Executive Summary
In June of 1996, the California Breast Cancer Research Program distributed nearly $14 million to 60 breast cancer researchers throughout the state. Located in 23 California institutions, these researchers are among the leaders in California's effort to reduce the economic and human cost of breast cancer. Because of this program, the research dollars devoted to the fight against breast cancer in California were significantly increased, sustaining and augmenting established laboratories and research groups with new projects, and bringing new researchers with cutting edge ideas into the field. The focus of these 60 projects range from finding new, better methods of detecting breast cancer while it is in its most curable stage, to identifying potential causes of breast cancer in the environment and bettering our understanding of how these agents bring on the disease, to developing new methods to treat breast cancer. Lastly, and most hopefully, some of these projects look at how we might best reduce the risk of breast cancer, and eventually prevent its occurrence. The funded projects include:
• 7 grants to investigate possible causes of breast cancer (including exploration of various pesticides, PCBs and dioxins, detection of a viral infection contracted through cows).
• 24 grants to further understanding of how breast cancer develops (including identifying and understanding the action of genes involved in cell growth control, determining actions of hormones and hormone-blocking drugs, exploring why breast cancer spreads to other parts of the body, looking at effects of vitamins on breast cancer cells).
• 5 grants to investigate ways to prevent breast cancer (including testing ways to identify women at higher risk, and looking at agents such as micronutrients, elements found in green tea, and hormone-blocking agents).
•13 grants to develop better methods to detect breast cancer (including testing ways to increase use of mammography, testing possible markers for cancer in blood, urine, or breast fluid; and developing new technologies to improve or replace mammograms).
•11 grants to investigate innovative treatment modalities (including finding ways to boost the immune system to fight breast cancer, developing methods to deliver drugs specifically to cancer cells, while sparing normal cells; exploring alternatives to surgery for the removal of early breast cancers; and testing the effectiveness of alternative treatments).
Understanding why some women develop breast cancer, and others do not, will provide clues about both risk and prevention. For example, one study is exploring levels of the individual components of industrial pollutants, such as DDT, other pesticides, PCBs and dioxins in African American women with and without breast cancer. The results should make a significant contribution to the current knowledge about possible environmental causes of breast cancer and may help explain the higher rates of breast cancer among younger African American women. Other studies are examining individual differences in the rate at which estrogen is produced or changed from less active to more active forms. Such differences may result in some women being exposed to higher levels of more active forms of estrogen, which can stimulate breast cell growth, possibly leading to an increased risk of breast cancer.
Several studies are exploring different ways to boost the body's immune system to prevent any breast cancer cells that form from developing into an invasive cancer. One study is examining the mechanism by which immune cells can stimulate cancer cell "suicide." Other studies are developing methods by which the immune system can be augmented or guided to kill tumor cells.
Until we learn to prevent breast cancer, it is best to detect it as early as possible, before it has spread and become very difficult to cure. While X-ray mammography is still the "gold standard" for finding small tumors, it has a number of disadvantages, for example its use of ionizing radiation and finding "suspicious" areas in the breast that 70% of the time are not cancer_but which require surgical procedures, or additional X rays, to know for certain. BCRP funded five projects to either improve this X-ray early detection technology (by better use of computers_instead of film_to image the breast; improving the sensitivity of the imager so that the levels of radiation can be reduced while improving the image) or to develop and improve other, non-ionizing detectors. In the latter group are positron emission (PET) and near-infrared detectors.
Other efforts to develop techniques to better detect breast
cancer earlier include the exploration of newly-discovered markers for breast
cancer, and testing the technique of aspirating breast fluid through the
nipple and examining the cells found in this fluid for abnormalities.
The development of new methods for treating breast cancer, a new area for
the Program in this Cycle, includes the exploration of 2 new alternatives
to surgery (radiosurgery and cryosurgery). Several studies are aimed at
designing new drugs which will specifically target breast cancer cells,
and thereby avoid damage to normal parts of the body. In another study,
the formal evaluation of existing alternative approaches to treatment of
advanced breast cancer is being undertaken through a study of Tibetan treatment.
The awards made to the 23 different institutions in the state included independent research institutions (e.g., The Burnham Institute), medical centers (e.g., Sidney Kimmel Cancer Center), for-profit industry firms (e.g., Nova R&D, Inc.), federal laboratories (e.g., Lawrence Berkeley National Laboratory), and universities, both private (Charles R. Drew University of Medicine and Science) and public (University of California campuses). This diversity reflects both the commitment of the BCRP to involve the best researchers that California has to offer, and one of the objectives of the breast cancer advocacy community to widen the sources of ideas for research into this disease.
The California Breast Cancer Research Program was established
in 1993, when the California Legislature passed, and the Governor signed,
the Breast Cancer Act and enabling legislation. The Program is funded with
a portion of the revenue from an increase in the State tobacco tax, resulting
in approximately $14 million per year devoted to breast cancer research.
By continuing to direct state funds towards important topics in breast cancer
that are less well-supported by federal research dollars, and that are of
particular importance to the people of this state, the BCRP promises to
accelerate progress in reducing the human and economic costs of breast cancer
in the state.
