May 15, 2008, 7:22 PM CT

Link between vitamin D status, breast cancer

Using newly available data on worldwide cancer incidence, scientists at the Moores Cancer Center at University of California, San Diego (UCSD) and the Department of Family and Preventive Medicine have shown a clear association between deficiency in exposure to sunlight, specifically ultraviolet B (UVB), and breast cancer.

UVB exposure triggers photosynthesis of vitamin D3 in the body. This form of vitamin D also is available through diet and supplements.

Approximately 1,150,000 cases and 410,000 deaths from breast cancer occur annually worldwide, including 215,000 new cases and 41,000 deaths in the United States.

The study is reported in the May-June 2008 issue of The Breast Journal.

This is the first study, to our knowledge, to show that higher serum levels of vitamin D are linked to reduced incidence rates of breast cancer worldwide, said Cedric F. Garland, Dr. P.H., professor of Family and Preventive Medicine in the UCSD School of Medicine, and member of the Moores UCSD Cancer Center.

This paper used worldwide data only recently available through a new tool called GLOBOCAN, developed by the World Health Organizations International Agency for Research on Cancer. GLOBOCAN is a database of cancer incidence, mortality and prevalence for 175 countries......... Posted by: Janet      Read more         Source

May 14, 2008, 9:32 PM CT

Risk For Developing Breast Cancer

A chemical reaction in genes that control breast cancer provides a molecular clock that could one day help scientists more accurately determine a woman's risk for developing breast cancer and provide a new approach for therapy, UT Southwestern Medical Center scientists have found.

As per a research findings published in today's issue of Cancer Epidemiology Biomarkers & Prevention, researchers from UT Southwestern show that the chemical process, called methylation, is strongly correlated with breast-cancer risk and with premalignant changes in the breast cells.

The scientists determined that methylation acts as a type of biological clock, indicating how a number of times a cell has divided. This information could aid scientists in determining an individual's cancer risk.

"The more a cell has divided, the greater the risk for cancer," said Dr. David Euhus, professor of surgical oncology. "Monitoring methylation levels could give scientists a way of seeing how often cells have divided and where a woman stands on that clock. Once the clock reaches a certain hour, breast cancer is more likely to ensue".

During methylation, small molecules called methyl groups attach themselves to a gene and turn off, or "silence," the gene.

Prior studies by Dr. Euhus have shown that apparently normal breast cells from women with breast cancer had increased methylation of a tumor-suppressor gene called RASSF1A......... Posted by: Janet      Read more         Source

May 13, 2008, 7:46 PM CT

Adding ultrasound screening to mammography

Adding a screening ultrasound examination to routine mammography reveals more breast cancers than mammography alone, as per results of a major new clinical trial. The trial, however, also observed that adding an ultrasound exam also increases the rate of false positive findings and unnecessary biopsies.

Results of the clinical trial, conducted by the American College of Radiology Imaging Network (ACRIN) and analyzed by Brown University statisticians, appear in the May 14, 2008 issue of the Journal of the American Medical Association.

The trial uncovered a significant trade-off with ultrasound screening, said Jeffrey Blume, an associate professor in the Department of Community Health and the deputy director of the ACRIN Biostatistics and Data Management Center at Brown. While supplemental ultrasound screening uncovers more breast cancers, it also substantially increases the risk of a false positive cancer finding and unnecessary biopsy.

The medical community may well decide that the screening benefit is offset by the increase in risk to women from a false positive finding, Blume said. However this study also shows that supplemental ultrasound may be beneficial in women at high risk of breast cancer who could not, or would not, otherwise undergo a magnetic resonance imaging scan. Women should consult their doctor for more information......... Posted by: Janet      Read more         Source

May 12, 2008, 9:43 PM CT

Physical activity prevent breast cancer

Physically active women are 25 per cent less likely to get breast cancer, but certain groups are more likely to see these benefits than others, finds a review of research published online ahead of print in the British Journal of Sports Medicine.

The type of activity undertaken, at what time in life and the womans body mass index (BMI) will determine how protective the activity is against the disease.

Lean women who play sport or undertake other physically active things in their spare time, particularly if they have been through the menopause, have the lowest risk of breast cancer.

The scientists evaluated the literature and analysed 62 studies looking at the impact of physical activity on breast cancer risk. They then examined the findings to find out how breast cancer risk appeared to be affected by type of activity, intensity of activity, when in life the activity waccording toformed and other factors.

