A SYDNEY woman with less than two months to live has been awarded more than $400,000 after a government-funded breast examination failed to detect a malignant tumour. Christine O'Gorman is not expected to live beyond the end of the year after cancer in her left breast spread to her lungs and brain.
The 57-year-old from Moorebank had her breast removed, has undergone multiple rounds of chemotherapy and radiation, and is now taking painkillers for her symptoms.
In the New South Wales Supreme Court today, Justin Clifton Hoeben awarded Ms O'Gorman $405,990 in damages and costs after she sued Sydney South West Area Health Service, which operates BreastScreen.
"(Ms O'Gorman) realises and is trying to come to terms with the fact that there is no hope of a cure and that she must live her life as best as she can between now and the end of December when medical opinion assesses that she will die," Justin Hoeben said in his judgment.
"Her final weeks will involve considerable pain and suffering."
Ms O'Gorman had undergone routine mammograms every two years from 1994 at BreastScreen – a free service funded by the Commonwealth and NSW Governments.
Daily Telegraph, 30 Oct 2008 Her 2002 and 2004 results detected a mass in her left breast, which reviewing doctors deemed had no suspicious features and had not increased in size between screenings.
She went for another screening in February 2006 and was not informed of any significant changes.
"I cannot, however, ignore my observation that on a simple visual comparison, the mass on the 2006 films appeared significantly larger than that of the 2004 films," Justice Hoeben said.
In early January 2007, Ms O'Gorman was on holiday when she scratched her left breast and notice a lump.
She was treated with chemotherapy to shrink the tumour before it was removed and continued the cancer treatment until the end of July.
In August, she underwent further tests that revealed she had cancer in her lungs, and a week later she had a mastectomy.
In June of this year, tumours were detected in her brain, prompting further chemotherapy.
"The plaintiff has become depressed and describes herself as being sad all the time. She cries easily," Justice Hoeben said.
"Although she tries to put on a brave face for her partner (Glen) and (daughter) Christie, she is finding it harder to do."
Justice Hoeben ruled that BreastScreen was negligent by failing to compare Ms O'Gorman's 2004 and 2006 mammogram results and by not recalling her for further tests after her 2006 screening.
She was awarded $247,500 for general damages with the remainder of the award comprising out-of-pocket costs and the estimated loss of past and future earnings.
He also ordered the area health service to pay her legal costs .
Article Source
Wednesday, October 29, 2008
Thursday, October 23, 2008
Busting breast cancer myths
Tall tales about what causes breast cancer can do more harm than good, writes Bronwyn McNulty.
Underwire bras, antiperspirants, big boobs and breastfeeding cause breast cancer. True or false? False. But the existence of these urban myths about breast cancer at least means women are talking about the disease.
Associate professor John Boyages, director of the NSW Breast Cancer Institute and spokesman for the National Breast Cancer Foundation, says 13,000 women are diagnosed with the disease in Australia each year, which means there is a high level of awareness.
Professor Michael Henderson, from Melbourne's Peter MacCallum Cancer Centre, says: "Our mothers will tell you that in the 1940s, '50s and '60s, if a woman had breast cancer, the last thing she did was tell anyone."
The National Breast and Ovarian Cancer Centre says to be sceptical of information "not from recognised medical and scientific experts". Here we dispel some of the myths.
MYTH ONE
Having a family history of breast cancer means you will get the disease.
Most women who get breast cancer don't have a family history of the disease, Boyages says.
"Therefore, all women should think about their breast health," he says. "For women aged 50-69, that means going for regular mammograms. Call 132 050 for information about the free breast-screening program."
MYTH TWO
Breast cancer is a young woman's disease
With the public face of breast cancer featuring the young faces of Belinda Emmett, Jane McGrath, Kylie Minogue and Christina Applegate, you could be forgiven for thinking it's a young woman's disease. It's not.
"The data is quite strong," Henderson says. "In Australia we are not seeing an increase in young women [under 50] with breast cancer. The [most common] age is the late 50s and 60s."
MYTH THREE
Antiperspirants and underwire bras cause breast cancer
"These are urban myths that have been debunked many times," Henderson says. Boyages says:
"Breast cancer has been around since the ancient Egyptians and I don't think they had underwire bras."
MYTH FOUR
Freezing water in plastic, or microwave cooking with plastics releases cancer-causing toxins
One email doing the rounds warns of the dangers of the above and is attributed to the John Hopkins Sidney Kimmel Comprehensive Cancer Centre in Baltimore. John Hopkins has labelled the email a hoax.
"Freezing water does not cause the release of chemicals from plastic bottles," Boyages says. "And there are clear recommendations to only use microwave-safe containers. "
MYTH FIVE
Lumpy breasts increase your risk
Boyages says: "A lot of women get lumpier breasts before their period or may have cysts, which are common in the breast. Nine out of 10 lumps are not cancer. But if you have a lump that doesn't go away, have a triple test."
MYTH SIX
Small breasts reduce your risk
Breast size has nothing to do with the risk of breast cancer but Henderson says obese women, specifically women who are post-menopausal, have an increased risk.
MYTH SEVEN
Implants increase your risk of breast cancer
Silicon breast implants are not linked to breast cancer risk. The National Breast and Ovarian Cancer Centre reports that a large study on the long-term effects of implants followed women for more than 10 years and showed no increased risk.
Boyages says: "In some ways it's easier to find breast cancer, because the implant pushes the breast tissue forward."
MYTH EIGHT
Breast pain indicates breast cancer
Most breast cancers don't cause significant pain but a few do. "So you can't be complacent if a lump is painful," Boyages says. "In about 10 per cent of cases of breast cancer there is pain."
MYTH NINE
Nipple discharge indicates breast cancer
The majority of nipple discharge has nothing to do with cancer but Henderson says bloody discharges are a concern. "Even then, more often than not, it is not breast cancer," he says. Boyages says doctors will also be concerned by discharge that is coloured "like straw".
MYTH TEN
Mammograms cause breast cancer
Exposure to ionising radiation can cause cancer. However, given the limited number of mammograms a woman has in her lifetime and the standards of mammographic equipment in use in Australia, the increased radiation exposure from a mammogram is minimal, says the NBOCC.
"If you are 50 [and] having a mammogram every two years, the risk of radiation is far less than other risks we take every day," Boyages says.
However, having radiation for other cancers does increase your risk of breast cancer.
"If, for example, someone had Hodgkin's lymphoma as a teenager and had radiation treatment, they would be at much higher risk of breast cancer, so should start having mammograms 10 years after their initial treatment," Boyages says.
Readers can support breast cancer research by buying a pink ribbon on Pink Ribbon Day, which is October 27.
For more information:National Breast Cancer Foundation: nbcf.org.au; Breast Cancer Australia: breastcanceraustralia.org; National Breast and Ovarian Cancer Centre: nbocc.org.au; Breast Cancer Network Australia: bcna.org.au; Cancer Council Australia: cancer.org.au.
How to improve your breast health
See your doctor regularly
"If you have a lump, get it checked out with the triple test," Boyages says. "Make sure the GP follows the national guidelines for breast checks."
Be breast aware
Be aware of changes in your breasts and find out what your normal pattern is. "Perhaps your breasts are lumpy before you get your period," Boyages says. "If so, do the breast self-examination after your period."
Participate in national breast screening
This should be done once you turn 50, Henderson says, adding that "women aged 40-50, after discussion with their doctor, may consider screening at an earlier stage".
Maintain a healthy lifestyleIt's estimated that one-quarter of breast cancers are attributable to our lifestyle - particularly obesity, diet and lack of exercise - says Henderson.
Once you've had breast cancer, a moderate amount of exercise, getting weight down and reducing the fat in your diet may help to reduce the risk of breast cancer coming back," he says.
Drink in moderation
People who drink alcohol to excess may have a slightly higher risk of breast cancer. Moderation is the key.
Have good vitamin D levels
"There's some evidence that low vitamin D levels can increase the risk of breast cancer," Boyages says.
Article Source
Underwire bras, antiperspirants, big boobs and breastfeeding cause breast cancer. True or false? False. But the existence of these urban myths about breast cancer at least means women are talking about the disease.
Associate professor John Boyages, director of the NSW Breast Cancer Institute and spokesman for the National Breast Cancer Foundation, says 13,000 women are diagnosed with the disease in Australia each year, which means there is a high level of awareness.
Professor Michael Henderson, from Melbourne's Peter MacCallum Cancer Centre, says: "Our mothers will tell you that in the 1940s, '50s and '60s, if a woman had breast cancer, the last thing she did was tell anyone."
The National Breast and Ovarian Cancer Centre says to be sceptical of information "not from recognised medical and scientific experts". Here we dispel some of the myths.
MYTH ONE
Having a family history of breast cancer means you will get the disease.
Most women who get breast cancer don't have a family history of the disease, Boyages says.
"Therefore, all women should think about their breast health," he says. "For women aged 50-69, that means going for regular mammograms. Call 132 050 for information about the free breast-screening program."
MYTH TWO
Breast cancer is a young woman's disease
With the public face of breast cancer featuring the young faces of Belinda Emmett, Jane McGrath, Kylie Minogue and Christina Applegate, you could be forgiven for thinking it's a young woman's disease. It's not.
