COVID-19 Has Not Stopped Research

Tuesday 21 July 2020

COVID-19 has not stopped breast cancer research

The COVID-19 pandemic has affected nearly every Australian and even put a stop to breast screening for almost two months, resulting in a reported 40 per cent drop in breast cancer diagnosis' - thankfully it hasn't halted the important breast cancer research of Queensland University of Technology researchers Dr Honor Hugo and Professor Rik Thompson.

Like many research teams at the PA Hospital (PAH) based Translational Research Institute, the restrictions placed upon workplaces due to COVID-19 allowed the mammographic density researchers, who are funded in part by the PA Research Foundation (PARF), to pivot and focus on other areas of their work.

Though COVID-19 did slow accruals (tissue donations) it didn't put the brakes on lab and research work.

"We were fortunate that things were ready for our academic paper, so quite a lot of work could be done by our student at home when she wasn't here and by us as well," Professor Thompson said.
"In the shutdown period, we published our work showing for the first time that mammographic density change could be measured in breast tissue cultured in a special way for 2-3 weeks, because before,these changes has always been measured by longitudinal studies in women over years," Dr Hugo said.
"We've been able to, using an agent, decrease density in a very marginal way, monitoring it by using the highly sensitive detection method of single sided MRI – a machine called the "NMR mouse". It's exciting for us because it's proof of principle.
"There are some experiments where we rely on fresh tissue, but we can use thawed out tissue accrued earlier and frozen, to do mechanical or more biophysical measurements, such as to optimise our NMR measurements."

PAH radiologist Dr Thomas Lloyd, a mammographic density research team member who also works with BreastScreen, said although breast screening was postponed for approximately seven weeks as a result of COVID-19 restrictions, all patients who were due to be screened are now being contacted.

At the height of the pandemic in Queensland, BreastScreen Units had to weigh up the screening of women aged 50-75 who were in the 'at risk' categories for COVID-19, against the slower moving nature of breast cancer growth, as well as being prepared for a potential influx of COVID-19 cases.

"Screening closed down for a period, during that time no women were screened, which means the cancers they would have had detected had they been screened were not. Those women were the priority when screening started up again and indeed now back to essentially normal," Dr Lloyd said.
"What we were looking at is a delay of two months in the diagnosis of a cancer, which then delays treatment. We think that because most breast cancers are generally slow growing, there shouldn't be too much of a downstream effect from that.
"The key message is if you missed your screen, go back and have it now."

As Dr Hugo and Professor Thompson, in collaboration with Dr Lloyd and others at the PAH campus, continue their research into mammographic density as a breast cancer risk factor, the rest of 2020 has much in store.

"We have one more paper to be published on the biology side of our work, on the hormonal regulation of mammographic density, so looking at androgen receptor, antagonism, agonism, and how that changes the density in the progression to potential treatments that may reduce mammographic density," Dr Hugo said.
"Secondarily we'll have another publication on mammographic density measurement, bringing together data on the 15 female healthy volunteers that we've recruited, where we have measured their density using the NMR Mouse. But we then want to use that to monitor more women."
"We have found that mammographic density is modifiable by estrogen, but also Tamoxifen, which is an anti-estrogen drug used to treat breast cancer, reduces density and that's a potential readout of Tamoxifen's ability to work in each woman treated."
"We could then use the NMR Mouse for these women instead of mammography, which has an element of discomfort, and involves exposure to low levels of ionizing radiation, making repeat measurements impractical. Using the NMR Mouse, we hope to be able to determine if patients are responding or not and know this earlier than we would normally do."

Testing of the NMR Mouse is ongoing.

"It critical for us to know whether the NMR mouse will work well enough to see these changes that have been indicated by mammography, which are usually from annual follow-up of patients receiving Tamoxifen. Otherwise, we've got to use different treatment modalities on these women, which we hope may ultimately include the pathways we've identified, which we think are contributing to the reasons that breast density causes malignancy," Professor Thompson said.

Dr Lloyd said with COVID-19 levels having dropped significantly in Queensland, women who have concerns should not hesitate to get checked.

"If you've got symptoms, you should always go and see your GP, the GPs are open and able to see you. Screening is back up and running at a capacity that they are able to get as many people screened as possible."

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