Today we'll wrap-up last week's breast cancer news. Topics include hot flashes, fatigue, mammography and environmental BPAs. Links to the news and research below may be found on the treatment pages of the LATESTBreastCancer.com website.
Effexor and Catapres effective for hot flashes
Some breast cancer treatments may induce menopause and cause unpleasant side effects such as hot flashes. A September 12 study in the Journal of Clinical Oncology compared Effexor (venlafaxine) to Catapres (clonidine) to a placebo for the treatment of hot flashes in breast cancer patients.
Both Effexor and Catapres were found to be effective in the management of hot flashes. Effexor resulted in a more immediate reduction in hot flashes, but at week 12, hot flashes were lower in the Catapres group. Reports of nausea, constipation and appetite loss were higher in the Effexor group.
A September 12 Family Practice News report on the study included a commentary which noted that the small size of the study was its "main weakness." In the end, only 35 patients took Effexor, 28 Catapres and 17 the placebo. A larger study would be needed to "reliably identify suspected differences between the study arms." Also, the study authors noted that the duration of the study may have been too short to adequately assess side effects.
Nonetheless, in the Family Practice News story, study authors said the "more rapid reduction in hot flashes suggests that venlafaxine is to be preferred over clonidine." They advised 37.5 mg daily in the first week, increasing to 75 mg "if greater efficacy is desired."
Fatigue after treatment associated with pain and depression
Last week EurekAlert! and the UPI covered a study from Spain on fatigue in breast cancer survivors. The study found that patients most affected by fatigue also suffered "episodes of depression, body image deterioration, neck and shoulder pain, and limited arm movement, possibly due to the surgical intervention," such as breast conserving surgery (lumpectomy) and mastectomy.
The lead author noted that these findings should "motivate" patient support programs to provide resources to improve psychological states and pain to improve fatigue.
Higher mammography rates associated with higher mastectomy rates
One of the goals of screening mammography is to detect breast cancer earlier to allow more women to undergo breast conserving surgery (lumpectomy) instead of mastectomy. A recent study in Norway found the opposite to be true.
The study compared breast surgery rates before and after the implementation of a breast screening program and rates between those invited for screening and those not. Screening was associated with an increase in all breast surgery (lumpectomy plus mastectomy) and an increase in mastectomy rates.
A September 13 story in US News and World Report/HealthDay noted that the study did not investigate why mastectomy rates climbed. Possible reasons include overdiagnosis (detecting and treating tumors that might never have posed a risk), poor access to radiation centers (making mastectomy a safer option), improved breast reconstruction techniques (making mastectomy a less "dreadful" choice) and patient decision to undergo more aggressive treatment due to recurrence fears.
BPA may interfere with tamoxifen
There may be another reason to avoid bisphenol-A (BPA). BPAs, which are used to make plastics, have been associated with a variety of health concerns. According to recent study in cells, BPA may not only increase the risk of developing breast cancer, may also interfere with tamoxifen therapy. (Link to the study.)
On September 13, the San Francisco Chronicle covered the study. In the lab, when non-cancerous cells from high-risk patients were exposed to BPA, they started to behave like cancer cells. When these BPA-exposed cells were exposed to tamoxifen, they continued to grow. "The study found that healthy cells exposed to BPA and methylparaben started figuring out ways to bypass drugs like tamoxifen."
Avoiding BPA may not be easy. According to Dr. William Goodson, lead study author, ""It's used so much. We kind of swim in it." Still, efforts to ban BPAs are underway. A current bill (AB1319) on the governor's desk would ban BPA in sippy cups and baby bottles in California.
At LATESTBreastCancer.com, we'll continue to follow the latest breast cancer news and research. You may access links to news articles, medical journal abstracts and FDA information on every breast cancer test and treatment option on our website anytime.
Monday, September 19, 2011
Friday, September 16, 2011
Breast Cancer News for BRCA 1/2 Mutation Carriers
BRCA 1/2 gene mutation carriers have been in the news lately. Today we'll share the latest headlines and the studies behind them.
ABC News: "Women Develop BRCA-Related Cancer Earlier Than Their Moms, Study Says"
This was the big story of the week. ABC News, US News and World Report, the Los Angeles Times and Medical News Today all ran stories. (Links may be found on the BRCAnalysis page of our website. From the home page, click the "Treatments" tab and search for "BRCAnalysis" in the box on the top right.)
The headlines stemmed from an MD Anderson study published in Cancer on September 12. According to the study, breast and ovarian cancers appear to be diagnosed at earlier ages in later generations. A statistical model revealed that for BRCA mutation carriers, breast cancer would be diagnosed almost 8 years earlier than in the generation before.