They found the most physically active women were least likely to get breast cancer. All types of activity reduced breast cancer risk but recreational activity reduced the risk more than physical activity undertaken as part of a job or looking after the house. Moderate and vigorous activity had equal benefits.

Women who had undertaken a lot of physical activity throughout their life had the lowest risk of breast cancer, and activity performed after the menopause had a greater effect than that performed earlier in life......... Posted by: Janet      Read more         Source

May 8, 2008, 8:43 PM CT

Benign Lesions Needs 6-month Mammogram Follow Up

Radiologists can, with confidence, recommend a six-month follow-up diagnostic mammogram rather than an immediate biopsy for patients with probably non-malignant breast lesions, a new study emphasizes.

The study observed that six-month short-interval follow-up examinations had an 83% sensitivity, which is similar to the sensitivity of other diagnostic mammograms, said Erin J. Aiello Bowles, MPH, lead author of the study from the Group Health Center for Health Studies. High sensitivity means identifying a high proportion of true positives (actual cancer cases) and a low proportion of false negatives (cases mistakenly deemed benign).

The study included 45,007 initial short-interval follow-up mammograms. Short-interval follow-up mammograms are done to monitor for changes in probably non-malignant breast lesions (findings seen on mammograms that have a very low probability of being cancer). Because the probability of cancer is so low, we dont want to put the patient through an unnecessary biopsy, which is an invasive procedure that increases both patient anxiety and medical costs, said Aiello Bowles. At the same time, we want to closely monitor these patients, because changes in probably non-malignant lesions occasionally mean cancer, and we want to detect the cancers as early as possible, she said. In the study, 360 women with probably non-malignant lesions were diagnosed with breast cancer within six months; and 506 women were diagnosed with cancer within 12 months (altogether about one in 100 of the probably non-malignant lesions), Aiello Bowles said......... Posted by: Janet      Read more         Source

April 28, 2008, 5:31 PM CT

Predicting breast cancer patient outcome

Not a day goes by without a new story about the environment. Eventhough we often consider the environment on a global scale, cells in our body also have to contend with environmental factors. New studies from a team of scientists from the Research Institute of the MUHC and McGill University show that the environment surrounding breast cancer cells plays a crucial role in determining whether tumor cells grow and migrate or whether they fade away. Their study is the first to identify the genes behind this environmental control and correlate them with patient outcome. Their findings appear in this weeks issue of Nature Medicine.

A tumour can not exist on its own. It has to be supported and nourished by the cell types around it, the microenvironment, says senior author Dr Morag Park, Director of the molecular oncology group at the Research institute if the MUHC. When we began this study there was little known about the importance of this microenvironment on cancer initiation and progression. We now know that this environment is pivotal; different patients have distinct tumour microenvironments at a gene level. Our findings show that the gene profile of these distinct microenvironments can be used to determine clinical outcome who will fare well and who will not.

Dr Park, a professor of oncology, biochemistry, and medicine at McGill University, and her team analyzed tissue from 53 patients with breast cancer. They used a unique technique, laser capture microdissection (LCM), to separate tumour cells from microenvironment tissue. They compared the gene expression between the microenvironment tissue and controls using micro-array analysis. From thousands of genes they identified 163, which correlated with patient outcome. A good outcome was defined as having no tumour metastasis and tumour migration and non-responsiveness to treatment was considered poor outcome......... Posted by: Janet      Read more         Source

April 24, 2008, 5:04 AM CT

Advances In Breast Reconstruction

Lumpectomy or breast conservation surgery is the most common type of breast cancer surgery currently performed. A benefit of the surgery is that only part of the breast is removed, but a drawback can be the resulting physical appearance of the breast, which may be disfigured, dented or uneven. A report in April's Plastic and Reconstructive Surgery® , the official medical journal of the American Society of Plastic Surgeons (ASPS), examines advances plastic surgeons have made in breast reconstruction to repair the damage left when cancer is removed.

"Eventhough breast conversation therapies are a huge advance in the therapy of breast cancer, women are still concerned about how their breast will look after surgery," said Sumner Slavin, MD, ASPS Member and report co-author. "Breast conservation surgery or lumpectomy can mean a number of things; a biopsy, partial mastectomy, wedge resection, or having a quarter of the breast taken. Women are often left with portions of their breasts removed and there are currently no implants that can address this unique cosmetic issue".