"The data is quite strong," Henderson says. "In Australia we are not seeing an increase in young women [under 50] with breast cancer. The [most common] age is the late 50s and 60s."
MYTH THREE
Antiperspirants and underwire bras cause breast cancer
"These are urban myths that have been debunked many times," Henderson says. Boyages says:
"Breast cancer has been around since the ancient Egyptians and I don't think they had underwire bras."
MYTH FOUR
Freezing water in plastic, or microwave cooking with plastics releases cancer-causing toxins
One email doing the rounds warns of the dangers of the above and is attributed to the John Hopkins Sidney Kimmel Comprehensive Cancer Centre in Baltimore. John Hopkins has labelled the email a hoax.
"Freezing water does not cause the release of chemicals from plastic bottles," Boyages says. "And there are clear recommendations to only use microwave-safe containers. "
MYTH FIVE
Lumpy breasts increase your risk
Boyages says: "A lot of women get lumpier breasts before their period or may have cysts, which are common in the breast. Nine out of 10 lumps are not cancer. But if you have a lump that doesn't go away, have a triple test."
MYTH SIX
Small breasts reduce your risk
Breast size has nothing to do with the risk of breast cancer but Henderson says obese women, specifically women who are post-menopausal, have an increased risk.
MYTH SEVEN
Implants increase your risk of breast cancer
Silicon breast implants are not linked to breast cancer risk. The National Breast and Ovarian Cancer Centre reports that a large study on the long-term effects of implants followed women for more than 10 years and showed no increased risk.
Boyages says: "In some ways it's easier to find breast cancer, because the implant pushes the breast tissue forward."
MYTH EIGHT
Breast pain indicates breast cancer
Most breast cancers don't cause significant pain but a few do. "So you can't be complacent if a lump is painful," Boyages says. "In about 10 per cent of cases of breast cancer there is pain."
MYTH NINE
Nipple discharge indicates breast cancer
The majority of nipple discharge has nothing to do with cancer but Henderson says bloody discharges are a concern. "Even then, more often than not, it is not breast cancer," he says. Boyages says doctors will also be concerned by discharge that is coloured "like straw".
MYTH TEN
Mammograms cause breast cancer
Exposure to ionising radiation can cause cancer. However, given the limited number of mammograms a woman has in her lifetime and the standards of mammographic equipment in use in Australia, the increased radiation exposure from a mammogram is minimal, says the NBOCC.
"If you are 50 [and] having a mammogram every two years, the risk of radiation is far less than other risks we take every day," Boyages says.
However, having radiation for other cancers does increase your risk of breast cancer.
"If, for example, someone had Hodgkin's lymphoma as a teenager and had radiation treatment, they would be at much higher risk of breast cancer, so should start having mammograms 10 years after their initial treatment," Boyages says.
Readers can support breast cancer research by buying a pink ribbon on Pink Ribbon Day, which is October 27.
For more information:National Breast Cancer Foundation: nbcf.org.au; Breast Cancer Australia: breastcanceraustralia.org; National Breast and Ovarian Cancer Centre: nbocc.org.au; Breast Cancer Network Australia: bcna.org.au; Cancer Council Australia: cancer.org.au.
How to improve your breast health
See your doctor regularly
"If you have a lump, get it checked out with the triple test," Boyages says. "Make sure the GP follows the national guidelines for breast checks."
Be breast aware
Be aware of changes in your breasts and find out what your normal pattern is. "Perhaps your breasts are lumpy before you get your period," Boyages says. "If so, do the breast self-examination after your period."
Participate in national breast screening
This should be done once you turn 50, Henderson says, adding that "women aged 40-50, after discussion with their doctor, may consider screening at an earlier stage".
Maintain a healthy lifestyleIt's estimated that one-quarter of breast cancers are attributable to our lifestyle - particularly obesity, diet and lack of exercise - says Henderson.
Once you've had breast cancer, a moderate amount of exercise, getting weight down and reducing the fat in your diet may help to reduce the risk of breast cancer coming back," he says.
Drink in moderation
People who drink alcohol to excess may have a slightly higher risk of breast cancer. Moderation is the key.
Have good vitamin D levels
"There's some evidence that low vitamin D levels can increase the risk of breast cancer," Boyages says.
Article Source
Wednesday, October 15, 2008
Sorting through the studies: breast cancer and diet
Breast cancer is the most common cancer diagnosed among Canadian women, accounting for about 30 per cent of all new cancer cases each year. One in 25 Canadian women will die from this disease and researchers are still not certain of the direct cause.
However, for the one in nine Canadian women who will develop breast cancer in their lifetime, nutrition research continues to find answers in the area of prevention and protection and also in tumor reduction.
Dr. Elaine Hardman, a researcher at Marshall's Joan Edward School of Medicine, says "we are beginning to understand that diet probably contributes to one-third to two thirds of all cancer that develops."
Breast tumour reduction
Medicine is increasingly looking at dietary changes as a way to reduce cancer tumours. In a current issue of Nutrition and Cancer, for example, it's reported that walnut consumption suppressed tumour growth in animals compared to those following a typical American diet.
Researchers found that a diet rich in omega-3 fatty acids had an effect on cancer growth, as tumours took twice as long to double in size as tumours in the control group.
When animals were fed a diet in which 18.5 per cent of the daily calories came from walnuts, the equivalent of two servings for humans, the growth rate of the tumours was dramatically reduced.
Researchers concluded that walnuts have at least three components that could account for their cancer-slowing effect: they are high in omega-3 fatty acids, but also include antioxidants and components called phytosterols.
From this research, Hardman suggests that, on the whole, individuals need to take in more of their fat calories from fats rich in omega-3 fatty acids and fewer fat calories from saturated fat or foods high in omega-6 fatty acids (corn and safflower oils).
Increasing your intake of omega-3 fatty-acid rich food such as walnuts, fish, canola and flaxseed oils, and/or omega-3 functional food is a good thing to do for breast cancer protection.
Breast cancer protection
Recently, in the American Journal of Epidemiology, it was shown that increased intake of vitamin D from the diet and from sunlight may reduce the risk of breast cancer by more than 20 percent.
Canadian researchers analyzed the vitamin-D intakes of 759 women with breast cancer and compared this to the vitamin-D intakes of 1,136 healthy controls.
Increased intakes of the sunshine vitamin were associated with a 24 per cent reduction in the risk of developing estrogen receptor and progesterone receptor positive tumours.
Moreover, increased intakes of vitamin D were also associated with 26 and 21 per cent reductions in the risk of receptor negative and mixed receptor tumours.
In addition, an evaluation of the data from the Women's Health Study examined calcium and vitamin D intake in relation to incidence of breast cancer in 10,578 pre-menopausal and 20,909 post-menopausal women.
Over an average of 10 years of follow-up, higher intakes of vitamin D and calcium were associated with a lower risk for pre-menopausal breast cancer.
Increasing your intake of vitamin D rich foods such as salmon, tuna, sardines, milk, margarine and vitamin D functional foods and/or taking a multivitamin with vitamin D is a good thing to do for breast cancer prevention.
Some types of breast cancer may also be related to the interaction between low folate intake and alcohol consumption.
An analysis of the Nurses Health Study reported the risk of breast cancer among post-menopausal females with low dietary folate intakes increased with any level of alcohol consumed.
In the American Cancer Society Cancer Prevention Study, the risk of breast cancer was 25 per cent higher with alcohol consumption.
Epidemiologic studies support a positive association between a high intake of dietary folate and reduced breast cancer risk.
Increasing your intake of folic-rich foods such as green, leafy vegetables, asparagus, fortified breakfast cereals and orange juice is a good thing to do for breast cancer prevention.
In some epidemiological studies, the dietary soy intake of 5 grams of soy protein per day is associated with a modest protective effect in reducing the risk of developing breast cancer in both Western and Asian women.
Menopausal status and body mass index may alter the effects of soy on breast cancer risk, but it is difficult to conclude from the existing research. At this time, there is a lack of human intervention studies that directly examine the effects of soy on breast cancer risk.
Bottom Line
- Consume omega-3 fatty acid rich foods daily.
- Eat at least 7 to 8 servings of vegetables and fruits each day. Include at least one dark green vegetable daily.
- Take a multivitamin with vitamin D each day.
- Maintain a healthy weight and do physical activity daily. Enjoy 30 to 60 minutes of moderate activity each and every day.
--- Samara Felesky-Hunt
Samara Felesky-Hunt is a registered dietitian at The Downtown Sports Clinics in Calgary. Her column appears weekly in the Herald. She can be reached at dietitian-online.com
Article Source
However, for the one in nine Canadian women who will develop breast cancer in their lifetime, nutrition research continues to find answers in the area of prevention and protection and also in tumor reduction.
Dr. Elaine Hardman, a researcher at Marshall's Joan Edward School of Medicine, says "we are beginning to understand that diet probably contributes to one-third to two thirds of all cancer that develops."
Breast tumour reduction
Medicine is increasingly looking at dietary changes as a way to reduce cancer tumours. In a current issue of Nutrition and Cancer, for example, it's reported that walnut consumption suppressed tumour growth in animals compared to those following a typical American diet.
Researchers found that a diet rich in omega-3 fatty acids had an effect on cancer growth, as tumours took twice as long to double in size as tumours in the control group.
