Scientists study breast milk as an early detection tool for breast cancer
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A new study taking place in Manchester is investigating whether breast milk could help detect breast cancer earlier than a blood test or a scan. The research, led by scientists at The University of Manchester, aims to improve how doctors detect breast cancer that develops during or just after pregnancy. It is often discovered late, when the cancer has already spread, leading to poorer survival rates.
Breast cancer is the most common cause of cancer-related death in women ages 35–64 in the U.K. and is increasing twice as fast in women under 50 as in women over 50. While breastfeeding is generally associated with lowering the long-term risk of developing breast cancer, risk rises during pregnancy and after giving birth and gradually falls over the following decade.
The study, called BRACELET-BM, has started recruiting participants at the Nightingale Centre in Wythenshawe, part of Manchester University NHS Foundation Trust (MFT). One of the first mothers to donate breast milk is Hannah Brennan, 31, a married mother of three from Glossop in Derbyshire. She has a 12-month-old baby girl, Ada, as well as a 5-year-old daughter and a 2-year-old son.
The registered midwife, who is currently studying for a Ph.D. at The University of Manchester, said, "As soon as I saw the research team were looking to recruit women who were breastfeeding, I wanted to do it. As I'm doing my doctorate, I'm passionate about people being involved in research.
"My paternal grandmother died at age 51 from breast cancer and sadly I never met her. However, I was named after her and I'm told I look like her so I'm doing this for her as well as my two daughters.
"Participating in the BRACELET-BM study was really straightforward. I just gave a blood sample and donated some breast milk and answered a few questions. As a midwife I feel it's really important to help other women, so if my small contribution can benefit other mothers in the future, I'm just glad to be able to make a difference and would encourage other breastfeeding moms to take part."
Pregnancy-related breast cancer, diagnosed during pregnancy or shortly afterward, occurs in approximately 1 in 3,000 pregnancies in the general population. Among women at very high risk of breast cancer, such as BRCA gene carriers, rates have been reported as high as 1 in 50 pregnancies.
Between 35% and 50% of breast cancer cases in women under 55 occur within 10 years of having a baby, and 5% of breast cancer cases in women under 45 occur within a year of giving birth. Better breast cancer screening is needed, especially in younger women.
The BRACELET-BM study is led by Dr. Niki Flaum from The University of Manchester, in partnership with Dr. Florent Mouliere at the CRUK National Biomarker Centre. Sacha Howell, a professor and consultant oncologist at The Christie NHS Foundation Trust and MFT, is a co-lead on the study.
Flaum, who is also a consultant oncologist at The Christie NHS Foundation Trust, said, "There is an urgent need to find better, more reliable ways to detect breast cancer in women during and after pregnancy. We believe breast milk may provide a unique and noninvasive window into what is happening inside the breast. We know surprisingly little about the genetic changes to breast milk, as this biofluid has been remarkably under-researched until now.
"Pregnancy-related breast cancer is more likely to be diagnosed at a later stage, when the cancer has already spread, and survival outcomes are significantly worse compared with women of the same age who have not recently given birth. Diagnosis is particularly challenging because breast imaging during pregnancy and lactation is often unreliable.
"Manchester has the opportunity to lead internationally in developing a completely new approach to breast cancer detection. If reliable methods for detecting cancer-related DNA in breast milk can be found, we hope future research will test whether this approach could be developed into a screening tool for women with breast cancer or those at high risk."
Initially, the study will recruit 40 lactating women, 25 with general population risk and 15 from a high-risk category with a family history of breast cancer. Researchers will collect breast milk and blood samples from patients at the Nightingale Centre and Saint Mary's Hospital, also part of MFT, to develop a Manchester Breast Biofluid Biobank with more than 200 samples available for future research.
The team within the Cancer Research UK National Biomarker Centre, part of The University of Manchester, will analyze the fluid samples.
Mouliere, who leads a research team at the Cancer Research UK National Biomarker Centre in Manchester, where the breast fluid samples are being analyzed, said, "Scientists in our laboratories have identified tiny fragments of genetic material shed by cells in some samples of breast milk that have been donated for this study. The DNA structure is unique in breast milk, and we now understand what this DNA looks like, which is a major step forward.
"We now need to focus on the main aim of this study, which is to explore how best to collect the samples, work out if they can be safely frozen in a home freezer (which would be a convenient method for a nursing mom), what time of day is best for a sample to be collected, and if other factors such as an infection in the mother or baby would affect the sample results."
An international study (September 2023) showed that circulating tumor DNA (ctDNA) could be detected in breast milk, but the best methods for collecting, processing and storing breast milk for this purpose have not yet been established.
Alongside donating blood and breast milk samples, participants will complete questionnaires and interviews to assess how acceptable this approach is, ensuring any future screening method is practical as well as effective.
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