After lumpectomy or breast conservation surgery, plastic surgeons are now approaching the challenge of misshapen breasts by immediately remodeling the breast with remaining breast tissue or tissue taken from another area of the body. The result is a more natural looking breast that is more symmetrical with the unaffected breast......... Posted by: Janet      Read more         Source

April 17, 2008, 3:56 AM CT

Capecitabine combo produces side effects

Adding capecitabine, a drug that inhibits DNA synthesis and slows the growth of tumour tissue, to docetaxel, in patients with early breast cancer, leads to more toxicities and does not improve the efficacy of therapy, a German scientist told the 6th European Breast Cancer Conference (EBCC-6) today (Thursday 17 April). Previously, such a combination had improved patient survival in metastatic disease, where the cancer has spread to other parts of the body.

Professor Gunter von Minckwitz, Chairman of the German Breast Group, Neu-Isenberg, Gera number of, and his team set out to look at the use of the combination in early breast cancer. We recruited 1510 patients with previously untreated primary tumours, he said. Each received the normal preoperative therapy of four cycles of epirubicin and cyclophosphamide. We then randomised them to either four cycles of docetaxel alone, four cycles of simultaneous docetaxel and capecitabine, or four cycles of docetaxel followed by four cycles of capecitabine. If capecitabine were to improve outcomes, we wanted to see how best to use it simultaneously or in sequence.

The researchers planned to study the pathologic response at surgery the way, if any, in which the tumour had reacted to the administration of the chemotherapy drug......... Posted by: Janet      Read more         Source

April 17, 2008, 3:53 AM CT

Lapatinib shrinks breast cancer tumors in just 6 weeks

A drug that targets the cell surface receptors that play an important role in a number of types of cancer can bring about significant tumour regression in breast cancer after only six weeks of use, a scientist told the 6th European Breast Cancer Conference (EBCC-6) today (Thursday 17 April). Dr. Angel Rodriguez, from the Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, USA, said that the work shown for the first time that the tyrosine kinase inhibitor lapatinib could decrease tumour-causing breast cancer stem cells in the primary breast cancers of women receiving neoadjuvant therapy (treatment given before the primary surgery for the disease).

Dr. Rodriguez and his colleagues studied 45 patients with locally advanced breast cancer in which the gene HER-2 was over-expressed. The patients received lapatinib for six weeks, followed by a combination of weekly trastuzumab and three-weekly docetaxel, given over 12 weeks, before primary surgery. Biopsies were performed at the time of diagnosis and also after six weeks of lapatinib and cells from the tumours were obtained and analyzed.

We saw significant tumour regression after six weeks of single agent lapatinib, said Dr. Rodriguez. Bi-dimensional tumour measurements showed a median decrease of minus 60.8%. We had previously showed that tumour-causing breast cancer stem cells were resistant to conventional preoperative chemotherapy; indeed, residual cancers that were exposed to such chemotherapy showed an increase in tumour-causing cells and enhanced tumour initiation by the formation of mammospheres, small tumours that form when tumour-causing cells are cultured in a test tube, which reflect the capacity of the cells to self-renew. So we were excited to see that the results with lapatinib were different......... Posted by: Janet      Read more         Source

April 17, 2008, 3:31 AM CT

Standard chemo works better against BRCA2 related breast cancer

The first study to investigate the effects of chemotherapy on metastatic breast cancer in women with the BRCA1 or BRCA2 gene mutation has shown that standard chemotherapy works better in these patients than in women without the BRCA1/2 mutation.

The authors of a study presented today (Thursday) at the 6th European Breast Cancer Conference (EBCC-6) in Berlin observed that women with BRCA2-associated breast cancer had a significantly higher response rate, a longer time without the disease progressing, and a longer overall survival when treated with anthracycline-based regimens than did women with sporadic breast cancers that were not linked to BRCA1/2.

Women with BRCA1-associated breast cancer also did better than women with sporadic breast cancer, but the rates were not statistically significant.

Scientists at the Daniel den Hoed Cancer Centre/Erasmus Medical Centre (Rotterdam, The Netherlands) conducted the study. They matched 112 women with BRCA1-associated metastatic cancer and 29 women with BRCA2-associated metastatic cancer with 141 women with sporadic breast cancers. The women had been treated with anthracycline-based or taxane-based regimens, CMF (cyclophosphamide, methotrexate and fluorouracil 5FU) or other chemotherapy regimens.