When animals were fed a diet in which 18.5 per cent of the daily calories came from walnuts, the equivalent of two servings for humans, the growth rate of the tumours was dramatically reduced.
Researchers concluded that walnuts have at least three components that could account for their cancer-slowing effect: they are high in omega-3 fatty acids, but also include antioxidants and components called phytosterols.
From this research, Hardman suggests that, on the whole, individuals need to take in more of their fat calories from fats rich in omega-3 fatty acids and fewer fat calories from saturated fat or foods high in omega-6 fatty acids (corn and safflower oils).
Increasing your intake of omega-3 fatty-acid rich food such as walnuts, fish, canola and flaxseed oils, and/or omega-3 functional food is a good thing to do for breast cancer protection.
Breast cancer protection
Recently, in the American Journal of Epidemiology, it was shown that increased intake of vitamin D from the diet and from sunlight may reduce the risk of breast cancer by more than 20 percent.
Canadian researchers analyzed the vitamin-D intakes of 759 women with breast cancer and compared this to the vitamin-D intakes of 1,136 healthy controls.
Increased intakes of the sunshine vitamin were associated with a 24 per cent reduction in the risk of developing estrogen receptor and progesterone receptor positive tumours.
Moreover, increased intakes of vitamin D were also associated with 26 and 21 per cent reductions in the risk of receptor negative and mixed receptor tumours.
In addition, an evaluation of the data from the Women's Health Study examined calcium and vitamin D intake in relation to incidence of breast cancer in 10,578 pre-menopausal and 20,909 post-menopausal women.
Over an average of 10 years of follow-up, higher intakes of vitamin D and calcium were associated with a lower risk for pre-menopausal breast cancer.
Increasing your intake of vitamin D rich foods such as salmon, tuna, sardines, milk, margarine and vitamin D functional foods and/or taking a multivitamin with vitamin D is a good thing to do for breast cancer prevention.
Some types of breast cancer may also be related to the interaction between low folate intake and alcohol consumption.
An analysis of the Nurses Health Study reported the risk of breast cancer among post-menopausal females with low dietary folate intakes increased with any level of alcohol consumed.
In the American Cancer Society Cancer Prevention Study, the risk of breast cancer was 25 per cent higher with alcohol consumption.
Epidemiologic studies support a positive association between a high intake of dietary folate and reduced breast cancer risk.
Increasing your intake of folic-rich foods such as green, leafy vegetables, asparagus, fortified breakfast cereals and orange juice is a good thing to do for breast cancer prevention.
In some epidemiological studies, the dietary soy intake of 5 grams of soy protein per day is associated with a modest protective effect in reducing the risk of developing breast cancer in both Western and Asian women.
Menopausal status and body mass index may alter the effects of soy on breast cancer risk, but it is difficult to conclude from the existing research. At this time, there is a lack of human intervention studies that directly examine the effects of soy on breast cancer risk.
Bottom Line
- Consume omega-3 fatty acid rich foods daily.
- Eat at least 7 to 8 servings of vegetables and fruits each day. Include at least one dark green vegetable daily.
- Take a multivitamin with vitamin D each day.
- Maintain a healthy weight and do physical activity daily. Enjoy 30 to 60 minutes of moderate activity each and every day.
--- Samara Felesky-Hunt
Samara Felesky-Hunt is a registered dietitian at The Downtown Sports Clinics in Calgary. Her column appears weekly in the Herald. She can be reached at dietitian-online.com
Article Source
Thursday, October 9, 2008
Painkillers may reduce breast cancer risk: study
Painkillers such as Aspirin and ibuprofen may help reduce the risk of some breast cancers, but it's too soon to suggest taking the pills as a prevention strategy, according to a Canadian researcher who led the study.
Dr. Mahyar Etminan, a professor of medicine at the University of British Columbia and his colleagues at UBC and the University of Santiago de Compostela in Spain, analyzed data from 38 observational studies involving more than 2.7 million women to see whether anti-inflammatory drugs reduced the risk of breast cancer.
It's thought that inflammation may be a risk factor in cancer, Etminan said. Previous studies have shown conflicting results on the value of non-steroidal anti-inflammatory drugs (NSAIDS) in reducing the risk of developing breast cancer, but by combining the results, reviewers aim to spot trends that individual studies may miss.
In Tuesday's online issue of the Journal of the National Cancer Institute, Etminan's team concluded that women who took any kind of NSAIDS regularly had a 12 per cent relative reduction in risk of developing breast cancer compared with those who didn't take the drugs.
In a separate analysis, those who took ibuprofen had a 21 per cent relative risk reduction, while those who took ASA showed a 12 per cent relative reduction, the researchers found.
Why does reducing inflammation help?
"The results are encouraging and may help us better understand the importance of role of inflammation in the pathology of the disease," Etminan said. "However, we don't recommend the routine use of NSAIDs for breast cancer prevention until large randomized trials confirm these findings. Results from an ongoing trial will be available in 2009."
Regular use of painkillers may cause serious side-effects such as ulcers and increased risk of stroke, so the potential benefits in terms of cancer risks would have to be weighed against the risk after the randomized trial is completed.
NSAIDS work by blocking two proteins that promote inflammation in the body. The proteins are also thought to drive the growth of tumours in three ways: disrupting how cells die, promoting blood vessels that fuel tumours, and affecting how the immune system responds when it detects cancer.
"This meta-analysis provides evidence that NSAID use is associated with reduced risk for breast cancer," the study's authors concluded. "Future research should include careful evaluation of the biologic mechanisms involved in the relationship between NSAIDs and breast cancer."
The review is limited in that participants are asked to remember what medications they took, and it's possible the researchers did not adjust for all factors linked with the reduced risk, such as healthier behaviour among those who took the pills.
In a journal editorial accompanying the study, Dr. Scott Lippman of the University of Texas M.D. Anderson Cancer Center in Houston pointed out that a woman's response to each NSAID may depend on her menopausal status and how hormone receptors are expressed in breast cells — factors that may also explain why observational studies have turned up conflicting results.
There are also other ways for women to reduce their risk of breast cancer by reducing inflammation, said Dr. Hal Gunn, head of Inspire Health, a government-funded holistic cancer care centre in Vancouver.
"We don't need to take antinflammatories to reduce inflammation in our body," Gunn said in an interview. "There are many natural ways that we can do that."
These include eating more fruits and vegetables, taking omega-3 fatty acids and vitamin D, eating the spice turmeric, drinking green tea, and avoiding stress, cigarettes and trans fat, Gunn said.
CBCnews Article Source
Dr. Mahyar Etminan, a professor of medicine at the University of British Columbia and his colleagues at UBC and the University of Santiago de Compostela in Spain, analyzed data from 38 observational studies involving more than 2.7 million women to see whether anti-inflammatory drugs reduced the risk of breast cancer.
It's thought that inflammation may be a risk factor in cancer, Etminan said. Previous studies have shown conflicting results on the value of non-steroidal anti-inflammatory drugs (NSAIDS) in reducing the risk of developing breast cancer, but by combining the results, reviewers aim to spot trends that individual studies may miss.
In Tuesday's online issue of the Journal of the National Cancer Institute, Etminan's team concluded that women who took any kind of NSAIDS regularly had a 12 per cent relative reduction in risk of developing breast cancer compared with those who didn't take the drugs.
In a separate analysis, those who took ibuprofen had a 21 per cent relative risk reduction, while those who took ASA showed a 12 per cent relative reduction, the researchers found.
Why does reducing inflammation help?
"The results are encouraging and may help us better understand the importance of role of inflammation in the pathology of the disease," Etminan said. "However, we don't recommend the routine use of NSAIDs for breast cancer prevention until large randomized trials confirm these findings. Results from an ongoing trial will be available in 2009."
Regular use of painkillers may cause serious side-effects such as ulcers and increased risk of stroke, so the potential benefits in terms of cancer risks would have to be weighed against the risk after the randomized trial is completed.
NSAIDS work by blocking two proteins that promote inflammation in the body. The proteins are also thought to drive the growth of tumours in three ways: disrupting how cells die, promoting blood vessels that fuel tumours, and affecting how the immune system responds when it detects cancer.
"This meta-analysis provides evidence that NSAID use is associated with reduced risk for breast cancer," the study's authors concluded. "Future research should include careful evaluation of the biologic mechanisms involved in the relationship between NSAIDs and breast cancer."
The review is limited in that participants are asked to remember what medications they took, and it's possible the researchers did not adjust for all factors linked with the reduced risk, such as healthier behaviour among those who took the pills.
In a journal editorial accompanying the study, Dr. Scott Lippman of the University of Texas M.D. Anderson Cancer Center in Houston pointed out that a woman's response to each NSAID may depend on her menopausal status and how hormone receptors are expressed in breast cells — factors that may also explain why observational studies have turned up conflicting results.
There are also other ways for women to reduce their risk of breast cancer by reducing inflammation, said Dr. Hal Gunn, head of Inspire Health, a government-funded holistic cancer care centre in Vancouver.
"We don't need to take antinflammatories to reduce inflammation in our body," Gunn said in an interview. "There are many natural ways that we can do that."
These include eating more fruits and vegetables, taking omega-3 fatty acids and vitamin D, eating the spice turmeric, drinking green tea, and avoiding stress, cigarettes and trans fat, Gunn said.
