Testing breast cancer cells for how closely they resemble stem cells could identify women with the most aggressive disease, new research has suggested.
Researchers found that breast cancers with a similar pattern of gene activity to that of adult stem cells had a high chance of spreading to other parts of the body.
Assessing a breast cancer's pattern of activity in these stem cell genes has the potential to identify women who might need intensive treatment to prevent their disease recurring or spreading, the study found.
Adult stem cells are healthy cells within the body which have not specialised into any particular type, and so retain the ability to keep on dividing and replacing worn out cells in parts of the body such as the gut, skin or breast.
Scientists identified a set of 323 genes whose activity was turned up to high levels in normal breast stem cells in mice and cross-referenced them with the genetic profiles of tumours from 579 women with triple-negative breast cancer - a form of the disease particularly difficult to treat.
They split the tumour samples into two categories based on their score for the activity of the stem cell genes and found women with triple-negative tumours in the highest-scoring category were much less likely to stay free of breast cancer than those with the lowest-scoring tumours.
Women with tumours from the higher-scoring group had around a 10% chance of avoiding relapse after 10 years, while women from the low-scoring group had around a 60% chance.
The results show that the cells of aggressive triple-negative breast cancers are particularly "stem-cell-like", taking on properties of stem cells such as self-renewal to help them grow and spread.
They also suggest that some of the 323 genes could be promising targets for potential cancer drugs.
Dr Matthew Smalley, deputy director of Cardiff University's European Cancer Stem Cell Research Institute, who led the study, said: "Triple negative breast cancer accounts for around 15% of breast cancers, but is more difficult to treat than other cancer types as it is not suitable for treatments such as anti-hormonal therapy.
"It's particularly important to understand the genetic factors that help it to spread around the body - and we were excited to find that a key factor seems to be the degree to which gene activity resembles that of stem cells.
"Although our work is not yet ready for clinical use, our next step will be to explore which of these 323 genes are the most important drivers of the disease and to use these to develop a new genetic test."
Co-author Clare Isacke, professor of molecular cell biology at the Institute of Cancer Research, London, said: "Cancer cells can behave very much like stem cells - but stem cells gone bad. They find a way to activate genes which are usually only turned up in normal stem cells, giving them characteristics - such as self-renewal and immortality - that make them more difficult to treat.
"Our study could ultimately help lead to a genetic test assessing breast cancer cells for how closely they resemble stem cells. Picking out women with this type of aggressive disease could give us new ways of personalising treatment."
Scientists from King's College London also took part in the study, which is published in the journal Breast Cancer Research.
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