Researchers unite to beat breast cancer

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Across UQ, nearly 100 researchers from a range of disciplines are banding together to prevent, better diagnose and treat breast cancer – an insidious disease that affects millions of lives around the world each year.


On a winter’s day in July 2017, Bogi Crilly-Toth, a UQ management accountant and vibrant 35-year-old mother of two children then aged under three, had a conversation about her breast that changed her life. 

“I’d found a lump in my left breast and my GP sent me for a mammogram, but I didn’t go for two months,” Bogi says.

“I was so busy with the kids and I was leaving a local job in Ipswich to start back at UQ. My focus was elsewhere."

Eventually Bogi had her mammogram and went back to her GP the next day, but only because her daughter was sick.

“I asked, off the cuff, if he’d had a chance to check my results," she recalls.

“He went pale, gave me a hug and said ‘I’m so sorry, it’s cancer’.”

Bogi discovered she not only had one but seven lumps in her breast. Because the cancer had spread, saving the breast wasn’t an option. 

“Within one week, I’d had a mastectomy, and was soon on chemotherapy known as the ‘red devil’,” she says.

Woman with short brown hair and colourful earrings

Cancer survivor Bogi Crilly-Toth. Image: Anjanette Webb

Cancer survivor Bogi Crilly-Toth. Image: Anjanette Webb

Sadly, Bogi’s story isn’t uncommon. Breast cancer is the most commonly diagnosed cancer among women globally, with an estimated 1700 women dying from the disease every day.

It’s so common that each person who reads this article has probably either had breast cancer or knows someone who has had it, and it’s a complex problem that will require diverse expertise and perspectives to solve.

But progress is underway, with nearly 100 researchers from a range of disciplines across UQ banding together to prevent, better diagnose and treat the disease.

Group shot of UQ breast cancer survivors and researchers

UQ breast cancer researchers and survivors. Back row: Dr Blerida Banushi, A/Prof Marina Reeves, A/Prof Marie-Odile Parat, Dr Amelia Peters, Prof Riccardo Dolcetti, PhD candidate Cristina Sánchez de la Rosa, Dr Peter Simpson, (seated) Dr Sheleigh Lawler, Dr Francisco Sadras, Dr Amy McCart-Reed, A/Prof Adrian Wiegmans, student Ekaterina Ivanova. Front row: (survivor) Josepha Dietrich, Dr Priyakshi Kalita de Croft, (survivor) Jocelyn Forsyth, Dr Jamie Kutasovic, (survivor) Bogi Crilly-Toth, Prof Gregory Monteith, Dr Roberta Mazzieri, Dr Jodi Saunus, Dr Sally Mortlock. Image: Anjanette Webb

UQ breast cancer researchers and survivors. Back row: Dr Blerida Banushi, A/Prof Marina Reeves, A/Prof Marie-Odile Parat, Dr Amelia Peters, Prof Riccardo Dolcetti, PhD candidate Cristina Sánchez de la Rosa, Dr Peter Simpson, (seated) Dr Sheleigh Lawler, Dr Francisco Sadras, Dr Amy McCart-Reed, A/Prof Adrian Wiegmans, student Ekaterina Ivanova. Front row: (survivor) Josepha Dietrich, Dr Priyakshi Kalita de Croft, (survivor) Jocelyn Forsyth, Dr Jamie Kutasovic, (survivor) Bogi Crilly-Toth, Prof Gregory Monteith, Dr Roberta Mazzieri, Dr Jodi Saunus, Dr Sally Mortlock. Image: Anjanette Webb

The Asia-Pacific Metaplastic Breast Cancer Consortium, formed by researchers at UQ's Centre for Clinical Research (UQCCR), is led by Professor Sunil Lakhani. Thanks to the work of his team and other researchers around the world, new pathology guidelines on how breast tumours are classified have been included in the World Health Organization’s iconic Blue Book, regarded as the gold standard for diagnosing tumours.

The new guidelines will help pathologists identify which patients have more aggressive forms of breast cancer, which could see them receive more targeted treatment.

Personalised models of care is a global movement in cancer science. Dr Amy McCart Reed, from Professor Lakhani’s molecular breast pathology team, is an expert in genetics who has helped develop a diagnostic test that in the future could determine if a patient with invasive lobular breast cancer – the second most common type of breast cancer – requires chemotherapy.

