Breast cancer: what progress has been made? Why should we continue to invest in research?


In the profession for 30 years, she has nevertheless witnessed progress: The survival of women who have a relapse of breast cancer has increased, the quality of life has improved. Breast cancers are diagnosed earlier and they are smaller in size, there is less lymph node invasion, so the prognosis is better.”.

And to add that the multidisciplinary approach, which has been strengthened over the years, has also made it possible to improve the chances of recovery, in particular within breast clinics with close dialogue between all those involved. “So breast cancer mortality has decreased slightly, but the fact remains that three times out of ten, there is a relapse that will occur and at that time, we will have more drugs at our provision to prolong the survival of these women, but we cannot get rid of the disease. And that’s very frustrating, I never imagined when I was a young oncologist that we would still be here 30 years later. So this shows that we must continue to do research to try to get rid of this scourge one day.“, confides the oncologist.

The recidivism still misunderstood

This recurrence where the cancer generalizes (we speak of “metastatic” breast cancer) can sometimes occur 10 years after the treatment of the initial disease. “At a time when the woman begins to feel comfortable, when she tells herself that she has made it through. A disease that is therefore difficult to live with day by day, especially since these people are not always understood by those around them who do not always measure the seriousness of the situation. The fact that sooner or later, the treatments will no longer work”.

However, with current technologies, which did not exist ten years ago, we could, according to Dr. Piccart, go much more in depth, understanding for example what abnormalities in the cancerous cell allow it to resist all treatments. “We imagine that the cells are dormant somewhere in the organism. But what makes them wake up at that moment? We understand nothing about it.

The Aurora Study

This is also one of the objectives of the Aurora program launched at the end of 2014 and for which 1,150 women have already been recruited in eleven European countries (250 others should still be recruited).

The objective of this study is also to understand why in certain cases, when two cancers seem identical, one will heal and the other will metastasize. “And once breast cancer is metastatic, it has extremely variable outcomes. Sometimes not very aggressive, with a disease that will remain in the bones for a few years; but sometimes the recurrence is fulminant and in a few months time, the disease is found everywhere, including in the brain“, specifies the oncologist.

But all this at a cost: more than 40 million euros because it will probably be necessary to call on an artificial intelligence team to decipher the impressive mass of data collected. But so far, the foundation is still far from having raised enough funds, even though nearly 25 million euros have been donated by BCRFan American non-profit foundation active in the search for funds to fight against cancer.

Targeted therapies

Note that Aurora is not the only study funded by BIG, there are currently around thirty in progress. Others have made it possible to offer patients more personalized treatments, particularly for young patients with the Olympia study. A new treatment, approved last August by the European Medicines Agency and which should make it possible to reduce the risk of recurrence in these young patients by around 32%, according to Dr Philippe Aftimos, oncologist and head of the research unit clinic at the Bordet Institute (Brussels).

Faced with a serious illness, we will first of all focus on the effectiveness and little on the side effects and therefore we accept serious side effects much more easily. But that was a few years ago“, explains this specialist.

And to continue:The more the patients recover, the more one is interested in the period after treatment. So prevent future sequelae. And so, we can move on to the moment when we manage to cure a lot of patients in what is called therapeutic de-escalation. And a large part of the research that we do today is in the direction of therapeutic de-escalation, that is to say better selecting patients who do not need more treatment. And so there, it can be done via tests that we do before but also by more targeted therapeutic strategies.

Hence the interest, according to him, of “support academic research that has no commercial interest, just patient welfare.

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Breast cancer: what progress has been made? Why should we continue to invest in research?

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