BRCA2 women had a higher response rate to chemotherapy (89% versus 50%), a longer progression-free survival (nearly a third better) and a longer overall survival (47% better) than did women with sporadic cancers. When the scientists looked more closely at the type of chemotherapy the women had received, they observed that the improved progression-free survival mainly occurred in patients on anthracyclines and disappeared for those treated with CMF......... Posted by: Janet      Read more         Source

April 13, 2008, 9:45 PM CT

Screening mammography in elderly patients

Eventhough guidelines keep changing regarding screening mammography in elderly patients, those older than 70 years old continue to benefit from this exam, showing that with frequent mammograms breast cancers can be found sooner, as per a recent study conducted by scientists at Jacobi Medical Center and Albert Einstein College of Medicine, in Bronx, NY.

Our initial interest was sparked by the changing mammographic guidelines in the elderly age group and the differences in the guidelines between organizations including the American Cancer Society and American College of Radiology, said Jason Salsamendi, MD, lead author of the study. We also noticed that we were performing a significant number of screening mammograms in elderly patients at our institution and became curious about the occurence rate of occult breast cancer in this age group, he said.

The study consisted of the review of 24 cases of breast cancer in 22 elderly patients age 70-89.

The scientists reviewed the mammograms for masses and calcifications and correlated the results to surgically proven histology, lymph node involvement and initial surgical management.

As per the study, 19 of the 24 cases of breast malignancy were initially identified on screening mammography. The study showed that mammographic findings in these 19 cases included 12 masses, 4 suspicious calcifications and 3 masses with calcifications. Of these, surgical management was available in 18 cases with 15 being treated by lumpectomy and 3 being treated with mastectomy. The study also showed that the average time interval from most recent previous mammogram to diagnosis was 2.6 years......... Posted by: Janet      Read more         Source

April 13, 2008, 9:12 PM CT

Radiation beneficial for older breast cancer patients

A patients with breast cancer age alone should not determine whether or not she receives standard breast-conservation therapys, including a lumpectomy and radiation treatment; however, if additional health problems (comorbidities) are present, therapys should be individualized based on age and the type of comorbidities, as per a research studyin the April 1 edition of the International Journal for Radiation Oncology*Biology*Physics, the official journal of the American Society for Therapeutic Radiology and Oncology.

The occurrence of breast cancer in women increases as women age. As per the National Cancer Institutes SEER Cancer Statistics Review, women between the ages of 75 and 79 have the highest occurence rate of breast cancer diagnoses at 497 cases per 100,000 people. Along with cancer, most women in this age group are dealing with additional health problems. As per a 1999 womens health and aging study in the Journal of Clinical Epidemiology, the majority of older patients diagnosed with cancer have at least one other medical condition and more than half of patients with cancer over the age of 65 have three or more associated medical conditions.

This study, conducted by the departments of Radiation Oncology, Biostatistics and Epidemiology, and Medicine, Division of Geriatrics, at the University of Pennsylvania School Of Medicine in Philadelphia, sought to determine the impact of these additional medical problems on patients with breast cancer who receive the same standard therapys as patients with no additional medical problems and if old age is a reason to deny some standard therapys......... Posted by: Janet      Read more         Source

April 13, 2008, 8:43 PM CT

Connection between protein and prognosis in breast cancer

Oregon Health & Science University Cancer Institute scientists have observed that a tumor protein present in an aggressive form of breast cancer is correlation to a poor prognosis.

The presence of the protein, called growth factor receptor-bound protein-7, often referred to as GRB-7, in breast cancer tumors, is strongly correlation to the growth and spread of the cancer, as per principal investigator Shiuh-Wen Luoh, M.D., Ph.D., assistant professor of medicine (hematology/medical oncology) in the OHSU School of Medicine.

The research will be presented Sunday, April 13, at 1 p.m. at the annual American Association for Cancer Research meeting in San Diego.

The GRB-7 protein previously has been shown to be important to cell communication in the spread of cancer. The GRB-7 gene is located close to the HER-2/Neu gene that regulates breast cancer growth. The OHSU Cancer Institute scientists discovered that the levels of GRB-7 protein are often heightened at the same time that HER-2/Neu levels are high. Also, not infrequently, they found breast tumors that overexpressed one but not the other protein. Overexpression means that there is an abundant presence of the protein.

