In the first century A.D, Roman family Greek slaves were surgeons. Celsus wrote an encyclopedic describing their methods in latin, laying a foundation for scientific literature on medical practice and surgery. The idea of diagnosis became paramount at this time, requiring close study and record keeping of injury and disease symptoms. It was understood that some breast cancers could be extirpated with breast removal. In the 19th century, after anesthesia and antisepsis had been established, (thank heavens!) a Johns Hopkins Hospital surgeon named William Stewart Halsted introduced, perhaps, the greatest advance to breast cancer treatment. The radical mastectomy. Throughout beast cancer history, the best prognosis post treatment, seemed to be based on early stage diagnosis. (1.)
Today we have exceptional technological advancements for cancer research. The notion of a “close study” has informational depth almost incomprehensible to those outside this expertise. Whole genome sequencing has shown the highly diverse nature of breast cancer, evident in the heterogeneity of its mutations.
Researchers from Johns Hopkins University, (How appropriate!) Humangenetisches Institut; Universitätsklinik Erlangen , Ghent University , University of Regensburg and the Memorial Sloan Kettering Cancer Center , have just published their successful results in identifying diagnostic and prognostic biomarkers for breast cancer. The group set out to prove their functional hypermethome screening method works. AND they did – with notable biomarker results. A combination of the methylated genes NDRG2 and HOXD1 were 94% sensitive and 90% specific for breast cancer detection. Methylated CKM and TAC1 genes, in combination were associated with poorest prognostic outcomes, independent of stage or age. The authors suggest clinical studies of body fluids (blood or acites?) from a large number of patients to follow up on these findings.
We are beginning to wade into the age of “personalized medicine”. I often wonder, will it be a gradual entry? Or when we look back at this time, will Epigenetics have acted as a diving board, allowing us to leap right in?
ana Jeschke, Leander Van Neste, Sabine C. Glöckner, Mashaal Dhir, Marilia Freitas Calmon, Valérie Deregowski, Wim Van Criekinge, Ilse Vlassenbroeck, Alexander Koch, Timothy A. Chan, Leslie Cope, Craig M. Hooker, Kornel E. Schuebel, Edward Gabrielson, Andreas Winterpacht, Stephen B. Baylin, James G. Herman, & Nita Ahuja1 (2012). Biomarkers for detection and prognosis of breast cancer identified by a functional hypermethylome screen Epigenetics DOI: 10.4161/epi.20445