Malignant Breast Tissue Neoplasm Clinical Trial
Official title:
Is Dietary Nitrate Effective in Reducing Aerobic Glycolysis (AG) in Breast Cancer? - A Longitudinal Study Using Specialist Magnetic Resonance (MR) Methods
Breast cancer is the most prevalent cancer affecting women, with 1 in 8 women in the UK
developing breast cancer in their life time. Chemotherapy drugs, currently used for locally
advanced breast cancers, are associated with side effects while dietary supplements have
complex effects with a relatively small effect size.
Breast tumours have different metabolism compared to healthy tissue, including elevated
lactate production by aerobic glycolysis (AG), an underpinning feature of metabolism in
breast cancer cells. Dietary nitrate, contained in leafy green vegetables and beetroot, has
been shown to improve energy efficiency in exercising skeletal muscle, positioning itself as
a disruptor of AG.
The purpose of this study is to examine if dietary nitrate can disrupt AG and as a result to
halt or even reverse tumour progression and survival. This study will look at scans of breast
tumours using magnetic resonance imaging (MRI). Changes to tumour related biochemical
substances will be measured by advanced magnetic resonance spectroscopy and changes to tissue
structure will be measured by advanced diffusion MRI techniques.
In this study, 16 patients undergoing surgery will be recruited for two MRI scans following a
5 day intervention programme.
In this longitudinal study, the investigators propose to examine the changes in lipid
composition and microstructure in breast tumours at baseline and post dietary nitrate
intervention through the applications of novel non-invasive magnetic resonance spectroscopy
(MRS) methods and diffusion and lipid profiling MR imaging methods in patients. The
investigators hypothesise that dietary nitrate disrupts tumour progression in breast cancer.
1. Is there a significant difference in lipid composition in the tumour measured by MRS
between baseline and post dietary nitrate intervention?
2. Is there a significant difference in lipid composition in the whole breast tissue
surrounding tumour measured by MRI between baseline and post dietary nitrate
intervention?
3. Is there a significant difference in tissue microstructure measured by MRI between
baseline and post dietary nitrate intervention in the breast tissue?
To assess the effect of dietary nitrate on tumour progression, paired t-tests will be
performed on lipid composition measured from tumour between baseline and post intervention.
To assess the effect of dietary nitrate on tumour progression, paired t-tests will be
performed on lipid composition in the whole breast tissue surrounding tumour between baseline
and post intervention. To assess the effect of dietary nitrate on tissue microstructure
paired t-tests will be performed on water displacement measured from tumour between baseline
and post intervention.
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