Artificial intelligence software that acts as a triage for breast cancer patients

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Software that can determine which breast cancer patients are most in urgent need of surgery or chemotherapy has been developed by British scientists.

The artificial intelligence algorithm uses data from different studies to identify patients who can go on hormone therapy rather than need urgent surgery.

Scientists created this technology to ensure that women receive the best treatment available during the COVID-19 pandemic, which saw surgeries cancelled.

It uses data from several international trials to select those whose tumors are less likely to respond to hormonal drugs and found that 5 percent were most at risk.

Software that can determine which breast cancer patients are most in urgent need of surgery or chemotherapy has been developed by British scientists. Stock image

AI looks at postmenopausal patients with estrogen-fuelled breast cancer – which applies to 70 per cent of breast cancer cases in the UK, say the authors.

Baroness Delyth Morgan, Executive Director of Breast Cancer Now, which helped fund the research, said it was a new and fantastic approach.

She said it “could help guide the best possible treatment for thousands of NHS breast cancer patients during the pandemic” and help best practices globally.

“These historical guidelines could now help identify women who need to be prioritized for surgery or chemotherapy urgently, and those who might be safe given hormone therapy to delay further treatment during the pandemic,” Morgan said.

“This is a true testament not only to British science, but also to the rapid collaboration of researchers around the world to help ensure that breast cancer patients can get the best possible care while minimizing the risks to them right now.”

Breast cancer is the most common cancer in the UK, with about 55,000 women and 370 men diagnosed each year, and about 11,500 women dying.

Professor Mitch Dowsett, director of the Ralph Lauren Centre for Breast Cancer Research, said 85 percent of patients whose surgery is postponed would be safe to remain on hormone therapy for up to six months.

This leaves 15 percent who would need to be given surgery or chemotherapy because of the risk of spreading the disease.

“By accessing the unpublished results of clinical trials involving thousands of patients, with colleagues at home and abroad, we have developed a new way of leading patient treatment in this global crisis,” Dowsett said.

“Using data on the estrogen receptor, progesterone receptors and tumor proliferation of newly diagnosed patients, our new single calculator can be used by other clinicians around the world to immediately identify the best treatment for about 80 percent of their patients.”

The software was built at the renowned Royal Marsden Hospital in Sutton and the Breast Cancer Now Research Centre at the Institute of Cancer Research in London.

It organizes patients with HER2 positive primary breast cancer, HER2, into three groups based on their estrogen and progesterone levels at diagnosis.

About 60 percent of people classified by AI have small amounts at diagnosis and can therefore receive hormone therapy for up to six months – and do not need surgery now.

About five percent with large amounts should not be given hormone therapy – but should instead be offered urgent surgery or chemotherapy.

For the remaining 35 per cent, it is recommended that they start hormone therapy.

They should also be measured for actively multiplying cancer cells – called Ki67.

This should be done after a few weeks of hormonal therapy to determine the best course of treatment.

If it is low, they should continue hormone therapy for at least six months.

Those with higher levels of estrogen and progesterone should be considered for surgery or chemotherapy, according to AI developers.

The team, which included scientists in Germany and the United States, say the pandemic has led to an international need to reassess the benefits and risks of cancer treatment.

Women who need surgery and chemotherapy the most should be given priority to protect staff and patients who may be more vulnerable to infection.

Scientists created this technology to ensure that women receive the best treatment available during the COVID-19 pandemic, which saw surgeries cancelled. Stock image

Scientists created this technology to ensure that women receive the best treatment available during the COVID-19 pandemic, which saw surgeries cancelled. Stock image

“Access to tests for Ki67 or imaging will now be needed to help determine whether some women should continue hormone therapy for longer, or should receive chemotherapy or surgery,” Morgan said.

“We hope that patients who need these services will be able to access them to ensure that they can receive the best treatment for them.

“With some cancer treatments delayed or modified due to the risks of coronavirus or NHS pressures, we must do everything we can to support patients, physicians and multidisciplinary teams to ensure the right choice for each person.”