“If a woman who is newly diagnosed and making critical decisions about treatment has a ‘low-risk signature’ and would likely not benefit from chemotherapy, it means she can choose not to have it,” Dr McCart Reed explains.

“Skipping unnecessary chemotherapy would have a huge impact on a woman’s quality of life and recovery, while undergoing other treatments like surgery or hormone therapy.”

Dr Amy McCart Reed discusses how personalised medicine could help researchers beat breast cancer.

By the time Bogi's invasive lobular breast cancer was discovered, it had already spread to her lymph nodes. She had 15 rounds of chemotherapy, 25 doses of radiotherapy, and will take an oestrogen-restricting drug for 10 years. She also had a full hysterectomy and salpingo-oophorectomy (removal of the ovaries and fallopian tubes).

Her treatment team, including her surgeon, oncologist and plastic surgeon, were all UQ alumni. While she felt confident she was in good hands, she admits she felt “so isolated” during her chemotherapy treatment.

“The needle inserting into my portacath was painful and, on the ward, I was alone with a curtain pulled around me,” she says.

She also had to endure the side-effects, including hair loss, nausea, and tingling pain in her hands and feet (known as neuropathy).

While Dr McCart Reed’s test would not have changed Bogi’s treatment plan, it could mean other patients who fit the criteria could skip unnecessary rounds of the ‘red devil’ and other types of chemotherapy, in favour of other, more targeted treatments.

But what other treatments are available?

Image: Image Source/Getty Images

Image: Image Source/Getty Images

Precision medicine is a new model of cancer care that operates under the premise that once you know how something works, you can do something about it. This is where UQ’s Research Chair of Cancer Medicine Professor Riccardo Dolcetti has made gains.

Professor Dolcetti and his team were finalists in the ‘Oscars’ of Australian science, the Johnson & Johnson 2018 Eureka Prize, for their personalised cancer vaccine technology.

“Our breakthrough in developing a treatment that is tailored, precisely, to a woman’s cancer can lead to a better outcome for her,” Professor Dolcetti says.

“It can also reduce the harmful side-effects of current therapies, like hair loss and gut disturbances.”

Man in checked shirt

Professor Riccardo Dolcetti. Image: Anjanette Webb

Professor Riccardo Dolcetti. Image: Anjanette Webb

Professor Dolcetti is an expert in identifying tumour-specific antigens. Antigens are structures that can induce immune responses in the body, which means you can use them for immunotherapy – using the body’s immune system to fight cancer.

“By using tailored NanoEmulsions, tiny carrier packages that encapsulate proteins made only by cancer cells, the immune system can be educated about cancer proteins,” Professor Dolcetti explains.

“This approach represents a precision cancer treatment strategy that stimulates the immune system to attack cancer cells, without affecting other cells in the body.”

After her treatments and surgeries, Bogi was prescribed a range of exercises to improve her strength and overall health ahead of her eventual return to work at UQ.

However, she said months of treatment meant she didn’t have the energy to follow an exercise regime.

“I went straight from chemo to radiation and then reconstructive surgery, so I haven’t had a break in interventions,” she says.

“People keep telling me how much exercise helps, but I don’t feel strong enough and I haven’t had the motivation.

“I constantly feel like I’m pushing myself – all day, every day.”

Associate Professor Marina Reeves from UQ’s School of Public Health hopes to help women with early-stage and metastatic breast cancer deal with this feeling of exhaustion and improve their quality of life by developing exercise and dietary recommendations tailored specifically for them.

Her research informed the ‘Healthy Living after Cancer’ program, which has been delivered to almost 800 cancer survivors across Australia via the Cancer Council’s telephone cancer information and support service. She is now working with Breast Cancer Network Australia to translate her findings into other resources for patients and clinicians.

While data collection for her pilot study is still ongoing, qualitative data from women who have completed the intervention suggest they have found the program beneficial, with improvements to both physical and mental aspects of their quality of life.

On the back of these results, Dr Reeves is now working on developing the first international cohort study in Australia and the United States to understand how exercise, diet and other ‘modifiable’ factors are associated with quality of life and survival in women with metastatic breast cancer. This evidence is crucial for informing recommendations given to women.

For Dr Reeves, there is a very personal reason behind her research.

“I chose this area of research because of my mother’s experience,” she says.

“By the time her breast cancer was diagnosed, it was metastatic. She died four years later.