It is surprising that we found discordance in the overexpression of these genes because they are so close together, Luoh said......... Posted by: Janet      Read more         Source

April 3, 2008, 10:00 PM CT

Breast cancer risk lingered years after HRT

A follow-up study of postmenopausal women who took the combination of estrogen and progestin for more than five years as part of the landmark Women's Health Initiative shows that the women continued to face an increased risk for breast cancer nearly three years after they quit taking the hormones.

The new study also shows that while some of the other health risks and benefits diminished after the women had stopped taking the estrogen-progestin combination, the overall health risk was 12 percent higher at the end of eight years (with women on the pills for an average of 5.6 years and then off for 2.4 years) compared with those who took placebos. This was largely due to the high risks of breast cancer, strokes and serious blood clots during the original trial while the women took the hormones.

The Stanford University School of Medicine researcher who is the senior author of the follow-up study said the results indicate that the potential harms from estrogen-progestin treatment still outweigh the benefits, and that women should continue to be cautious in deciding whether to take the hormones to relieve menopausal symptoms.

"Menopausal women really need to think through whether using estrogen-progestin is the right thing to do, especially if continued for more than a few years," said Marcia Stefanick, PhD, professor of medicine at the Stanford Prevention Research Center, noting that the breast-cancer risks apply only to women who take the combination treatment, and not those who take estrogen alone. A different portion of the WHI study showed that estrogen-only treatment doesn't increase the risk of breast cancer......... Posted by: Janet      Read more         Source

April 1, 2008, 8:48 PM CT

Hormone replacement therapy and breast cancer

Millions of post-menopausal women use hormone replacement treatment (HRT) as a method to reduce symptoms linked to menopause. In a recent University of Missouri study, scientists observed that one of the hormones used in HRT, a synthetic progestin, could be a major factor in promoting breast cancer. At the same time, the scientists have compelling evidence that using an antibody that prevents new blood vessel formation in tumors, or a small molecular drug, known as PRIMA, with similar properties as the antibody may be effective in treating or preventing the negative effects of progestin.

As per a research findings reported in the journal, Cancer Research, MU scientist Salman Hyder and his research team observed that exposing tumor cells to progestin caused an increase in a growth factor that is involved in the formation of new blood vessels in tumors. Increasing the blood supply allows the tumors to expand as the availability of nourishment increases. However, when they used an antibody that inhibits the growth factor, the tumor shrank. Hyders team found similar results using PRIMA, which re-activated a protein known as p53. When p53 was activated within tumor cells, the number of breast cancer cells reduced significantly.

As women age, a number of develop tiny lesions in their breasts, said Hyder, professor of biomedical sciences in the College of Veterinary Medicine and the Dalton Cardiovascular Research Center. The majority of the time, these lesions never expand. We think this might be due to a specific protein, p53, that, under normal circumstances, prevents tumor cells from living. We found in our study that when the protein is active, it reduces the number of breast cancer cells in the body by inhibiting the growth factor that supplies blood vessels to the tumor. However, when the cells of these lesions are exposed to progestin in a body that does not have an active p53 protein, we observed that the cells might start expanding and turn into tumors......... Posted by: Janet      Read more         Source

March 27, 2008, 9:36 PM CT

Too many women still dying from breast cancer

Thousands of women die from breast cancer each year because current therapys are not always effective and in some cases fail to stem the disease, warns Breast Cancer Campaign today.

In a comprehensive review of breast cancer research published recently, 56 of the UKs most influential breast cancer experts have identified the key research gaps and priorities for the greatest potential impact on patients.

Breast cancer therapy has improved over the past few decades and led to increased survival rates and better quality of life, the report highlights. However over 44,000 women in the UK are diagnosed with breast cancer each year and around 12,500 will die.

Unfortunately, not enough is known about why therapys dont work for some patients or why breast cancer can return, sometimes a number of years later, says Breast Cancer Campaign.

The new study, one of the largest ever carried out in the UK and published by the open access journal Breast Cancer Research, is a unique insight into the current state of breast cancer research and its future challenges.

