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Can Breast Cancer Be Detected In Blood

General Breast Cancer Terms

What is a liquid biopsy? Can cancer cells be detected in the blood?

Here are some of the key words used to describe breast cancer.

Carcinoma

This term describes a cancer that begins in the lining layer of organs such as the breast. Nearly all breast cancers are carcinomas .

Adenocarcinoma

An adenocarcinoma is a type of carcinoma that starts in glandular tissue . The ducts and lobules of the breast are glandular tissue , so cancers starting in these areas are sometimes called adenocarcinomas.

Carcinoma in situ

This is an early stage of cancer, when it is confined to the layer of cells where it began. In breast cancer, in situ means that the abnormal cells remain confined to ducts . These cells have not grown into deeper tissues in the breast or spread to other organs in the body. Ductal carcinoma in situ of the breast is sometimes referred to as non-invasive or pre-invasive breast cancer because it might develop into an invasive breast cancer if left untreated.

When cancer cells are confined to the lobules it is called lobular carcinoma in situ . This is not actually a true pre-invasive cancer because it does not turn into an invasive cancer if left untreated. It is linked to an increased risk of invasive cancer in both breasts. LCIS is rarely, if ever seen in men.

Invasive carcinoma

An invasive cancer is one that has already grown beyond the layer of cells where it started . Most breast cancers are invasive carcinomas, either invasive ductal carcinoma or invasive lobular carcinoma.

Sarcoma

Can Blood Tests Detect Cancer Topic Guide

How Does Cancer Blood Testing Work

The proliferation of cancer cells is brought about by mutated DNA. Fragments of the erroneous DNA and certain proteins get released into the bloodstream as the tumors start to grow. Some of these proteins include antigens released by the tumor. A total of 16 gene mutations and a number of proteins related to cancer can be identified from the blood. Each of these proteins corresponds to a different type of cancer, making it possible to identify all eight types of cancer using just one blood sample.

Cancer blood tests can also be performed to detect circulating tumor cells , which are another indicator of malignant cells in the body. The cells that are identified in the blood can be used to trace back to where they originated from and find the part of the body where the tumor might be.

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Study Examines Whether Blood Test Can Identify Early Cancers

In a new study, an experimental blood test identified cancers for which there are recommended screening tests and other cancer types for which no screening tests exist.

In the first study of its kind, a blood test combined with imaging tests detected tumorssome at an early stagein women without a history of cancer or any symptoms.

The blood test identified breast, lung, and colorectal cancers, for which there are recommended screening tests. But it also identified seven other cancer types for which no screening tests exist.

Researchers led by Nickolas Papadopoulos, Ph.D., of Johns Hopkins University School of Medicine, designed the study to see whether it was possible to use such a blood test to detect cancers before symptoms developed. They also wanted to make sure the testing process did not cause participants distress or lead to many unnecessary diagnostic procedures.

The study was not designed to determine whether finding and treating the cancers identified by the test reduced the number of deaths from cancer among participants.

The findings were presented at the American Association for Cancer Research annual meeting and published in Science on April 28.

Although its counterintuitive, detecting a cancer early does not necessarily reduce the likelihood of dying from cancer, explained David Ransohoff, M.D., of UNC Lineberger Comprehensive Cancer Center, who was not involved with the study. Some screening may actually cause more harm than good, Dr. Ransohoff said.

What If You Have Already Had Breast Cancer

Blood Test Could Detect Breast Cancer Sooner

If you had early-stage breast cancer and have no signs that your cancer has returned, you may not need imaging or tumor marker tests. It is not likely that your cancer has returned. These tests usually do not help you live longer. And they can lead to a wrong diagnosis and unneeded treatments.

Usually, the best way to monitor your cancer is to have a mammogram each year and a physical exam every six months. And watch for symptoms, such as a new lump or pain in the breast. Studies show that most breast cancer that returns is found through symptoms, not imaging tests.

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Complete Blood Count: Getting The Big Picture

To get a general overview of a patients health, many doctors order a complete blood count first. After taking blood, physicians can analyze the number of red blood cells, white blood cells, platelets and hemoglobin in the sample to detect abnormalities. Many diseases, including cancers, alter these levels, changing the proportion of white blood cells to red blood cells, for example.

One major aspect of the CBC is called a white cell differential. White blood cells, or leukocytes, are part of your immune system. They take on most of the responsibility in responding to infectious diseases, but abnormalities in their levels can also be a sign of some blood cancers. White cell differential is also a helpful indicator in judging a patients response to chemotherapy.

Testing The Liquid Biopsy Test

Figuring out how liquid biopsies might fit into the diagnostic process is something that researchers on the DETECT study hoped to find out.

According to the studys results, 96 of the 10,000 enrolled women received diagnoses of cancer during the trial. Of those, 26 were identified by the blood test, 24 by standard screening methodsand 46 after they developed symptoms.

