Breast Cancer News Weekly Wrap-Up (Aug. 28 to Sept. 1)

What's new in breast cancer news? Today we'll share the week's headlines and the studies behind them.

US News and World Report: "Some Older Breast Cancer Patients Can Skip Hormone Therapy: Study"

This headline sounds encouraging. For hormone receptor positive breast cancer, hormonal therapy is typically prescribed for five years and associated with unpleasant side effects. Who wouldn't want to skip it?

However, there is some fine print. (Links to the US News and World Report/HealthDay story, the underlying study and related Memo to the Media may be found on the Arimidex (anastrozole) page of our website.)

The August 31 Journal of the National Cancer Institute (JNCI) study evaluated mortality (death) rates for women in Denmark with early-stage, node-negative, hormone-receptor positive breast cancer. Women over 60, with small tumors (up to 10mm), who received no hormonal therapy or chemotherapy were not at an increased risk of death compared with women the same age in the general population.

In an accompanying editorial, the authors noted that even if there is no benefit in terms of mortality, hormonal therapy reduces the risk of recurrence in the same or opposite breast, and many "will continue to take it for that reason." (See the JNCI Memo to the Media under the News tab.)

For women in this subset, this study is another factor to be considered in the decision on whether to take hormonal therapy. According to the Memo to the Media, "patient preferences regarding risks and benefits play a critical role" in the decision. In US News and World Report, Dr. Jennifer Griggs, a study co-author, suggested a three month trial of hormone therapy to gauge side effects before deciding whether to continue.

Reuters: "New breast cancer gene may help predict risk"

The gene at issue, known as CHEK2, is not really new. The CHEK2 genetic test is available, but not generally offered. Instead, BRCA 1/2 genetic tests are typically used to assess hereditary risk. (More on the test and links to the study and story below may be found on the CHEK 2 gene testing page of our website.)

The August 29 Journal of Clinical Oncology study from Poland estimated breast cancer risk in women with CHEK2 mutations and family histories of breast cancer. Baseline lifetime risk was assumed to be 6%. Women with a CHEK2 mutation and no family history had an estimated lifetime risk of 20%. Risk increased with family history. A second-degree relative with breast cancer raised the risk to 28%, one first-degree relative to 34% and both a first- and second-degree relative to 44%.

An August 29 story in Reuters noted that the study may not be "ready for prime time yet." According to Reuters, Dr. James P. Evans, editor-in-chief of Genetics in Medicine, called the study a "nice start," but said it would be "premature" to recommend CHEK2 testing for everyone with a family history now. Dr. Diana Petitti, of Arizona State University in Phoenix, said the study is "an important breakthrough," but more research is needed, noting that "this is a field where replication is critical."

One of the concerns is that the Polish women in the study may be different than Americans. In America, the lifetime risk of breast cancer is about 12% (1 in 8). According to the study authors, that number is only about 6 percent in Poland.

ScienceDaily.com: "Breast Cancer Risk Drops When Diet Includes Walnuts, Researchers Find"

A recent study in Nutrition and Cancer found that walnut consumption reduced breast cancer risk in mice. Study leader Elaine Hardman, Ph.D was quoted in ScienceDaily.com to say, "The results of this study indicate that increased consumption of walnut could be part of a healthy diet and reduce risk for cancer in future generations." (Link on the the Fruits, Vegetables and Nuts page of our website.)

Animals studies such as this one are often interesting, but the applicability in humans has not yet been proven in human trials.

Toronto Sun: "Smoking after menopause could increase risk for breast cancer: Study"

This week, the Toronto Sun, US News and World Report/HealthDay and WebMD covered an August 10 study in The Journal of Endocrinology and Metabolism which found higher androgen and estrogen levels in smokers.

According to the study, because hormone levels dropped with smoking cessation, "hormone related disease risks could potentially be modified by changing smoking habits."

Next week, we'll share the latest research on soy for breast cancer survivors. Until then, all the latest news and research on any breast cancer test or treatment option may be found on the treatment pages of the LATESTBreastCancer.com website.

Breast Cancer News (8/18): Survival and Vitamin D, Exercise and CYP2D6 Variations

Recent studies suggest a worse prognosis for breast cancer patients with low blood levels of vitamin D. Do vitamin D supplements improve prognosis? A recent review asked that very question. Today, we'll also share the latest research on how CYP2D6 variations and exercise affect survival. As always, links to the studies below may be found on the treatment pages of the LATESTBreastCancer.com website.

Vitamin D supplementation for cancer patients

Should breast cancer patients take vitamin D supplements to improve prognosis? An August 11 review in The Oncologist evaluated 25 studies involving several cancers. For breast cancer, the two studies reviewed reached opposite conclusions about the prognostic importance of vitamin D. Three prostate cancer trials showed no survival benefit of vitamin D supplementation. The authors concluded that even though low vitamin D was associated with worse prognosis in some cancers, the "currently available evidence is insufficient to recommend vitD supplementation in cancer patients in clinical practice."