Gaps in key areas of breast cancer research have been identified in the report, says the charity: prevention, detection, spread or recurrence of the disease, therapy, pathology, physiology, genetics and psychosocial aspects of breast cancer......... Posted by: Janet      Read more         Source

March 17, 2008, 10:05 PM CT

Breast cancer in black women

Scientists at the University of Chicago are studying possible connections between living in disadvantaged neighborhoods and the development of early onset breast cancer in a path-breaking project led by Sarah Gehlert, Director of the Center for Interdisciplinary Health Disparities Research at the University.

The initiative is funded with a $9.7 million grant from National Institutes of Health and is the first to use animal models to help determine what the biological factors might be behind the development of certain forms of breast cancer.

Gehlert is lead author of the paper discussing the findings, titled "Targeting Health Disparities: Linking Upstream Determinants to Downstream Interventions" reported in the current issue of Health Affairs.

Joining Gehlert, who is the Helen Ross Professor in the School of Social Service Administration at the University, as an author in the paper is Olufunmilayo Olopade, the Walter L. Palmer Distinguished Service Professor in Medicine and Human Genetics at the University. As part of the work of the CIHDR, Olopade and other scholars studied early onset breast cases in Nigerian women, whose genetic heritage is similar to African-Americans' because the ancestors of African-Americans largely came from West Africa.

African-American, like Nigerian, women, develop breast cancer earlier than white women, and it is often much deadlier. While white women commonly develop the disease after menopause, it develops previous to menopause among women of African heritage......... Posted by: Janet      Read more         Source

March 7, 2008, 5:30 AM CT

Drugs like aspirin could reduce breast cancer

Anti-inflammatory drugs like aspirin may reduce breast cancer by up to 20 per cent, as per an extensive review carried out by experts at Londons Guys Hospital and reported in the recent issue of IJCP, the International Journal of Clinical Practice.

But they stress that further research is needed to determine the best type, dose and duration and whether the benefits of regularly using non-steroidal anti-inflammatory drugs (NSAIDs) outweigh the side effects, particularly for high-risk groups.

Our review of research published over the last 27 years suggests that, in addition to possible prevention, there may also be a role for NSAIDs in the therapy of women with established breast cancer says Professor Ian Fentiman from the Hedley Atkins Breast Unit at the hospital, part of Guy's and St Thomas' NHS Foundation Trust.

NSAID use could be combined with hormone treatment or used to relieve symptoms in the commonest cause of cancer-related deaths in women.

Professor Fentiman and Mr Avi Agrawal evaluated 21 studies covering more than 37,000 women published between 1980 and 2007.

Their review included 11 studies of women with breast cancer and ten studies that compared women who did and did not have the disease.

The purpose of a review like this is to look at a wide range of published studies and see if it is possible to pull together all the findings and come to any overarching conclusions explains Professor Fentiman. This includes looking at any conflicting results and exploring how the studies were carried out......... Posted by: Janet      Read more         Source

February 28, 2008, 10:39 PM CT

Breast cancer death rates among black women

A new study from the American Cancer Society finds that while breast cancer death rates are decreasing for white women in every U.S. state, for African American women, death rates are either flat or rising in at least half the states. The study, published early online in the journal Cancer Causes and Control, finds breast cancer death rates among African American women are decreasing in only 11 of 37 states with sufficient numbers for analysis and in the District of Columbia. In the rest, death rates are either flat (24 states) or actually increasing (two states: Arkansas and Mississippi).

American Cancer Society scientists led by Carol DeSantis, MPH, analyzed mortality data from the National Center for Health Statistics (NCHS) for the years 1975 through 2004 by state and race. At the national level, death rates began to decline in 1990 for white women and in 1991 for African American women. But they decreased far slower in African American women. As a result, the gap in death rates from breast cancer between African American and white women has increased substantially. In 1991, death rates among African American women were 18 percent higher in comparison to white women; by 2004, they were 36 percent higher. Eventhough breast cancer death rates have decreased in both African American and white women in the U.S. as a whole, the study found death rates have increased or remained level for African American women in 26 states......... Posted by: Janet      Read more         Source

February 28, 2008, 10:23 PM CT

Targets Against Hormone-Dependent Breast Cancer

The identification of two cellular receptors that likely contribute to the genesis of hormone-dependent breast cancer points the way to new, highly targeted therapies against the disease, says a team led by researchers at Weill Cornell Medical College in New York City.

