313to enter the blood stream to begin their deadly journey. The number of these “win-
dows” correlated to the probability of distant site metastases. MetaStat™ Breast
Cancer Test uses conventional staining techniques to count these windows, and the
count correlates to the risk of metastasis. In clinical trials, the high-risk cohort
proved to be 22 times as likely to experience metastasis as the low. The test is inex-
pensive and fast because archived human tissue samples are used accompanied by
their corresponding medical records. The predictions are compared to known out-
comes in the corresponding medical records.
Racial Factors in the Management of Breast Cancer
Gene expression analysis has identifi ed several breast cancer subtypes, including
basal-like, human epidermal growth factor receptor-2 positive/estrogen receptor
negative (HER2+/ER–), luminal A, and luminal B. The basal-like breast cancer
subtype was more prevalent among premenopausal African American women
(39 %) compared with postmenopausal African American women (14 %) and non–
African American women (16 %) of any age (Carey et al. 2006 ). Although breast
cancer is less common in blacks than whites, when black women do develop the
disease, they are more likely to die from it, especially if they are under 50. Among
those younger women, the breast cancer death rate in blacks is 11 per 100,000,
compared with only 6.3 in whites. A higher prevalence of basal-like breast tumors
and a lower prevalence of luminal A tumors could contribute to the poor prognosis
of young African American women with breast cancer. The fi nding has no immedi-
ate effect on treatment, because there is no treatment that specifi cally concentrates
on basal-like cancer. Basal-like tumors tend to grow fast and spread quickly, and
they are more likely than other types to be fatal. They are not estrogen-dependent,
and cannot be treated or prevented with estrogen-blocking drugs like tamoxifen or
raloxifene. Herceptin, another breast cancer drug, is also useless against these
tumors. But efforts are being made to create drugs that will zero in on it. The work
involves fi nding drugs to block specifi c molecules that these tumors need to grow.
RATHER Consortium to Study Personalized Approach to Breast Cancer
RATHER consortium (Rational Therapy for Breast Cancer: Individualized
Treatment for Diffi cult-to-Treat Breast Cancer Subtypes) investigators in Europe
received a grant of €6 million ($8.4 million) from the EU in 2011 for a 5-year project
to study two breast cancer types that are diffi cult to treat and amount to one quarter
of all breast cancer cases: invasive lobular carcinoma and triple-negative breast can-
cer. The aim is to profi le tumors in search of genetic mutations or other anomalous
molecular processes involving kinases in these two cancer types in the hope that
these studies will result in differences that are at the root of these cancers and could
be targeted by novel drugs. RATHER partners include: University College Dublin;
Agendia; Oncomark; the Netherlands Cancer Institute; the University of Cambridge;
Personalized Management of Cancers of Various Organs