Currently, BRCA mutation carriers are advised to start screening by 25. In the Los Angeles Times, the authors said their findings may support earlier screenings for future generations.
Medical News Today: "BRCA1 Gene Mutation Associated With Neoadjuvant Chemotherapy"
Another BRCA study from MD Anderson made news this month. This one revealed some good news for BRCA 1 carriers.
Last week, Medical News Today and US News and World Report covered a Journal of Clinical Oncology study which found that carriers of the BRCA 1 mutation had a better response to chemotherapy before surgery, known as neoadjuvant chemotherapy.
In the study, 46% of the BRCA 1 carriers achieved a pathological complete response (pCR), meaning the tumor disappeared in response to treatment. Only 13% of the BRCA 2 carriers and 22% of the non-BRCA carriers achieved pCR.
However, after about 3 years, BRCA status made no significant difference in survival. But, BRCA 1 carriers who achieved a pCR had better 5 year relapse-free and overall survival rates than BRCA 1 carriers who did not.
In the media stories, lead author, Dr. Banu Arun noted,
Next week, we'll share the latest breast cancer news and research on hot flashes and fatigue after treatment. Until then, you may explore all the latest news and research on any breast cancer test or treatment option at our LATESTBreastCancer.com website anytime.
ABC News: "Women Develop BRCA-Related Cancer Earlier Than Their Moms, Study Says"
This was the big story of the week. ABC News, US News and World Report, the Los Angeles Times and Medical News Today all ran stories. (Links may be found on the BRCAnalysis page of our website. From the home page, click the "Treatments" tab and search for "BRCAnalysis" in the box on the top right.)
The headlines stemmed from an MD Anderson study published in Cancer on September 12. According to the study, breast and ovarian cancers appear to be diagnosed at earlier ages in later generations. A statistical model revealed that for BRCA mutation carriers, breast cancer would be diagnosed almost 8 years earlier than in the generation before.
Currently, BRCA mutation carriers are advised to start screening by 25. In the Los Angeles Times, the authors said their findings may support earlier screenings for future generations.
Medical News Today: "BRCA1 Gene Mutation Associated With Neoadjuvant Chemotherapy"
Another BRCA study from MD Anderson made news this month. This one revealed some good news for BRCA 1 carriers.
Last week, Medical News Today and US News and World Report covered a Journal of Clinical Oncology study which found that carriers of the BRCA 1 mutation had a better response to chemotherapy before surgery, known as neoadjuvant chemotherapy.
In the study, 46% of the BRCA 1 carriers achieved a pathological complete response (pCR), meaning the tumor disappeared in response to treatment. Only 13% of the BRCA 2 carriers and 22% of the non-BRCA carriers achieved pCR.
However, after about 3 years, BRCA status made no significant difference in survival. But, BRCA 1 carriers who achieved a pCR had better 5 year relapse-free and overall survival rates than BRCA 1 carriers who did not.
In the media stories, lead author, Dr. Banu Arun noted,
"This new insight tempts us to speculate that the presence of the BRCA1 mutation determines how some women will respond to neoadjuvant chemotherapy. However, we need future prospective studies with larger cohorts and longer-term follow up to validate these findings and determine optimum treatment."
Next week, we'll share the latest breast cancer news and research on hot flashes and fatigue after treatment. Until then, you may explore all the latest news and research on any breast cancer test or treatment option at our LATESTBreastCancer.com website anytime.
Wednesday, September 14, 2011
Herceptin for Small, Early-Stage Breast Cancer: Does Tumor Size Matter?
When it comes to Herceptin for HER2 positive breast cancer, does tumor size matter? What if the tumor is very small? Should Herceptin still be considered? Today we'll share the latest research on Herceptin (trastuzumab) for women with small, node-negative, HER2 positive breast cancer.
Clinical Breast Cancer: HER2 positive breast cancer has a higher risk of recurrence than other breast cancers
A July 15 Clinical Breast Cancer study from MD Anderson compared the risk of recurrence for women with different breast cancer subtypes. All of the women had small (less than 2cm), node-negative breast cancer. None were treated with chemotherapy or Herceptin.
The study found that women with HER2 positive breast cancer had a greater risk of recurrence than women with hormone-receptor positive breast cancer. Triple-negative breast cancer also had a greater risk than hormone-receptor positive breast cancer, but the difference was not as high as with the HER2 group.
Cancer (6/16): Herceptin plus chemotherapy beneficial for tumors 2cm or less
A June 16 study in Cancer from the Memorial Sloan-Kettering Cancer Center compared recurrence rates for women treated with and without Herceptin plus chemotherapy for small (2cm or less), node-negative, HER2 positive breast cancer. Based on their comparison, the authors concluded, "Women with small, node-negative, HER2+ primary breast cancers likely derive significant benefit from adjuvant trastuzumab with chemotherapy."