Consultant breast surgeon at the Royal Marsden, Peter Barry said it was important that many urgent patients were treated as safely and quickly as possible.

“This innovative algorithm will help clinicians deliver the best treatment to their patients in these unprecedented times,” he said.

“I have already identified patients who would have been reported to receive neoET, who may well have been at risk of progression within six months.”

Grandmother Carole Smith, 68, of Surrey said she was expected to have surgery in April, but that was suspended because of the coronavirus.

“I was surprised when my surgeon at Royal Marsden called me and said I could do it a few weeks after my initial surgery date,” Smith said.

“When you’re told you have cancer in your body, you just want it out, so I was really relieved that they called me back. I am so grateful for the researchers who made this discovery that I could have made progress if it was left for a few months.

Breast cancer is one of the most common cancers in the world and affects more than two MILLION women a year

Breast cancer is one of the most common cancers in the world. Every year in the UK, there are more than 55,000 new cases, and 11,500 people are killed in the disease. In the United States, it affects 266,000 people each year and kills 40,000. But what is the cause and how can it be treated?

What is breast cancer?

Breast cancer develops from a cancer cell that develops in the lining of a duct or lobule in one of the breasts.

When breast cancer has spread to the surrounding breast tissue, it is called “invasive” breast cancer. Some people are diagnosed with “in situ carcinoma,” where no cancer cells have grown beyond the duct or lobule.

Most cases develop in women over the age of 50, but younger women are sometimes affected. Breast cancer can develop in men although this is rare.

The staging means the extent of cancer and the spread of cancer. Stage 1 is the stage and the earliest stage 4 means that the cancer has spread to another part of the body.

Cancer cells are classified as low, which means slow, high-growth, which is growing rapidly. High-quality cancers are more likely to return after being treated for the first time.

What causes breast cancer?

A cancerous tumour starts from an abnormal cell. The exact reason why a cell becomes cancer is not clear. Something is thought to damage or alter certain genes in the cell. This makes the cell abnormal and multiplies “out of control.”

Although breast cancer may develop for no apparent reason, there are certain risk factors that can increase the risk of developing breast cancer, such as genetics.

What are the symptoms of breast cancer?

The first usual symptom is a painless lump in the breast, although most breast lumps are not cancerous and are fluid-filled cysts, which are benign.

The first place where breast cancer usually spreads is the lymph nodes in the underpitly. If this happens, you will develop swelling or lump in an underpitle.

How is breast cancer diagnosed?

  • Initial assessment: A doctor examines the breasts and armpits. They can do tests such as a mammogram, a special x-ray of breast tissue that may indicate the possibility of tumors.
  • Biopsy: A biopsy is when a small sample of tissue is removed from a part of the body. The sample is then examined under a microscope to look for abnormal cells. The sample can confirm or exclude cancer.

If you are confirmed to have breast cancer, further tests may be needed to assess whether it has spread. For example, blood tests, liver ultrasound or chest x-rays.

How is breast cancer treated?

Treatment options that may be considered include surgery, chemotherapy, radiotherapy and hormone treatment. Often a combination of two or more of these treatments are used.

  • Surgery: Breast-conserving surgery or removal of the affected breast depending on the size of the tumor.
  • Radiation therapy: A treatment that uses high-energy radiation beams focused on cancerous tissues. This kills cancer cells, or prevents cancer cells from multiplying. It is mainly used in addition to surgery.
  • Chemotherapy: Cancer treatment with anti-cancer drugs that kill cancer cells or prevent them from multiplying
  • Hormone treatments: Some types of breast cancer are affected by the hormone “female” estrogen, which can stimulate cancer cells to divide and multiply. Treatments that reduce the level of these hormones, or prevent them from working, are commonly used in people with breast cancer.

How effective is the treatment?

The prospects are best in those diagnosed when the cancer is still small, and has not spread. Surgical removal of a tumour at an early stage can then give a good chance of recovery.

Routine mammography for women aged 50 to 70 means that more breast cancers are diagnosed and treated at an early stage.

For more information, visit breastcancercare.org.uk or www.cancerhelp.org.uk

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