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Rutgers unlocks mysteries of lobular breast cancer

10/15/2015

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New Brunswick, NJ – According to Kathleen O’Brien, of New Jersey On-Line LLC., “Imagine a gang of thugs is marauding the landscape, killing 4,000 to 6,000 women a year."
"Police know the name of the gang - but not the identities of the individual gangsters. Then someone comes up with a way to get all their fingerprints, so law enforcement around the world can start hunting them down.

That's roughly what researchers - including one at the Rutgers Cancer Institute of New Jersey - have accomplished with their lengthy analysis of the genetic mutations the accompany  lobular breast cancer.

Lobular cancer accounts for just 10-15 percent of breast cancer cases, with nearly all of the rest ductal cancer, the kind that originates in the breast's milk ducts. While there is very little difference in the overall prognosis of the two types, they can behave differently if they spread.

In addition, lobular cancer tends to be detected later because the pattern in which it grows makes it harder to spot on mammograms.

"Prior to this study, there had been very little clarity about the genetic defects driving lobular cancer development," said Michael Gatza, one of the lead authors on the analysis of more than 200 such tumors. The findings appear in the current edition of the medical journal Cell.

Now, courtesy of his efforts along with those of colleagues around the country, a whopping 8,173 genetic coding mutations in lobular tumors have been identified. That lead them to be able to come up with three broad categories of sub-types of lobular cancer.

There was no single mutation common enough to be on par with the BRCA1 and 2 mutations, for which women with a family history of breast cancer are now tested. However, some of the mutations show up in other types of cancer - prostate cancer, for example - which raises the intriguing prospect existing drugs might be repositioned to battle lobular cancer.

​Before the work of Gatza and his colleagues, not much was known about the biologic underpinnings of this form of cancer. Even less was known about tumors that displayed a mix of both ductal and lobular traits.

"The question we wanted to ask was, 'Is this really a third kind of cancer?," Gatza said. The answer is that when researchers look at these mixed tumors on the molecular level, they find they split into two categories of mostly ductal or mostly lobular, a distinction that might become important in considering treatment.


The ultimate goal in drilling down to the genetic level is to be able to customize drug therapies to each patient's unique tumor. "It would be using the genetics of the tumor to tell us how to battle the disease," Gatza said. "We're identifying the Achilles heel of the tumor."


​Because the research was funded by public money - instead of private pharmaceutical research - the results are online, available to doctors around the world in their quest to devise more tailored treatments.

"The idea is you could personalize therapy so Mrs. Smith would get a different treatment than Mrs. Jones would," Gatza said. "It's not so far down the road."" 
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