Cancer (9/1): Herceptin reduces recurrence after lumpectomy for tumors 5cm or less
A September 1 study in Cancer from the Memorial Sloan-Kettering Cancer Center compared localregional recurrence rates (LRR) for women treated with or without Herceptin after lumpectomy (breast conserving surgery) and radiation. All women had node-negative, HER2 positive breast cancer measuring 5cm or less.
According to the conclusion, "Even among women with lower risk breast cancer, the relatively high locoregional failure rates associated with positive HER2 status could be reduced markedly with adjuvant trastuzumab chemotherapy." Within 3 years, there was a 10% recurrence rate for women not treated with Herceptin compared to a 1% rate with Herceptin.
Internal Medicine News: Uncertainty for tumors less than 1cm
An August 16 Internal Medicine News article discussed the uncertainty about Herceptin for women with very small (less than 1cm), node-negative, HER2 positive breast cancer.
Although studies such as the July 15 Clinical Breast Cancer study above suggest a higher risk of recurrence for small, HER2 positive breast cancer, an American Society of Clinical Oncology (ASCO) presentation suggested that for women with very small tumors (1cm or less), the risk of recurrence may be so low that the benefit of Herceptin may not be worth the risk of cardiovascular disease.
Nonetheless, Dr. Gabriel Hortobagyi from MD Anderson was quoted to say he discusses Herceptin and chemotherapy with anyone with HER2 positive breast cancer, regardless of tumor size.
For more on Herceptin for HER2 positive breast cancer, including two-years worth of news, research and overviews, please visit the Hercetpin (trastuzumab) page of our website. From the home page of our site, click the "Treatments" tab and search for "Herceptin" in the box in the top right corner.
Clinical Breast Cancer: HER2 positive breast cancer has a higher risk of recurrence than other breast cancers
A July 15 Clinical Breast Cancer study from MD Anderson compared the risk of recurrence for women with different breast cancer subtypes. All of the women had small (less than 2cm), node-negative breast cancer. None were treated with chemotherapy or Herceptin.
The study found that women with HER2 positive breast cancer had a greater risk of recurrence than women with hormone-receptor positive breast cancer. Triple-negative breast cancer also had a greater risk than hormone-receptor positive breast cancer, but the difference was not as high as with the HER2 group.
Cancer (6/16): Herceptin plus chemotherapy beneficial for tumors 2cm or less
A June 16 study in Cancer from the Memorial Sloan-Kettering Cancer Center compared recurrence rates for women treated with and without Herceptin plus chemotherapy for small (2cm or less), node-negative, HER2 positive breast cancer. Based on their comparison, the authors concluded, "Women with small, node-negative, HER2+ primary breast cancers likely derive significant benefit from adjuvant trastuzumab with chemotherapy."
Cancer (9/1): Herceptin reduces recurrence after lumpectomy for tumors 5cm or less
A September 1 study in Cancer from the Memorial Sloan-Kettering Cancer Center compared localregional recurrence rates (LRR) for women treated with or without Herceptin after lumpectomy (breast conserving surgery) and radiation. All women had node-negative, HER2 positive breast cancer measuring 5cm or less.
According to the conclusion, "Even among women with lower risk breast cancer, the relatively high locoregional failure rates associated with positive HER2 status could be reduced markedly with adjuvant trastuzumab chemotherapy." Within 3 years, there was a 10% recurrence rate for women not treated with Herceptin compared to a 1% rate with Herceptin.
Internal Medicine News: Uncertainty for tumors less than 1cm
An August 16 Internal Medicine News article discussed the uncertainty about Herceptin for women with very small (less than 1cm), node-negative, HER2 positive breast cancer.
Although studies such as the July 15 Clinical Breast Cancer study above suggest a higher risk of recurrence for small, HER2 positive breast cancer, an American Society of Clinical Oncology (ASCO) presentation suggested that for women with very small tumors (1cm or less), the risk of recurrence may be so low that the benefit of Herceptin may not be worth the risk of cardiovascular disease.
Nonetheless, Dr. Gabriel Hortobagyi from MD Anderson was quoted to say he discusses Herceptin and chemotherapy with anyone with HER2 positive breast cancer, regardless of tumor size.
For more on Herceptin for HER2 positive breast cancer, including two-years worth of news, research and overviews, please visit the Hercetpin (trastuzumab) page of our website. From the home page of our site, click the "Treatments" tab and search for "Herceptin" in the box in the top right corner.
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