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Promise and Progress - Cancer Cells Revealed in a Drop of Fluid

Leading the Way Fall 2009 Winter 2010

Cancer Cells Revealed in a Drop of Fluid

By: Valerie Mehl
Date: December 1, 2009

Breast Cancer Test Update, Clinical Cancer Research, June 1, 2009


Clinical Cancer Research, June 1, 2009 Researcher Saraswati Sukumar, Ph.D., imagined that it might be possible to detect breast cancer from a tiny drop of breast fluid, and now she has proven that it can be done.

In a small clinical study, six of seven cancers were detected by QM-MSP, a test developed in her laboratory in 2003. By comparison, just two cancers were detected
by cytology, the current standard of care which involves using a microscope to look for abnormal cells in breast fluid.

Sukumar’s study focused on a small group of 64 women who had abnormal nipple discharge and were undergoing a procedure known as a ductoscopy. Using a tiny fiberoptic tube inserted through the nipple into the leaky breast duct, clinicians can
look inside the duct for a cause of the discharge. Often, it is a benign condition
known as a papilloma, but it also can be an early stage cancer. The problem is, there is currently no way to tell the difference between the two. Cytology is done on the fluid
discharged from the breast, but frequently misses cancers, says Sukumar. As a result, all women must have surgery to get the duct removed. Using her test on a tiny amount of
breast fluid (about the size of a pinhead) left behind in the tube following ductoscopy, her team identified all but one cancer. The test simultaneously determines the percentage of
a biological process known as methylation in each of four to five known breast cancer genes. Too much methylation is known to turn off key tumor suppressor genes. The percentages are added together for a cumulative score, which is then compared to
a threshold value. A score above the threshold indicates the presence of cancer cells, Sukumar explains.

“This preliminary study provides proof of principle that detecting breast cancer with QM-MSP is feasible,” says Sukumar, Barbara M. Rubenstein Professor of Oncology and
co-director of the breast cancer program.

Her plan now is to confirm her results in a larger study of 400 to 500 women. “If we can confirm these findings,” she says, “it would be possible for many women to avoid surgery.”

This research was funded by the National Cancer Institute Breast Cancer SPORE program.

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