Dr. Susan Love serves on the front lines in the battle to destroy breast cancer. Her Army of Women is an unprecedented initiative that partners scientists with a database of volunteers. More than 350,000 women participate in clinical trials to enable researchers to better understand the disease. Dr. Love talks about the biggest misconception surrounding breast cancer today, her efforts to find the cause of breast cancer and why social media has been revolutionary.
You’ve said in the past that this generation could eliminate breast cancer. How far have researchers come since last October? Are there any major or minor breakthroughs that the general public should know about?
None at all. (Laughs). Research doesn’t work in that kind of time frame, so it’s an unrealistic expectation, but there are two areas of research that are going on very vigorously right now, moving us closer to understanding the cause of breast cancer. If we’re going to eliminate breast cancer, we have to find the cause. When you think about, for example, cancer of the cervix, which we’re really on target to eliminate with the vaccine, it’s because we know it’s caused by an HPV virus.
The two areas that are important — it’s not just having a mutated cell that you need to get any kind of cancer, but it needs to be in a local environment that’s egging it on. So, the things that can cause mutated cells are viruses, radiation, inheriting mutated cells, other carcinogens in the environment and potentially bacteria, things like that. Now there is a big effort to map every mutated cell and every cancer, and the hope is that it will help us in that regard. We’re just about to launch a new study looking for bacteria and viruses in the breast because, believe it or not, nobody has ever done that before.
The other side of it is, what is the environment that eggs tumors on? What can do that? We have some clues. Hormone replacement therapy will do it, being obese will do it, chronic inflammation will do it. One of the newer sets of research that’s come out of the University of Colorado is that pregnancy and breastfeeding will do it. We’re all very used to the data showing that if you have an early first pregnancy, you have a lower risk of breast cancer, but what we hadn’t realized was that during pregnancy and for the next five to 10 years, you have a higher risk of breast cancer, and then the fact that you were pregnant makes the risk lower.
How does breastfeeding factor into that?
When you start to think about it, it makes sense. When you’re pregnant and when you’re breastfeeding, the breast is going from being at rest to changing into a milk factory. A lot of changes, a lot of growth factors, a lot of stimulation, a lot of hormonal changes are going on. So if you have a mutated cell sitting around and you have that active environment, then it’s more likely that it will get aggravated and become cancer. When you’re finished breastfeeding, then everything gets cleaned up, all the ducts get knocked off and you make new ones ready for the next kid, so again all kinds of growth factors, all kinds of inflammatory things, are going on. So that whole period of pregnancy and then breastfeeding and then tailing off as you stop breastfeeding is actually a period when you’re at higher risk for getting breast cancer.
Probably the reason more people don’t get breast cancer when they’re pregnant is because most of them are really young and they haven’t acquired the mutations yet. The longer you live, the more opportunity you have to acquire mutations in the DNA and the cells. If mostly young people are getting pregnant, they probably don’t have as many mutations, so most of them probably do fine; ones that don’t are more likely to have mutations that get activated.
Your Army of Women has created an invaluable database of healthy women and cancer patients for clinical trials. Having those volunteers has made an impact on research, but are there other obstacles that stand in the way of progress?
I think that what we’re finding, and what was a little bit of a surprise for me, is that in general the scientists don’t want to do things differently. The way that the research enterprise is set up really is not conducive to a lot of novel thinking. If you get your Ph.D. and you want to cure cancer … well, you soon realize you have to get tenure, and in order to get tenure at a university, you have to have grants and publications, and you have to do it within a certain amount of time, so you can’t take on too big of a project, like curing cancer, or they won’t fund you. You need to have a project that has a beginning and an end, and it can’t be too way out there, because no one will fund you. So it has to be slightly different than what your professor is doing, and you’ll get funded; and you do another one that’s slightly different from your professor, then you finally get funded, and by the time you do, you forgot you were going to cure cancer.
They’ve been doing things the same way, so changing the culture to have them think differently … It’s easier for us to convince women about the Army of Women, but to explain it to the scientists to think differently is harder.