August is always my favorite month, as it is a slower time that allows us to regroup before the fall meetings and October's Breast Cancer Awareness Month. It's also a good time to use this space to explain how we approach our research projects and what we are doing that's unique and different. Our Mapping the Breast Ducts study is a perfect example - and it relates to my August Research Worth Watching as well.
One of the problems in basic breast cancer research is the fact that it is done on mice and rats rather than women. While it's certainly true that mice and rats are easier to obtain, manipulate, and study, the problem is that their breasts are not like women's. They have one duct for each teat, and their breasts develop only during pregnancy and lactation and then regress.
In fact, one of the latest research techniques allows scientists to 'humanize' the mouse breast in order to study it. While this may harmonize the molecular biology for research, it does not take into consideration the fact that the mammary tissue does not match that of women. We have breasts that develop at puberty, change with menstruation, become capable of making milk with pregnancy, and then return to their normal condition, ready for the next child. Pretty amazing, but also complicated!
What's more, mice don't get cancer, but we do (along with macaque monkeys and domesticated dogs!). If we are going to be able to understand and prevent breast cancer in women, we need to study women.
Breast cancer research and treatment could benefit enormously from knowing the pattern of the breast ducts in women. If we had a map of the ducts, just as we have a map of the bile ducts in the liver and the airways in the lungs, we could precisely treat abnormalities in the lining of the ducts (DCIS) and eliminate them before invasive breast cancer takes hold.
Helpful as it would be, that map doesn't exist! In the 1800s, Sir Astley Cooper dissected the breasts of women who died in childbirth and came up with a two-dimensional depiction. What we need is a 3D map of the usual patterns of ducts so that we can access them through the nipple for minimally invasive surgery. Creating a map like that is obviously hard, or someone would have done it sometime between the 1800s and now. But this is the kind of research that could change and save women's lives.
The good news is'¦this is exactly the kind of challenge that the Foundation takes on! By talking with colleagues from other disciplines, we came up with an idea: Why not take advantage of the fact that lactating women already have milk in their ducts that could be seen on ultrasound?
With seed money from one of our generous donors in hand, we identified a 3D ultrasound machine in Orange County, California, and easily recruited women to participate in our study. We performed 3D ultrasound on women both before and after they breastfed or pumped. (As a definite side benefit, we got to play with their babies during the study!) Next we repeated the study on two women in Northern California on a different kind of ultrasound machine where you lie on your stomach. Then we drew upon the expertise we needed to analyze the images by partnering with the Jet Propulsion Lab in Pasadena, California, and a wonderful Greek physicist who was doing a fellowship there.
While I can't give you the answers yet, I can tell you that we have already identified some interesting findings that not only are helping us with our map but are also giving us new insight into where in the breast cancer is most common and why. (Hint: It may be the ducts that don't get used or that get recruited into action last.) Stay tuned.
This study is a good example of the kind of out-of-the-box research we focus on, and we hope to find the funding to expand it. As I talk about in Research Worth Watching, the medical community is still discussing the appropriate margins for removing DCIS. At the Foundation, we are working on going beyond blindly removing tissue and hoping the area with disease is removed to mapping the exact area involved so that it can be clearly observed and dealt with precisely.
We continue to do not just the easy stuff that results in research articles, but research that will actually change the treatment of breast cancer and help us prevent it. For that, we need your help! Join the Army of Women® and participate in research studies, or help us raise funds for research by hosting an Act with Love® event. Together we can prevent breast cancer once and for all.