CBCnews Article Source
Monday, October 6, 2008
Breast cancer vaccine is possible, says expert
A vaccine to prevent breast cancer is a realistic prospect, but more research is vital if it is to be achieved, according to a leading expert.
By Aislinn Simpson Last Updated: 7:54AM BST 06 Oct 2008
Professor Valerie Beral of Oxford University, who leads the Million Women's Study into the causes of the disease, said her research had already proven beyond doubt that childbirth and the act of breastfeeding prevents breast cancer.
She wants scientists to look more closely at how they could mimic the hormones associated with childbirth and rearing in a bid to stamp out the disease, instead of trying to cure it once it has developed, as is mostly the case at present.
She pointed out that while death rates have been dramatically reduced by new drugs and earlier diagnosis, the number of women developing breast cancer and having to go through traumatic surgery and chemotherapy was rising.
She said it was impossible to return to an era where all women had babies and breastfed for longer periods of time, but added: "Why aren't we thinking of mimicking the effects of childbirth?
"We don't know how this happens and nobody is doing research on it. We should be looking at hormone production during late pregnancy and lactation."
Prof Beral's Cancer Research UK-funded work as the director of the cancer epidemiology unit of Oxford University sees her use large ammounts of statistical data to establish trends in why women develop the disease.
Speaking at the National Cancer Research Institute's annual conference, she queried why the avenue of breast cancer prevention which might lead to a drug or vaccine was not being pursued.
She pointed to the example of cervical cancer, where most cases were found to be caused by the humanpapilloma virus, and the development of a vaccine which is now being given to schoolgirls aged 12 and 13.
But "fewer than a dozen people" are looking in this direction with regard to breast cancer, she said, despite the likelihood that anyone who made the breakthrough would almost certainly win the Nobel Prize.
"It is not well-funded. It is not mainstream research. Why isn't it a priority of the cancer community?" she said.
Dr Jane Cope, director of the National Cancer Research Institute, said it too wanted to boost research into prevention.
"Research into breast cancer has been a great success story, with survival rates at an all-time high," she said.
"However, the number of women diagnosed with the disease is increasing year after year.
"Preventing all types of cancer is now an exciting prospect for researchers in the UK."
Article Source
By Aislinn Simpson Last Updated: 7:54AM BST 06 Oct 2008
Professor Valerie Beral of Oxford University, who leads the Million Women's Study into the causes of the disease, said her research had already proven beyond doubt that childbirth and the act of breastfeeding prevents breast cancer.
She wants scientists to look more closely at how they could mimic the hormones associated with childbirth and rearing in a bid to stamp out the disease, instead of trying to cure it once it has developed, as is mostly the case at present.
She pointed out that while death rates have been dramatically reduced by new drugs and earlier diagnosis, the number of women developing breast cancer and having to go through traumatic surgery and chemotherapy was rising.
She said it was impossible to return to an era where all women had babies and breastfed for longer periods of time, but added: "Why aren't we thinking of mimicking the effects of childbirth?
"We don't know how this happens and nobody is doing research on it. We should be looking at hormone production during late pregnancy and lactation."
Prof Beral's Cancer Research UK-funded work as the director of the cancer epidemiology unit of Oxford University sees her use large ammounts of statistical data to establish trends in why women develop the disease.
Speaking at the National Cancer Research Institute's annual conference, she queried why the avenue of breast cancer prevention which might lead to a drug or vaccine was not being pursued.
She pointed to the example of cervical cancer, where most cases were found to be caused by the humanpapilloma virus, and the development of a vaccine which is now being given to schoolgirls aged 12 and 13.
But "fewer than a dozen people" are looking in this direction with regard to breast cancer, she said, despite the likelihood that anyone who made the breakthrough would almost certainly win the Nobel Prize.
"It is not well-funded. It is not mainstream research. Why isn't it a priority of the cancer community?" she said.
Dr Jane Cope, director of the National Cancer Research Institute, said it too wanted to boost research into prevention.
"Research into breast cancer has been a great success story, with survival rates at an all-time high," she said.
"However, the number of women diagnosed with the disease is increasing year after year.
"Preventing all types of cancer is now an exciting prospect for researchers in the UK."
Article Source
Thursday, October 2, 2008
Passionately pink for breast cancer cure
Passionately pink for breast cancer cure
By MONA LOCKEGUEST
As we all watch Wall Street and wonder how the numbers will affect our lives, here are some other numbers to consider as we observe National Breast Cancer Awareness Month.
Ninety-eight: The percentage of a woman's chance of surviving breast cancer if it is caught early. We've made tremendous strides in the fight against breast cancer. With billions of dollars invested in research and awareness education, and millions of survivors around the world, we can feel proud of our progress and hopeful for the future -- but we still have a long way to go.
Twenty-eight: Our state's current rank in the nation for the number of women who receive regular mammograms, the very thing that can turn a victim into a survivor. For women who receive an annual mammogram, the test can detect tumors long before they are big enough to feel. Yet, about one in four women fail to receive a mammogram each year. Many women simply forget to schedule it, causing another year to pass by. For others the reason is a bit more significant. More than 46,000 women in Washington cannot afford a mammogram. The risk of dying from breast cancer increases 30 percent to 50 percent for women who are uninsured.
Eleven: The number of families in Washington each day who find out they must face this disease. Washington is one of the top three states in the nation with the highest rate of breast cancer. The Puget Sound Affiliate of Susan G. Komen for the Cure helps fund the Washington Breast and Cervical Health Program, which provides no-cost mammograms to low-income and uninsured women between the ages of 40-64.
One: The number of people it takes to save a life. Schedule your mammogram today. Remind your mother, sisters, daughters and friends to do the same. This October in support of Breast Cancer Awareness Month, we have partnered with Gene Juarez Salons & Spas to offer mammography screenings at Gene Juarez locations throughout the Northwest. No-cost screenings are available for uninsured women with limited incomes. To schedule an appointment, find out more information about WBCHP, call 800-756-5437.
Bottom line -- mammograms save lives.
Take it one step further and go pink this October to help us spread the word about the
effectiveness of mammograms while raising funds to help those in your community. Participate in "Passionately Pink for the Cure," a grassroots program in which companies, organizations or individuals pick a day to wear pink to raise awareness for breast cancer. Visit passionatelypink.org to receive a free participation kit to help organize your own Passionately Pink for a Cure day.
We thank KING-TV, KOMO/4, KCPQ/13 and KIRO/7 for celebrating "Passionately Pink for the Cure" by asking their television anchors and on-air talent to wear pink on Thursday during their newscasts in solidarity for Susan G. Komen for the Cure and breast cancer awareness month.
We are fighting every minute of every day to end breast cancer forever. Please join us in the fight. Pick your pink. Play your part. End breast cancer forever.
Mona Locke is executive director of the Puget Sound affiliate of Susan G. Komen for the Cure.
Article Source
By MONA LOCKEGUEST
As we all watch Wall Street and wonder how the numbers will affect our lives, here are some other numbers to consider as we observe National Breast Cancer Awareness Month.
Ninety-eight: The percentage of a woman's chance of surviving breast cancer if it is caught early. We've made tremendous strides in the fight against breast cancer. With billions of dollars invested in research and awareness education, and millions of survivors around the world, we can feel proud of our progress and hopeful for the future -- but we still have a long way to go.
Twenty-eight: Our state's current rank in the nation for the number of women who receive regular mammograms, the very thing that can turn a victim into a survivor. For women who receive an annual mammogram, the test can detect tumors long before they are big enough to feel. Yet, about one in four women fail to receive a mammogram each year. Many women simply forget to schedule it, causing another year to pass by. For others the reason is a bit more significant. More than 46,000 women in Washington cannot afford a mammogram. The risk of dying from breast cancer increases 30 percent to 50 percent for women who are uninsured.
Eleven: The number of families in Washington each day who find out they must face this disease. Washington is one of the top three states in the nation with the highest rate of breast cancer. The Puget Sound Affiliate of Susan G. Komen for the Cure helps fund the Washington Breast and Cervical Health Program, which provides no-cost mammograms to low-income and uninsured women between the ages of 40-64.
One: The number of people it takes to save a life. Schedule your mammogram today. Remind your mother, sisters, daughters and friends to do the same. This October in support of Breast Cancer Awareness Month, we have partnered with Gene Juarez Salons & Spas to offer mammography screenings at Gene Juarez locations throughout the Northwest. No-cost screenings are available for uninsured women with limited incomes. To schedule an appointment, find out more information about WBCHP, call 800-756-5437.
Bottom line -- mammograms save lives.
Take it one step further and go pink this October to help us spread the word about the
effectiveness of mammograms while raising funds to help those in your community. Participate in "Passionately Pink for the Cure," a grassroots program in which companies, organizations or individuals pick a day to wear pink to raise awareness for breast cancer. Visit passionatelypink.org to receive a free participation kit to help organize your own Passionately Pink for a Cure day.
We thank KING-TV, KOMO/4, KCPQ/13 and KIRO/7 for celebrating "Passionately Pink for the Cure" by asking their television anchors and on-air talent to wear pink on Thursday during their newscasts in solidarity for Susan G. Komen for the Cure and breast cancer awareness month.
