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Medications taken by thousands of breast cancer patients create deadly "dormant cells" that can cause incurable tumors years later.
Researchers say that hormonal treatments kill most cancer cells but put some cells to sleep and help spread them.
These can wake up until 20 years later, causing treatment-resistant tumors elsewhere in the body.
Scientists from Imperial College London made this discovery by studying 50,000 human breast cancer cells in a lab. The results are published in Nature Communications.
They think they can use their results to develop treatments that allow the cells to stay asleep longer or wake them up to kill them.
Hormonal treatments are used to treat a type of breast cancer called a positive estrogen receptor.
They account for 70% of the 55,000 breast cancer cases in the UK each year and are powered by the hormone estrogen.
These cancers are usually treated surgically to remove the tumor, followed by aromatase inhibitors or tamoxifen.
Patients see their cancer return
About 30% of breast cancer patients who undergo hormonal treatment see their cancer recur, sometimes until 20 years later.
This recurrent cancer is usually metastatic, which means that it has spread throughout the body. And tumors are often resistant to drugs.
Dr. Luca Magnani said, "If we can reveal the secrets of these dormant cells, we may be able to find a way to prevent the return of cancer."
Dr. Rachel Shaw, Cancer Research UK, said, "This study highlights a key pathway that researchers can now explore to combat" dormant "cancer cells that can wake up years after treatment.
"It could potentially save the lives of many more women with the disease."
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