Breast cancer research news is not always about breast cancer treatment. Today, we'll examine the latest data on breast cancer in America and highlight the latest breast cancer research on risk and prevention.
U.S. breast cancer incidence rates vary by estrogen receptor status
Yesterday, msnbc.com, citing a Journal of the National Cancer Institute study, revealed that although American breast cancer incidence rates appear to be stable, rates of estrogen-receptor negative breast cancer are actually falling and rates of estrogen-receptor positive breast cancer are on the rise. The decline in ER-negative breast cancer, which is more difficult to treat, is good news. The rise in ER-positive tumors, however, is concerning, and will likely be the focus of future research on risk and prevention.
Three new risk studies: fiber, breast density and BRCA biology
According to Reuters, a Chinese study in the American Journal of Clinical Nutrition found that women who were in the top fifth of fiber consumers were 11 percent less likely to develop breast cancer than those who were in the bottom fifth. Reuters notes that the findings do not prove that fiber lowers breast cancer risk. Fiber consumers may just be healthier overall. Also, Dr. Linos, from Stanford, noted that the potential effect of fiber was "very small." More on diet and breast cancer can be found on the fruits, vegetables and nuts page of the LATESTBreastCancer.com website.
Medical News Today reports that a Harvard study in the Journal of the National Cancer Institute discovered that women whose mammograms reveal dense breasts have not only a greater risk of breast cancer, but a greater risk of developing more aggressive tumors. The women in the study were postmenopausal. Higher breast density was associated with larger tumors, higher-grade tumors, estrogen receptor-negative status and a higher risk of developing ductal carcinoma in situ (DCIS). This was the first study to link breast density with tumor characteristics.
From the biology labs, BRCA 1/2 gene mutations have long been associated with a higher risk of breast cancer. Yesterday, a EurekAlert! press release discussed a Spanish study which examined the chromosomes of BRCA carriers. It found that BRCA 1/2 carriers have chromosomes with short telomeres, which are complex structures that protect the end of chromosomes. Interestingly, it also found "genetic anticipation" of breast cancer in daughters whose telomeres were shorter than their mother's. According to the press release, "The significance of generational changes in telomere length has interesting potential clinical applications in the management of familial breast cancer, and could be extended to other hereditary cancer syndromes."
Low risk of some serious side effects when Tamoxifen is taken for prevention
According to a July 18 study in Cancer Treatment Reviews, women younger than 50 who take tamoxifen for breast cancer prevention have only a low risk of developing endometrial cancer, deep vein thrombosis and pulmonary embolism. The risk decreases from the active to follow-up phase of treatment. The authors note that education and counseling are "the cornerstones of breast cancer chemoprevention."
Please check back on Monday for the weekend breast cancer news highlights. Even though we don't write the daily news blog on the weekends, we continue to add the latest breast cancer news and research to the LATESTBreastCancer.com website and database.
Friday, July 29, 2011
Thursday, July 28, 2011
The Breast Cancer News Update: July 28
One of the most serious side effects associated with breast cancer surgery is lymphedema. In today's breast cancer news update, we'll discuss a white paper by an expert panel on a plan for early detection and treatment. We'll also
look at the latest news on computer-aided detection in mammography and an alternative to surgical nipple reconstruction. Links to today's news stories may be found on the treatment pages of the LATESTBreastCancer.com website.
The early detection of lymphedema
Lymphedema is a painful arm swelling caused by lymphatic fluid accumulation. It is most commonly associated with axillary lymph node dissection, but can be caused by any treatment which damages the lymphatic system. It is universally recognized that early detection and treatment yields the best results.
Yesterday, an expert panel convened by the Avon Foundation for Women, the Lymphatic Research Foundation and the National Lymphatic Network issued a white paper on lymphedema detection and care. Both the white paper and a PR Newswire press release may be found on the axillary lymph node dissection page of our website.
Typically, lymphedema is not detected until discomfort is present or swelling is visible. The white paper reviews the recent research and recommends pre-treatment baseline measurement and continuous monitoring post-treatment to detect lymphedema before visible swelling and discomfort. This is a novel recommendation. For example, the National Cancer Institute publishes a comprehensive summary of lymphedema (link), but the only preventative measure suggested is notifying your doctor if you notice signs of lymphedema such as discomfort and swelling.
In addition to early detection, the benefits of physical therapy, weight bearing exercise the compression sleeves are also discussed in the paper.
Breast cancer patients facing surgery or radiation may want to print the white paper and/or press release and discuss baseline measurements, post-treatment monitoring, exercise, compression sleeves and other lymphedema prevention techniques with their doctors. With proper monitoring, lymphedema may be detected and treated before obvious symptoms appear.
Computer-aided detection does not improve mammography
There's been some media buzz on a July 27 Journal of the National Cancer Institute study of computer-aided detection CAD) in screening mammography. Yesterday, both the Los Angeles Times and US News and World Report covered the study.