We are fighting every minute of every day to end breast cancer forever. Please join us in the fight. Pick your pink. Play your part. End breast cancer forever.
Mona Locke is executive director of the Puget Sound affiliate of Susan G. Komen for the Cure.
Article Source
Tuesday, September 23, 2008
Acupuncture Eases Breast Cancer Treatment Side Effects
Acupuncture Eases Breast Cancer Treatment Side Effects
By Serena Gordon
HealthDay Reporter
Monday, September 22, 2008; 12:00 AM
MONDAY, Sept. 22 (HealthDay News) -- Lifesaving treatments for breast cancer come at a cost -- many women experience hot flashes, fatigue, night sweats and more.
Now new research suggests that acupuncture may help ease some of these side effects, and it may be more effective than antidepressants for relieving hot flashes and more.
"This study compared the effectiveness of acupuncture to drug therapy, and we found acupuncture was just as effective and had no side effects," said study author Dr. Eleanor M. Walker, director of breast radiation oncology at Henry Ford Hospital in Detroit.
"We were also able to show that the effect of acupuncture was longer lasting. After about two weeks of stopping drug therapy, women started having symptoms. With acupuncture, it was 15 weeks," she said.
Walker was expected to present the findings Monday at the American Society for Therapeutic Radiology and Oncology's annual meeting, in Boston.
Acupuncture is an ancient treatment that's a mainstay of Chinese medicine. It has been practiced for thousands of years, according to the National Center for Complementary and Alternative Medicine. Acupuncture involves the placement of very slender needles into the skin along certain points.
In Chinese medicine, it's believed that acupuncture works by unblocking the flow of energy along meridians. In Western medicine, the exact reason acupuncture might work isn't clear, but some theorize that the placement of needles may release endorphins, a chemical that make you feel good. Walker added that the meridian lines from Chinese medicine closely correspond to the body's network of nerves.
Treatments for breast cancer can induce early menopause, and many dampen the production of estrogen, leaving women with hot flashes, excessive sweating, fatigue and more.
Women with breast cancer can't be given hormone replacement therapy, so doctors often prescribe antidepressants, which can have their own side effects.
In the current study, Walker and her colleagues compared acupuncture with the use of the antidepressant Effexor in 47 women with breast cancer. Each woman was randomly assigned to receive a 12-week course of the antidepressant or acupuncture. Prior to the study, the women reported having at least 14 hot flashes per week.
After the study intervention, both groups reported similar improvements in hot flashes and other menopausal symptoms. However, there were no side effects reported in the acupuncture group, whereas some women in the antidepressant group had nausea, dry mouth, headache, trouble sleeping, constipation and other side effects.
Walker also said that many of those receiving acupuncture reported having more energy, a greater sense of well-being, and an improved sex drive.
"There are alternatives to drugs. This is a viable treatment without side effects, but it's going to take patients pushing insurance companies to get them to pay," said Walker. Currently, most insurance companies won't pay for acupuncture.
Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La., said that this is "an interesting, but very small study. Right now, I wouldn't recommend acupuncture to patients outside of a clinical trial. We need a larger prospective trial. Because the symptoms you're measuring are so variable, it really requires a large number of people to answer."
More information
To learn more about acupuncture, visit the National Center for Complementary and Alternative Medicine.
SOURCES: Eleanor Walker, M.D., director, breast radiation oncology, Henry Ford Hospital, Detroit; Jay Brooks, M.D., chairman, hematology/oncology, Ochsner Health System, Baton Rouge, La.; Sept. 22, 2008, presentation, American Society for Therapeutic Radiology and Oncology's annual meeting, Boston
News Source
By Serena Gordon
HealthDay Reporter
Monday, September 22, 2008; 12:00 AM
MONDAY, Sept. 22 (HealthDay News) -- Lifesaving treatments for breast cancer come at a cost -- many women experience hot flashes, fatigue, night sweats and more.
Now new research suggests that acupuncture may help ease some of these side effects, and it may be more effective than antidepressants for relieving hot flashes and more.
"This study compared the effectiveness of acupuncture to drug therapy, and we found acupuncture was just as effective and had no side effects," said study author Dr. Eleanor M. Walker, director of breast radiation oncology at Henry Ford Hospital in Detroit.
"We were also able to show that the effect of acupuncture was longer lasting. After about two weeks of stopping drug therapy, women started having symptoms. With acupuncture, it was 15 weeks," she said.
Walker was expected to present the findings Monday at the American Society for Therapeutic Radiology and Oncology's annual meeting, in Boston.
Acupuncture is an ancient treatment that's a mainstay of Chinese medicine. It has been practiced for thousands of years, according to the National Center for Complementary and Alternative Medicine. Acupuncture involves the placement of very slender needles into the skin along certain points.
In Chinese medicine, it's believed that acupuncture works by unblocking the flow of energy along meridians. In Western medicine, the exact reason acupuncture might work isn't clear, but some theorize that the placement of needles may release endorphins, a chemical that make you feel good. Walker added that the meridian lines from Chinese medicine closely correspond to the body's network of nerves.
Treatments for breast cancer can induce early menopause, and many dampen the production of estrogen, leaving women with hot flashes, excessive sweating, fatigue and more.
Women with breast cancer can't be given hormone replacement therapy, so doctors often prescribe antidepressants, which can have their own side effects.
In the current study, Walker and her colleagues compared acupuncture with the use of the antidepressant Effexor in 47 women with breast cancer. Each woman was randomly assigned to receive a 12-week course of the antidepressant or acupuncture. Prior to the study, the women reported having at least 14 hot flashes per week.
After the study intervention, both groups reported similar improvements in hot flashes and other menopausal symptoms. However, there were no side effects reported in the acupuncture group, whereas some women in the antidepressant group had nausea, dry mouth, headache, trouble sleeping, constipation and other side effects.
Walker also said that many of those receiving acupuncture reported having more energy, a greater sense of well-being, and an improved sex drive.
"There are alternatives to drugs. This is a viable treatment without side effects, but it's going to take patients pushing insurance companies to get them to pay," said Walker. Currently, most insurance companies won't pay for acupuncture.
Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La., said that this is "an interesting, but very small study. Right now, I wouldn't recommend acupuncture to patients outside of a clinical trial. We need a larger prospective trial. Because the symptoms you're measuring are so variable, it really requires a large number of people to answer."
More information
To learn more about acupuncture, visit the National Center for Complementary and Alternative Medicine.
SOURCES: Eleanor Walker, M.D., director, breast radiation oncology, Henry Ford Hospital, Detroit; Jay Brooks, M.D., chairman, hematology/oncology, Ochsner Health System, Baton Rouge, La.; Sept. 22, 2008, presentation, American Society for Therapeutic Radiology and Oncology's annual meeting, Boston
News Source
Wednesday, September 17, 2008
Breast cancer testing mistakes 'wake-up call' to world, expert says
Breast cancer testing mistakes 'wake-up call' to world, expert says
Last Updated: Wednesday, September 17, 2008 5:48 AM ET CBC News
U.S. pathologist David Dabbs says the lessons learned at a St. John's lab can be applied globally. (CBC)A world-renowned author has told Newfoundland and Labrador's breast cancer inquiry that the mistakes at a St. John's lab will yield lessons for labs everywhere else.
David Dabbs, chief of pathology at Magee-Women's Hospital in Pittsburgh and author of a respected textbook on diagnostic immunohistochemistry, said Tuesday he has no doubt that human error led to hundreds of Newfoundland and Labrador patients receiving inaccurate results.
"I think it is a wake-up call in general, to the global community of everyone who does [hormone receptor] testing in their laboratory and other complex testing for breast cancer patients,"
Dabbs told reporters after testifying Tuesday at the Cameron inquiry.
Dabbs said the hormone receptor tests used to help determine treatment are complex, and involve dozens of intricate steps. Nonetheless, he said some basics must be followed from the start.
"Whenever tissues are collected from patients, the most important aspect of all is to make sure that those tissues are obtained as quickly as possible and processed in the appropriate fluids," Dabbs said.
Justice Margaret Cameron, who has been collecting evidence as the head of the inquiry since March, has already been told that was not consistent practice within Eastern Health.
Some operating rooms did not have refrigerators, and some tissue samples were left in the open over weekends before they were then processed.
Dabbs said labs elsewhere should learn from what happened with how estrogen receptor and progesterone receptor tests were handled in St. John's.
"It is a critically important test. Patients are going on therapies that are either very expensive and/or have potentially serious side effects," Dabbs told reporters.
"So these tests need to be done correctly."
Meanwhile, Dabbs said that Eastern Health made the right decision when it started retesting samples in 2005, soon after it learned that there were problems with the hormone receptor tests. The tests determine whether a patient can benefit or not from powerful antihormonal therapies, usually Tamoxifen.
News Article Source
Last Updated: Wednesday, September 17, 2008 5:48 AM ET CBC News
U.S. pathologist David Dabbs says the lessons learned at a St. John's lab can be applied globally. (CBC)A world-renowned author has told Newfoundland and Labrador's breast cancer inquiry that the mistakes at a St. John's lab will yield lessons for labs everywhere else.
David Dabbs, chief of pathology at Magee-Women's Hospital in Pittsburgh and author of a respected textbook on diagnostic immunohistochemistry, said Tuesday he has no doubt that human error led to hundreds of Newfoundland and Labrador patients receiving inaccurate results.
