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The continuous rise in breast cancer diagnoses points to the need for committing more effort to the interception of cancer driver factors before its development, alongside trying to detect it at a stage that is as early as possible. If anything, current prevention strategies based on mammography screening for early detection can prevent cancer death, but not cancer development. This is one of the conclusions to which everyone can come after the publication of the Breast Cancer Statistics for 2022, which highlight a breast cancer incidence rate increasing by 0.5% annually.

At present, no traditional cancer prevention strategy is based on the analysis of biomarkers of cancer development predisposition, such as, for example, cholesterol in the case of cardiovascular diseases (CVDs). Such biomarkers could be utilized both for intercepting cancer driver factors and as targets for chemopreventive treatments aimed at reducing cancer incidence – just like blood cholesterol is both a marker for CVD risk and a target for CVD risk-reducing agents (e.g. statins).

Bioscience Institute developed HELIXAFE, an innovative program for cancer driver interception, which enables real cancer prevention by analyzing actionable biomarkers of the cancer prodromal stage – that is, the phase lasting years to decades during which healthy cells collect alterations that predispose to cancer development.

Data on female breast cancer statistics in the United States were published in “CA: A Cancer Journal for Clinicians” by a group of experts of the American Cancer Society (Atlanta, Georgia). Contrary to incidence rates, breast cancer mortality keeps declining steadily, even if at a slower pace (1.3% annually from 2011 to 2020) than in the past (1.9% annually from 2002 to 2011).

Breast Cancer Statistics 2022: the data

Breast Cancer Statistics for 2022 stem from population-based cancer incidence data collected by the Surveillance, Epidemiology, and End Results (SEER) program of the National Cancer Institute (NCI) and the National Program of Cancer Registries of the Centers for Disease Control and Prevention (CDC). According to their analysis, approximately 43,250 women will die from breast cancer in 2022 – a huge number in absolute terms, but a better statistic than the ones from the past.

In fact, in the USA, since 1989, the overall breast cancer death rate has declined by 43% through 2020. This reduction can be attributed to better and more targeted treatment and early detection by means of secondary prevention programs, in particular mammography-based screening. However, as stated by the authors of the statistics, «the decline in breast cancer mortality has slowed (…) potentially reflecting the steady increase in breast cancer incidence and stable screening mammography prevalence

Focusing on breast cancer incidence, the experts sketched the situation from 1980s to today. During the 80s and 90s, it rose largely because of the increased detection of asymptomatic cases via mammography screening, whose prevalence increased from 29% (1987) to 70% (2000). From 2001 to 2004, invasive breast cancer incidence sharply dropped because of the decreased use of menopausal hormones. However, during the most recent times, breast cancer incidence increased.

«We can not overlook the fact that a cancer diagnosis translates to the need for cancer treatment», Giuseppe Mucci, CEO of Bioscience Institute, comments. «Even if at the earliest stage as possible, cancer diagnosis never is a good news.»

Breast cancer: the solution after the diagnosis

Breast cancer is staged based on its characteristics, such as its dimensions and whether it has hormone receptors. Stage 0 corresponds to non-invasive or pre-invasive breast cancer; no abnormal cells have broken out the part of the breast from which they originate. Stages I, II, and III correspond to invasive breast cancer, and stage IV is an invasive breast cancer that has spread to other organs beyond the breast and nearby lymph nodes.

According to the 2022 statistics, in 2018 63% of women with stage I or stage II breast cancer underwent conservative surgery with or without radiotherapy, whereas 33% underwent mastectomy. What is more, controlateral prophylactic mastectomy prevalence among patients with unilateral early stage cancer is still increasing since 1998.

«Even if not yet invasive, stage 0 breast cancer is often treated too», Mucci adds. «If left alone, some cells can transform into invasive breast cancer able to spread. The option are not milder than the ones for more advanced diseases, including mastectomy. That is why it is mandatory to shift the focus from early detection (that is, secondary prevention) to primary prevention or, even better, from cancer interception to cancer driver interception

What is cancer driver interception?

Cancer driver interception refers to the detection of the factors that promote cancer development or that contribute to its genesis by creating the ideal microenvironment for its development. «Notably, genomic instability is the main cancer driver», Mucci explains. «Other cancer drivers, such as low-grade chronic inflammation, immune imbalance, and gut dysbiosis, can promote genomic instability or insist on it. Fortunately, genomic instability takes years to decades to promote healthy cells transformation into cancer cells. During these years we can intercept it and the other cancer drivers, and take action against them. This possibility shift the concept of primary prevention from a passive approach (avoiding risk factors, such as smoke) to a more active approach based on the intake of chemopreventive agents (such as aspirin in the case of colorectal cancer), just as in the case of CVD prevention, where the interception of CVD drivers (such as high blood cholesterol), their monitoring, and their management via lifestyle and drugs (such as statins) is an approach that has proved effective and is widely accepted

What is more, cancer driver interception could foster a further decline in cancer mortality. «Treatment of biomarkers of cardiovascular diseases – such as high blood cholesterol and high blood pressure – played a pivotal role in the decline in the risk of dying from heart disease», Mucci adds. «We can expect that treatment of actionable cancer driver factors will boost the decline in cancer mortality in a similar way. In fact, we expect to obtain a reduction in cancer incidence by counteracting cancer driver factors, and this could translate into a further reduction in cancer mortality

Cancer driver interception: the solution

HELIXAFE is Bioscience Institute’s program devoted to cancer driver interception that provides the actionable cancer prodromal phase biomarkers to be monitored for real prevention of cancer development. It is based on 5 tests:

. HELIXBALANCE: a Next-Generation Sequencing (NGS)-based approach to the analysis of genomic instability as simple as a blood draw. Circulating cell-free DNA is analyzed looking for gene variants associated with the alteration of the mechanisms that warrant genome stability.

. CYTOBALANCE: a test to unveil low-grade chronic inflammation, that is, asymptomatic inflammation, which increases health risk, including cancer risk.

. IMMUNEBALANCE: the innovative approach to detect immune system imbalance that could promote cancer development by hindering the immune system’s ability to eliminate cells from which cancer could develop.

. MICROBALANCE: Bioscience Institute’s tool to detect imbalances in gut flora that could be associated with cancer.

For more information on HELIXAFE, please do not hesitate to contact us at info@bioinst.com. Our biologists will answer your questions with no commitment on your part.

References

  • Breastcancer.org. Breast Cancer Stages. Last viewed Oct 7th, 2022.
  • Giaquinto AN et al. Breast Cancer Statistics, 2022. CA Cancer J Clin. 2022 Oct 3. doi: 10.3322/caac.21754
  • Siegel RL et al. Cancer statistics, 2022. CA Cancer J Clin. 2022 Jan;72(1):7-33. doi: 10.3322/caac.21708
  • Weir HK et al. Heart Disease and Cancer Deaths — Trends and Projections in the United States, 1969–2020. Prev Chronic Dis 2016;13:160211. doi: 10.5888/pcd13.160211
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