auto-antibodies

Antigens and T-cells

Image source: Juan Gaertner /Shutterstock

Antigens are substances produced by cells, including tumor cells. When an antigen comes into contact with other cells in the body, the immune system generates an antibody optimized specifically for that antigen called "auto-antibodies."

The team from Nottingham has found that the presence of tumor-associated antigens (TAAs) constitutes a reliable indicator of cancer. Likewise, the presence of an antigen's auto-antibody is a good indicator that the antigen, and thus a tumor, is present.

The researchers developed blood panels against which blood can be screened using protein microarray for auto-antibodies linked to TAAs associated with breast cancer tumors. The team was able to screen for 40 such antibodies overall, as well as 27 not associated with the disease, with each panel targeted to a subset of those.

The experiments

Image source: Victor Moussa/Shutterstock

The researchers from the Centre of Excellence for Autoimmunity in Cancer (CEAC) group at Nottingham's School of Medicine took blood samples from 90 breast cancer patients shortly after diagnosis, and from a control group of 90 volunteers not afflicted with the disease.

According to Daniyah Alfattani, one of the researchers, "The results of our study showed that breast cancer does induce auto-antibodies against panels of specific tumor-associated antigens. We were able to detect cancer with reasonable accuracy by identifying these autoantibodies in the blood."

The team focused on three panels: One with five TAAs, one with seven, and one with nine. The larger the panel, the more accurate the testing, as it turned out.

  • With the panel of five TAAs, breast cancer was detected in 29% of the samples from cancer patients, while 84% of the control samples were positively identified as being without cancer.
  • With seven TAAs, the cancer-detection rate rose to 35%, while the findings of no disease in the control group went down slightly to 79%.
  • A nine-TAA panel was similar, correctly detecting cancer in 37% of cancer patients, and its absence verified it in 79% of the control group.

Moving forward

Image source: Simon Annable/Shutterstock

While accurate cancer detection in roughly 30% of patients isn't anywhere near good enough for widespread use as a diagnostic tool, the researchers are nonetheless upbeat about the results. "We need to develop and further validate this test," says Alfattani. "However, these results are encouraging and indicate that it's possible to detect a signal for early breast cancer. Once we have improved the accuracy of the test, then it opens the possibility of using a simple blood test to improve early detection of the disease."

Further study is currently underway with 800 patients being tested using a panel of nine TAAs, and the researchers expect to see greater accuracy in this larger cohort.

If there's a chance of substantially improving accuracy in this approach to early detection, the benefits would be obvious. Says Alfattani, "A blood test for early breast cancer detection would be cost effective, which would be of particular value in low- and middle-income countries. It would also be an easier screening method to implement compared to current methods, such as mammography."

The researchers estimate that with full funding, a clinic-ready version of the test could be developed in four to five years.

The study was presented at the 2019 NCRI Cancer Conference in Glasgow, and NCRI CEO Iain Frame is impressed. "Early diagnosis using simple, non-invasive ways of detecting the first signs of cancer is a key strategic priority for NCRI and something we'd all like to see working in practice. The results from this pilot study for a blood test to detect early breast cancer are promising and build on this research group's expertise in other cancers, such as lung cancer. It's obviously early days but we look forward to seeing the results from the larger group of patients that are now being investigated."

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Surprising Science
  • Before the hurricane season even started in 2020, Arthur and Bertha had already blown through, and Cristobal may be brewing right now.
  • Weather forecasters see signs of a rough season ahead, with just a couple of reasons why maybe not.
  • Where's an El Niño when you need one?

Welcome to Hurricane Season 2020. 2020, of course, scoffs at this calendric event much as it has everything else that's normal — meteorologists have already used up the year's A and B storm names before we even got here. And while early storms don't necessarily mean a bruising season ahead, forecasters expect an active season this year. Maybe storms will blow away the murder hornets and 13-year locusts we had planned.

NOAA expects a busy season

According to NOAA's Climate Prediction Center, an agency of the National Weather Service, there's a 60 percent chance that we're embarking upon a season with more storms than normal. There does, however, remain a 30 percent it'll be normal. Better than usual? Unlikely: Just a 10 percent chance.

Where a normal hurricane season has an average of 12 named storms, 6 of which become hurricanes and 3 of which are major hurricanes, the Climate Prediction Center reckons we're on track for 13 to 29 storms, 6 to 10 of which will become hurricanes, and 3 to 6 of these will be category 3, 4, or 5, packing winds of 111 mph or higher.

What has forecasters concerned are two factors in particular.

This year's El Niño ("Little Boy") looks to be more of a La Niña ("Little Girl"). The two conditions are part of what's called the El Niño-Southern Oscillation (ENSO) cycle, which describes temperature fluctuations between the ocean and atmosphere in the east-central Equatorial Pacific. With an El Niño, waters in the Pacific are unusually warm, whereas a La Niña means unusually cool waters. NOAA says that an El Niño can suppress hurricane formation in the Atlantic, and this year that mitigating effect is unlikely to be present.

Second, current conditions in the Atlantic and Caribbean suggest a fertile hurricane environment:

  • The ocean there is warmer than usual.
  • There's reduced vertical wind shear.
  • Atlantic tropical trade winds are weak.
  • There have been strong West African monsoons this year.

Here's NOAA's video laying out their forecast:

But wait.

ArsTechnica spoke to hurricane scientist Phil Klotzbach, who agrees generally with NOAA, saying, "All in all, signs are certainly pointing towards an active season." Still, he notes a couple of signals that contradict that worrying outlook.

First off, Klotzbach notes that the surest sign of a rough hurricane season is when its earliest storms form in the deep tropics south of 25°N and east of the Lesser Antilles. "When you get storm formations here prior to June 1, it's typically a harbinger of an extremely active season." Fortunately, this year's hurricanes Arthur and Bertha, as well as the maybe-imminent Cristobal, formed outside this region. So there's that.

Second, Klotzbach notes that the correlation between early storm activity and a season's number of storms and intensities, is actually slightly negative. So while statistical connections aren't strongly predictive, there's at least some reason to think these early storms may augur an easy season ahead.

Image source: NOAA

Batten down the hatches early

If 2020's taught us anything, it's how to juggle multiple crises at once, and layering an active hurricane season on top of SARS-CoV-2 — not to mention everything else — poses a special challenge. Warns Treasury Secretary Wilbur Ross, "As Americans focus their attention on a safe and healthy reopening of our country, it remains critically important that we also remember to make the necessary preparations for the upcoming hurricane season." If, as many medical experts expect, we're forced back into quarantine by additional coronavirus waves, the oceanic waves slamming against our shores will best be met by storm preparations put in place in a less last-minute fashion than usual.

Ross adds, "Just as in years past, NOAA experts will stay ahead of developing hurricanes and tropical storms and provide the forecasts and warnings we depend on to stay safe."

Let's hope this, at least, can be counted on in this crazy year.

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