"I think it is a wake-up call in general, to the global community of everyone who does [hormone receptor] testing in their laboratory and other complex testing for breast cancer patients,"
Dabbs told reporters after testifying Tuesday at the Cameron inquiry.
Dabbs said the hormone receptor tests used to help determine treatment are complex, and involve dozens of intricate steps. Nonetheless, he said some basics must be followed from the start.
"Whenever tissues are collected from patients, the most important aspect of all is to make sure that those tissues are obtained as quickly as possible and processed in the appropriate fluids," Dabbs said.
Justice Margaret Cameron, who has been collecting evidence as the head of the inquiry since March, has already been told that was not consistent practice within Eastern Health.
Some operating rooms did not have refrigerators, and some tissue samples were left in the open over weekends before they were then processed.
Dabbs said labs elsewhere should learn from what happened with how estrogen receptor and progesterone receptor tests were handled in St. John's.
"It is a critically important test. Patients are going on therapies that are either very expensive and/or have potentially serious side effects," Dabbs told reporters.
"So these tests need to be done correctly."
Meanwhile, Dabbs said that Eastern Health made the right decision when it started retesting samples in 2005, soon after it learned that there were problems with the hormone receptor tests. The tests determine whether a patient can benefit or not from powerful antihormonal therapies, usually Tamoxifen.
News Article Source
Tuesday, September 9, 2008
Can Breast MRI Help Evaluate Cancer?
Can Breast MRI Help Evaluate Cancer?
Study Weighs the Benefits, Risks of Routine Breast MRIs for Cancer Evaluation
By Kathleen Doheny WebMD Health News
Reviewed by Louise Chang, MD
Sept. 8, 2008 -- Routine use of breast MRI (magnetic resonance imaging) scans to help evaluate cancer after diagnosis is not as beneficial as some believed, according to a new study."The bottom line is it doesn't help us as much as we thought it did," says Richard J. Bleicher, MD, a surgical oncologist at Fox Chase Cancer Center in Philadelphia and lead author of the study, presented Saturday at the American Society of Clinical Oncology Breast Cancer Symposium in Washington, D.C.
But another expert who reviewed the study abstract for WebMD says the study was small and that the role of breast MRI to evaluate cancer is still evolving.On one point all sides seem to agree: More research is needed to determine if MRI can improve the outcomes of women with breast cancer.
Breast MRI
Bleicher and his colleagues reviewed the records of 577 breast cancer patients, including 130 who had MRIs before treatment and 447 who did not. The goal was to determine the effect, if any, of getting an MRI on the time to start treatment, the chances of removal of all the cancer, and other outcomes.
"We wanted to ascertain whether routine MRIs [for cancer, not for screenings] are helpful and do they, in fact, assist us in treatment planning," Bleicher tells WebMD.The role of breast MRI for screening, he says, is clearer. The American Cancer Society, for instance, advises that MRIs be used in combination with mammograms for preventive screenings of certain women at especially high risk of breast cancer.
But the role of the breast MRI to evaluate breast cancer is not as clear, he says.The thinking among experts, he says, is that MRIs, because they are so sensitive, may allow better visualization of the cancer, so using one when cancer is diagnosed or suspected should help guide treatment decisions.
Breast MRI Study Findings
Among the findings:
Breast MRI was associated with a 22-day delay in the start of treatment. "We don't know why," Bleicher says. It could be because of the scheduling of the MRI itself, or perhaps MRI prompts other biopsies." Three weeks should not change a patient's survival chances, he says, but waiting can clearly add to a patient's anxiety.
Those who got the breast MRI were nearly twice as likely to have a mastectomy as breast-conserving surgery, even after controlling for size and stage of the tumor. One reason, he says, may be that the MRI, being highly sensitive, picked up something that looked like cancer but turned out not to be -- a false positive.
Those who got the breast MRI were slightly more likely to have what surgeons call positive margins, although this finding could have been a chance finding. The goal is negative margins. "The goal is to excise out the tumor so there is a margin of normal tissue around it, reassuring us the cancer has been completely removed," he says.
Younger women were more likely than older women to have MRIs, but the use of the MRI did not correlate with other factors such as family history of breast or ovarian cancer.
Breast MRI Research Evolving
Another expert, Constance Lehman, MD, PhD, professor and vice chair of radiology and head of breast imaging at the University of Washington Medical Center and director of imaging at the Seattle Cancer Care Alliance, reviewed the study for WebMD. She says the new study is "not the kind of study we need to make firm conclusions."
She points out that the study was small and that only 130 women had breast MRIs.
Research on the value of breast MRI when used in cancer treatment decision is evolving, she says, and not all the answers are in.
The Bleicher study has inherent limitations, she says, because it wasn't a study that randomized people to get one treatment or not. Rather, it was a study that took a look backward, and it lacked some information, such as why some women got MRIs and others didn't.
The findings from the current study, she says, don't hold up at her center.
"This study shouldn't rule out a preoperative MRI,'' she says. "This is one abstract from one center that did one study in a very select group of patients."
She points to another study, published in the Journal of Clinical Oncology, which reviewed the results of 19 studies and found the rate of mastectomy because of false positives on the MRI is 1%.
Breast MRI: Advice for WomenIf a woman has suspected or diagnosed breast cancer, Lehman says, she should ask about the potential benefits and risk of a breast MRI.
"Go to a center with a high level of experience," she advises.
Bleicher's advice: "Women who walk into their doctor's office with breast cancer should not be immediately thinking, 'I have to have an MRI.' There are false positives [to MRIs], unnecessary biopsies, a lot of anxiety ... and a three-week delay [to treatment]. All these disadvantages have not been offset by an improvement in our ability to choose the proper treatment."
More study is needed, he says, to decide the best role for breast MRI in cancer diagnosis.
Thursday, September 4, 2008
Younger women detecting breast cancer in early stages
MANILA, Philippines—There are more reported cases of breast cancer among younger Filipino women these days, but the Philippine Cancer Society says this means more women are aware of the dreaded disease and have been able to detect it in its early stages.
"Breast-cancer victims used to be aged 40 and above. But now women are getting it in their early 30s and now even in their late 20s. This, however, means naagapan na (it is treated in its early stage)," said PCS executive director Kelly Salvador.
As part of an awareness campaign, around 30,000 people are expected to gather in 16 different locations in the country next month in a walk against breast cancer, the no. 1 killer disease among women.
The event to be held on October 5 will be sponsored by the "Kiss Goodbye to Breast Cancer" (KGBC) campaign of beauty company Avon, and several partners including the PCS and the Philippine General Hospital Breast Care Center, KGBC's beneficiary.
The PGH facility, which was launched in 2002, has funded the treatments of indigents, initiated support groups and conducted regular gatherings for sufferers and survivors.
As part of its fundraising efforts, P30 from each KGBC shirt (priced at P149) sold will go to the breast cancer fund while P5 will go to the same fund with each sale of the KGBC limited edition of the Skin So Soft Ultra Healing Hand and Body Lotion.
Since one out of nine Filipinas could develop cancer, PCS chair Roberto Paterno stressed that monthly self-examination would be crucial in nipping breast cancer in the bud.
Mammography, he added, should be done yearly starting age 40 by high-risk persons or those with family history of cancer, and starting age 50 for those without any history of cancer.
By Allison Lopez
Philippine Daily Inquirer
News Article Source
"Breast-cancer victims used to be aged 40 and above. But now women are getting it in their early 30s and now even in their late 20s. This, however, means naagapan na (it is treated in its early stage)," said PCS executive director Kelly Salvador.
As part of an awareness campaign, around 30,000 people are expected to gather in 16 different locations in the country next month in a walk against breast cancer, the no. 1 killer disease among women.
The event to be held on October 5 will be sponsored by the "Kiss Goodbye to Breast Cancer" (KGBC) campaign of beauty company Avon, and several partners including the PCS and the Philippine General Hospital Breast Care Center, KGBC's beneficiary.
The PGH facility, which was launched in 2002, has funded the treatments of indigents, initiated support groups and conducted regular gatherings for sufferers and survivors.
As part of its fundraising efforts, P30 from each KGBC shirt (priced at P149) sold will go to the breast cancer fund while P5 will go to the same fund with each sale of the KGBC limited edition of the Skin So Soft Ultra Healing Hand and Body Lotion.
Since one out of nine Filipinas could develop cancer, PCS chair Roberto Paterno stressed that monthly self-examination would be crucial in nipping breast cancer in the bud.
Mammography, he added, should be done yearly starting age 40 by high-risk persons or those with family history of cancer, and starting age 50 for those without any history of cancer.
By Allison Lopez
Philippine Daily Inquirer
News Article Source
New breast cancer screening tool shows promise
News Article Source
New breast cancer screening tool shows promise
By Will Dunham
WASHINGTON (Reuters) - A new screening tool works three times better than mammography at finding tumors in women who have dense breast tissue, which can confound mammograms, U.S. researchers said on Wednesday.
Mammography, an X-ray of the breasts, detected fewer than a third of the tumors found using a new technique called molecular breast imaging, or MBI, the researchers said ahead of a breast cancer meeting sponsored by the American Society of Clinical Oncology and other groups.