Does this mean that breast cancer patients should not take vitamin D? Not necessarily.

First, The Oncologist study reviewed only two breast cancer studies. Recent studies suggest that low serum vitamin D at diagnosis may be associated with a worse prognosis. An April 29 University of Rochester Medical Center study (under the News tab) linked low vitamin D with more aggressive tumors and a worse prognosis. A July 27 Breast Cancer Research study found that low serum vitamin D "may be associated with poorer overall survival and distant disease-free survival in postmenopausal breast cancer patients." These recent studies were likely not considered in The Oncologist review. (The Breast Cancer Research study also noted that the only two previous studies were inconclusive.)

Also, even though vitamin D supplementation is not yet proven to improve prognosis, recent studies suggest it may be beneficial for breast cancer patients to preserve bone mineral density (Annals of Oncology, April 2 and Breast Cancer Research and Treatment, March 8) and to reduce bone and joint pain associated with aromatase inhibitors (Breast Cancer Research and Treatment, June 21).

The bottom line is that breast cancer patients with low serum vitamin D should discuss vitamin D supplementation with their doctors.

CYP2D6 variations do not affect risk of recurrence

Variations in CYP2D6 genes affect how tamoxifen is metabolized. Some women metabolize tamoxifen well. Some do not. Do variations in CYP2D6 affect the risk of recurrence? According to a August 5 study in Cancer, no. Researchers from MD Anderson found that variations in CYP2D6 genes "had no significant effect" on the risk of recurrence in women with early breast cancer treated with adjuvant tamoxifen.

Exercise after breast cancer diagnosis may improve survival

Studies have associated exercise with improved quality of life, but can exercise affect breast cancer survival? An August 12 study in Breast Cancer Research and Treatment revealed that exercise after a breast cancer diagnosis may affect the regulation of tumor suppressor genes, which have "favorable impacts on survival outcomes of breast cancer patients."

Please check back tomorrow for more breast cancer research news from LATESTBreastCancer.com.

The Breast Cancer News Update: July 22

There's been a lot of buzz about a recent study which found that tall women have a higher risk of breast cancer. According to the story in the Los Angeles Times, breast cancer risk increased 17% with every 4 inches in height. While this may be interesting, it's not really useful. Height is not a modifiable risk. Today we'll look at recent studies on modifiable risk factors such as diet, exercise, and alcohol use. All of the studies below can be found on the complementary therapy and lifestyle pages of the LATESTBreastCancer.com website.

Diet and breast cancer risk: soy, omega-3s and vitamins

Breast cancer research does not always have a positive ending. This month, two studies found that soy and omega-3 fatty acids do not reduce the hormones associated with breast cancer risk. Another study found that while vitamin A may reduce risk, vitamins C and E do not appear to have an effect.

Dietary soy does not modify estrogen levels

A July 8 study in Cancer Epidemiology, Biomarkers & Prevention examined the effect of dietary soy on blood and nipple aspirate fluid estrogen levels to assess impact on breast cancer risk. The authors concluded that soy in the amounts typically consumed by Asians did not significantly modify blood or nipple fluid estrogen levels. They did observe a non-significant trend towards lower estrogen levels in nipple fluid during the high-soy diet, which "counters concerns about adverse effects of soy foods on breast cancer risk."

Omega-3 fatty acids do not reduce hormones associated with risk

A July 11 study in Nutrition and Cancer found, contrary to expectations, that omega-3 fatty acids did not reduce the hormones associated with breast cancer risk.

Retinol and vitamin A may reduce breast cancer risk

A July 15 review in Cancer Causes & Control analysed the research on retinol, vitamin A, vitamin C and vitamin E and breast cancer risk. The authors concluded that intake of retinol and vitamin A "could reduce breast cancer risk," but the association between vitamins C and E and risk "seem to be limited."

Lifetime exercise reduces precancerous benign breast disease

According to a July 12 study in Cancer Causes & Control, "exercise may be inversely associated with the risk of developing proliferative benign breast disease, one of the earliest steps in the development of breast cancer." The study followed over 40,000 women for four years. Women in the study reported on levels of physical activity during adolescence and adulthood. A significant inverse association was found between walking and the risk of benign breast disease.

Alcohol and breast cancer risk

This month there have been two stories on the use of alcohol and breast cancer risk.

First, a July 11 story in the Los Angeles Times reported that although government health agencies often publish recommended drinking limits, no amount of alcohol is safe in terms of breast cancer risk.

On July 19 and 20, BBC News and Cancer Research UK reported on a study which found that obesity has the greatest effect on the hormones associated with breast cancer risk, followed by alcohol use then smoking. Women who drank 2.5 units of alcohol a day had higher levels of all hormones. A large glass of wine is 3 units of alcohol.

Please check back Monday for highlights of the weekend breast cancer news. Until then, all the latest breast cancer news and research may be found on the treatment pages of the LATESTBreastCancer.com website.