What is CAD? Basically, it's a software that scans a mammographic image to identify abnormalities. As defined by the American College of Radiology, it's a "computer-based process designed to analyze mammographic images for suspicious areas; in effect, it is a "second pair of eyes" for the radiologist." In the U.S., it is used in three out of four breast cancer screenings.
What did the study find? An analysis of 1.6 million screening mammograms revealed that CAD did not improve the detection of invasive breast cancer. It did improve the detection of DCIS, but not with statistical significance. In US News and World Report, study author, Dr. Joshua J. Fenton mentioned a "slightly increased chance" of unnecessary recall if a mammogram was read with CAD. "For every 200 women who are screened with CAD who have a second mammogram, one additional woman is called back unnecessarily for further testing," he said.
Tattoos as an alternative to surgical nipple reconstruction
What are nipple tattoos? The latest fad or fashion statement? No, nipple tattoos may be a realistic option to surgical nipple reconstruction for women who have had breast reconstruction after mastectomy. An interesting Philadelphia Inquirer story discusses the procedure and interviews a tattoo artist and her patients.
Please check back tomorrow for more news updates from LATESTBreastCancer.com.
look at the latest news on computer-aided detection in mammography and an alternative to surgical nipple reconstruction. Links to today's news stories may be found on the treatment pages of the LATESTBreastCancer.com website.
The early detection of lymphedema
Lymphedema is a painful arm swelling caused by lymphatic fluid accumulation. It is most commonly associated with axillary lymph node dissection, but can be caused by any treatment which damages the lymphatic system. It is universally recognized that early detection and treatment yields the best results.
Yesterday, an expert panel convened by the Avon Foundation for Women, the Lymphatic Research Foundation and the National Lymphatic Network issued a white paper on lymphedema detection and care. Both the white paper and a PR Newswire press release may be found on the axillary lymph node dissection page of our website.
Typically, lymphedema is not detected until discomfort is present or swelling is visible. The white paper reviews the recent research and recommends pre-treatment baseline measurement and continuous monitoring post-treatment to detect lymphedema before visible swelling and discomfort. This is a novel recommendation. For example, the National Cancer Institute publishes a comprehensive summary of lymphedema (link), but the only preventative measure suggested is notifying your doctor if you notice signs of lymphedema such as discomfort and swelling.
In addition to early detection, the benefits of physical therapy, weight bearing exercise the compression sleeves are also discussed in the paper.
Breast cancer patients facing surgery or radiation may want to print the white paper and/or press release and discuss baseline measurements, post-treatment monitoring, exercise, compression sleeves and other lymphedema prevention techniques with their doctors. With proper monitoring, lymphedema may be detected and treated before obvious symptoms appear.
Computer-aided detection does not improve mammography
There's been some media buzz on a July 27 Journal of the National Cancer Institute study of computer-aided detection CAD) in screening mammography. Yesterday, both the Los Angeles Times and US News and World Report covered the study.
What is CAD? Basically, it's a software that scans a mammographic image to identify abnormalities. As defined by the American College of Radiology, it's a "computer-based process designed to analyze mammographic images for suspicious areas; in effect, it is a "second pair of eyes" for the radiologist." In the U.S., it is used in three out of four breast cancer screenings.
What did the study find? An analysis of 1.6 million screening mammograms revealed that CAD did not improve the detection of invasive breast cancer. It did improve the detection of DCIS, but not with statistical significance. In US News and World Report, study author, Dr. Joshua J. Fenton mentioned a "slightly increased chance" of unnecessary recall if a mammogram was read with CAD. "For every 200 women who are screened with CAD who have a second mammogram, one additional woman is called back unnecessarily for further testing," he said.
Tattoos as an alternative to surgical nipple reconstruction
What are nipple tattoos? The latest fad or fashion statement? No, nipple tattoos may be a realistic option to surgical nipple reconstruction for women who have had breast reconstruction after mastectomy. An interesting Philadelphia Inquirer story discusses the procedure and interviews a tattoo artist and her patients.
Please check back tomorrow for more news updates from LATESTBreastCancer.com.
Wednesday, July 27, 2011
The Breast Cancer News Update: July 27
Today's breast cancer news update is brought to you by the letter "M". We'll look at the latest research on micrometastasis and mastectomy for multicentric breast cancer. (We hope you don't mind a little midweek humor.)
Lymph node micrometastasis is not prognostically significant
Breast cancer patients frequently ask about the significance of lymph node micrometastasis. Micrometastases are sometimes called "occult" metastasis because they were not seen during routine lymph node staging. Patients may be first diagnosed as node-negative, but upon more refined inspection of the tissue after biopsy are reclassified as having lymph node micrometastasis.
What does this mean? Well, according to recent research, not much.
A new Journal of the American Medical Association (JAMA) study found no association between occult lymph node metastasis and overall survival. In the study, 3,326 sentinel lymph nodes which were considered negative after stain testing underwent further immunohistochemical testing. 349 were found to contain occult metastasis. The authors concluded, "Among women receiving breast-conserving therapy and SLN dissection, immunohistochemical evidence of SLN metastasis was not associated with overall survival over a median of 6.3 years. . ."
