|Mapping Breast Cancer Genes|
As scientists learn more about the genetic mutations that can lead to cancer, they are able to tailor patient therapy. They can also target people who are at high risk for cancer, so they can benefit from preventative treatments and lifestyles. Breast cancer has been a major focus of cancer genetics and prevention efforts.
Crane: Over a decade ago, scientists discovered that mutations of the BRCA 1 and 2 genes cause a higher risk of breast cancer.
Olopade: We started thinking about clinical cancer genetics about fifteen years ago, just as BRCA1 was being identified as the first major breast cancer susceptibility gene.
Crane: Dr. Olufunmilayo Olopade is an internationally renowned leader in the field of clinical cancer genetics. She has led efforts to educate oncologists about how genetics could be used for both treatment and prevention. In 1997, Dr. Olopade served as Chair of the American Society of Clinical Oncologists Task Force on Genetics Education.
Olopade: When we started in 1997, we had no idea that in fact within a short period of time that we would actually find genes and that those genes can be tested in individuals, and that those individuals can avail themselves of prevention strategies.
Crane: The BRCA 1 and 2 mutations gave way to the discovery of other breast cancer genes. Some drugs were then designed specifically for people with those genetic mutations.
Olopade: Now we're not talking about one size fits all, you know, everybody go get your mammogram; we're talking about individualizing risk assessment, that we're talking about personalizing treatment for breast cancer patients. And so, it really has implications for molecular diagnostics, for a lot of things.
Crane: Dr. Olopade has been especially interested in risk factors for women of African origin. She led a study of women in her native Nigeria that showed 73 percent of women with breast cancer had aggressive tumors characterized by the BRCA mutations. That type of cancer does not respond to the hormone therapy that is often used as first-line treatment in the West. Women of Ashkenazi Jewish origin are prone to the same type of cancer. Dr. Olopade says discovering these common threads has prompted a more global approach to cancer research.
Olopade: We began to ask ancestry instead of black white. We went back to Africa, we learned a lot about some of the reasons why young women get breast cancer. And we learned about things that we totally did not expect and which the Africans had not been able to study because they didn't have the technology. And by bringing that to the United States we opened up a whole new area of research, for everybody.
Crane: Dr. Olopade says more international research projects should address the development of new therapies.
Olopade: Because after all we are all an immigrant population, right. And so a number of things that we have to think about in the different countries in fact or in our country may originate in different countries.
Crane: And Dr. Olopade emphasizes that cancer genetics could benefit people everywhere.
Olopade: It's leading to greater therapeutic discovery. It's leading to people feeling empowered to do something with their risk instead of feeling paralyzed by it. And we've learned that we have to touch on a lot of different things in order to get there. But it's been rewarding to see how far we've come, and what I hope we would do is that we don't rest on our laurels, but get out there and make these advances accessible to people all over the world.
Crane: Dr. Olopade is director of the Cancer Risk Clinic at the University of Chicago, where she evaluates risk factors and designs individualized prevention plans. She recently spoke at the National Cancer Institute's Fellowship Research Program. This is Kristine Crane at the National Institutes of Health, Bethesda, Maryland.