Of the patients diagnosed by the blood test, 14 had hard-to-find cancers in organs such as ovaries, kidneys or the lymphatic system. Nine of these tumors had not yet spread beyond their original sites.

One of the things we wanted to see with this trial was if we were competing with the standard of care, or if the test is additive and synergistic, Papadopoulos says. We detected 26 cancers with our blood tests within the population that we tested. And then detected with the standard of care. So the blood test doubled the screen-detected cancers, which was a very good result.

According to Buchanan, the goal of the trial was primarily to assess the tests feasibility and safety. Researchers wanted to know how well it worked, but also if it could be used to minimize negative outcomes like false positives that would lead people to have additional medical tests.

Thats why the GRAIL test can tell the clinician not only if the patient likely has a tumor but also what type of cancer it is likely to be. In a clinical trial of the test, researchers detected more than 50 cancer types with 93% accuracy.

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Finding Changes In Genetic Information

Cytogenic tests provide evidence of changes to the genetic material in cells. Some types of leukemia can alter chromosomes, structures made up of protein and DNA in the nucleus of individual cells. Chromosomes are best seen when cells are dividing, so pathologists will take samples of a patients blood or bone marrow and then grow the cells in the lab. Philadelphia chromosome, a shortening of chromosome 22, is indicative of chronic myeloid leukemia.

Fluorescent in situ hybridization uses fluorescent dyes to light up specific chromosomes under a microscope. In this test, doctors are looking for BCR-ABL, a gene abnormality that ends up creating Philadelphia chromosome. Beyond chronic myeloid leukemia, BCR-ABL may be present in patients with lymphoblastic leukemia and acute myelogenous leukemia.

Blood tests become extremely important after a cancer diagnosis, when doctors are trying to decide on the best treatment method. Investigating a patients blood and bone marrow can help physicians know whether or not a therapy is working, by highlighting changes in chemical levels. Before a proper diagnosis, blood work is one piece in a much larger puzzle, and usually cant lead to the truth on its own.

Using Blood To Spot Cancer

Possible blood test to detect breast cancer

Stefan H. Bossmann, PhD, is a distinguished professor at Kansas State University and was part of a team that developed blood test technology that looked at cancer-related enzymes in blood.

He told Healthline about some of the ways to detect cancer in blood. These include looking for circulating tumor DNA or RNA, tumor cells, epigenetic markers, TAAs, and proteases and kinases .

Another blood test for breast cancer in testing claims to be able to detect 15 different biomarkers in the blood, spotting metastatic and recurring cancers at an early stage, as well as small tumors.

That test may also be used for long-term monitoring to gauge treatment efficacy and is meant to complement other screening methods. It may be out later this year in European markets, according to reports.

Another blood test for early cancer detection, CancerSEEK, is a liquid biopsy test aimed at detecting multiple types of cancer by looking at circulating DNA. It recently obtained venture capital funding.

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Testing The Tumor Cells For Hormone Receptors

A hormone receptor is a specialized protein located on the surface of or within a cell. The receptor binds to the female hormones estrogen and progesterone, which flow through the blood. Once bound, the hormone signals the cell to start growing and multiplying.

Many breast cancer tumors contain hormone receptors, often in large numbers. When hormone receptors are present, estrogen and/or progesterone can fuel the growth of the cancer. Such hormone-dependent cancers often respond well to hormone therapy, which differs from hormone replacement therapy . If neither estrogen receptors nor progesterone receptors are present, the cancer is said to be hormone-receptor-negative, and hormone therapy would likely be ineffective. Knowing whether the cancer cells have hormone receptors can be valuable to your medical team and your treatment plan.

What Is Breast Cancer Staging

To determine the stage of your cancer, doctors look at how large your tumor is, where it is, and if it has spread. They also look at your medical history, physical exams, diagnostic tests, and tests of your tumor and lymph nodes.

  • Early-stage breast cancer includes stages 0, I, II and IIIA .
  • In stage 0, there are abnormal cells in the ducts or lobes of the breast. They have not broken through the wall of the duct or spread.
  • In stages I, II, and IIIA, there is a tumor. It may have spread to lymph nodes under the arm, but it has not spread anywhere else.
  • Later-stage breast cancer is stages IIIB and IV . The cancer has spread beyond the breast and lymph nodes under the arm.
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    What Is A Cbc

    When you visit a clinic setting for any sort of complaint, the first blood test and the most common investigation of choice is a Complete Blood Count.

    CBC or a Complete Blood Count or a Full Blood Count is a test performed for quantitative and qualitative analysis of blood cells present in circulation. A complete blood count also helps one to know what the hemoglobin count of a person is.

    Although a complete blood count test may seem very basic, it is often the simplest and most economical test to evaluate the health status of any individual.

