Test 'predicts breast cancer resistance'

A genetic test could one day spot breast cancer patients most at risk of relapsing after treatment with a commonly used powerful chemotherapy.

The find could spare patients the side-effects of a drug destined to fail.

US researchers tested tumours for activity from two genes which appeared to cut the effectiveness of a class of cancer drugs.

UK cancer experts said it was another step towards "personalised" cancer treatment.

The fact that a drug may be highly effective in some patients, but not others, cannot be easily explained.

Scientists now believe that the molecular properties of patients and their tumours may be the key to understanding this - and choosing the right type of treatment.

The team from the Dana-Farber Cancer Institute, in Boston, Massachusetts, scanned the genetic code of tumours taken from women who had undergone treatment, looking for differences which could account for differences in outcome, focusing on a single class of drugs called anthracyclines.

They found a small region on a single chromosome, and within it two genes which seemed to be unusually active in drug-resistant tumours.

When checks were made on samples from 85 other women, those with high levels of activity from these two genes were those who did worst when treated with anthracyclines.

They believe that by checking tumours in advance, treatment regimes could be changed to those involving alternative drug types.

'Appropriate treatment'

Dr Eric Winer, director of the Breast Oncology Center at Dana-Farber, said: "While this work remains preliminary, it may ultimately help us use the anthracyclines in a much more thoughtful manner and allow us greater ability to personalise our breast cancer treatments to the tumour and the patient."

UK cancer charities welcomed the research, although they cautioned that it could be some time before the results were confirmed and any test developed.

Meg McArthur, from Breakthrough Breast Cancer, said: "This research is a step towards discovering why some patients benefit more than others from a common form of chemotherapy.

"Research like this is important for identifying the appropriate treatment for individual patients."

Oliver Childs, from Cancer Research UK, said: "Finding ways to predict how patients will respond to chemotherapy is important to help them benefit as much as possible from their cancer treatment.

"It is too early to say whether this research will lead to a predictive test, but work like this inches us a little closer towards an age of personalised cancer treatment."

New strategies may cut screening errors, says US study

US scientists have found a way they believe may cut the number of mistakes made by medical staff looking for breast and cervical cancers.

Writing in the journal Current Biology, the researchers say that people in all walks of life looking for rare events often miss them.

But accuracy improves if people first get used to looking at samples of what they need to find.

Screening professionals said it was a recognised problem.

They carried out a study which showed that the number of mistakes made during a visual search varied according to the chances of finding the "target".

Time searching

Twelve volunteers were asked to identify target items in X-ray images of assorted objects in empty bags.

The accuracy of their search was monitored as the frequency of the target was altered.

The laboratory results are to be tested in clinics and airports.

The study found that the amount of time the observers spent looking for something depended on how often if appeared.

"If you don't find it often, you often don't find it," said lead author, Jeremy Wolfe of Harvard Medical School.

"If you are trying to find 20 cases of breast cancer from 40 mammograms, you'll find more of them than if you look for the same 20 cases from 2,000 mammograms.

"From an evolutionary point of view it makes sense for people to give up searching more quickly if they don't expect to find what they were looking for," he said.

"If you know berries are there, you keep looking until you find them. If they are never there, you don't spend your time hunting."

But this causes difficulties when the aim is to accurately spot rare phenomenon like cancers or bombs in travellers' luggage.

Instant feedback

The authors say that one benefit of staff doing a booster exercise before starting work is that it helps them to visualise what they are looking for and improves their search success rate in the subsequent session.

They say that this kind of exercise could also sharpen search skills by providing instant feedback.

In the real world it often takes many months for radiographers and radiologists to discover if they have made mistakes.

The research has been welcomed by the Society of Radiographers.

Chief executive Richard Evans said: "The difficulty of spotting abnormal results among large numbers of normal cases is a recognised problem.

"I look forward to seeing more details about this research, but radiographers would welcome techniques which help ensure the best possible standards."

He pointed out that the NHS already monitors the performance of everyone involved in breast screening through a regular audit.

Women 'too busy' to go for cancer screenings

Practical reasons could be more significant than emotional ones in explaining why many women miss cervical cancer screenings, a study suggests.

It had been thought emotional factors - such as embarrassment or fear - were largely to blame for low take-up rates.                           

But a Journal of Medical Screening study found women who said they rarely or never voted in elections were more likely to be overdue for screening.

And researchers say the women could simply be too busy for either activity.

The team, from the charity Cancer Research UK, found the association was strongest in women aged 26-44.

Cervical screening saves about 4,500 lives every year.

Researcher Dr Jo Waller said: "With uptake of cervical screening in England still much lower than we would like, these findings suggest that overcoming practical barriers may be the most important factor in maximising cervical screening uptake.

"These results are encouraging. In the past, it was thought that emotional factors such as concern about embarrassment and pain were the best predictors. Minimising practical difficulties is a more achievable goal.

"In terms of the correlation between voting and screening attendance, it may be that as both activities require a degree of organisation, women who do not manage to vote because of busy lives may also be unlikely to attend screening."

Practical

The researchers suggest that measures to minimize practical difficulties, such as evening and weekend clinics, could have a significant effect.

A separate US study, published in the same journal, suggests the more children living in a household, the lower the cancer screening attendance in adults from that household.

The researchers suggest that parents could have less time to attend screenings and prioritise the needs of their children above their own.

Professor Julietta Patnick, director of the NHS Cancer Screening programmes, said: "We have been concerned for some time about falling acceptance rates for screening, particularly amongst certain groups in society, such as women under 35 and the over 55s.

"This study helps us understand what the issue might be and will be useful for us in addressing the issues."