Breast cancer: diet, nanophotonics and fertility protection the research milestones

Fertility preservation in young women with breast cancer, calorie restriction used as a drug, and nanophotonics at the service of diagnosis and therapy. These are just three of the many feathers in the cap of Made in Italy breast cancer research recounted in the third Sole 24 Ore videoforum dedicated to breast cancer prevention month, with a number of guests: Mauro Biffoni, director of the Department of Oncology and Molecular Medicine of the Iss, Lucia Del Mastro, vice-president of the Alliance against Cancer, Filippo De Braud, professor of Oncology at the University of Milan and director of the Oncology Department Irccs Istituto tumori di Milano, and Anna Chiara De Luca, research director of the Institute of Endocrinology and Experimental Oncology 'Gaetano Salvatore' of the CNR.

Some figures: In 2023, an estimated 55,900 new breast cancer diagnoses in women are expected. Net survival at 5 years after diagnosis is 88%. The probability of living an additional 4 years after diagnosis is 91%. There are 834,200 women living in Italy after a breast cancer diagnosis.

"In breast cancer, we have been studying the mechanisms involved in the growth and proliferation of tumour cells, trying to identify targets for therapeutic approaches and immunotherapy. We evaluated the possibility of using active immunisations of patients against tumour-specific antigens. And we have contributed to international studies evaluating the outcomes of therapies for the largest and most common cancers,' Mauro Biffoni points out.

As for the practical effects of public research, Lucia Del Mastrom emphasises that 'academic research plays a fundamental role because it deals with issues that very often industrial research, the research carried out in pharmaceutical companies, does not deal with. I am part of the Gim group (Gruppo italiano mammella), which is a group of Italian centres that are also part of the Alliance Against Cancer and with the collaboration of various cancer centres. We have developed a strategy to preserve the ovarian function of young women who get breast cancer and are candidates for chemotherapy. Women who face a high risk of early menopause. We have shown that through the use of this drug, it is possible to significantly reduce the incidence of premature menopause, and thanks to our study, this strategy is now being offered to all women worldwide who are scheduled for chemotherapy and who want to preserve ovarian function. And thanks to this study, Aifa has made this drug available free of charge to all young women who want to preserve ovarian function'. Every year about 3,500 women under 40 years of age get breast cancer and may wish to become pregnant at the end of treatment.

There are diets that represent lifestyles and thus serve to reduce the risks of developing diseases, and then there are diet-related approaches that can be used like drugs. 'On calorie restriction,' emphasises Filippo De Braud, 'we have conducted very original research. In a study published in 2022, we established that by restricting calories for five days we completely change the immune system's asset towards the disease. Very often in the presence of cancer there is a stimulation of cells that suppress immunity: with the strict five-day calorie restriction, based exclusively on natural and vegetable products, which is done in conjunction with medical treatment, we have seen that it completely changes the immune system's profile. The Breakfast study combines this calorie restriction with chemotherapy in the pre-operative setting in triple-negative patients. And so the goal is to arrive at surgery with a high percentage of patients who no longer have detectable disease at surgery, which is a favourable prognostic factor for this type of disease. Calorie restriction as we use it, we consider it a drug because it enhances the effect of standard medical treatment by boosting the immune response to the tumour'.