    What Are The Warning Signs Of Breast Cancer

    Cancer mutation signature can be reproducibly detected in ...
    • A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
    • A mass or lump, which may feel as small as a pea.
    • A change in the size, shape, or contour of the breast.
    • A blood-stained or clear fluid discharge from the nipple.
    • A change in the look or feel of the skin on the breast or nipple .
    • Redness of the skin on the breast or nipple.
    • An area that is distinctly different from any other area on either breast.
    • A marble-like hardened area under the skin.

    These changes may be found when performing monthly breast self-exams. By performing breast self-exams, you can become familiar with the normal monthly changes in your breasts.

    Breast self-examination should be performed at the same time each month, three to five days after your menstrual period ends. If you have stopped menstruating, perform the exam on the same day of each month.

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    Who Gets Breast Cancer

    Breast cancer is the most common cancer among women other than skin cancer. Increasing age is the most common risk factor for developing breast cancer, with 66% of breast cancer patients being diagnosed after the age of 55.

    In the US, breast cancer is the second-leading cause of cancer death in women after lung cancer, and it’s the leading cause of cancer death among women ages 35 to 54. Only 5 to 10% of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The majority of breast cancer cases are “sporadic, meaning there is no definitive gene mutation.

    What If You Have Early

    If you have early-stage breast cancer but no symptoms to suggest the cancer has spread, you should not get an imaging test to look for cancer in other places in your body. The chance that your cancer has spread is very small. Studies show that breast cancer spreads to the liver and bones in fewer than 6 out of 100 people. And this is usually in patients with stage III breast cancer.

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    Signs And Symptoms Of Breast Cancer May Include:

    • A breast lump or thickening that feels different from the surrounding tissue
    • Bloody discharge from the nipple
    • Change in the size, shape or appearance of a breast
    • Changes to the skin over the breast, such as dimpling
    • A newly inverted nipple
    • Peeling, scaling or flaking of the pigmented area of skin surrounding the nipple or breast skin
    • Redness or pitting of the skin over your breast, like the skin of an orange

    When Do Signs And Symptoms First Appear

    HealthWatch: Blood Test Could Help Detect Breast Cancer

    Typically, cancer signs and symptoms first appear when the cancerous tumor or mass has grown large enough that it begins to push against nearby organs and tissue, blood vessels, and nerves.

    This can lead to pain, a change in how the nearby organs function, or both. A brain tumor pressing against the optic nerve will affect vision, for example.

    Some cancers are fast moving, such as liver and pancreatic cancers. Prostate cancer, however, is usually slow moving. This is why many older men with prostate cancer forego treatment theyre more likely to die with prostate cancer than because of it.

    Screenings for certain cancers should be part of your normal preventive healthcare. These include cancers of the:

    • prostate
    • cervix
    • skin

    Your age, sex, family history, and your own medical history will dictate when routine screenings should begin and how often they should be done.

    If youre concerned about symptoms associated with various cancers, then you shouldnt hesitate to see your doctor. You can connect to a physician in your area using the Healthline FindCare tool.

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    What Is Breast Cancer In Men

    A breast cancer is a malignant tumor that starts from cells of the breast. A malignant tumor is a group of cancer cells that may grow into surrounding tissues or spread to distant areas of the body. Breast cancer occurs mainly in women, but men can get it, too. Many people do not realize that men have breast tissue and that they can develop breast cancer.

    How The Test Works

    Often long before causing any symptoms, even very small tumours will begin to release minute amounts of mutated DNA and abnormal proteins into blood. While DNA and proteins are also released from normal cells, the DNA and proteins from cancer cells are unique, containing multiple changes not present in normal cells.

    The newly developed blood-based cancer DNA test is exquisitely sensitive, accurately detecting one mutated fragment of DNA among 10,000 normal DNA fragments, literally finding the needle in the haystack.

    We used CancerSEEK in just over 1,000 people with different types of early stage cancers. It was shown to accurately detect the cancer, including in 70% or more of pancreas, ovary, liver, stomach and esophageal cancers. For each of these tumour types there are currently no screening tests available blood based or otherwise.

    Along with cancer detection, the blood test accurately predicted what type of cancer it was in 83% of cases.

    Published in the journal Science, the research was led by a team from John Hopkins University, with collaboration from Australian scientists at the Walter and Eliza Hall Institute.

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    Molecular Tests For Gene Changes

    In some cases, doctors may test for specific gene changes in the breast cancer cells that could mean certain targeted drugs or immunotherapy drugs might help treat the cancer.

    These molecular tests can be done on tissue taken during a biopsy or surgery for breast cancer. If the biopsy sample is too small and all the molecular tests cannot be done, the testing may also be done on blood that is taken from a vein just like a regular blood draw. This blood contains the DNA from dead tumor cells found in the bloodstream of people with advanced breast cancer. Obtaining the tumor DNA through a blood draw is sometimes called a “liquid biopsy” and can have advantages over a standard needle biopsy, which can carry risks.

    Some genes that might be tested for include:

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