Papanicolaou stain specimens may one day detect breast and ovarian cancer

Although mammograms are the gold standard for detecting breast cancer, recent studies suggest that other screenings may be able to detect breast cancer and other types of cancer at the same time.

In one study, researchers found that cells collected in Papanicolaou stain, a routine procedure for testing for cervical cancer, could also detect ovarian cancer. In the second study used, researchers used these cervical cells to predict the risk of individuals developing breast cancer in the future. Both studies were published in Nature Communications.

Having one test to screen for multiple cancers may help detect one-eighth breast cancer cases that are not detected during mammography.

“Because of the density of the breast, you are more likely to miss cancer.” Jack Jacob, MDA medical oncology scholar and medical director at the Memorial Care Cancer Institute at the Orange Coast Medical Center told Verywell. “Breast density is more common among young and hormonal women, and as women grow older, density is lost over time, making breast mammography more sensitive to cancer.”

Simplifying the number of cancer screenings a person needs each year may also encourage people to seek medical care. It will make screening more convenient for low-income communities who may not have the resources to quit their jobs and move to multiple appointments.

And because of the COVID-19 pandemic, there is a lot of delayed care and the need for screening is more pressing than ever.

“The pandemic affected many screenings, but it was considered an option in many views because of the risks associated with accessing the healthcare system during a crisis,” explains Jacoub. did. “The delay may indicate a future cancer diagnosis, advanced stage cancer, and an increase in cancer that may have been discovered earlier but is now a little more advanced.”

Screening for current and future cancers

The first study analyzed the genetic information of cervical cells from Papanicolaou stains with or without ovarian cancer.

They were able to identify a high percentage of people with ovarian cancer.The cells are also breast cancer, endometrial cancer, and even BRCA1 mutation— This puts them at greater risk.

In the second study, researchers studied cervical DNA in people with and without breast cancer to build a mathematical model that calculates the risk of future breast cancer. The model predicted that these particular DNA signatures could be found in 70% to 75% of all ovarian and breast cancers. In addition, people in the top quartiles of the model were 15.7 times more at risk of developing breast cancer.

The idea of ​​observing epigenetic changes in cervical cells and predicting multiple hormone-sensitive cancers is interesting, Jacob said.

However, he claims that Papanicolaou stain specimens and algorithms have a long way to go to the clinic. Moving the needle requires a larger study involving multiple countries to confirm these current discoveries. Second, researchers need to design blood tests that are cheaper and more accessible than traditional screening methods.

“There is a big gap in research [the study authors] It needs to be met, but the concept of cellular abnormalities that reflect the risk of cancer is interesting because it doesn’t have to stop with breast cancer, “says Jacoub. “Cells can be sampled regardless of whether they are in blood, tissue, or an easily wiped area such as the cervix or mouth, and that the causes that lead to these changes in genes cause certain cancers. If it can be proved in some way, it is a new direction for the future of cancer treatment. ”

Are there other screening options on the horizon?

Papanicolaou stain specimens are not the only method being studied as a potential test for multiple cancers.

For example, some blood tests can detect cancer risk and diagnosis at the same time.One example is CA125 blood test It measures the amount of cancer antigen 125 protein in the blood to indicate ovarian or endometrial cancer.

Jacoub emphasized that blood tests are a more practical tool than Papanicolaou stains for predicting multiple cancer risks.

“This data is relatively early, and some of the biomarkers and blood-based tests are a bit advanced, some of which are currently on the market,” Jacoub added.

Another possible but unconventional way to screen for breast cancer is to test a person’s milk.

Recent studies have shown that breast milk samples contain live breast cells, previously thought to contain only dead or dying cells. Due to the high density of breast tissue during breastfeeding, it is difficult for mammograms to detect potential signs of breast cancer unless a pump is used immediately before. This finding may give researchers a non-invasive approach to check for abnormalities that may indicate breast cancer.