The finding also helps explain how daily use of medicines such as aspirin might help keep these breast tumors at bay.

"These two receptors, called EP2 and EP4, form key links in a biochemical pathway that boosts estrogen production in fat and breast cancer cells - this, in turn, may increase a woman's risk for developing hormone receptor-positive breast cancer. Finding ways to interrupt this pathway in a manner that causes few side effects is the ultimate goal of this research," explains the study's senior author Dr. Andrew Dannenberg, director of the newly established Cancer Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, and the Henry R. Erle, M.D.-Roberts Family Professor of Medicine at Weill Cornell Medical College.

The new findings were published recently in the online edition of the Journal of Biological Chemistry.

About 75 percent of all breast malignancies are "estrogen receptor-positive," meaning that their cells carry receptors attuned to estrogen. In the presence of the hormone, these cancer cells will divide and grow. For this reason, anti-estrogen drugs such as tamoxifen and aromatase inhibitors have come to the forefront in the fight against hormone-dependent breast cancer......... Posted by: Janet      Read more         Source

February 25, 2008, 9:13 PM CT

Test can reduce recurrence of breast cancer

A new test that examines large sections of the sentinel lymph node for genes expressed by breast cancer could reduce the risk of recurrence and multiple surgeries, doctors say.

The GeneSearch Breast Lymph Node Assay, manufactured by Veridex, L.L.C., a Johnson & Johnson company, is being used at the Medical College of Georgia to examine half of the tissue in the sentinel lymph node, the first place breast cancer typically spreads. The sample represents more than 10 times the amount of tissue examined in traditional biopsies.

And because the test examines the tissue with molecular tools, it is more sensitive, says Dr. Zixuan (Zoe) Wang, molecular biologist and scientific director of MCG's Georgia Esoteric and Molecular Diagnostic Labs, L.L.C.

"When we look at the tissue with the GeneSearch test, we are looking for excessive amounts of mamoglobin and cytokeratin 19, both genes that are expressed more in breast cancer tissue," Dr. Wang says. "If those genes are present in excessive amounts, we know the cancer has metastasized."

MCG is the first place in Georgia to offer the test, which Time Magazine named one of the top-10 medical breakthroughs of 2007.

Done during a lumpectomy, the GeneSearch test uses molecular diagnostic methods to examine more tissue than traditional sentinel node biopsies, reducing the chance of false negative results, says Dr. Stephen Peiper, chair of the MCG Department of Pathology and Georgia Cancer Coalition Distinguished Cancer Physician and Scientist......... Posted by: Janet      Read more         Source

February 14, 2008, 10:19 PM CT

Single reader with CAD more efficient

Single reading of screening mammograms with computer-aided detection (CAD) is more efficient than double reading and yields a higher sensitivity than the first reader in a double reading program, as per a research studyconducted by scientists at Charlotte Radiology in Charlotte, NC. In addition, the readings with CAD had a significantly lower recall rate than double reading.

The double reading method consisted of the mammogram being first read by sub-specialized mammographers, with the second reading performed by either a specialist or a general radiologist who is certified in mammography. Single reading with CAD waccording toformed by sub-specialized mammographers.

The study compared the recall rate, sensitivity, positive predictive value (PPV), and cancer detection rate of single reading with CAD to double reading and to the first reader in the double reading program in 231,221 mammograms from 2001-2005. The study shows that single reading with CAD was as effective at finding cancers as double reading and had a lower recall rate.

Because double reading is time consuming and not generally reimbursed, CAD has become increasingly popular in the United States as an alternative way to increase sensitivity, said Matthew Gromet, JD, MD, author of the study......... Posted by: Janet      Read more         Source

January 31, 2008, 10:56 PM CT

BRCA1 mutation linked to breast cancer stem cells

A new study may explain why women with a mutation in the BRCA1 gene face up to an 85 percent lifetime risk of breast cancer.

Scientists from the University of Michigan Comprehensive Cancer Center observed that BRCA1 plays a role in regulating breast stem cells, the small number of cells that might develop into cancers.

The study, in mice and in human breast cancer cells, observed that BRCA1 is involved in the stem cells differentiating into other breast tissue cells. When BRCA1 is missing, the stem cells accumulate unregulated and develop into cancer.