Mammography is used commonly to screen for breast cancer, but about a quarter of women have dense breast tissue -- and mammogram X-rays may not see through this to spot small tumors. Doctors are eager for other methods that perform better.
The study, involving 940 women, is the largest to date to compare MBI to mammography. MBI is still experimental and is not commonly available to women.
The women, considered at high risk for breast cancer due to a family history of the disease, genetic susceptibility or other factors, underwent both screening methods.
With MBI, patients are injected with a radioactive agent that gets absorbed by breast tissue. Cancer cells tend to absorb more of it than healthy cells, and specialized cameras that detect gamma rays from the agent then differentiate tumors from healthy tissue.
"We're certainly not advocating replacing mammography in any way. But we think it (MBI) would have a role as an additional test for those women that aren't served as well by mammography as we would like," Carrie Hruska of the Mayo Clinic in Rochester, Minnesota, who led the study, told reporters.
Using MBI, the ability to see a tumor is not affected by the density of the surrounding breast tissue, so it offers great promise for women whose mammograms may not provide an accurate assessment, Hruska said.
Among the 940 women, 13 tumors were found in 12 women. MBI found 10 and mammography found three, the researchers said.
Dr. Eric Winer of Harvard Medical School and Dana-Farber Cancer Institute in Boston, commenting for the American Society of Clinical Oncology, said between 10 percent and 15 percent of breast cancers cannot be detected using mammograms.
"More and more we may be getting away from one-size-fits-all in terms of screening approaches, and instead think about screening approaches that are directed more to an individual women based on her risk and on the characteristics of her breasts," Winer told reporters in a conference call.
There has been increasing use of costly MRI exams on some women with dense breasts or with high risk for breast cancer.
Hruska said MBI may be a lower-cost alternative. She estimated it would cost about $500 to perform, and expressed hope its availability would increase in the next year.
The technology used special cameras developed by GE Medical Systems and privately held Gamma Medica-Ideas, Hruska said. The study was funded in part by Bristol-Myers Squibb, which provided the radioactive agent, Hruska added.
The radioactive agent typically exits the body in a day.
Hruska said MBI as currently used presents a very low risk of radiation if a woman has it a few times in a lifetime, but the researchers must lower the radiation if the technology begins to be used as a screening test every year or two.
New breast cancer screening tool shows promise
By Will Dunham
WASHINGTON (Reuters) - A new screening tool works three times better than mammography at finding tumors in women who have dense breast tissue, which can confound mammograms, U.S. researchers said on Wednesday.
Mammography, an X-ray of the breasts, detected fewer than a third of the tumors found using a new technique called molecular breast imaging, or MBI, the researchers said ahead of a breast cancer meeting sponsored by the American Society of Clinical Oncology and other groups.
Mammography is used commonly to screen for breast cancer, but about a quarter of women have dense breast tissue -- and mammogram X-rays may not see through this to spot small tumors. Doctors are eager for other methods that perform better.
The study, involving 940 women, is the largest to date to compare MBI to mammography. MBI is still experimental and is not commonly available to women.
The women, considered at high risk for breast cancer due to a family history of the disease, genetic susceptibility or other factors, underwent both screening methods.
With MBI, patients are injected with a radioactive agent that gets absorbed by breast tissue. Cancer cells tend to absorb more of it than healthy cells, and specialized cameras that detect gamma rays from the agent then differentiate tumors from healthy tissue.
"We're certainly not advocating replacing mammography in any way. But we think it (MBI) would have a role as an additional test for those women that aren't served as well by mammography as we would like," Carrie Hruska of the Mayo Clinic in Rochester, Minnesota, who led the study, told reporters.
Using MBI, the ability to see a tumor is not affected by the density of the surrounding breast tissue, so it offers great promise for women whose mammograms may not provide an accurate assessment, Hruska said.
Among the 940 women, 13 tumors were found in 12 women. MBI found 10 and mammography found three, the researchers said.
Dr. Eric Winer of Harvard Medical School and Dana-Farber Cancer Institute in Boston, commenting for the American Society of Clinical Oncology, said between 10 percent and 15 percent of breast cancers cannot be detected using mammograms.
"More and more we may be getting away from one-size-fits-all in terms of screening approaches, and instead think about screening approaches that are directed more to an individual women based on her risk and on the characteristics of her breasts," Winer told reporters in a conference call.
There has been increasing use of costly MRI exams on some women with dense breasts or with high risk for breast cancer.
Hruska said MBI may be a lower-cost alternative. She estimated it would cost about $500 to perform, and expressed hope its availability would increase in the next year.
The technology used special cameras developed by GE Medical Systems and privately held Gamma Medica-Ideas, Hruska said. The study was funded in part by Bristol-Myers Squibb, which provided the radioactive agent, Hruska added.
The radioactive agent typically exits the body in a day.
Hruska said MBI as currently used presents a very low risk of radiation if a woman has it a few times in a lifetime, but the researchers must lower the radiation if the technology begins to be used as a screening test every year or two.
Understanding Breast Cancer
Source
Before you can launch an effective battle against breast cancer, it's important to understand some basics: What is breast cancer and how does it happen? What are some of the myths about your risk of breast cancer?
In this section, you'll find answers that help you move forward with a solid grounding in the facts, including information about:
How Breast Cancer Happens
Who Gets Breast Cancer
Myths About Breast Cancer
How Breast Cancer Happens
The breast is a gland designed to make milk. The lobules in the breast make the milk, which then drains through the ducts to the nipple. Like all parts of your body, the cells in your breasts usually grow and then rest in cycles. The periods of growth and rest in each cell are controlled by genes in the cell's nucleus. The nucleus is like the control room of each cell. When your genes are in good working order, they keep cell growth under control. But when your genes develop an abnormality, they sometimes lose their ability to control the cycle of cell growth and rest.
Breast cancer is an uncontrolled growth of breast cells.
Cancer has the potential to break through normal breast tissue barriers and spread to other parts of the body. While cancer is always caused by a genetic "abnormality" (a "mistake" in the genetic material), only 5–10% of cancers are inherited from your mother or father. Instead, 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and life in general.
While there are things every woman can do to help her body stay as healthy as possible (such as eating a balanced diet, not smoking, minimizing stress, and exercising regularly), breast cancer is never anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is counterproductive.
Who Gets Breast Cancer
Breast cancer is the most common cancer to affect women. In 2007, it is estimated that there will be about 178,480 new cases of invasive breast cancer diagnosed in the United States, along with 62,030 new cases of non-invasive breast cancer.
Every woman is at SOME risk for breast cancer—this is merely the "risk" of living as a woman. But there are many risk factors that can make one woman's picture differ substantially from another's. When you understand your own particular risk profile, you are in a better position to manage it and don't have to fear the unknown.
Myths About Breast Cancer
What is your risk of breast cancer? Which breast cancer treatment is right for you? What about antiperspirants and breast cancer? What you don't know CAN hurt you. Misinformation can keep you from recognizing and minimizing your own risk of breast cancer or getting the very best possible care. Arm yourself with the facts.
Here are ten common myths about breast cancer, followed by myths about specific types of breast cancer treatment.
1. Breast cancer only affects older women.
No. While it's true that the risk of breast cancer increases as we grow older, breast cancer can occur at any age. From birth to age 39, one woman in 231 will get breast cancer (<0.5% risk); from age 40–59, the risk is one in 25 (4% risk); from age 60–79, the risk is one in 15 (nearly 7%). Assuming you live to age 90, the risk of getting breast cancer over the course of an entire lifetime is one in 7, with an overall lifetime risk of 14.3%.
2. If you have a risk factor for breast cancer, you're likely to get the disease. No. Getting breast cancer is not a certainty, even if you have one of the stronger risk factors, like a breast cancer gene abnormality. Of women with a BRCA1 or BRCA2 inherited genetic abnormality, 40–80% will develop breast cancer over their lifetime; 20–60% won't. All other risk factors are associated with a much lower probability of being diagnosed with breast cancer.
3. If breast cancer doesn't run in your family, you won't get it. No. Every woman has some risk of breast cancer. About 80% of women who get breast cancer have no known family history of the disease. Increasing age – just the wear and tear of living – is the biggest single risk factor for breast cancer. For those women who do have a family history of breast cancer, your risk may be elevated a little, a lot, or not at all. If you are concerned, discuss your family history with your physician or a genetic counselor. You may be worrying needlessly.
4. Only your mother's family history of breast cancer can affect your risk. No. A history of breast cancer in your mother's OR your father's family will influence your risk equally. That's because half of your genes come from your mother, half from your father. But a man with a breast cancer gene abnormality is less likely to develop breast cancer than a woman with a similar gene. So, if you want to learn more about your father's family history, you have to look mainly at the women on your father's side, not just the men.
5. Using antiperspirants causes breast cancer. No. There is no evidence that the active ingredient in antiperspirants, or reducing perspiration from the underarm area, influences breast cancer risk. The supposed link between breast cancer and antiperspirants is based on misinformation about anatomy and a misunderstanding of breast cancer.
