Centre for Cancer Biomarkers CCBIO
New doctorate - cancer research

New biomarkers in breast cancer

Gøril Knutsvik defended Monday October 31st 2016 her thesis ”Biomarkers in breast cancer, with special focus on tumor cell proliferation” for the PhD degree at the University of Bergen.

Group photo of the candidate with opponents and supervisors.
Gøril Knutsvik with evaluation committee and supervisors. From the left: Professor Leiv M. Hove, supervisor Associate Professor Ingunn M. Stefansson, Gøril Knutsvik, Associate Professor Tibor Tot (Uppsala University Sweden), Professor Nils Erik Gilhus, Professor Anna Sapino (University of Turin, Italy) and main supervisor Professor Lars A. Akslen.
Geir Olav Løken

Main content

Better targeted treatment

Breast cancer is the most common cancer among women, and second to lung cancer, the leading cause of cancer related death. Primary treatment is surgery. Additional treatment in the form of chemotherapy is used in subgroups to avoid relapse. Chemotherapy can cause serious side effects, and more precise markers for selecting the right patient for the right treatment is important.

Cell proliferation in breast cancer

Knutsvik has in this PhD project investigated different biomarkers in breast cancer, particularly focusing on cell division (proliferation) in tumors. Studies have shown that the percentage of cancer cells that proliferate is of significance for the prognosis and that treatment with certain types of chemotherapy can increase survival in patients who have tumors with high cell division. Assessment of the cell proliferation marker Ki67 was from 2010 included in breast cancer treatment in Norway. Patients who have a tumor with high cell division (called Luminal B type of breast cancer), receive today additional treatment with chemotherapy. Internationally, however, there is no consensus on how cell division is to be determined or what limit should be set for Ki67 for the selection of patients for chemotherapy.

Avoiding unnecessary use of chemotherapy

An important finding in this study is that quantifying cell division in tumor varies depending on the type of tumor sample analyzed (cylinder biopsy, incision sample from surgery, tissue microarrays). Treatment limits based on tissue microarrays can lead to excessive use of chemotherapy. Furthermore, the study shows that a simpler method for counting cell divisions can be used to select patients who may need chemotherapy following surgery.

The study has led to increased knowledge of measuring cell division in breast cancer, and this may form the basis for improved diagnostics and treatment of this patient group.

Work done at CCBIO and the Department of Clinical Medicine

Gøril Knutsvik (1971) is born and raised at Sola (Stavanger) and received her medical degree at the University of Bergen in 2000. She now works as a senior consultant at the Department of Pathology, Haukeland University Hospital, Bergen. The doctoral work is funded through a grant from Helse Vest RHF. The work was performed at the Centre for Cancer Biomarkers CCBIO and the Department of Clinical Medicine, Gades Laboratory of Pathology, University of Bergen in the period from 2011 to 2016, under the supervision of CCBIO Director Professor Lars A. Akslen and Associate Professor Ingunn Stefansson.

Positive evaluation

The dissertation was very positively received by the opponents and the dialogue between the critical opponents and Gøril was good and at times humorous. 1st opponent was Professor Anna Sapino, University of Turin, Italy, 2nd opponent was Associate Professor Tibor Tot, Uppsala University, Sweden, 3rd member of the committee was Professor Leif M. Hove, University of Bergen and the defense was led by Professor Nils Erik Gilhus, head of the Department of Clinical Medicine.

We congratulate Gøril with her Ph.D.!