“I don’t want others to go through the terrible experience that she did."

Image: marvinh/Getty Images

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While breast cancer has a favourable prognosis, with a five-year survival rate higher than 90 per cent,  the management of metastatic, triple negative (no identifiable biomarkers like oestrogen, progesterone or the protein Her2) and aggressive tumours remain a challenge. 

One researcher tackling this is UQCCR’s Dr Peter Simpson, whose lab is sequencing familial breast cancers caused by genes like BRCA1 and BRCA2 to understand how these DNA repair genes cause the disease. This work is reliant on resources like the Brisbane Breast Bank, established by Professor Lakhani in 2005, to provide frozen tumour tissue. 

Identifying the defects in cancers gives insight into how the patient got the disease and whether they might benefit from certain therapies. A class of drugs called PARP inhibitors are being trialled in BRCA1 and BRCA2 patients, but could potentially be used to treat patients whose cancer is caused by other mutated genes. This opens up more ways for oncologists to treat aggressive breast cancer. 

Professor Sunil Lakhani's Breast Group is also looking at treatments for aggressive and metastatic cancer. In 2017, they were the only group outside North America that year to be awarded funding under the United States Department of Defense (DoD). 

The DoD’s Breast Cancer Breakthrough Scheme committed AU$1.3 million from its Breast Cancer Research Program to UQCCR’s study tackling the spread of tumours to the brain. The project (2017–2020) builds on previous findings from UQCCR Professor Lakhani and Dr Jodi Saunus and UQ School of Pharmacy Professors Gregory Monteith and Sarah Roberts-Thomson.

Professor Lakhani says as well as immunotherapy, the team is looking at another line of therapy altogether to target this aggressive disease. 

“An idea gaining support in the biomedical community is to simultaneously target tumour cells and the features of the normal tissues surrounding them – the ‘tumour microenvironment’,” Professor Lakhani explains.

Co-lead on the project, Professor Monteith, said the study has been designed to provide preclinical data needed for patient trials or drug development programs. Answers in tumour microenvironments could lead to greater chances of survival.

Image of three women

UQ breast cancer survivors (from left): Jocelyn Forsyth, Bogi Crilly-Toth and Josepha Dietrich. Image: Anjanette Webb

UQ breast cancer survivors (from left): Jocelyn Forsyth, Bogi Crilly-Toth and Josepha Dietrich. Image: Anjanette Webb

Looking to the future, Bogi is positive. She’s in remission with no signs of disease, and is hopeful that the chemical cocktail she endured, while traumatising, has stopped her cancer in its tracks. 

“I’m looking forward to putting this terrible part of my life behind me,” she says.

“I want my whole family to put this behind them too, so we can enjoy life to the max again.

“I want to be there for my kids. I want to have grandkids. I want to live.”

What can I do?


Join a Breast Cancer Trial and get the best scientists on your case and free drugs. Alumnus and UQ Associate Professor in Medicine Dr Nicole McCarthy is one of a group of world-leading breast cancer doctors and researchers based in Australia and New Zealand with a commitment to exploring and finding better treatments for people affected by breast cancer through clinical trials research.

Author Josepha Dietrich is an Impact Advocate – someone who advocates for breast cancer trials participation. Anyone who’s had breast cancer is eligible to apply for this program. Complete an application form.

Join a hot flush trial run by oncologists in Australia, New Zealand and the United States through QUE Oncology. QUE was formed in 2013 through a joint venture between Emory University in Atlanta and UQ research commercialisation company, UniQuest, backed by an A$21.5 million capital raise in 2017 led by Australia’s Medical Research Commercialisation Fund (MRCF) and Uniseed.

Donate to the Brisbane Breast Bank. If you are interested in donating tissue for research, please discuss this with your doctors. For more information on donation, speak with Kaltin Ferguson, Tissue Bank Manager; k.ferguson2@uq.edu.au; +61 7 3346 6020.

Help women in the future. Dr Amy McCart Reed runs BROCADEBReast Origin Cancer tissue donated After DEath. Once a woman dies from breast cancer, she can contribute to those currently living with the disease. Contact Dr McCart Reed for more information.

Words by Josepha Dietrich and Cristina Sanchez de la Rosa
Image: marvinh/Getty Images
Opening image:
Alejandro Muñoz/Getty Images

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