6. Birth control pills cause breast cancer.
No. Modern day birth control pills contain a low dose of the hormones estrogen and progesterone. Many research studies show no association between birth control pills and an increased risk of breast cancer. However, one study that combined the results of many different studies did show an association between birth control pills and a very small increase in risk. The study also showed that this slight increase in risk decreased over time. So after 10 years, birth control pills were not associated with an increase in risk. Birth control pills also have benefits:
- decreasing ovarian and endometrial cancer risk
- relieving menstrual disorders, pelvic inflammatory disease, and ovarian, and cysts
- improving bone mineral density
As with any medicine, you have to weigh the risks and benefits and decide what is best for YOU.
7. Eating high-fat foods causes breast cancer.
No. Several large studies have not been able to demonstrate a clear connection between eating high-fat foods and a higher risk of breast cancer. Ongoing studies are attempting to clarify this issue further. We can say that avoidance of high-fat foods is a healthy choice for other reasons: to lower the "bad" cholesterol (low-density lipoproteins), increase the "good" cholesterol (high-density lipoproteins); to make more room your diet for healthier foods, and to help you control your weight. Excess body weight, IS a risk factor for breast cancer, because the extra fat increases the production of estrogen outside the ovaries and adds to the overall level of estrogen in the body. If you are already overweight, or have a tendency to gain weight easily, avoiding high-fat foods is a good idea.
8. A monthly breast self-exam is the best way to diagnose breast cancer.
No. Digital mammography or high quality film-screen mammography is the most reliable way to find breast cancer as early as possible, when it is most curable. By the time a breast cancer can be felt, it is usually bigger than the average size of a cancer first found on mammography. Breast examination by you or your healthcare provider is still very important. About 25% of breast cancers are found only on breast examination (not on the mammogram), about 35% are found on mammography alone, and 40% are found by both physical exam and mammography. Keep both bases covered.
9. I'm at high risk for breast cancer and there's nothing I can do about it.
No. There are several effective ways to reduce—but not eliminate—the risk of breast cancer in women at high risk. Options include lifestyle changes (minimize alcohol consumption, stop smoking, exercise regularly), medication (tamoxifen, also called Nolvadex); and in cases of very high risk, surgery may be offered (prophylactic mastectomies, and for some women, prophylactic ovary removal). Be sure that you have consulted with a physician or genetic counselor before you make assumptions about your level of risk.
10. A breast cancer diagnosis is an automatic death sentence.
No. Fully 80% of women diagnosed with breast cancer have no signs of metastases (no cancer has spread beyond the breast and nearby lymph nodes). Furthermore, 80% of these women live at least five years, most longer, and many live much longer. Even women with signs of cancer metastases can live a long time. Plus promising treatment breakthroughs are becoming available each day.
Before you can launch an effective battle against breast cancer, it's important to understand some basics: What is breast cancer and how does it happen? What are some of the myths about your risk of breast cancer?
In this section, you'll find answers that help you move forward with a solid grounding in the facts, including information about:
How Breast Cancer Happens
Who Gets Breast Cancer
Myths About Breast Cancer
How Breast Cancer Happens
The breast is a gland designed to make milk. The lobules in the breast make the milk, which then drains through the ducts to the nipple. Like all parts of your body, the cells in your breasts usually grow and then rest in cycles. The periods of growth and rest in each cell are controlled by genes in the cell's nucleus. The nucleus is like the control room of each cell. When your genes are in good working order, they keep cell growth under control. But when your genes develop an abnormality, they sometimes lose their ability to control the cycle of cell growth and rest.
Breast cancer is an uncontrolled growth of breast cells.
Cancer has the potential to break through normal breast tissue barriers and spread to other parts of the body. While cancer is always caused by a genetic "abnormality" (a "mistake" in the genetic material), only 5–10% of cancers are inherited from your mother or father. Instead, 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and life in general.
While there are things every woman can do to help her body stay as healthy as possible (such as eating a balanced diet, not smoking, minimizing stress, and exercising regularly), breast cancer is never anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is counterproductive.
Who Gets Breast Cancer
Breast cancer is the most common cancer to affect women. In 2007, it is estimated that there will be about 178,480 new cases of invasive breast cancer diagnosed in the United States, along with 62,030 new cases of non-invasive breast cancer.
Every woman is at SOME risk for breast cancer—this is merely the "risk" of living as a woman. But there are many risk factors that can make one woman's picture differ substantially from another's. When you understand your own particular risk profile, you are in a better position to manage it and don't have to fear the unknown.
Myths About Breast Cancer
What is your risk of breast cancer? Which breast cancer treatment is right for you? What about antiperspirants and breast cancer? What you don't know CAN hurt you. Misinformation can keep you from recognizing and minimizing your own risk of breast cancer or getting the very best possible care. Arm yourself with the facts.
Here are ten common myths about breast cancer, followed by myths about specific types of breast cancer treatment.
1. Breast cancer only affects older women.
No. While it's true that the risk of breast cancer increases as we grow older, breast cancer can occur at any age. From birth to age 39, one woman in 231 will get breast cancer (<0.5% risk); from age 40–59, the risk is one in 25 (4% risk); from age 60–79, the risk is one in 15 (nearly 7%). Assuming you live to age 90, the risk of getting breast cancer over the course of an entire lifetime is one in 7, with an overall lifetime risk of 14.3%.
2. If you have a risk factor for breast cancer, you're likely to get the disease. No. Getting breast cancer is not a certainty, even if you have one of the stronger risk factors, like a breast cancer gene abnormality. Of women with a BRCA1 or BRCA2 inherited genetic abnormality, 40–80% will develop breast cancer over their lifetime; 20–60% won't. All other risk factors are associated with a much lower probability of being diagnosed with breast cancer.
3. If breast cancer doesn't run in your family, you won't get it. No. Every woman has some risk of breast cancer. About 80% of women who get breast cancer have no known family history of the disease. Increasing age – just the wear and tear of living – is the biggest single risk factor for breast cancer. For those women who do have a family history of breast cancer, your risk may be elevated a little, a lot, or not at all. If you are concerned, discuss your family history with your physician or a genetic counselor. You may be worrying needlessly.
4. Only your mother's family history of breast cancer can affect your risk. No. A history of breast cancer in your mother's OR your father's family will influence your risk equally. That's because half of your genes come from your mother, half from your father. But a man with a breast cancer gene abnormality is less likely to develop breast cancer than a woman with a similar gene. So, if you want to learn more about your father's family history, you have to look mainly at the women on your father's side, not just the men.
5. Using antiperspirants causes breast cancer. No. There is no evidence that the active ingredient in antiperspirants, or reducing perspiration from the underarm area, influences breast cancer risk. The supposed link between breast cancer and antiperspirants is based on misinformation about anatomy and a misunderstanding of breast cancer.
6. Birth control pills cause breast cancer.
No. Modern day birth control pills contain a low dose of the hormones estrogen and progesterone. Many research studies show no association between birth control pills and an increased risk of breast cancer. However, one study that combined the results of many different studies did show an association between birth control pills and a very small increase in risk. The study also showed that this slight increase in risk decreased over time. So after 10 years, birth control pills were not associated with an increase in risk. Birth control pills also have benefits:
- decreasing ovarian and endometrial cancer risk
- relieving menstrual disorders, pelvic inflammatory disease, and ovarian, and cysts
- improving bone mineral density
As with any medicine, you have to weigh the risks and benefits and decide what is best for YOU.
7. Eating high-fat foods causes breast cancer.
No. Several large studies have not been able to demonstrate a clear connection between eating high-fat foods and a higher risk of breast cancer. Ongoing studies are attempting to clarify this issue further. We can say that avoidance of high-fat foods is a healthy choice for other reasons: to lower the "bad" cholesterol (low-density lipoproteins), increase the "good" cholesterol (high-density lipoproteins); to make more room your diet for healthier foods, and to help you control your weight. Excess body weight, IS a risk factor for breast cancer, because the extra fat increases the production of estrogen outside the ovaries and adds to the overall level of estrogen in the body. If you are already overweight, or have a tendency to gain weight easily, avoiding high-fat foods is a good idea.
8. A monthly breast self-exam is the best way to diagnose breast cancer.
No. Digital mammography or high quality film-screen mammography is the most reliable way to find breast cancer as early as possible, when it is most curable. By the time a breast cancer can be felt, it is usually bigger than the average size of a cancer first found on mammography. Breast examination by you or your healthcare provider is still very important. About 25% of breast cancers are found only on breast examination (not on the mammogram), about 35% are found on mammography alone, and 40% are found by both physical exam and mammography. Keep both bases covered.
9. I'm at high risk for breast cancer and there's nothing I can do about it.
No. There are several effective ways to reduce—but not eliminate—the risk of breast cancer in women at high risk. Options include lifestyle changes (minimize alcohol consumption, stop smoking, exercise regularly), medication (tamoxifen, also called Nolvadex); and in cases of very high risk, surgery may be offered (prophylactic mastectomies, and for some women, prophylactic ovary removal). Be sure that you have consulted with a physician or genetic counselor before you make assumptions about your level of risk.
10. A breast cancer diagnosis is an automatic death sentence.
No. Fully 80% of women diagnosed with breast cancer have no signs of metastases (no cancer has spread beyond the breast and nearby lymph nodes). Furthermore, 80% of these women live at least five years, most longer, and many live much longer. Even women with signs of cancer metastases can live a long time. Plus promising treatment breakthroughs are becoming available each day.
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