"Our data suggest that an important reason women with BRCA1 mutations get breast cancer is that BRCA1 is directly involved in the regulation of normal breast stem cells. In these women, loss of BRCA1 function results in the proliferation of breast stem cells. Since we think that breast cancer may originate in these cells, this explains why these women have such a high occurence rate of breast cancer," said senior study author Max S. Wicha, M.D., Distinguished Professor of Oncology and director of the U-M Comprehensive Cancer Center.

The study, published online this week in the Proceedings of the National Academy of Sciences, provides strong support for the hypothesis that a small number of cells, called cancer stem cells, are responsible for fueling a tumor's growth. Wicha's lab was part of the team that first identified stem cells in human breast cancer in 2003......... Posted by: Janet      Read more         Source

January 29, 2008, 9:24 PM CT

Digital mammography superior to film mammography

For some women, digital mammography may be a better screening option than film mammography, as per newly published results from a national study led by a University of North Carolina at Chapel Hill researcher.

The results, from the Digital Mammographic Imaging Screening Trial (DMIST), appear in the recent issue of Radiology. UNCs Dr. Etta D. Pisano is principal investigator and lead author of the study, which observed that digital mammography performed better than film mammography for pre- and perimenopausal women under age 50 with dense breasts.

We looked at a cross-section of characteristics, Pisano said. This paper confirms that if you are under 50, pre- or perimenopausal, and have dense breasts, you should definitely be screened with digital rather than film.

Pisano is Kenan professor of radiology and biomedical engineering and vice dean for academic affairs and in the UNC School of Medicine. She is also director of the Biomedical Research Imaging Center and a member of UNC Lineberger Comprehensive Cancer Center.

DMIST enrolled 49,528 women at 33 centers in the U.S. and Canada. The women underwent both digital and film mammography. Breast cancer status was determined for 42,760 women.

The original DMIST results showed that digital was statistically similar to film in the overall screening population but performed better than film in pre- and perimenopausal women under 50, Pisano said......... Posted by: Janet      Read more         Source

January 28, 2008, 10:26 PM CT

Device Zeroes in on Small Breast Tumors

A new medical imager for detecting and guiding the biopsy of suspicious breast cancer lesions is capable of spotting tumors that are half the size of the smallest ones detected by standard imaging systems, as per a new study.

The results of initial testing of the PEM/PET system, designed and constructed by researchers at the Department of Energy's Thomas Jefferson National Accelerator Facility, West Virginia University School of Medicine and the University of Maryland School of Medicine would be reported in the journal Physics in Medicine and Biology on Feb. 7.

"This is the most-important and most-difficult imager we've developed so far," Stan Majewski, Jefferson Lab Radiation Detector and Medical Imaging Group leader said. "It is another example of nuclear physics detector technology that we have put a lot of time and effort into adapting for the common good".

Testing of the new imager was led by Ray Raylman, a professor of radiology and vice chair of Radiology Research at WVU and lead author on the study. Raylman's team imaged various radioactive sources to test the resolution of the system.

"We had good performance characteristics, with image resolution below two millimeters. In regular PET, the image resolution is over five millimeters, so we're quite a bit better than that," Raylman said. In addition, the initial tests revealed that the PEM/PET system can complete an image and biopsy in about the same amount of time as a traditional biopsy......... Posted by: Janet      Read more         Source

January 21, 2008, 8:15 PM CT

Infections rates of breast surgery

Infections at the incision site occurred in more than 5 percent of patients following breast surgery and cost them more than $4,000 each in hospital-related expenses, as per a report in the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

Reported surgical site infection rates following mastectomy (surgical removal of the breast) and other breast procedures range from 1 percent to 28 percent, as per background information in the article. Given the state of fiscal constraints within the U.S. health care system, it is important to calculate the cost-effectiveness of infection control interventions to justify their use from an economic perspective, the authors write. Cost-effectiveness analyses require accurate estimates for the attributable costs of hospital-acquired infections, which are lacking for surgical site infections.

Margaret A. Olsen, Ph.D., M.P.H., of the Washington University School of Medicine, St. Louis, and his colleagues studied 949 hospital admissions for mastectomy or breast reconstruction procedures at a university-affiliated hospital between 1999 and 2002. Surgical site infections were identified in an electronic hospital database and verified by review of medical records. Costs were taken from the hospital accounting database and included those from the original admission to the hospital for surgery as well as any readmissions within one year of surgery......... Posted by: Janet      Read more         Source