In women with obesity, there is cooperation between all the cell types, not just the cancer cells, which helps an early pre-cancer to become an invasive breast cancer
Elizabeth Wellberg
Researchers also identified differences in the “neighborhood” of cells and tissues surrounding the cancer. Epithelial cells, where the tumor originally develops, co-opt other cells around them to create an environment even more conducive to cancer growth.
“In women with obesity, there is cooperation between all the cell types, not just the cancer cells, which helps an early pre-cancer to become an invasive breast cancer,” said co-lead author Elizabeth Wellberg, Ph.D., assistant professor in the Department of Pathology at the OU College of Medicine. “That may be an area of future study – can a drug or intervention that targets only one cell type interrupt the whole network of progression toward invasive cancer?”
The research team also discovered higher levels of an enzyme called Sulfatase 2 (SULF2) in tumor cells of women with obesity, suggesting that it may play an important role in cancer progression. SULF2 will be another focus of future studies.
Understanding what causes early, noninvasive tumors (ductal carcinoma in situ, or DCIS) to become invasive is important because not all women will develop invasive cancer, yet they receive the same treatment.
“In women diagnosed with DCIS, about half will later develop invasive ductal carcinoma (IDC) that spreads into surrounding breast tissue. But we currently have no way of determining which women are most at risk. As a result, many women with DCIS receive the same treatments used for IDC, including surgery, radiation and sometimes hormone therapy. Overtreatment is a major concern, but if we had better ways of determining risk, unnecessary treatments could potentially be reduced,” Hannafon said.
While breast cancer survival rates have improved over the past two decades, the number of women diagnosed with invasive breast cancer has not declined, underscoring the need for better ways to predict and prevent disease progression.
“Obesity is on the rise – 50% of Americans are expected to be obese by 2030,” said the paper’s first author, Cole Hladik, Ph.D., who worked in Hannafon’s lab while earning his doctorate. “That statistic further highlights the importance of considering a patient’s metabolic health alongside the biology of the tumor itself.”
Source: University of Oklahoma