Improving outcomes of women diagnosed with and at increased risk of breast cancer: the results of translational research and national and international clinical trials

Breast cancer is the most common cause of cancer and cancer mortality in women worldwide.

Research conducted at The University of Manchester on the treatment and prevention of breast cancer has benefited over 1.5 million women globally who develop breast cancer each year.

Tony Howell, Professor of Breast Oncology, and Nigel Bundred, Professor of Surgical Oncology, developed new approaches to endocrine therapy (treatment that blocks the body's natural hormones) for breast cancer in postmenopausal women.

Their work has:

• increased the duration of survival of women with advanced breast cancer;
• reduced relapse rates and improved survival after surgery for early breast cancer;
• prevented disease in women at high risk.

The team had developed a therapy using tamoxifen, an anti-oestrogen drug taken in pill form, in the 1970s.

It blocked oestrogen receptors in tumours, which meant that the cancer grew more slowly or stopped growing altogether.

Clinical trials conducted as a result of research carried out at Manchester from the 1990s showed that fulvestrant, another anti-oestrogen drug delivered by injection, was effective in women with advanced breast cancer who had become resistant to tamoxifen.

Fulvestrant is now usually taken when other hormonal therapies are no longer controlling the cancer.

The team also showed in clinical trials, in collaboration with colleagues at AstraZeneca, that anastrozole, another hormone therapy, prevented relapse of breast cancer to a greater extent than tamoxifen.

Anastrozole has now become the first line treatment for both early and advanced breast cancer.

Its comparison with tamoxifen in 2005 caused considerable impact worldwide. It led to a steep increase in anastrozole use and AstraZeneca called it a cancer 'blockbuster'.

The drug has grossed over $1 billion per year and has replaced tamoxifen as the major endocrine therapy for breast cancer.

“The development and implementation of this new hormone therapy intervention has resulted in tens of thousands of women with early stage breast cancer remaining free of breast cancer recurrence.”

Tony Howell / Professor of Medical Oncology