If sentinel lymph node micrometastasis is not prognostically significant, is immunohistochemical testing necessary? The Los Angeles Times and US News and World Report suggest not. In an interview with JAMA News, study author Armando E. Giuliano, MD noted,
Dr. Giuliano clarified that while immunohistochemical testing may be unecessary, sentinel lymph node biopsies are still important. He said,
Importantly, Dr. Giuliano notes that all women in the study were treated with breast conserving surgery, whole breast irradiation and systemic therapy - chemotherapy, hormone therapy or both. Micrometastatic lymph nodes may not require extra testing or treatment, but the standard of care for stage I or II breast cancer still applies.
Links to the study abstract and news stories may be found on the sentinel lymph node biopsy page of the LATESTBreastCancer.com website.
No scientific evidence to support mastectomy for multicentric breast cancer
The use of preoperative MRI has been associated with higher mastectomy rates. Just this year alone, studies in The Breast Journal (March 16), the Journal of Surgical Oncology (May 25) and Annals of Surgical Oncology (July 13) associated MRI use with higher mastectomy rates. Sometimes MRI reveals cancer in the opposite breast. Sometimes it reveals multicentric breast cancer in one breast.
Is a mastectomy necessary to treat multicentric breast tumors? A July 15 review in the Journal of the National Cancer Institute suggests not. After an "extensive examination" of the vast amount of material on the subject, the author concluded that aside from a large trial which demonstrated no statistically significant difference in disease-free survival or overall survival between lumpectomy and mastectomy, "there has been no information in any of the few recently conducted studies involving multicentricity to justify the current resurgence in mastectomy."
Links to all of these studies may be found on the mastectomy page of the LATESTBreastCancer.com website.
Please check back tomorrow for more breast cancer news and research updates from LATESTBreastCancer.com. Until then, all the latest news and research for any breast cancer test or treatment option may be found on our website anytime.
Lymph node micrometastasis is not prognostically significant
Breast cancer patients frequently ask about the significance of lymph node micrometastasis. Micrometastases are sometimes called "occult" metastasis because they were not seen during routine lymph node staging. Patients may be first diagnosed as node-negative, but upon more refined inspection of the tissue after biopsy are reclassified as having lymph node micrometastasis.
What does this mean? Well, according to recent research, not much.
A new Journal of the American Medical Association (JAMA) study found no association between occult lymph node metastasis and overall survival. In the study, 3,326 sentinel lymph nodes which were considered negative after stain testing underwent further immunohistochemical testing. 349 were found to contain occult metastasis. The authors concluded, "Among women receiving breast-conserving therapy and SLN dissection, immunohistochemical evidence of SLN metastasis was not associated with overall survival over a median of 6.3 years. . ."
If sentinel lymph node micrometastasis is not prognostically significant, is immunohistochemical testing necessary? The Los Angeles Times and US News and World Report suggest not. In an interview with JAMA News, study author Armando E. Giuliano, MD noted,
This study, along with other recent studies, argues against the routine examination of sentinel nodes with immunohistochemistry and argues against basing more extensive treatment on these micrometastatic findings.
Dr. Giuliano clarified that while immunohistochemical testing may be unecessary, sentinel lymph node biopsies are still important. He said,
Sentinel lymph node biopsy should still be performed for patients with early breast cancer as findings may change the use or type of adjuvant systemic therapy or reveal the need for axillary dissection. Sentinel node biopsy remains part of the standard management for early breast cancer.
Importantly, Dr. Giuliano notes that all women in the study were treated with breast conserving surgery, whole breast irradiation and systemic therapy - chemotherapy, hormone therapy or both. Micrometastatic lymph nodes may not require extra testing or treatment, but the standard of care for stage I or II breast cancer still applies.
Links to the study abstract and news stories may be found on the sentinel lymph node biopsy page of the LATESTBreastCancer.com website.
No scientific evidence to support mastectomy for multicentric breast cancer
The use of preoperative MRI has been associated with higher mastectomy rates. Just this year alone, studies in The Breast Journal (March 16), the Journal of Surgical Oncology (May 25) and Annals of Surgical Oncology (July 13) associated MRI use with higher mastectomy rates. Sometimes MRI reveals cancer in the opposite breast. Sometimes it reveals multicentric breast cancer in one breast.
Is a mastectomy necessary to treat multicentric breast tumors? A July 15 review in the Journal of the National Cancer Institute suggests not. After an "extensive examination" of the vast amount of material on the subject, the author concluded that aside from a large trial which demonstrated no statistically significant difference in disease-free survival or overall survival between lumpectomy and mastectomy, "there has been no information in any of the few recently conducted studies involving multicentricity to justify the current resurgence in mastectomy."
Links to all of these studies may be found on the mastectomy page of the LATESTBreastCancer.com website.
Please check back tomorrow for more breast cancer news and research updates from LATESTBreastCancer.com. Until then, all the latest news and research for any breast cancer test or treatment option may be found on our website anytime.
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