Issue 41, August 2013

Breast Cancer Risk Factors


Innovation: SPARTA - Intelligent Software for Patient-Friendly Radiation Therapy

Breast Cancer

With approximately 1.38 million new cases each year, breast cancer is the most common cancer and the most frequent cause of cancer death in women globally. Among the countries with the highest incidence rates are Germany and the US, where 81.8 and 76.0 per 100,000 women, respectively, are diagnosed annually with the disease.

In addition to a genetic predisposition, other risk factors include unusual hormonal characteristics, an unhealthy lifestyle, and increasing age. To foster prevention of the disease, the World Cancer Research Fund and the American Institute for Cancer Research created a list of recommendations, which includes maintaining a low level of body fat, engaging in daily physical activity, and keeping a healthy diet with limited salt and alcohol consumption. Breastfeeding infants following pregnancy also decreases risk of the disease. In addition to prevention, further aspects of comprehensive cancer control involve early detection, diagnosis and treatment, rehabilitation, and palliative care.

Although the number of individuals diagnosed with cancer has increased over the past two decades, predictions about the prevention and treatment of the disease remain positive. By 2013, the EU has almost reached its goal of decreasing cancer deaths by 15% by 2025. From 2007 to 2012, cancer deaths in the EU fell 18% for men and 13% for women. Similarly, deaths caused specifically by breast cancer decreased 9% on average and 17% in young women. A recent comparative study by the German Cancer Research Center shows that breast cancer survival rates have steadily improved in Germany and in the US over the last 20 years, resulting in a 97% survival rate of localized breast cancer in both countries between 2005 and 2008. This positive trend is an outcome of treatment advances and earlier diagnosis due to a more widely educated population.

Article2Breast Cancer Risk Factors  


Text provided by: German Cancer Research Center in the Helmholtz Association 


Whether or not a woman develops breast cancer depends on a variety of factors: Genes play a role, as do the environment and personal behavior.

A research team from the German Cancer Research Center (DKFZ) in Heidelberg, Germany, has been the first to prove that genetic and environmental risk factors for breast cancer do not act independently of each other.
In their current work, the scientists combined the results of 24 international studies, which involved more than 34,000 breast cancer patients and 41,000 healthy women. "Given so many participants, we were able to identify even slight changes in risk," says Dr. Stefan Nickels, first contributing author of the study.

The results demonstrated that a genetic variant of the CASP8 gene elevated the risk of breast cancer by 45% only in women who drank more than 200 grams of alcohol per day. The researchers also found a genetic variant of the LSP 1 gene raising the breast cancer risk in women who gave birth to four or more children by 26%, even though multiple births normally lower the risk of breast cancer. The exact biological mechanisms underlying these interactions are still unclear. To read the study, click here.

Image: Abbildung einer Brustkrebszellen. Pink: Proteine des Zellskelletts. Source: DKFZ, Lutz Langbein.  

Article3Innovation: SPARTA - Intelligent Software for Patient-Friendly Radiation Therapy


Source: Fraunhofer MEVIS

In radiation therapy, malignant tumors are treated with radiation while sparing healthy organs. It is an essential treatment method used for the majority of cancer patients.

During the course of the treatment, which is applied daily over several weeks, changes in the size of the tumor, the patient's body weight, and the body's movement while breathing, can affect the tumor's position. This can lead to a partial tumor miss during treatment. To decrease the risk of missing parts of the tumor, large safety margins surrounding the mutated cells are often included in the region targeted for irradiation. As an unintended consequence, healthy tissue is also damaged. 

The expandable radiotherapy software system (SPARTA) addresses this problem. With an accurate measuring of variations, a precise calculation of the delivered dose, a detailed analysis of the tumor, and an adequately adapted treatment plan, variations of the patient's body are taken into account. In so doing, the researchers aim to increase the safety and effectiveness of radiation therapy for patients. 

The project partners, Fraunhofer MEVIS, German Cancer Research Center DKFZ, Fraunhofer ITWM, University Hospital Heidelberg, University Hospital LMU M�nchen, OncoRay - National Center for Radiation Research in Oncology Dresden, Heidelberg Ion-Beam Therapy Center, Siemens AG, MeVis Medical Solutions AG, and Precisis AG, are partially funded by the German Federal Ministry of Education and Research (BMBF). For more information, click here

Image: High precision radiotherapy treatment room with rotatable linear accelerator, state-of-the art image guidance including X-ray patient positioning system and in-room CT. (Copyright: Fraunhofer MEVIS)  

Article4Stem Cells for Metastasis Found in Blood of Breast Cancer Patients 


Source: German Cancer Research Center in the Helmholtz Association

Individual cancer cells that break away from the original tumor and circulate through the blood stream are considered responsible for the development of metastases.

For the first time, scientists have detected cancer cells that can initiate metastases in the blood of breast cancer patients. Patients with large numbers of these cells found in their blood show an unfavorable disease progression.

The researchers from the German Cancer Research Center (DKFZ) and the National Center for Tumor Diseases (NCT) Heidelberg analyzed the blood of more than 350 breast cancer patients. Using specific surface molecules, they isolated circulating tumor cells (CTC) from the blood and transplanted them directly into the bone marrow of mice with defective immune systems. The resulting metastases that formed in several organs proved that CTCs contain stem cells. Further research showed that the identified cells - triple-positive cells - have properties of cancer stem cells and are characterized by three surface proteins.

"The triple-positive cells we have found turn out to be not only a promising biomarker of disease progression in breast cancer," says Prof. Andreas Trumpp, Head of DFKZ's Division of Stem Cells and Cancer and Director of the Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM) at DKFZ, "but they are also a prospect for potential new therapeutic approaches for treating advanced breast cancer." To read the study, click here.

Image: Circulating tumor cells isolated from the blood of breast cancer patients form a metastatic tumor in the bone marrow of mice. The stem cell marker CD44 is dyed red. | � Ir�ne Baccelli, DKFZ 

Schmutzler photo 
Article5Interview: Prof. Dr. Rita Schmutzler

Prof. Dr. Rita Schmutzler, member of the German national guideline committee on breast cancer, is one of the leading researchers in Germany in the field of breast and ovarian cancer.

Since 1997, Prof. Dr. Schmutzler has served as Head of the Centre for Familial Breast and Ovarian Cancer at the University Hospital of Cologne. Since 2005, she has also acted as speaker for the 15 centers that constitute the German Consortium of Hereditary Breast and Ovarian Cancer. Her research focuses on the genetic causes of breast cancer, namely the identification of new predisposing genes and risk alleles, and genotype-/phenotype correlations.


She received her doctorate and habilitation from the University of Bonn. Since 2003, she has held a full professorship in the Molecular Gyneco-Oncology division at the University of Cologne. An award-winning researcher, Prof. Dr. Schmutzler also serves as a member on various expert committees, including the Deutsche Krebshilfe and the ethics committee at the Bundes�rztekammer.


In her interview with GCRI, Prof. Dr. Schmutzler discusses the indicators of a genetic predisposition to breast cancer, the available preventive care options for women from high-risk families, and the research prospects in the field of hereditary breast and ovarian cancer. She also explains the differences between genetically triggered and spontaneous breast cancer during the course of the disease. To read the full interview, click here.