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JERUSALEM — Fact: Every year, breast cancer attacks one in every eight Israeli women.

Fact: In more than a third of them, the disease has spread beyond the breast by the time it is diagnosed.

Fact: Within two years of diagnosis, a quarter of its victims will be dead.

"Metastatic breast cancer remains an undefeated enemy, but it's coming under tightening siege," says Professor Tamar Peretz, who heads the Sharett Institute of Oncology at the Hadassah-Hebrew University Medical Center in Jerusalem, where a quarter of all Israel's cancer patients are treated.

"Years of basic and clinical research are finally bearing fruit. Where we're able to help, we help a lot. And where we can't cure, we can do much to extend a patient's life and improve its quality," Peretz says.

A woman's breast is more susceptible to cancer than any other organ in her body, but breast cancer's ravages are, it seems, far from indiscriminate. Breast cancer in Israel attacks, for example, 65 Jewish women compared with 17 non-Jewish women in every 1,000. Its incidence is significantly higher among Ashkenazi immigrants to the country than among newly arrived Sephardim.

Jewish newcomers from Russia have the highest rate of all, while the disease is virtually unknown in the Ethiopian Jewish community. But in Israeli-born Jewish women of all ethnic backgrounds, breast cancer levels approach those found among Ashkenazi newcomers.

All of which constitutes an unparalleled human laboratory, within which Israeli researchers are urgently working to learn more about the causes and prevention of this growing scourge.

The susceptibility of Ashkenazi women to breast cancer was confirmed some years back by discovery of a so-called "cancer gene" — genetic mutations known as BRCA1 and BRCA2, which bestow an unwelcome 90 percent lifetime risk of developing breast cancer. Professor Nadine Cohen-Elbaz of the Technion's Tamkin Molecular Human Genetics Research Facility estimates that 5 to 10 percent of women diagnosed with breast cancer each year have a family history of the disease, with around 45 percent of them carrying a BRCA mutation.

In a unique multidisciplinary study involving clinical geneticists, oncologists, psychologists, epidemiologists and a philosopher, she is screening families of different ethnic backgrounds to identify common gene mutations, and studying their medical histories, diet and lifestyle. The aim is to identify environmental and lifestyle factors that may contribute to development of the disease.

One of her early findings is that breast cancer is 50 percent less common among Arab women in Israel than among Jewish women. Professor Eliezer Robinson of the Technion's Faculty of Medicine has observed that while the disease is far rarer among Israeli Arab women, it tends to surface at younger ages, metastasize more vigorously and offer far shorter survival. To explain these differences, Robinson has been looking at nutrition, genetics, lifestyle and socio-economics, and one area of his research that seems, quite literally, to be bearing fruit is diet. Arab women generally eat far more fruit and vegetables.

"Evidence suggests that a population which eats a lot of cruciferous vegetables, such as cabbage, broccoli and radishes, has a lower incidence of breast cancer," says Professor Shmuel Yanai of the Technion's faculty of food engineering and biotechnology. With other researchers, he has isolated what he believes is a protective substance from these vegetables. Tests run on kibbutz volunteers have supported these early results.

Vegetables, specifically tomatoes, are the focus of Dr. Michael Koretz, director of the Elisheva Eshkol Breast Health Center at the Ben-Gurion University of the Negev. "Epidemiological data show lower incidence of breast cancer among women who eat a lot of tomatoes," he says. Together with endocrinologist Yossi Levy, he has isolated from tomatoes what may be a preventive substance called lycopene, and he is now studying its absorption into body tissues.

At the laboratory bench in Hadassah, researchers are trying to stimulate the body's own immune system into fighting the cancer — urging its cells to defend themselves in what they call immunotherapy. They are also examining the mechanism of tumor metastasis, and looking for ways to block that mechanism.

While the search for protection and prevention continues, early detection and speedy treatment still offer women the best chance of survival.

Despite this, however, fewer than half of Israeli women ages 50 and more go for mammograms. "It's women with a Western perception of health and a Western belief in the power and correctness of medical intervention who tend to seek mammography," says Professor Lea Baider, psycho-oncologist at the Hadassah Medical Center. "Among Arab, Bedouin and certain ultra-Orthodox Jewish communities, for example, pain and body changes are regarded as normal. Neither is a reason to run to a doctor."

In two of every three instances, they are right.

Only one in three breast lumps is, in fact, malignant, but it takes a biopsy to find out — though this may now be changing. Researchers at the Weizmann Institute of Science in Rehovot have pioneered a non-invasive way of identifying breast tumors, which they call 3TP. Developed by Professor Hadassa Degani of the biological regulation department, together with radiologists from Hadassah, their method consists of injecting a dye into the patient's blood stream and monitoring how it is taken up and cleared by tumor tissue, using magnetic resonance imaging or MRI.

As well as diagnosing breast tumors, the method may help establish the prognosis of the cancer and also monitor the effectiveness of therapy.

And what of the 36,000 women in Israel who, despite all efforts, are today fighting breast cancer? Despite those advances, Israel's kaleidoscope of women share the unhappy distinction of sharing one of the world's highest rates of breast cancer. Whether the ultimate answer lies with cellular warfare, eating more vegetables or with something not yet stumbled on, they may yet share the prize of comprising the human laboratory in which the disease finally meets its defeat.