Urine Samples Could Reveal Breast Cancer Risk

FRIDAY Oct. 3, 2008 -- A simple urine test could one day be an effective way to screen for breast cancer, a new study suggests.

The notion of a so-called "dipstick" test envisions a high-tech sifting through just a few drops of urine in the search for elevated levels of two particular biomarkers, MMP-9 and ADAM-12, which can sometimes indicate the earliest stages of tumor growth, the researchers noted.

"We have had longstanding interest in identifying and validating noninvasive biomarkers of human cancers, including breast cancer," noted study author Marsha A. Moses, of the Vascular Biology Program at Children's Hospital Boston. "Recently, we identified a small panel of proteins in the urine of women who have breast cancer, and these proteins predict both disease status and stage of the cancer."

Moses' team published its findings in a recent issue of Cancer Epidemiology, Biomarkers, & Prevention.

To explore the potential of urine screening for breast cancer, the authors obtained samples from 148 women, 44 of whom had a precancerous condition known as "atypical hyperplasia." Another 24 women had a cancer-risk elevating condition known as lobular carcinoma in situ (LCIS), while the rest of the patients were healthy.

The research team concluded that elevated MMP-9 levels were associated with a fivefold increase in the risk for atypical hyperplasia and more than a 13-fold increased risk for LCIS.

Although such screening is not currently an option for patients, Moses has co-founded a company called Predictive Biosciences, which has been given a license for clinical research by Children's Hospital to develop practical screening applications based on her team's ongoing research.

Yet as Moses moves forward with efforts "to move these noninvasive cancer tests into the clinic," others suggest some caution is warranted.

For his part, Dr. Eric P. Winer, director of the Breast Oncology Center at the Dana-Farber Cancer Institute in Boston, emphasized that the "findings are very preliminary."

"Any test -- particularly an easier blood, urine or saliva test -- that could reliably give us a better sense of risk could be useful," he said. "But we have to be very careful when we apply new tests like this in the clinic to make sure that, before we do so, these tests are shown to be reliable and an improvement over what presently exists. So, there's still a lot of work to be done."

Debbie Saslow, director of breast and gynecologic cancer at the American Cancer Society, agreed.

"In theory, this could be really good," she said. "And biomarkers are an exciting field. But aside from this being preliminary, we also have to deal with the question, what are we going to do with those women who have this biomarker? Because we already have ways to know which women are at increased risk, but we don't have a lot to recommend for them once they're identified."

"So, before going further, we really have to figure out just how high risk are women with these biomarkers in the first place," Saslow added. "And while we'd all like to find a noninvasive way to detect cancer risk, until such questions are answered. my immediate reaction is a little more negative than positive."

More information

For the latest on breast cancer screening, visit the National Cancer Institute.

Posted: October 2008


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